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An infant with kwashiorkor: The forgotten disease

Kamaruzaman NA, Jamani NA, Said AH

Malays Fam Physician, 2020;15(2):46-49.
PMID: 32843945

Undernutrition remains a major public health concern, especially in developing countries. Despite being rich in resources, Malaysia is still home to children suffering from severe undernutrition. This paper presents the case of a 5-month-old boy with kwashiorkor stemming from improper weaning which was overlooked. This case highlights the importance of recognizing the early signs of kwashiorkor to allow for early referrals for proper management and prevent its possible complications.
Fulltext Inhalation of honey reduces airway inflammation and histopathological changes in a rabbit model of ovalbumin-induced chronic asthma

Kamaruzaman NA, Sulaiman SA, Kaur G, Yahaya B

BMC Complement Altern Med, 2014;14:176.
PMID: 24886260 DOI: 10.1186/1472-6882-14-176

Honey is widely used in folk medicine to treat cough, fever, and inflammation. In this study, the effect of aerosolised honey on airway tissues in a rabbit model of ovalbumin (OVA)-induced asthma was investigated. The ability of honey to act either as a rescuing agent in alleviating asthma-related symptoms or as a preventive agent to preclude the occurrence of asthma was also assessed.
Removal of Ca2+ and Zn2+ from aqueous solutions by zeolites NaP and KP

Yusof AM, Malek NA, Kamaruzaman NA, Adil M

Environ Technol, 2010 Jan;31(1):41-6.
PMID: 20232677 DOI: 10.1080/09593330903313794

Zeolites P in sodium (NaP) and potassium (KP) forms were used as adsorbents for the removal of calcium (Ca2+) and zinc (Zn2+) cations from aqueous solutions. Zeolite KP was prepared by ion exchange of K+ with Na+ which neutralizes the negative charge of the zeolite P framework structure. The ion exchange capacity of K+ on zeolite NaP was determined through the Freundlich isotherm equilibrium study. Characterization of zeolite KP was determined using infrared spectroscopy and X-ray diffraction (XRD) techniques. From the characterization, the structure of zeolite KP was found to remain stable after the ion exchange process. Zeolites KP and NaP were used for the removal of Ca and Zn from solution. The amount of Ca2+ and Zn2+ in aqueous solution before and after the adsorption by zeolites was analysed using the flame atomic absorption spectroscopy method. The removal of Ca2+ and Zn2+ followed the Freundlich isotherm rather than the Langmuir isotherm model. This result also revealed that zeolite KP adsorbs Ca2+ and Zn2+ more than zeolite NaP and proved that modification of zeolite NaP with potassium leads to an increase in the adsorption efficiency of the zeolite. Therefore, the zeolites NaP and KP can be used for water softening (Ca removal) and reducing water pollution/toxicity (Zn removal).
Mini review: Potential therapeutic values of mitragynine as an opioid substitution therapy

Harun N, Kamaruzaman NA, Mohamed Sofian Z, Hassan Z

Neurosci Lett, 2022 Jan 31;773:136500.
PMID: 35114335 DOI: 10.1016/j.neulet.2022.136500

Opioid use disorder (OUD) has become a significant public health issue worldwide. Methadone and buprenorphine are the most common medications used for treating OUD. These drugs have the potential to assist many patients in managing their opioid dependence and withdrawal but they are currently misused and associated with certain compliance issues, side effects, and risk of relapse. As an opioid-like herbal supplement, Mitragyna speciosa Korth or kratom has received increased attention for managing chronic pain and opioid withdrawal symptoms. Nevertheless, the use of kratom as a self-treatment medication for opioid dependence continues to be controversial due to concerns raised about its effectiveness, safety, and abuse liability. The main active alkaloid constituent of the plant, mitragynine, has been shown to act as a partial mu-opioid agonist. Given this pharmacology, studies have been focusing on this psychoactive compound to examine its potential therapeutic values as medication-assisted therapy (MAT). This review aims to provide a current preclinical overview of mitragynine as a prospective novel option for MAT and summarise the recent developments in determining if the plant's active alkaloid could provide an alternative to opioids in the treatment of OUD.
Stunting and its association with feeding problem among under five children: a case-control study in Kuantan district, Malaysia

Kamaruzaman NA, Musa AL, Pasi H, Osman IF

Med J Malaysia, 2024 Jul;79(4):436-442.
PMID: 39086341

INTRODUCTION: Stunting is the most prevalent form of malnutrition among infants and young children population, both globally and locally. It refers to low height-for-age children and is primarily caused by chronic under nutrition. The objective of this study is to determine the association between stunting and feeding problems and to explore the risk factors for stunting among children aged 6 to 59 months attending health clinics in the Kuantan district.
MATERIALS AND METHODS: A case-control study involving 160 children that attended six health clinics in Kuantan from August to October 2021 with a ratio of 1 case: 3 controls. Data were collected from mothers using a questionnaire consisting of sociodemographic and feeding assessment adapted from a validated World Health Organization (WHO) integrated management of childhood illness (IMCI) assessment form. The data was analysed using IBM SPSS version 26.0. Binary logistic regression analysis was used to identify factors associated with stunting. The odds ratio was used to measure the strength of the association between outcome and predictor variables. The significance value was set at p<0.05.
RESULTS: Children with identified feeding problems have more than four-time significantly higher risk of becoming stunted (Odds Ratios, OR: 4.2; 95% Confidence Intervals, 95%CI: 1.4, 12.8) as compared to children with no feeding problems. Specifically, children with inadequacy in feeding components; amount, variety and frequency of meal each have significantly six-time higher risk (OR: 6.2; 95%CI: 2.7, 14.5), four-time higher risk (OR: 4.2; 95%CI: 1.4, 12.3), and three-time higher risk (OR: 2.8; 95%CI: 1.1, 6.9), of becoming stunted as compared to children with adequate feeding. Additionally, with a decrease of one week in delivery week, one kilogram in birth weight and one centimetre in maternal height, there is a respectively significant 40.0% (OR: 0.6; 95%CI: 0.4, 0.9), 80.0% (OR: 0.2; 95%CI: 0.1, 0.7) and 11.0% (OR: 0.89; 95%CI: 0.82, 0.98) increase in the risk of become stunted among children.
CONCLUSION: Feeding problems specifically inadequate food amount, food variety and meal frequency not following the recommendation contribute to stunting in young children. Other factors identified are lower maternal height and children with lower birth weight and delivery week. This highlights the need for more excellent detection and intervention of nutritional concerns and risk factors to prevent stunting.
Fulltext The rabbit as a model for studying lung disease and stem cell therapy

Kamaruzaman NA, Kardia E, Kamaldin N', Latahir AZ, Yahaya BH

Biomed Res Int, 2013;2013:691830.
PMID: 23653896 DOI: 10.1155/2013/691830

No single animal model can reproduce all of the human features of both acute and chronic lung diseases. However, the rabbit is a reliable model and clinically relevant facsimile of human disease. The similarities between rabbits and humans in terms of airway anatomy and responses to inflammatory mediators highlight the value of this species in the investigation of lung disease pathophysiology and in the development of therapeutic agents. The inflammatory responses shown by the rabbit model, especially in the case of asthma, are comparable with those that occur in humans. The allergic rabbit model has been used extensively in drug screening tests, and this model and humans appear to be sensitive to similar drugs. In addition, recent studies have shown that the rabbit serves as a good platform for cell delivery for the purpose of stem-cell-based therapy.
A case of rotenone poisoning from ingesting Derris trifoliata Lour. (Tuba fruit/pod) in Malaysia

Yeoh SL, Choong PS, Zakaria R, Kamaruzaman NA, Md Rashid S, Razali MF, et al.

Toxicon, 2024 Jan;237:107557.
PMID: 38072318 DOI: 10.1016/j.toxicon.2023.107557

Derris trifoliata is mainly found in mangrove area in tropical regions and the plant extract is traditionally used for fishing by poisoning. This is the first case report of rotenone poisoning in a child from ingesting Derris trifoliata seed. The child developed altered consciousness, vomiting, hypotension, metabolic acidosis, and acute kidney injury. Species identification of this case requires the collaborative efforts of various agencies. She survived from the poisoning with no neurological sequelae.
Fulltext The properties and mechanism of action of plant immunomodulators in regulation of immune response - A narrative review focusing on Curcuma longa L., Panax ginseng C. A. Meyer and Moringa oleifera Lam

Balasubramaniam M, Sapuan S, Hashim IF, Ismail NI, Yaakop AS, Kamaruzaman NA, et al.

Heliyon, 2024 Apr 15;10(7):e28261.
PMID: 38586374 DOI: 10.1016/j.heliyon.2024.e28261

Herbal treatments have been utilized for millennia to cure a variety of ailments. There are over 20, 000 herbal remedies available to treat cancer and other disease in humans. In Ayurveda, traditional plants having revitalizing and nourishing characteristics are known as "Rasayanas." They have anti-inflammatory, anticancer, anti-microbicidal, antiviral, and immunomodulatory effects on the immune system. Immunomodulation is a mechanism through which the body stimulates, suppresses, or boosts the immune system to maintain homeostasis. Plant-derived immunomodulators are typically phytocompounds, including carbohydrates, phenolics, lipids, alkaloids, terpenoids, organosulfur, and nitrogen-containing chemicals. Immunomodulation activity of phytocompounds from traditional plants is primarily mediated through macrophage activation, phagocytosis stimulation, peritoneal macrophage stimulation, lymphoid cell stimulation, and suppression or enhancement of specific and non-specific cellular immune systems via numerous signalling pathways. Despite extensive research, the precise mechanism of immunomodulation of most traditional plants has not yet been fully elucidated, justifying the need for further experimentation. Therefore, this review describes the immunomodulatory agents from traditional plants such as Curcuma longa L., Panax ginseng C.A. Meyer, and Moringa oleifera Lam, further highlighting the common molecular targets and immunomodulatory mechanism involved in eradicating diseases.
Fulltext Epidemiology and risk factors of pesticide poisoning in Malaysia: a retrospective analysis by the National Poison Centre (NPC) from 2006 to 2015

Kamaruzaman NA, Leong YH, Jaafar MH, Mohamed Khan HR, Abdul Rani NA, Razali MF, et al.

BMJ Open, 2020 06 01;10(6):e036048.
PMID: 32487578 DOI: 10.1136/bmjopen-2019-036048

OBJECTIVE: Pesticide poisoning is a global health problem, and its progressive deterioration is a major cause of concern. The objective of this study is to assess epidemiological characteristics and identify risk factors of pesticide poisoning in Malaysia.
SETTING: Pesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.
PARTICIPANTS: Telephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).
OUTCOMES: The outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.
RESULTS: Within the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.
CONCLUSIONS: Deliberate pesticide ingestion as a method of suicide has become a disturbing trend among Malaysians. Therefore, regulation of highly hazardous pesticides must be enforced to ensure controlled and limited access to these chemicals by the public.