Displaying publications 21 - 40 of 4829 in total

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  1. Fulltext Therapeutic aerosol: principles and practices
    Zainudin BM
    Med J Malaysia, 1993 Sep;48(3):259-68.
    PMID: 8183136
    Delivering a drug direct to the site of disease has several advantages. In the case of aerosols, it only requires about one-twentieth of the oral dose of the drug to exert its effect, thus resulting in less or minimal systemic side-effects. The onset of action is fast and the efficacy is superior to the oral drug. Because of the anatomy of the airways which are protective against the inhalation of foreign substances, the aerosol particles must be inhaled in an optimal way in order to reach the sites of action which are the peripheral airways. The particle size must be small and the aerosol must be inhaled in a coordinated manner, especially when a pressurised metered dose inhaler is used. Because of the high pressure of the propellants used in the canister, the particles will travel at a rapid speed upon actuating, causing great impaction in the throat. Only a small percentage reaches the peripheral airways and this percentage is even smaller if the coordination between actuation and inhalation is poor. Spacers have been shown to be able to overcome this problem of incoordination and to reduce throat impaction. Alternatively, the breath-actuated dry powder inhaler can be effectively used. The nebuliser, which is another aerosol delivery system, needs proper setting of the flow rate of compressed air and an appropriate volume of solution in order to optimise the drug delivery.
    Matched MeSH terms: Aerosols/therapeutic use*
  2. Fulltext Idiopathic paroxysmal choreoathetosis--report of 2 cases and review of literature
    Jusoh MR
    Med J Malaysia, 1983 Sep;38(3):224-7.
    PMID: 6672565
    2 cases of idiopathic paroxysmal choreoathetosis with late onset and non familial were described. Examinations and investigations were normal and both responded to phenobarbitone.
    Matched MeSH terms: Phenobarbital/therapeutic use
  3. Fulltext Porokeratosis: a report of three clinical variants
    Singh R, Ghazali W, Nor M
    Med J Malaysia, 1991 Mar;46(1):99-103.
    PMID: 1836046
    Three patients presenting with distinct clinical variants of porokeratosis are reported. This article discusses the etiology, classification and response to different modalities of treatment.
    Matched MeSH terms: Fluorouracil/therapeutic use
  4. Targeting Cancer using Curcumin Encapsulated Vesicular Drug Delivery Systems
    Hardwick J, Taylor J, Mehta M, Satija S, Paudel KR, Hansbro PM, et al.
    Curr Pharm Des, 2021;27(1):2-14.
    PMID: 32723255 DOI: 10.2174/1381612826666200728151610
    Curcumin is a major curcuminoid present in turmeric. The compound is attributed to various therapeutic properties, which include anti-oxidant, anti-inflammatory, anti-bacterial, anti-malarial, and neuroprotection. Due to its therapeutic potential, curcumin has been employed for centuries in treating different ailments. Curcumin has been investigated lately as a novel therapeutic agent in the treatment of cancer. However, the mechanisms by which curcumin exerts its cytotoxic effects on malignant cells are still not fully understood. One of the main limiting factors in the clinical use of curcumin is its poor bioavailability and rapid elimination. Advancements in drug delivery systems such as nanoparticle-based vesicular drug delivery platforms have improved several parameters, namely, drug bioavailability, solubility, stability, and controlled release properties. The use of curcumin-encapsulated niosomes to improve the physical and pharmacokinetic properties of curcumin is one such approach. This review provides an up-to-date summary of nanoparticle-based vesicular drug carriers and their therapeutic applications. Specifically, we focus on niosomes as novel drug delivery formulations and their potential in improving the delivery of challenging small molecules, including curcumin. Overall, the applications of such carriers will provide a new direction for novel pharmaceutical drug delivery, as well as for biotechnology, nutraceutical, and functional food industries.
    Matched MeSH terms: Liposomes/therapeutic use
  5. Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis
    Lim ST, Thijs V, Murphy SJX, Fernandez-Cadenas I, Montaner J, Offiah C, et al.
    J Neurol, 2020 Oct;267(10):3021-3037.
    PMID: 32518978 DOI: 10.1007/s00415-020-09932-y
    BACKGROUND: The prevalence of ex vivo 'high on-treatment platelet reactivity (HTPR)' and its relationship with recurrent vascular events/outcomes in patients with ischaemic cerebrovascular disease (CVD) is unclear.

    METHODS: A systematic review and meta-analysis was performed in accordance with the PRISMA statement. MEDLINE, EMBASE and Cochrane Library were searched for completed manuscripts until May 2019 on TIA/ischaemic stroke patients, ≥ 18 years, treated with commonly-prescribed antiplatelet therapy, who had platelet function/reactivity testing and prospective follow-up data on recurrent stroke/TIA, myocardial infarction, vascular death or other cerebrovascular outcomes. Data were pooled using random-effects meta-analysis. Primary outcome was the composite risk of recurrent stroke/TIA, myocardial infarction or vascular death. Secondary outcomes were recurrent stroke/TIA, severe stroke (NIHSS > 16) or disability/impairment (modified Rankin scale ≥ 3) during follow-up.

    RESULTS: Antiplatelet-HTPR prevalence was 3-65% with aspirin, 8-56% with clopidogrel and 1.8-35% with aspirin-clopidogrel therapy. Twenty studies (4989 patients) were included in our meta-analysis. There was a higher risk of the composite primary outcome (OR 2.93, 95% CI 1.90-4.51) and recurrent ischaemic stroke/TIA (OR 2.43, 95% CI 1.51-3.91) in patients with vs. those without 'antiplatelet-HTPR' on any antiplatelet regimen. These risks were also more than twofold higher in patients with vs. those without 'aspirin-HTPR' and 'dual antiplatelet-HTPR', respectively. Clopidogrel-HTPR status did not significantly predict outcomes, but the number of eligible studies was small. The risk of severe stroke was higher in those with vs. without antiplatelet-HTPR (OR 2.65, 95% CI 1.00-7.01).

    DISCUSSION: Antiplatelet-HTPR may predict risks of recurrent vascular events/outcomes in CVD patients. Given the heterogeneity between studies, further prospective, multi-centre studies are warranted.

    Matched MeSH terms: Platelet Aggregation Inhibitors/therapeutic use
  6. Does methylprednisolone reduce the mortality risk in hospitalized COVID-19 patients? A meta-analysis of randomized control trials
    Hasan SS, Kow CS, Mustafa ZU, Merchant HA
    Expert Rev Respir Med, 2021 08;15(8):1049-1055.
    PMID: 33945381 DOI: 10.1080/17476348.2021.1925546
    Objectives: The question remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths.Methods: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13 April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI).Results: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 - 1.43, n = 652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high dose methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42).Conclusions: In determining equipotent doses for an acute short-course pulse therapy of corticosteroids, the biological half-life of steroids should also be accounted for besides the potency factor. A short duration (3-5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths.
    Matched MeSH terms: Glucocorticoids/therapeutic use
  7. Fulltext Disseminated talaromycosis in an HIV-infected patient
    Chang CY, Wahid AA, Ong ELC
    Rev Soc Bras Med Trop, 2021 03 22;54:e0896-2020.
    PMID: 33759937 DOI: 10.1590/0037-8682-0896-2020
    Matched MeSH terms: Antifungal Agents/therapeutic use
  8. A case series with literature review on adjunctive usage of intravitreal ceftazidime in ocular syphilis with human immunodeficiency virus infection
    Lim YW, Lott PW, Mohamad NF, Begam Iqbal T
    Int J STD AIDS, 2021 09;32(10):968-973.
    PMID: 33969754 DOI: 10.1177/09564624211011917
    BACKGROUND: Penicillin is the conventional treatment for all stages of syphilis, including ocular and neurosyphilis, according to the recommendations by the Centre for Disease Control and Prevention Sexually Transmitted Disease. This case series highlighted three cases of ocular syphilis which showed prompt treatment response as early as 24 h after the adjunctive intravitreal ceftazidime injection.

    METHODS: Case Series.

    RESULTS: In case 1, there was significant improvement in the vision and vitritis after 24 h of a single intravitreal ceftazidime injection. In case 2, the patient achieved his best vision after a total of three intravitreal injections in his left eye and one in his right eye. In case 3, there was a further resolution of perivascular sheathing and retinal haemorrhages seen 1 week after a single intravitreal ceftazidime injection.

    CONCLUSION: The efficacy of intravitreal ceftazidime injection as a local adjunctive therapy in ocular syphilis treatment is noteworthy. It can be considered in cases which show suboptimal or slower treatment response despite early commencement of systemic penicillin to prevent devastating ocular sequelae.

    Matched MeSH terms: Ceftazidime/therapeutic use
  9. Studies on the chemotherapy of malaria. II. The treatment of acute malaria with proguanil (paludrine)
    FIELD JW, STRAHAN JH, EDESON JF, WILSON T
    Med J Malaya, 1954 Jun;8(4):303-17.
    PMID: 13193268
    Matched MeSH terms: Proguanil/therapeutic use*
  10. Studies on the chemotherapy of malaria. III. The treatment of acute malaria with chloroquine
    WILSON T, EDESON JF
    Med J Malaya, 1954 Dec;9(2):115-31.
    PMID: 14355275
    Matched MeSH terms: Chloroquine/therapeutic use*
  11. An account of clinical results of 33 months of sulphetrone treatment in leprosy
    BLAAUW KH
    Med J Malaya, 1955 Jun;9(4):292-317.
    PMID: 13253131
    Matched MeSH terms: Sulfones/therapeutic use*
  12. Piperazine in the treatment of ascariasis
    PALLISTER RA
    Med J Malaya, 1955 Mar;9(3):212-5.
    PMID: 14393211
    Matched MeSH terms: Piperazines/therapeutic use*
  13. Current Status and Challenges in Rotigotine Delivery
    Md S, Karim S, Saker SR, Gie OA, Hooi LC, Yee PH, et al.
    Curr Pharm Des, 2020;26(19):2222-2232.
    PMID: 32175832 DOI: 10.2174/1381612826666200316154300
    Rotigotine is a non-ergoline, high lipophilic dopamine agonist. It is indicated as the first-line therapy for Parkinson's disease (PD) and Restless Leg Syndrome (RLS). However, the precise mechanism of rotigotine is yet to be known. Rotigotine has similar safety and tolerability to the other oral non-ergolinic dopamine antagonists in clinical trials, which include nausea, dizziness and somnolence. Neupro® was the first marketed transdermal patch formulation having rotigotine. The transdermal delivery system is advantageous as it enables continuous administration of the drug, thus providing steady-state plasma drug concentration for 24-hours. Intranasal administration of rotigotine allows the drug to bypass the blood-brain barrier enabling it to reach the central nervous system within minutes. Rotigotine can also be formulated as an extended-release microsphere for injection. Some challenges remain in other routes of rotigotine administration such as oral, parenteral and pulmonary, whereby resolving these challenges will be beneficial to patients as they are less invasive and comfortable in terms of administration. This review compiles recent work on rotigotine delivery, challenges and its future perspective.
    Matched MeSH terms: Tetrahydronaphthalenes/therapeutic use
  14. Fulltext Corticosteroid-related In-Hospital Hyperglycemia: Does It Negate Mortality Benefits in Coronavirus Disease 2019?
    Kow CS, Hasan SS
    Clin Infect Dis, 2021 11 02;73(9):e2848-e2849.
    PMID: 32948881 DOI: 10.1093/cid/ciaa1423
    Matched MeSH terms: Adrenal Cortex Hormones/therapeutic use
  15. Sofosbuvir as treatment against dengue?
    Gan CS, Lim SK, Chee CF, Yusof R, Heh CH
    Chem Biol Drug Des, 2018 02;91(2):448-455.
    PMID: 28834304 DOI: 10.1111/cbdd.13091
    Dengvaxia® (CTD-TDV), the only licensed tetravalent dengue vaccine by Sanofi Pasteur, was made available since 2015. However, administration of CTD-TDV, in general, has not received the prequalification recommendation from the World Health Organization. Having a universal antidengue agent for treatment will therefore beneficial. Accordingly, the development of nucleoside inhibitors specific to dengue viral polymerase that perturb dengue infection has been studied by many. Alternatively, we have used a marketed anti-HCV prodrug sofosbuvir to study its in silico and in vitro effects against dengue. As a result, the active metabolite of sofosbuvir (GS-461203) was predicted to bind to the catalytic motif (Gly-Asp-Asp) of dengue viral polymerase with binding affinity of -6.9 kcal/mol. Furthermore, sofosbuvir demonstrated excellent in vitro viral inhibition with an EC90 of 0.4 μm. In addition, this study demonstrated the requirement of specific liver enzymes to activate the prodrug into GS-461203 to exert its antidengue potential. All in all, sofosbuvir should be subjected to in-depth studies to provide information of its efficacy toward dengue and its lead potential as DENV polymerase inhibitor in human subjects. In conclusion, we have expended the potential of the clinically available drug sofosbuvir as treatment for dengue.
    Matched MeSH terms: Sofosbuvir/therapeutic use
  16. Antimicrobial betalains
    Wijesinghe VN, Choo WS
    J Appl Microbiol, 2022 Dec;133(6):3347-3367.
    PMID: 36036373 DOI: 10.1111/jam.15798
    Betalains are nitrogen-containing plant pigments that can be red-violet (betacyanins) or yellow-orange (betaxanthins), currently employed as natural colourants in the food and cosmetic sectors. Betalains exhibit antimicrobial activity against a broad spectrum of microbes including multidrug-resistant bacteria, as well as single-species and dual-species biofilm-producing bacteria, which is highly significant given the current antimicrobial resistance issue reported by The World Health Organization. Research demonstrating antiviral activity against dengue virus, in silico studies including SARS-CoV-2, and anti-fungal effects of betalains highlight the diversity of their antimicrobial properties. Though limited in vivo studies have been conducted, antimalarial and anti-infective activities of betacyanin have been observed in living infection models. Cellular mechanisms of antimicrobial activity of betalains are yet unknown; however existing research has laid the framework for a potentially novel antimicrobial agent. This review covers an overview of betalains as antimicrobial agents and discussions to fully exploit their potential as therapeutic agents to treat infectious diseases.
    Matched MeSH terms: Betalains/therapeutic use
  17. Role of topical spironolactone in the treatment of acne: A systematic review of clinical trials-Does this therapy open a path towards favorable outcomes?
    Rehan ST, Khan Z, Abbas S, Imran L, Munir S, Tahir MJ, et al.
    J Dermatol, 2023 Feb;50(2):166-174.
    PMID: 36412248 DOI: 10.1111/1346-8138.16637
    Acne vulgaris is the eighth most common disease worldwide and presents with inflammatory and noninflammatory skin lesions along with other dermal abnormalities. Oral spironolactone is used for treating acne vulgaris due to its antiandrogenic properties and inhibition of sebogenesis. Recent evidence shows that spironolactone in topical form has similar efficacy to its oral form with comparatively fewer adverse events associated with its use. However, to establish an evidence-based understanding, this systematic review aims to investigate the efficacy and safety of topical spironolactone in the treatment of acne vulgaris. PubMed, ClinicalTrials.gov, Cochrane library, and Google Scholar were comprehensively searched from the date of inception till March 18, 2022 All the clinical trials experimenting with the role of topical spironolactone in the treatment of acne were included. Articles examining the effects of oral spironolactone or other topical agents were excluded. The Cochrane risk of bias assessment tool (RoB 2.0, version 2019) was used to assess the risk of bias in each study. The study findings have been reported in line with PRISMA 2020 guidelines. The literature search yielded 600 articles. Five clinical trials with 195 patients were included in this review. Out of the five trials, two showed a high risk of bias while three had overall some concerns. Patients treated with topical spironolactone showed a significant decrease in the number of papules (p = 0.004), closed comedones (p  0.05). Topical spironolactone yields better results than other first-line treatments for acne and displays fewer side effects. However, further large-scale clinical trials are required before spironolactone can be used as the preferred treatment in the clinical management of acne.
    Matched MeSH terms: Clindamycin/therapeutic use
  18. Understanding the dynamics of COVID-19; implications for therapeutic intervention, vaccine development and movement control
    Salvamani S, Tan HZ, Thang WJ, Ter HC, Wan MS, Gunasekaran B, et al.
    Br J Biomed Sci, 2020 Oct;77(4):168-184.
    PMID: 32942955 DOI: 10.1080/09674845.2020.1826136
    The COVID-19 disease is caused by the SARS-CoV-2 virus, which is highly infective within the human population. The virus is widely disseminated to almost every continent with over twenty-seven million infections and over ninety-thousand reported deaths attributed to COVID-19 disease. SARS-CoV-2 is a single stranded RNA virus, comprising three main viral proteins; membrane, spike and envelope. The clinical features of COVID-19 disease can be classified according to different degrees of severity, with some patients progressing to acute respiratory distress syndrome, which can be fatal. In addition, many infections are asymptomatic or only cause mild symptoms. As there is no specific treatment for COVID-19 there is considerable endeavour to raise a vaccine against SARS-CoV-2, in addition to engineering neutralizing antibody interventions. In the absence of an effective vaccine, movement controls of varying stringencies have been imposed. Whilst enforced lockdown measures have been effective, they may be less effective against the current strain of SARS-CoV-2, the G614 clade. Conversely, other mutations of the virus, such as the Δ382 variant could reduce the clinical relevance of infection. The front runners in the race to develop an effective vaccine focus on the SARS-Co-V-2 Spike protein. However, vaccines that produce a T-cell response to a wider range of SARS-Co-V-2 viral proteins, may be more effective. Population based studies that determine the level of innate immunity to SARS-CoV-2, from prior exposure to the virus or to other coronaviruses, will have important implications for government imposed movement control and the strategic delivery of vaccination programmes.
    Matched MeSH terms: Viral Vaccines/therapeutic use
  19. Molecular insights and therapeutic implications of nanoengineered dietary polyphenols for targeting lung carcinoma: part I
    Das SS, Tambe S, Prasad Verma PR, Amin P, Singh N, Singh SK, et al.
    Nanomedicine (Lond), 2022 Oct;17(23):1779-1798.
    PMID: 36636930 DOI: 10.2217/nnm-2022-0133
    Lung cancer is the second leading cause of cancer-related mortality globally, and non-small-cell lung cancer accounts for most lung cancer cases. Nanotechnology-based drug-delivery systems have exhibited immense potential in lung cancer therapy due to their fascinating physicochemical characteristics, in vivo stability, bioavailability, prolonged and targeted delivery, gastrointestinal absorption and therapeutic efficiency of their numerous chemotherapeutic agents. However, traditional chemotherapeutics have systemic toxicity issues; therefore, dietary polyphenols might potentially replace them in lung cancer treatment. Polyphenol-based targeted nanotherapeutics have demonstrated interaction with a multitude of protein targets and cellular signaling pathways that affect major cellular processes. This review summarizes the various molecular mechanisms and targeted therapeutic potentials of nanoengineered dietary polyphenols in the effective management of lung cancer.
    Matched MeSH terms: Polyphenols/therapeutic use
  20. Fulltext Metformin in COVID-19: clinical trials are needed to prove its benefits
    Kow CS, Ramachandram DS, Hasan SS
    Ir J Med Sci, 2022 Dec;191(6):2641-2642.
    PMID: 34997410 DOI: 10.1007/s11845-021-02869-9
    Matched MeSH terms: Hypoglycemic Agents/therapeutic use
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