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  1. The effects of metformin on ovarian cancer: a systematic review
    Dilokthornsakul P, Chaiyakunapruk N, Termrungruanglert W, Pratoomsoot C, Saokaew S, Sruamsiri R
    Int. J. Gynecol. Cancer, 2013 Nov;23(9):1544-51.
    PMID: 24172091 DOI: 10.1097/IGC.0b013e3182a80a21
    OBJECTIVE: The potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aim to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer.

    METHODS: We performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included "metformin" AND ("ovarian cancer" OR "ovary tumor"). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model.

    RESULTS: Of 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16-1.99).

    CONCLUSIONS: Our findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.

    Matched MeSH terms: Ovarian Neoplasms/drug therapy*
  2. Fulltext In-vivo effect of andrographolide on alveolar bone resorption induced by Porphyromonas gingivalis and its relation with antioxidant enzymes
    Al Batran R, Al-Bayaty FH, Al-Obaidi MM
    Biomed Res Int, 2013;2013:276329.
    PMID: 24151590 DOI: 10.1155/2013/276329
    Alveolar bone resorption is one of the most important facts in denture construction. Porphyromonas gingivalis (Pg) causes alveolar bone resorption, and morphologic measurements are the most frequent methods to identify bone resorption in periodontal studies. This study has aimed at evaluating the effect of Andrographolide (AND) on alveolar bone resorption in rats induced by Pg. 24 healthy male Sprague Dawley rats were divided into four groups as follows: normal control group and three experimental groups challenged orally with Pg ATCC 33277 five times a week supplemented with 20 mg/kg and 10 mg/kg of AND for twelve weeks. Alveolar bones of the left and right sides of the mandible were assessed by a morphometric method. The bone level, that is, the distance from the alveolar bone crest to cementumenamel junction (CEJ), was measured using 6.1 : 1 zoom stereomicroscope and software. AND reduced the effect of Pg on alveolar bone resorption and decreased the serum levels of Hexanoyl-Lysine (HEL); furthermore the reduced glutathione/oxidised glutathione (GSH/GSSG) ratio in AND treated groups (10 and 20 mg/kg) significantly increased when compared with the Pg group (P < 0.05). We can conclude that AND suppresses alveolar bone resorption caused by Pg in rats.
    Matched MeSH terms: Alveolar Bone Loss/drug therapy*
  3. Prescribing of antidiabetic therapies in Ireland: 10-year trends 2003-2012
    Zaharan NL, Williams D, Bennett K
    Ir J Med Sci, 2014 Jun;183(2):311-8.
    PMID: 24013870 DOI: 10.1007/s11845-013-1011-1
    BACKGROUND: Over the last decade there have been significant changes in the prescribing of antidiabetic therapies. It is of interest to know about these trends and variations in the Irish population so that future prescribing patterns can be estimated.

    AIMS: To examine the trends in prescribed antidiabetic treatments, including variations across age, gender, socioeconomic status and regions in the Irish population over the last 10 years.

    METHODS: The Irish national pharmacy claims database was used to identify patients ≥ 16 years dispensed antidiabetic agents (oral or insulin) from January 2003 to December 2012 through the two main community drug schemes for diabetes. The rate of prescribing per 1,000 population was calculated. Logistic regression was used to examine variations in prescribing in patients with diabetes.

    RESULTS: There was a significant increase in the prescribing of fast and long-acting insulin analogues with a rapid decline in the prescribing of human insulin (p < 0.0001). Increased prescribing of metformin, incretin modulators and fixed oral combination agents was observed (p < 0.0001). Females and older aged patients were more likely to be prescribed human insulin than other insulins. Metformin was less likely while sulphonylureas were more likely to be prescribed in older than younger aged patients. Socioeconomic differences were observed in increased prescribing of the newer and more expensive antidiabetic agents in the non-means tested scheme. Regional variations were observed in the prescribing of both insulin and oral antidiabetic agents.

    CONCLUSION: There has been an increase over time in the prescribing of both insulin and oral antidiabetic agents in the Irish population with increasing uptake of newer antidiabetic agents. This has implications for projecting future uptake and expenditure of these agents given the rising level of diabetes in the population.

    Matched MeSH terms: Diabetes Mellitus/drug therapy*
  4. Treatment of congenital chylothorax with octreotide in a hydropic preterm infant
    Choo YM, Lim CT
    Paediatr Int Child Health, 2013 May;33(2):116-9.
    PMID: 23925288 DOI: 10.1179/2046905512Y.0000000030
    Congenital chylothorax is rare in preterm infants. While most cases respond to conservative treatment, a few require surgery. Treatment with intravenous octreotide has been reported to have varying success in preterm infants. A fetus was diagnosed with bilateral hydrothoraces at 29 weeks of gestation and repeated thoracocentesis was performed antenatally to allow growth of the lungs. She was delivered electively at 32 weeks by caesarean section. Hydrops fetalis was confirmed and chest tubes were inserted bilaterally soon after birth. Intravenous octreotide was commenced on day 4 of life, titrated to a maximum of 10 μg/kg/hr for a total of 28 days. Hydrothorax resolved at day 30 and total parenteral nutrition was given for a total of 37 days. She was successfully extubated on day 40 of life and discharged on day 80. On review at 6 months of age, she was thriving and developing normally.
    Matched MeSH terms: Chylothorax/drug therapy
  5. Pharmacist-patient communication on use of antidepressants: a simulated patient study in community pharmacy
    Chong WW, Aslani P, Chen TF
    Res Social Adm Pharm, 2014 Mar-Apr;10(2):419-37.
    PMID: 23787139 DOI: 10.1016/j.sapharm.2013.05.006
    BACKGROUND: Effective communication between community pharmacists and patients, particularly with a patient-centered approach, is important to address patients' concerns relating to antidepressant medication use. However, few studies have investigated community pharmacists' communication behaviors in depression care.
    OBJECTIVE: To characterize community pharmacist-patient interactions during consultations involving use of antidepressants.
    METHODS: Twenty community pharmacists received 3 simulated patient visits involving issues related to the use of antidepressants: 1) patient receiving a first-time antidepressant prescription; 2) patient perceiving lack of efficacy of antidepressants after 2 weeks of treatment, and 3) patient intending to discontinue treatment prematurely. All 60 encounters were audio-recorded and analyzed using the Roter Interaction Analysis System (RIAS), a quantitative coding system that characterizes communication behaviors through discrete categories. A patient-centeredness score was calculated for each encounter.
    RESULTS: The majority of pharmacist communication was biomedical in nature (50.7%), and focused on providing therapeutic information and advice on the antidepressant regimen. In contrast, only 5.4% of pharmacist communication was related to lifestyle/psychosocial exchanges. There were also few instances of emotional rapport-building behaviors (8.6%) or information gathering (6.6%). Patient-centered scores were highest in the scenario involving a first-time antidepressant user, as compared to other scenarios involving issues with continued therapy.
    CONCLUSIONS: Community pharmacists appeared to adopt a "medication-centered" approach when counseling on antidepressant issues. There is scope for improvement in patient-centered communication behaviors, particularly lifestyle/psychosocial discussions, facilitating patient participation, and emotional rapport-building. The RIAS appears suited to characterize brief consultations in community pharmacies and can provide a framework in guiding communication training efforts. Further research is needed to assess the impact of pharmacist communication behaviors on patient care outcomes.
    KEYWORDS: Antidepressant adherence; Patient-centeredness; Pharmacist–patient communication; Roter Interaction Analysis System
    Matched MeSH terms: Depression/drug therapy*
  6. Health-related quality of life associated with treatment adherence in patients with hypertension: a cross-sectional study
    Zyoud SH, Al-Jabi SW, Sweileh WM, Wildali AH, Saleem HM, Aysa HA, et al.
    Int J Cardiol, 2013 Oct 3;168(3):2981-3.
    PMID: 23647601 DOI: 10.1016/j.ijcard.2013.04.105
    Matched MeSH terms: Hypertension/drug therapy*
  7. Fulltext Association of creatinine clearance with neutropenia in breast cancer patients undergoing chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide (FAC)
    Montoya JE, Luna HG, Morelos AB, Catedral MM, Lava AL, Amparo JR, et al.
    Med J Malaysia, 2013 Apr;68(2):153-6.
    PMID: 23629563
    Fluorouracil, doxorubicin, cyclophosphamide protocol (FAC) is a commonly used regimen for breast cancer due to its proven efficacy, acceptable toxicity, high affordability. While hepatic insufficiency dosing for doxorubicin and fluorouracil have been set, there is paucity of data in the literature on how to reduce doses in renal insufficiency. We sought to determine whether there is an association with pre-chemotherapy creatinine clearance, and the occurrence of clinically significant grade 3 to 5 neutropenia during the course of FAC chemotherapy.
    Matched MeSH terms: Breast Neoplasms/drug therapy
  8. Fulltext Plasmodium knowlesi infection: a diagnostic challenge
    Fan L, Lee SY, Koay E, Harkensee C
    BMJ Case Rep, 2013;2013:bcr2013009558.
    PMID: 23608876 DOI: 10.1136/bcr-2013-009558
    Plasmodium knowlesi malaria is an uncommon, but highly prevalent parasitic infection in parts of Malaysia. This is the case of a 14-year-old Singaporean boy presenting to our emergency department with an 11-day history of fever following a school trip to Malaysia. Hepatosplenomegaly was the only clinical finding; laboratory tests showed thrombocytopaenia, lymphopaenia, mild anaemia and liver transaminitis. Specific malaria antigen tests were negative, but the peripheral blood film showed plasmodia with atypical features, with a parasite load of 0.5%. PCR confirmed the diagnosis of P knowlesi. The patient was successfully treated with chloroquine. The clinical course of P knowlesi malaria is indistinguishable from that of Plasmodium falciparum. This case highlights the importance of taking detailed travel history, careful examination of malaria blood films and judicious use of molecular techniques. Antigen tests alone may have missed a malaria diagnosis altogether, while blood film examination may wrongly identify the species as Plasmodium malariae or P falciparum. Third-generation PCR assays can be used to reliably identify P knowlesi.
    Matched MeSH terms: Malaria/drug therapy
  9. Fulltext Potential anti-dengue medicinal plants: a review
    Abd Kadir SL, Yaakob H, Mohamed Zulkifli R
    J Nat Med, 2013 Oct;67(4):677-89.
    PMID: 23591999 DOI: 10.1007/s11418-013-0767-y
    Dengue fever causes mortality and morbidity around the world, specifically in the Tropics and subtropic regions, which has been of major concern to governments and the World Health Organization (WHO). As a consequence, the search for new anti-dengue agents from medicinal plants has assumed more urgency than in the past. Medicinal plants have been used widely to treat a variety of vector ailments such as malaria. The demand for plant-based medicines is growing as they are generally considered to be safer, non-toxic and less harmful than synthetic drugs. This article reviews potential anti-dengue activities from plants distributed around the world. Sixty-nine studies from 1997 to 2012 describe 31 different species from 24 families that are known for their anti-dengue activities. About ten phytochemicals have been isolated from 11 species, among which are compounds with the potential for development of dengue treatment. Crude extracts and essential oils obtained from 31 species showed a broad activity against Flavivirus. Current studies show that natural products represent a rich potential source of new anti-dengue compounds. Further ethnobotanical surveys and laboratory investigations are needed established the potential of identified species in contributing to dengue control.
    Matched MeSH terms: Dengue/drug therapy*
  10. 15 years of APOC--a lifetime of public health evidence
    Allotey P, Amazigo U, Adjei S, Seddoh A, Lusamba-Dikassa PS
    Lancet, 2012 Oct 20;380(9851):1361-3.
    PMID: 23084441 DOI: 10.1016/S0140-6736(12)60723-5
    Matched MeSH terms: Onchocerciasis, Ocular/drug therapy
  11. Fulltext Antipsychotic-like activity of noni (Morinda citrifolia Linn.) in mice
    Pandy V, Narasingam M, Mohamed Z
    BMC Complement Altern Med, 2012;12:186.
    PMID: 23082808 DOI: 10.1186/1472-6882-12-186
    Noni fruit is widely consumed in tropical regions of Indonesia to the Hawaiian Islands. The noni plant has a long history of use as a medicinal plant to treat a wide variety of ailments including CNS disorders. The present investigation was designed to evaluate the antipsychotic effect of noni fruits (Morinda citrifolia Linn.) using mouse models of apomorphine-induced climbing behaviour and methamphetamine-induced stereotypy (licking, biting, gnawing and sniffing).
    Matched MeSH terms: Psychotic Disorders/drug therapy*
  12. Fulltext Missed perforation presenting as sympathetic ophthalmia in an adolescent Malay girl
    Bastion ML, Mohamad MH
    BMJ Case Rep, 2012;2012.
    PMID: 22914237 DOI: 10.1136/bcr-2012-006525
    To describe the rare presentation of sympathetic ophthalmia in a teenage girl with no previous known ocular injury.
    Matched MeSH terms: Endophthalmitis/drug therapy*
  13. The role of proton pump inhibitors in adenoid hypertrophy in children
    Iqbal FR, Goh BS, Mazita A
    Otolaryngol Head Neck Surg, 2012 Aug;147(2):329-34.
    PMID: 22496101 DOI: 10.1177/0194599812444528
    To establish the efficacy of proton pump inhibitors (PPI) in the treatment of adenoid hypertrophy in children.
    Matched MeSH terms: Hypertrophy/drug therapy
  14. Burden of stroke in the Philippines
    Loo KW, Gan SH
    Int J Stroke, 2013 Feb;8(2):131-4.
    PMID: 22568853 DOI: 10.1111/j.1747-4949.2012.00806.x
    Based on disability-adjusted life-years, stroke is the second leading cause of death and among the top five diseases with the greatest burden. Although two community-based studies have been conducted to determine the prevalence of stroke in the Philippines, the incidence has not been nationally recorded to date. The prevalence ranged from 1·9% to 6·59%, and 'Wiihabilitation', a rehabilitation stroke therapy, is widely practiced. A clinical trial for stroke rehabilitation using the Chinese Medicine NeuroAid®, which consists of several herbs, is ongoing in many hospitals across the Philippines. Due to their ready availability, phytomedicines are widely used, especially in the rural areas, for the treatment of hypertension, diabetes mellitus, and hypercholesterolemia, which are predisposing factors for stroke in the Philippines. Due to the increasing number of stroke cases annually, the government of the Philippines should emphasize primary and secondary prevention strategies.
    Matched MeSH terms: Stroke/drug therapy*
  15. Efficacy and safety of diphenylcyclopropenone among Chinese patients with steroid resistant and extensive alopecia areata
    Luk NM, Chiu LS, Lee KC, Chau CT, Lee VW, Chang M, et al.
    J Eur Acad Dermatol Venereol, 2013 Mar;27(3):e400-5.
    PMID: 23057682 DOI: 10.1111/jdv.12009
    BACKGROUND: Topical immunotherapy has recently been found useful in the treatment of chronic and extensive Alopecia Areata (AA).
    OBJECTIVE: To evaluate the efficacy and safety of diphenylcyclopropenone (DPCP) use among Chinese patients with steroid resistant and extensive AA in our institute.
    METHODS: The medical records of 31 Chinese patients treated with DPCP were analysed retrospectively. The efficacy, adverse effects, and relapse rate of DPCP treatment were reviewed.
    RESULTS: Thirty-one (16 male, 15 female) Chinese patients with extensive, steroid resistant Alopecia Areata and a mean age of 28.9 years (SE 10.4) were treated. The mean age of onset was 17.8 years (SE 8.8) with an average disease duration of 11.2 years (SE 7.7). Ten patients had a history of atopy and 4 had a history of thyroid disease. Nail changes were found in 14 patients and a family history of AA was found in 2 patients. Thirteen patients (41.9%) had experienced total hair loss. Two patients abandoned the treatment due to severe side effects. Of the remaining 29 patients, 4 (13.8%), 7 (24.1%), 5 (17.2%), and 13 (44.8%) achieved >90% complete response, >50-90% partial response, >10-50% minimal response, and <10% no response hair regrowth, respectively. Adverse effects included pruritus, erythema, vesiculation, scaling, cervical lymphadenopathy, dyspigmentation and urticarial reactions. Relapse occurred (>25% hair loss) in 69.23% of patients after 18 months of follow up.
    CONCLUSIONS: DPCP is an effective and tolerable treatment for Chinese patients with extensive, steroid resistant AA.
    Matched MeSH terms: Alopecia Areata/drug therapy*
  16. Fulltext Neonatal rash - a case study
    Kwa SK, Sinniah D, Tan KK
    Aust Fam Physician, 2012 Sep;41(9):707-9.
    PMID: 22962649
    An infant, aged 48 days, is brought in by her mother to her doctor because of a rash that started during the neonatal period.
    Matched MeSH terms: Scabies/drug therapy
  17. Fulltext Use of newly available febuxostat in a case of chronic tophaceous gout contraindicated to allopurinol and probenecid
    Abdullah H, Asmahan MI, Rosman A
    Med J Malaysia, 2012 Feb;67(1):125-6.
    PMID: 22582566 MyJurnal
    Urate lowering therapy in this country has mainly been achieved by the use of allopurinol and probenecid. A new xanthine oxidase inhibitor called febuxostat has been approved in 2009 for treatment of hyperuricaemia in gout. In this report, we describe the management of a patient with chronic tophaceous gout using febuxostat. The reduction in serum uric acid to target levels was rapid, and the tophi size had also reduced significantly while on therapy. There was no unwanted side effect observed during the therapy. Therefore, febuxostat would be a useful alternative drug in the treatment of hyperuricaemia in gout patients who have contraindications to allopurinol and probenecid.
    Study site: Rheumatology clinic, Selayang Hospital, Kuala Lumpur, Malaysia
    Matched MeSH terms: Gout/drug therapy*
  18. Fulltext The health seeking trajectories of Malaysian women and their husbands in delay cases of breast cancer: a qualitative study
    Yusoff N, Taib NA, Ahmad A
    Asian Pac J Cancer Prev, 2011;12(10):2563-70.
    PMID: 22320956
    The aim of this study was to assess why women delay in getting treatment (i.e. surgery) for breast cancer, as well as to explore on what type of issues are involved in such delay cases. Basic interpretative of qualitative methodology was applied to construct the reality of delay phenomena, and its interaction with social worlds. Six themes were identified: new conception of breast cancer treatment, psychological defenses, health support system, symtomatology experience, model and barriers. The delay issue in breast cancer requires attention as a multidimensional problem as this will facilitate more comprehensive and effective intervention to reduce delay.
    Matched MeSH terms: Breast Neoplasms/drug therapy
  19. Fulltext Concurrent massive breast enlargement, myasthenia gravis and dermopathy as manifestations of penicillamine toxicity in a Wilson's disease patient
    Tan SS, Latif SA, Poh WY
    Med J Malaysia, 2012 Jun;67(3):323-5.
    PMID: 23082426 MyJurnal
    Penicillamine toxicity in Wilson's disease has been well reported but rarely seen now as newer agents are being used. We present a case who developed multiple rare complications of Penicillamine concurrently. Our patient is one of three siblings on Penicillamine, she was the only one who developed massive breast enlargement four months after commencing Penicillamine therapy, as well as dermatological adverse reactions and myasthenia gravis three more months later. All the adverse effects improved soon after substitution of the offending agent with Trientine.
    Matched MeSH terms: Hepatolenticular Degeneration/drug therapy
  20. Fulltext Lemierre syndrome
    Lim AL, Pua KC
    Med J Malaysia, 2012 Jun;67(3):340-1.
    PMID: 23082433 MyJurnal
    Lemierre syndrome is an uncommon disease which commonly arise from acute bacterial oropharyngeal infection. This disease was first described in 1900 by Courmont and Cade Lemierre. It is commonly caused by Fusobacterium necrophorum. Lemierre syndrome has been reported to be serious and potentially fatal in the preantibiotic era. It is characterized by an oropharyngeal infection leading to secondary septic thrombophlebitis of the internal jugular vein with embolization to the lungs and other organs. The incidence has become relatively rare at present and is usually only diagnosed when unsuspected culture results are available. We report a case of Lemierre syndrome which was recently diagnosed in our centre.
    Matched MeSH terms: Lemierre Syndrome/drug therapy*
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