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LC-PDA-MS/MS-Based Characterization of Key Phytochemicals in Eurycoma Longifolia Roots

Chua LS, Segaran A, Wong HJ

J Chromatogr Sci, 2021 Jun 21;59(7):659-669.
PMID: 33876232 DOI: 10.1093/chromsci/bmab041

The objective of the study was to fractionate the crude extract of Eurycoma longifolia (E. longifolia) roots and identify the intense peaks using HPLC-PDA-MS/MS, UPLC-MS/MS and H-NMR. Column chromatography was used to fractionate the crude extract into individual fractions using six solvent systems ranged from ethyl acetate, methanol and water in increasing polarity. Two fractions with nearly pure and intense peaks were selected for compound identification. Chromenone (coumarin) and chromone derivatives were putatively identified, besides several previously reported quassinoid glycosides (eurycomanone derived glycoside, 2,3-dehydro-4α-hydroxylongilactone glucoside, eurycomanol glycoside and eurycomanol trimer) in the fraction 11 of 100% methanol. A newly reported compound, namely hydroxyl glyyunanprosapogenin D (838 g/mol) was proposed to be the compound detected in the fraction 11 of 50% ethyl acetate and 50% methanol. This is also the first study to report the identification of chromenones and chromones in E. longifolia extract.
Fulltext Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study

Wong HJ, Moy FM, Nair S

BMC Public Health, 2014;14:785.
PMID: 25086853 DOI: 10.1186/1471-2458-14-785

Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia.
The first record of human infection with Bertiella studeri in Malaya

Desowitz RS, Wong HJ, Fernando MA

J Helminthol, 1961;35:207-8.
PMID: 13885756 DOI: 10.1017/S0022149X00004569

A six year old child living in Singapore was found to be
infected with the cestode Bertiella studeri. Apparent cure was affected by use of Dichlorophen.
Fulltext Health-related quality of life profiles and their dimension-specific associated factors among Malaysian stroke survivors: a cross sectional study

Wong HJ, Lua PL, Harith S, Ibrahim KA

Health Qual Life Outcomes, 2021 Aug 30;19(1):210.
PMID: 34461920 DOI: 10.1186/s12955-021-01847-0

BACKGROUND: Apart from maximizing functional abilities and independence after stroke, improving overall health-related quality of life (HRQoL) should also become part of the stroke treatment and rehabilitation process goals. This study aimed to assess the HRQoL profiles and explore the dimension-specific associated factors of HRQoL among stroke survivors.
METHODS: This was a cross-sectional study of stroke survivors attending post-stroke care clinics in three public hospitals in the states of Pahang and Terengganu, Malaysia. The HRQoL was assessed by EuroQol-5 dimension-5 levels. Data on socio-demographic, clinical profiles, malnutrition risk, and physical activity level were collected through an interviewer-administered survey. Descriptive analyses for HRQoL profiles and multiple logistic regression analyses for its associated factors were performed. Crude and adjusted odds ratios were reported.
RESULTS: A total of 366 stroke survivors were recruited with a mean age of 59 ± 11 years. The most -commonly reported health problems were mobility (85%), followed by usual activities (82%), pain/discomfort (63%), anxiety/depression (51%) and self-care (41%). The mean of the EQ visual analogue scale and the median of the EQ5D summary index was reported at 60.3 ± 14.2 and 0.67 ± 0.37, respectively. Malnutrition risk (mobility, usual activities, and self-care), wheelchair users (self-care and usual activities), speech impairment (usual activities and pain/discomfort), number of stroke episodes (self-care and pain/discomfort), body mass index, physical activity level and types of strokes (usual activities), age and use of a proxy (anxiety/depression), working and smoking status (mobility), were factors associated with either single or multiple dimensions of HRQoL.
CONCLUSION: Routine malnutrition screening, tailored program for speech therapy, prevention of recurrent stroke, and physical activity promotion should be addressed and further reinforced in current rehabilitation interventions to improve the HRQoL among stroke survivors in Malaysia.
Fulltext Comparison of concurrent validity of different malnutrition screening tools with the Global Leadership Initiative on Malnutrition (GLIM) among stroke survivors in Malaysia

Wong HJ, Harith S, Lua PL, Ibrahim KA

Sci Rep, 2023 Mar 30;13(1):5189.
PMID: 36997594 DOI: 10.1038/s41598-023-31006-y

Individuals with stroke are at high malnutrition risk in both the acute and chronic phases. This study aimed to assess the validity of different malnutrition screening tools for stroke patients in rehabilitation phase. Participants in this study were 304 stroke patients from three hospitals in the East-Coast region of Peninsular Malaysia from May-August 2019. The concurrent validity of the Malnutrition Risk Screening Tool-Hospital (MRST-H), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002) was assessed with the diagnostic criteria for malnutrition proposed by the Global Leadership Initiative on Malnutrition (GLIM-DCM). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve were computed. MUST and MRST-H demonstrated good validity regardless of different age groups (> 80% sensitivity and specificity); meanwhile, MST and MNA-SF had fair validity, yet NRS-2002 had poor to fair validity with GLIM-DCM. Only MRST-H and NRS-2002 were significantly correlated with all anthropometric indices, dietary energy intake, and health-related quality of life in both age groups. In conclusion, MRST-H and MUST showed good concurrent validity with GLIM-DCM and can be considered as appropriate malnutrition screening tool in discriminating malnutrition among stroke individuals attending rehabilitation centre in Malaysia regardless of their age groups.
Lipid profiles and lifestyle habits of stroke survivors in the east coast region of peninsular Malaysia: Preliminary findings

Wong HJ, Harith S, Lua PL, Ibrahim KA

Nutr Health, 2023 Dec;29(4):695-705.
PMID: 35763460 DOI: 10.1177/02601060221097459

Background: Stroke survivors are at high risk for recurrent cardiovascular events if no prevention strategies are undertaken. Aim: This study aimed to investigate the fasting serum lipid profiles and lifestyle habits in stroke survivors, and the factors associated with suboptimal lipid profiles. Methods: A cross-sectional retrospective study was conducted in three public hospitals in Malaysia. Stroke survivors' data regarding the socio-demographic characteristics, clinical profiles, fasting serum lipid profiles, dietary adherence, and physical activity levels were acquired. Binary logistic regression was used to examine the factors associated with suboptimal lipid goals. Results: A total of 104 stroke survivors were recruited from patients attending the neurology and rehabilitation departments. Only 22% of the stroke survivors attained the targeted low-density lipoprotein cholesterol level (LDL-C < 1.8 mmol/L). Meanwhile, more than two thirds of patients achieved the targeted total cholesterol, triglyceride, and high-density lipoprotein cholesterol goals. Patients with a longer stroke duration (Adjusted odds ratio, AOR 3.33, 95% confidence intervals, CI: 1.09, 10.13, p = 0.034), elevated blood pressure (AOR 4.74, 95% CI: 1.65, 13.62, p = 0.004), chronic kidney disease (AOR 3.30, 95% CI: 1.05, 10.34, p = 0.041), abdominal obesity (AOR 3.14, 95% CI: 1.20, 8.21, p = 0.020), excessive energy intake (AOR 2.72, 95% CI: 1.07, 6.91, p = 0.036), and excessive saturated fatty acids intake (AOR 2.85, 95% CI: 1.02, 7.93, p = 0.045) were significantly associated with suboptimal lipid profiles. Conclusion: The lipid goals attainment was low, particularly the LDL-C levels among Malaysian stroke survivors. Greater efforts are warranted to fully utilise the lipid-lowering therapy and the lifestyle changes in these high-risk patients.
Fulltext Prevalence and Predictors of Malnutrition Risk among Post-Stroke Patients in Outpatient Setting: A Cross-Sectional Study

Wong HJ, Harith S, Lua PL, Ibrahim KA

Malays J Med Sci, 2020 Jul;27(4):72-84.
PMID: 32863747 MyJurnal DOI: 10.21315/mjms2020.27.4.7

Background: The present study examined the prevalence and predictors of malnutrition risk among post-stroke patients.
Methods: Post-stroke patients who attended the outpatient clinics in three hospitals of Peninsular Malaysia were enrolled in the study. The risk of malnutrition was assessed using the Malnutrition Risk Screening Tool-Hospital. Data including demographic characteristics, clinical profiles, dietary nutrients intake, body mass index (BMI) and hand grip strength were collected during the survey. The crude odds ratio (OR) and adjusted odds ratio (AOR) were reported for univariate and multivariate logistic regression analyses, respectively.
Results: Among 398 patients included in the study, 40% were classified as high-risk for malnutrition. In the multivariable logistic regression, tube feeding (AOR: 13.16, 95% confidence interval [CI]: 3.22-53.77), loss of appetite (AOR: 8.15, 95% CI: 4.71-14.12), unemployment (AOR: 4.26, 95% CI: 1.64-11.12), wheelchair-bound (AOR: 2.23, 95% CI: 1.22-4.09) and BMI (AOR: 0.87, 95% CI: 0.82-0.93) were found to be significant predictors of malnutrition risk among stroke patients.
Conclusion: The risk of malnutrition is highly prevalent among post-stroke patients. Routine nutritional screening, identification of risk factors, and continuous monitoring of dietary intake and nutritional status are highly recommended even after the stroke patient is discharged.
Fulltext In vitro and ex-vivo cellular antioxidant protection and cognitive enhancing effects of an extract of Polygonum minus Huds (Lineminus™) demonstrated in a Barnes Maze animal model for memory and learning

George A, Ng CP, O'Callaghan M, Jensen GS, Wong HJ

BMC Complement Altern Med, 2014;14:161.
PMID: 24886679 DOI: 10.1186/1472-6882-14-161

Polygonum minus Huds.is a culinary flavouring that is common in South East Asian cuisine and as a remedy for diverse maladies ranging from indigestion to poor eyesight. The leaves of this herb have been reported to be high in antioxidants. Flavonoids which have been associated with memory, cognition and protection against neurodegeneration were found in P. minus.
Fulltext Posterior reversible encephalopathy syndrome secondary to dengue fever: a case report

Cheo SW, Wong HJ, Ng EK, Low QJ, Chia YK

Hong Kong Med J, 2021 02;27(1):55-57.
PMID: 33568560 DOI: 10.12809/hkmj208509
Fulltext Effects of a Proprietary Standardized Orthosiphon stamineus Ethanolic Leaf Extract on Enhancing Memory in Sprague Dawley Rats Possibly via Blockade of Adenosine A 2A Receptors

George A, Chinnappan S, Choudhary Y, Choudhary VK, Bommu P, Wong HJ

Evid Based Complement Alternat Med, 2015;2015:375837.
PMID: 26649059 DOI: 10.1155/2015/375837

The aim of the study was to explore a propriety standardized ethanolic extract from leaves of Orthosiphon stamineus Benth in improving impairments in short-term social memory in vivo, possibly via blockade of adenosine A2A receptors (A2AR). The ethanolic extract of O. stamineus leaves showed significant in vitro binding activity of A2AR with 74% inhibition at 150 μg/ml and significant A2AR antagonist activity with 98% inhibition at 300 μg/mL. A significant adenosine A1 receptor (A1R) antagonist activity with 100% inhibition was observed at 300 μg/mL. Its effect on learning and memory was assessed via social recognition task using Sprague Dawley rats whereby the ethanolic extract of O. stamineus showed significant (p < 0.001) change in recognition index (RI) at 300 mg/kg and 600 mg/kg p.o and 120 mg/kg i.p., respectively, compared to the vehicle control. In comparison, the ethanolic extract of Polygonum minus aerial parts showed small change in inflexion; however, it remained insignificant in RI at 200 mg/kg p.o. Our findings suggest that the ethanolic extract of O. stamineus leaves improves memory by reversing age-related deficits in short-term social memory and the possible involvement of adenosine A1 and adenosine A2A as a target bioactivity site in the restoration of memory.