METHODS: This was a cross-sectional study conducted between November 2019 and November 2021 at seven tertiary hospitals in Malaysia. Participants registered with Malaysian Thalassemia Registry were recruited by convenience sampling. Adherence was measured via pill count and self-reported adherence. Knowledge about thalassemia and ICT was measured using a questionnaire from Modul Thalassemia by Ministry of Health of Malaysia. A decision tree was used to identify predictors of non-adherence.
RESULTS: A total of 135 patients were recruited. The prevalence of non-adherence to ICT in those who took subcutaneous ± oral medications was 47.5% (95% CI: 31.5%, 63.9%) and the prevalence of non-adherence to ICT in those who took oral medications only was 21.1% (95% CI: 13.4%, 30.6%). The median knowledge score was 67.5% (IQR 15%). A decision tree has identified two factors associated with non-adherence. They were ICT's route of administration and knowledge score. Out of 100 patients who were on oral medications only, 79 were expected to adhere. Out of 100 patients who were on subcutaneous ± oral medications and scored less than 56.25% in knowledge questionnaire, 86 were expected to non-adhere. Based on the logistic regression, the odds of non-adherence in patients who took oral medications only was 71% lower than the odds of non-adherence in patients who took subcutaneous ± oral medications (OR = 0.29; 95% CI = 0.13, 0.65; p = .002).
CONCLUSION: The prevalence of non-adherence to ICT among children with beta thalassemia major in Malaysia was 20/95 (21.1%) in those who took oral medications only and the prevalence of non-adherence was 19/40 (47.5%) in those who took subcutaneous ± oral medications. The factors associated with non-adherence were ICT's route of administration and knowledge score.
METHODS: The free radical scavenging activity of the L. siceraria (Molina) fruit extract was assayed by using α,α-diphenyl-β-picrylhydrazyl (DPPH), 2,20-azinobis 3-ethyl benzothiazoline-6-sulfonate (ABTS), FRAP, reducing power, chelating ability and β-carotene bleaching assay.
RESULTS: The IC(50) values of DPPH and ABTS radical-scavenging activity was found to be 1.95 mg/mL and 19 mg/mL, respectively. In ferrous chelation assay, the percentage of inhibition was found to be 89.21%. The reducing power of ethanolic extract of L. siceraria (Molina) fruit was 0.068 at 1 mg/mL and increased to 0.192 at 5 mg/mL. The β-carotene linoleate bleaching assay was 46.7% at 5 mg/mL and antioxidant activity using FRAP at 0.305 for 1 mg/mL to 0.969 for 5 mg/mL.
CONCLUSIONS: The results indicate that L. siceraria (Molina) fruit could be an important sources of natural radical scavengers.