A randomized, doubled-blind study comparing multiple doses of Channa striatus supplementation for knee osteoarthritis

Knee osteoarthritis (OA) is the leading cause of chronic disability at older age. Channa striatus (CS) is a freshwater fish that is traditionally valued for its medicinal properties in promoting wound healing and reducing post-operative pain. This study evaluate the efficacy of different doses of oral Channa striatus extract on primary knee osteoarthritis patients. A randomized, double-blind, placebo-controlled 3-arm trial was conducted comparing oral CS extract 1000 mg/day or 500 mg/day and placebo among knee OA patients for a 6-month intervention period. The main outcome measures were Western Ontario and McMaster University Osteoarthritis Index (WOMAC), analgesic scores and serum cartilage oligomeric matric protein (COMP). Laboratory-based blood tests were used as safety measures. A total of 120 patients were randomized, and 112 patients were included in the intention-to-treat analysis. Significant reductions in WOMAC stiffness and function scores were achieved at month 6 in CS 1000 mg/day and CS 500 mg/day compared to placebo groups (p < 0.05). No significant differences were found between the groups in terms of analgesic scores, serum COMP and biochemical parameters. No serious adverse events were reported in the study. In conclusion, both doses of CS showed similar efficacy and were more effective than the placebo in treating the symptoms of knee OA

Psychometric evaluation of a newly developed elderly - Constipation Impact Scale

Background. Chronic constipation is a common symptom among the elderly, and it may affect their quality of life (QoL). A lack of available research focused on the elderly means that this effect is not well understood. This study aimed to develop and validate a new scale (Elderly-Constipation Impact Scale (E-CIS)) to measure the impact of chronic constipation on QoL among the elderly. Methods. A pool of items was generated from a qualitative study, literature reviews, and expert reviews. Exploratory factor analysis (EFA) was performed on the original 40 items of the E-CIS and followed by 27 items for confirmatory factor analysis (CFA). A total of 470 elderly people with chronic constipation were involved. Results. The mean age of the participants was 68.64 ± 6.57. Finally, only 22 items were indicated as appropriately representing the E-CIS, which were grouped into seven subscales: ‘daily activities’, ‘treatment satisfaction’, ‘lack of control of bodily function’, ‘diet restriction’, ‘symptom intensity’, ‘anxiety’ and ‘preventive actions’. The scale was confirmed as valid (root mean square error of approximation (RMSEA) = 0.04, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.952 and chisquare/degree of freedom (chiSq/df) = 1.44) and reliable (Cronbach’s alpha: 0.66–0.85, composite reliability (CR) = 0.699–0.851) to assess the impact of chronic constipation on the elderly’s QoL. Conclusions. The E-CIS is useful to measure the impact of chronic constipation on the elderly’s QoL. A further test is needed to determine the validity and reliability of this scale in other elderly population

Menopausal women’s experiences of husband’s support: a negative view

Objective: This study explores how menopausal women perceived supports provided by their husbands. Methodology: Total of 13 menopausal women recruited using a combination of purposive and snowball techniques from two sources, tertiary hospital and local communities in the state of Kelantan, Malaysia. The in-depth semi-structured interview guided was used to explore how they perceived supports provided by their husbands. The data were then analysed using a thematic analysis. Results: Five (5) themes have emerged which comprises of emotional, instrumental, appraisal, guidance, and sexual supports. One of which was a new theme (sexual intimacy support) that had not been existed previously in other literature reviews. Conclusion: Majority of menopausal women perceived the supports provided by their husband were negative, rather than positive supports that they had hoped. These findings suggest that an education program tool for husbands as a support person is much needed to ensure women walk through the menopause phase in a more meaningful life

Knowledge and Attitude on Childhood Vaccination among Healthcare Workers in Hospital Universiti Sains Malaysia

(1) Background: Vaccine hesitancy is recognized as an important issue globally and healthcare workers (HCWs) have a powerful influence on the public. Recent studies have reported that there are increasing numbers of vaccine hesitancies among HCWs. This study was conducted to assess the knowledge and attitudes on childhood vaccinations among HCWs in Hospital Universiti Sains Malaysia (HUSM). (2) Methods: This is a cross-sectional study conducted among one hundred and ninety-eight HCWs in HUSM, Kubang Kerian, Kelantan who were selected via convenient sampling. Data on their socio-demographic details, working experience, and main source of information regarding childhood vaccination were collected. A validated, Malay version of the knowledge and attitude on childhood vaccination (KACV) questionnaire was used during the study. (3) Results: Female (OR (95% CI):3.15, (1.39, 7.12), p < 0.05) and a higher education level (degree and above) (OR (95% CI): 2.36 (1.14, 4.89), p < 0.05) are significantly associated with good knowledge. Respondents with a history of side effects of the vaccines among their relatives were about 66% less likely to have good knowledge (OR (95% CI): 0.342 (0.16, 0.73), p < 0.05). A positive attitude towards childhood vaccination was significantly associated with a higher level of education participants, who had significantly better knowledge than participants with a lower education level (OR (95% CI): 3.81, (1.92, 7.57), p < 0.001). On the contrary, participants having direct contact with patients were less likely to have a good attitude towards childhood vaccination (OR (95% CI): 0.207 (0.043, 0.10), p < 0.05), and those with a history of severe side effects of the vaccines among their relatives were also significantly associated with a poor attitude towards childhood vaccination (OR (95% CI): 0.342 (0.16, 0.76), p < 0.05). (4) Conclusions: The survey findings showed a good level of knowledge and a good attitude of participants towards childhood vaccination. Good knowledge is important for the HCWs to have a favorable attitude to educate the general population on childhood vaccination

Predictive Factors of Physician Visits in Older People with Chronic Constipation

Objective: The aim of this study was to examine the predictive factors of physician visits in Malaysian older people with chronic constipation. Methods: A retrospective cohort study was conducted among 129 community-dwelling older people aged 60 years old and self-reported chronic constipation. The data were obtained from a multicenter health clinics survey that was conducted in a state of the northeast of Peninsular Malaysia between November 2016 and January 2017. The participants were stratified according to the physician visit to manage chronic constipation (yes or no) within the past 12 months. The binary logistic regression analysis was used to identify the predictive factors of the physician visit. Results: A total of 11% (N = 14) older people had visited the physicians to manage their chronic constipation. The employed or retired older people (OR = 5.14, 95% CI = 1.29 - 20.48, p = 0.02), having between moderate and high physical activity (OR = 12.85, 95% CI = 1.30 - 127.10, p = 0.029), and presence of abdominal bloating (OR =7.7, 95% CI = 1.97 - 30.06, p = 0.003) and Bristol stool forms of type 1 and 2 (OR =4.59, 95% CI = 1.11 - 18.97, p = 0.035) predicted the physician visit in older people with chronic constipation. Conclusion: Older people who were financially independent, kept an active life, and presented with symptoms of abdominal bloating and hard stool, tended to visit the physician to manage chronic constipation. Clinically, monitoring satisfaction with chronic constipation management following a visit to the physician could be beneficial. Keywords: chronic constipation, older people, healthcare utilization, Malaysia, physician visi

The Effect of Labisia pumila var. alata on Postmenopausal Women: A Pilot Study

This is a randomized, double-blind, placebo-controlled study comparing the effects of a water extract of Labisia pumila var. alata at 280 mg/day with placebo, given for 6 months in postmenopausal Malay women. There were 29 patients treated with Labisia pumila and 34 patients in the placebo group. Menopausal symptoms were assessed at baseline and at 6 months. The blood pressure, body mass index, waist circumference, fasting blood sugar, lipid profile, and hormonal profile (follicle stimulating hormone/luteinizing hormone/estradiol) were measured during visits every two months. ANCOVA model analysis showed significantly lower triglycerides levels in LP subjects at 6 months after treatment as compared to placebo (1.4 versus 1.9 mmol/L; adj. mean difference 0.5, 95% CI: 0.02, 0.89 after adjusted for the baseline values, age, BMI, and duration of menopause placebo). Other parameters in both groups did not differ significantly. In conclusion, daily intake of Labisia pumila at 280 mg/day for six months was found to provide benefit in reducing the triglyceride (TG) values

Efficacy of oral intake of haruan [Channa striatus (Bloch, 1793)] extract versus glucosamine sulfate on knee osteoarthritis

Knee osteoarthritis (OA) is the most prevalent degenerative arthritis and currently there are no pharmacological agents that able to retard the disease progressions. Channa striatus (CS) is a freshwater fish and its potential for treating knee OA has been explored but no comparison study has been done with glucosamine (GlcN), which has been widely used to treat osteoarthritis. In vivo study was conducted to evaluate the efficacy of CS extract versus GlcN on histomorphometric examinations in experimental OA rabbit model and a clinical trial was done to assess the efficacy of different doses of CS extract versus GlcN on primary knee osteoarthritis patients in terms of knee OA symptoms based on Western Ontario and McMaster University Osteoarthritis Index (WOMAC), analgesic drug consumption, serum cartilage oligomeric matric protein (COMP), cyclooxygenase 2 (COX-2) enzyme and serum Prostaglandin E2 (PGE2). OA was induced using Anterior Cruciate Ligament transection in thirty three rabbits and were divided into three groups namely: CS, GlcN and control group. The CS and GlcN groups were orally administered with 51.4 mg/kg of CS extract and 77.5 mg/kg of GlcN sulphate respectively based on the dosage used for human study for eight weeks. The articular cartilage was evaluated macroscopically and histologically using semi-quantitative and quantitative methods. One-way analysis of variance (ANOVA) was used to analyse the histologic assessment and Kruskall Wallis test was used to analyse the macroscopic grading. A randomized, double-blind, placebo-controlled trial comparing the effects of oral CS extract at the dose rate of 1000mg/day or 500mg/day, 1500mg/day of glucosamine sulphate and placebo among knee OA patients for 6-month intervention period was conducted. Repeated measures analysis of covariance and variance was used to analyse the WOMAC index. One-way ANOVA was used to analyse the analgesic score, COMP, COX-2 and PGE2 level. The results revealed that the severity of macroscopic score was significantly less in CS as compared to GlcN (p<0.05) group. CS exhibit less severity of semi-quantitative histology score compared to control (p<0.05) in more compartments of the joints compared to GlcN. Both CS (p<0.05) and GlcN (p<0.05) groups demonstrated higher cartilage thickness and area; lower roughness than control group. Moreover, less cartilage roughness was expressed in CS group compared to the GlcN group (p<0.05). In the clinical trial, 153 patients were analysed. Both CS (p<0.05) and GlcN (p<0.05) groups demonstrated significant improvement of WOMAC stiffness and physical function compared to placebo. CS (1000mg/day) (p<0.05), CS (500mg/day) (p<0.05) and GlcN (p<0.05) groups reduced serum COX-2 level compared to placebo. Serum PGE2 was reduced in CS (1000mg/day) (p<0.05) compared to placebo. In conclusion, it was found that based on macroscopic, semi-quantitative and quantitative histological examination, CS extract was superior to GlcN in maintaining the structure of the cartilage degeneration on an ACLT OA-induced rabbit model. In the clinical trial, both doses of CS extract had similar efficacy with GlcN in alleviating the symptoms of knee OA and had an anti-inflammatory effect through the reduction of serum COX-2. CS administered at the dose rate of 1000mg/day was effective in reducing PGE2 level compared to GlcN

A study on prevalence of cognitive impairment and dementia and its associated factors among elderly patients attending outpatient clinic {KRK and/ KPP) HUSM

To detennine the prevalence of cognitive impainnent and dementia among elderly patients attending outpatients clinic HUS

The effect of channa stratus (ikan haruan) extract on post lower segment caesarian section (lscs) women

Channa striatus or its local name Haruan, is a fresh water fish consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives were to compare post-operative pain score; wound healing, safety profile, anteroposterior (AP) measurement of the uterus, pulsatility index (PI), resistive index (Rl) of uterine artery and superficial skin wound artery between Channa striatus and placebo groups following six weeks of Lower Segment Caesarean Section (LSCS) delivery. This is a randomized, double blind, placebo-controlled study, done in post Lower Segment Caesarean Section (LSCS) women. Subjects were randomized into either Channa striatus or placebo group with daily dosage of 500mg of Channa striatus extract or 500mg maitodextrin respectively for six weeks post-operation. The women were assessed on Post-operative pain score, Wound Evaluation Scale (WES), Visual Analogue Scale (VAS), Patient's Satisfaction Score (PSS), anteroposterior (AP) measurement of the uterus in longitudinal and oblique transverse planes, pulsatility index (PI), resistive index (Rl) of uterine artery and superficial skin wound artery at baseline (day 3), two weeks, four weeks and six weeks post-operatively. The safety profile (RFT, LFT and FBC) were assessed at baseline and six weeks post-operatively.Seventy six subjects were successfully randomised into this study with 38 in Channa striatus group and 38 in placebo group. There were no significant difference detected in terms of post-operative pain (p=0.814), WES (p=0.160), pulsatility index (PI), resistive index (Rl) of uterine artery and superficial skin wound artery between Channa striatus and placebo group. However, (VAS) and (PSS), AP measurement of uterus on longitudinal plane and oblique transverse plane in Channa striatus group was significantly better compared to placebo group. Safety profile showed no significant difference between both groups. In conclusion, the consumption of 500mg of Channa striatus extract daily showed marked differences in cosmetic appearance, patient’s satisfaction towards wound healing and reduction of uterine size in post LSCS women. It is also safe for human consumption

Pattern of complementary and alternative medicine use among Malaysian stroke survivors: A hospital-based prospective study

Complementary and alternative medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué) is widely practiced among stroke patients globally. We conducted a study to determine the pattern of CAM use and its associated factors in stroke survivors attending a tertiary hospital in Malaysia within 6 months after the stroke. This was a prospective cohort study that included all stroke patients who were admitted to a tertiary center in Malaysia from December 2009 to December 2010. Patients were interviewed and examined within 72 hours of admission. The sociodemographic data and medical history were collected. Clinical examinations were done to assess the stroke severity using the Scandinavian Stroke Scale and functional status based on modified Barthel index (MBI). Patients were reassessed at 6 months after the stroke on the CAM use and functional status (MBI). The response rate was 92%. The study population consisted of 52 men and 41 women with a mean age of 63.7 ± 10.3 years. Sixty-seven percent practiced CAM. Massage was the most frequently used method (63.4%), followed by vitamins (7.5%). In multiple logistic regression analysis, functional status (MBI score) on discharge (p = 0.004, odds ratio 1.034, 95% confidence interval 1.01–1.06) and Scandinavian Stroke Scale score (p = 0.045, odds ratio 1.87, 95% confidence interval 1.01–3.43) were significant predictors for use of CAM. In conclusion, the use of CAM among stroke survivors is high. Patients who have better functional status on discharge and less severe stroke are more likely to use CAM