Oxidative Dna Damage In Leukocytes And Its Association With Metabolic Control In Diabetic Patients With And Without Microalbuminuria

Type 2 diabetes mellitus is the predominant type of diabetes mellitus and the type likely to go undiagnosed. Oxidative damage was suggested in the development of diabetic microangiopathic and macroangiopathic complications in these patients. Since the long-term complications are the main cause of morbidity and mortality in diabetic patients, a quantitative determination of the level of oxidative stress is a valuable indicator of the degree of the severity of the disease and of the effectiveness of treatment. The main aim of this study is to evaluate the extent of oxidative DNA damage with different severity of microalbuminuria in diabetic patients and its associations with other metabolic controls. The comet assay was adopted to measure the level of oxidative DNA damage in leukocytes. One hundred and twenty seven (127) Type 2 diabetic patients with- and without microalbuminuria were recruited from the Outpatients Department an

Inhibition of neuronal nitric oxide synthase expression and prevention of mitochondrial dysfunction at spinal ventral horn after c7 spinal root avulsion in rats with taxol

Introduction Functional outcome following surgical repair in brachial plexus avulsion injury remains poor. Spinal motorneuron death after brachial plexus avulsion injury has been identified as the neurobiological barrier to functional restitution. Post injury oxidative stress reaction, for example, up-regulation of neuronal nitric oxide synthase (nNOS), not only cause direct damage to the motoneurons, but lead to mitochondrial dysfunction as well, especially the cytochrome c oxidase (CcO) activity, which serve as the main energy generator for neuronal normal activities. Furthermore, the impaired retrograde axonal transport of neurotrophic factors (which are vital for motoneurons survival) secondary to neurofibrogenesis and mitochondrial dysfunction has retarded the neuronal regeneration process. Taxol, a diterpene alkaloid, has the effect in slowing the neurofibrogenesis by microtubule stabilization and facilitate axonal regeneration in rats. This study was designed to evaluate the neuroprotective effect of intrathecally infused Taxol in the prevention of motoneuron death and mitochondrial dysfunction following brachial plexus avulsion injury. Material and Method Sprague-Dawley rats were divided into Treatment and Control groups (each group N=32). Brachial root avulsion injury was induced in each rat. The Treatment group received 5 days intrathecal infusion of Taxol (256ng/day) via a micro infusion pump, whereas the Control group received normal saline. Cervical cord was harvested at survival interval of 1 week, 2 weeks, 4 weeks and 6 weeks (n=8 in each subgroup). Number of surviving motoneurons and nNOS-positive motoneurons at injuredventral horn were determined with NADPH-d histochemistry with neutral red counterstaining. Mitochondrial function at the injured ventral horn was measured with CcO histochemistry and densitometer. Independent t-test was applied to detect differences between the study groups at specific survival interval. Results Compared to Control group, the Taxol treated group showed significant reduction in the nNOS expression at 2 weeks, 4 weeks, and 6 weeks, and significantly improved mitochondrial functions at 4 weeks and 6 weeks. The motoneurons survival rate was significantly increased at 2 weeks, 4 weeks, and 6 weeks in Taxol treated rats. Conclusions Taxol has the neuroprotective effect to prevent spinal motoneuron degenaration following brachial plexus avulsion injury by inhibiting nNOS expression and preventing mitochondrial dysfunction

Team-based self-directed learning enhanced students’ learning experience in undergraduate surgical teaching.

Introduction: To evaluate the effectiveness of team-based self-directed learning (SDL) in the teaching of the undergraduate Year 5 surgical posting. Materials and Methods: A quasi-experimental study was conducted to develop and administer a team-based SDL versus a conventional SDL to teach undergraduate surgical topics. One hundred and seventy-four medical students who underwent the Year 5 surgical posting were recruited. They were assigned to two groups receiving either the team-based SDL or the conventional SDL. Pre- and post-SDL assessments were conducted to determine students’ understanding of selected surgical topics. A self-administered questionnaire was used to collect student feedback on the team-based SDL. Results: The team-based SDL group scored significantly higher than the conventional SDL group in the post-SDL assessment (74.70 ± 6.81 vs. 63.77 ± 4.18, t = −12.72, p < 0.01). The students agreed that the team-based SDL method facilitated their learning process. Conclusion: The study demonstrated that the use of a team-based SDL is an effective learning strategy for teaching the Year 5 surgical posting. This method encouraged peer discussion and promoted teamwork in completing task assignments to achieve the learning objectives

Jejunal gastrointestinal stromal tumour masquerading as an ovarian cancer: A case report

A 60-year-old lady presented with lower abdominal discomfort and a huge palpable intra-abdominal mass for 4 months, with significant weight loss over half a year. Transvaginal ultrasonography and computed tomography (CT) abdomen showed a large right solid cystic mass likely ovarian in origin. The CA-125 was raised. With the provisional diagnosis of ovarian cancer patient underwent laparotomy at Hospital Umum Sarawak, Malaysia. However intraoperative findings showed that uterus and both ovaries were normal. The tumour was arising from the jejunum and adherent to the dome of the urinary bladder and right broad ligament. The tumour was resected and final diagnosis was jejunal gastrointestinal stromal tumour (GIST). We described this case which was misinterpreted as an ovarian cancer

Right ureteric reconstruction with vascularised interpositional appendix graft in retroperitoneal leiomysarcoma

We present here a case of a 66-year-old lady who was diagnosed with right iliac fossa retroperitoneal leiomyosarcoma at Hospital Umum Sarawak. The challenge in this case was the extension of tumour with the involvement of her right ureter causing proximal hydroureter and hydronephrosis. After resection of tumour en-block with the involved segment of ureter, it was not possible to repair the ureteric defect directly. We used interpositional vascularized appendix graft to repair this large (7 cm) ureteric defect. We describe here this uncommon technique of ureter reconstruction

Large falcine meningioma presented as treatment-resistant depression : A case report

Large intracranial tumour may present only with psychiatric symptoms without any neurological deficits. Delay in surgical treatment may significantly affect the quality of life in these patients. We report a case of a young engineering student who was diagnosed as treatment-resistant depression without initial neuroimaging study. Further neuroimaging studies revealed he has a large falcine meningioma. His psychiatric symptoms resolved following surgical resection of the tumour. We emphasized the importance of initial neuroimaging study in young patients presenting with psychiatric symptoms

Paclitaxel Inhibits Expression of Neuronal Nitric Oxide Synthase and Prevents Mitochondrial Dysfunction in Spinal Ventral Horn in Rats After C7 Spinal Root Avulsion

AIm: This study evaluated the neuroprotective effect of intrathecally infused paclitaxel in the prevention of motoneuron death and mitochondrial dysfunction following brachial plexus avulsion injury. Mat erIal and Methods: Brachial root avulsion injury was induced in Sprague-Dawley rats. The Paclitaxel treatment group (n = 32) received a 5-d intrathecal infusion of paclitaxel (256 ng/d) via a micro infusion pump, whereas the Control group (n = 32) received normal saline. The cervical cord was harvested at survival times of 1, 2, 4, and 6 wk (n = 8 each). The number of surviving and nNOS-positive motoneurons at the injury level in the ventral horn was determined with NADPH-d histochemistry. Mitochondrial function at this location was measured with CcO histochemistry and densitometry. An independent t-test was applied to detect differences between the study groups at specific survival times. Result s: The Paclitaxel treatment group showed a significant relative reduction in nNOS expression at 2, 4, and 6 wk, and significantly improved mitochondrial function at 4 and 6 wk. Motoneuron survival was significantly increased at 2, 4, and 6 wk. ConclusIon: Paclitaxel has a significant neuroprotective effect against spinal motoneuron degeneration following brachial plexus avulsion injury, which involves inhibition of nNOS expression and prevention of mitochondrial dysfunction

Psychological Symptoms Among Healthcare Workers Handling COVID-19 Patients.

Introduction: Healthcare workers serve as the frontliners against the coronavirus 2019 disease (COVID-19) and this puts them most at risk of infection as they attend to numerous patients with unknown status. This study aimed to examine stress, anxiety, and depression among healthcare workers caring for COVID-19 patients in Sarawak General Hospital (SGH), Malaysia. Materials and Methods: This cross-sectional observational study conducted in SGH during the pandemic with an online self-administered questionnaire composed of two parts, the socio-demographic characteristics, and the Depression Anxiety Stress Scale (DASS). Results: A total of 105 healthcare workers responded to this study. A questionnaire in both Bahasa Melayu and English was used. The findings showed that all healthcare workers had mild anxiety, with the majority experiencing mild stress (57.1%), and almost half of the respondents experiencing mild depression (41%). Female subjects had a significant higher mean score in anxiety level and stress level compared to male subjects (10.0±3.20 vs. 8.6±2.93, p<0.05; 14.1±4.76 vs. 10.7±3.70, p<0.05, respectively). Staff who were transferred from other units to handle COVID-19 cases experienced more psychological symptoms. There were significant correlations between the depression, anxiety and stress levels among the healthcare workers and the number of children they had (r=0.739, p=0.001; r=0.642, p=0.001; r=1, p =0.001 respectively). However, the stress level among the healthcare workers was reversely correlated with their years of working experience (r=-0.199, p=0.042). Conclusion: This study identified some socio-demographic factors associated with increased levels of stress, anxiety and depression among the healthcare workers during pandemic, which may lay ground for future interventions