Evaluation of Bioactivities and Phenolic Content of Selected Edible Mushrooms in Malaysia

Purpose: To determine the radical scavenging, metal chelating, antibacterial and cytotoxic activities of five edible mushrooms in Malaysia.Methods: Mushrooms (H. tessulatus, P. eryngii, P. florida, A. polytricha and F. velutipes) were ovendried and extracted with 90 % ethanol. Radical scavenging and metal chelating assays were based on the measurement of 1,1-diphenyl-2-picrylhydrazyl (DPPH) and ferrozine absorbance at 517 and 562 nm, respectively. Mushrooms total phenolic and flavonoid contents were determined by spectrophotometric methods. Antimicrobial activity was measured using Kirby-Bauer Susceptibility Test. Cytotoxicity was assessed using brine shrimp toxicity assay.Results: Total phenolic and flavonoid contents ranged from 0.90 - 6.03 mg GAE per g of dry sample and 0.17 - 6.95 mg QE per g of dry sample, respectively. A. polytricha demonstrated the strongest radical scavenging and metal chelating activities. Moderate antimicrobial activity was found for extracts of both P. florida and A. polytricha. Cytotoxicity LD50 ranged from 46.9 - 115.8 μg/ml.Conclusion: The results suggest that A. polytricha is a suitable candidate for chemoprevention and would safe for use in large doses.Keywords: Cytotoxicity, Flavonoid, Free radical scavenging, Metal chelating, Mushroom, Phenoli

Cloning and expression of oil palm (Elaeis guineensis Jacq.) type 2 ribosome inactivating protein in Escherichia coli

EgT2RIP is a type 2 ribosome-inactivating protein isolated from oil palm (Elaeis guineensis Jacq.). Its transcript abundance was reported to be up-regulated in oil palm roots upon inoculation of pathogenic fungus Ganoderma boninense in a recent study. This study aims to produce an active recombinant EgT2RIP protein for biological studies. The DNA fragments encoding Chain A (CA) and Chain B (CB) of EgT2RIP were cloned individually in an expression vector. Soluble CA and partially soluble CB were expressed in Escherichia coli Rosetta-gami 2 (DE3). Purified recombinant CA and CB were associated in a cysteine/cystine reduced/oxidized system, yielding a heterodimer protein (AB). The AB protein showed growth inhibitory activity against breast cancer cell lines (MCF-7) as well as non-tumorigenic breast epithelial cell line (MCF-10A) at IC50 = 1.4 and 10.9 μg mL−1, respectively. The active protein produced from this study may have the potential to be used for treatment in medical and agricultural fields

Copd assessment test (cat) score of patients with chronic obstructive pulmonary disease based on clinical phenotypes

Background and Aims: Spanish chronic obstructive pulmonary disease (COPD) guideline classifies COPD into 4 clinical phenotypes: nonexacerbator (A), asthma-COPD overlap (B), exacerbator with emphysema (C) and exacerbator with bronchitis (D). Methods: A cross-sectional observational study of quality of life (QOL) of COPD patients utilizing COPD Assessment Test (CAT), conducted in University of Malaya Medical Center from 1 June 2017 – 31 May 2018. Results: Of 220 patients traeted for COPD, 189 patients with post bronchodilator Force Expiratory Volume in 1 second (FEV1)/Force Vital Capacity (FVC) of <0.70 were recruited. Patients’ demographic, clinical characteristics and CAT score are as shown in Table 1. Patients with COPD phenotype C and D had poorer modified medical research center (MMRC) functional status and global initiative of COPD (GOLD) class based on their FEV1. Patients with phenotype D had significantly higher total CAT score than patients with other clinical phenotypes. Other than sleep quality, patients with phenotype D had significantly higher score in every other components, notably cough severity, phlegm volume, chest tightness, breathlessness upon walking uphill, activity limitation at home, ability toleave home and energy. There was no different in terms of total and components CAT score of patients with phenotype A, B and C. Conclusion: Patients with phenotype D had significant higher CAT score, thus poorer quality of life and higher tendency of execebration. This group of patients need better medical treatment and closer monitoring

Clinical phenotypes of COPD and health-related quality of life: a cross-sectional study

The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes

COPD exacerbations and patient-reported outcomes according to post-bronchodilator FEV1 – a post-hoc analysis of pooled data

Background Management strategies of chronic obstructive pulmonary disease (COPD) need to be tailored to the forced expiratory volume in one second (FEV1), exacerbations, and patient-reported outcomes (PROs) of individual patients. In this study, we analyzed the association and correlation between the FEV1, exacerbations, and PROs of patients with stable COPD. Methods This was a post-hoc analysis of pooled data from two cross-sectional studies that were previously conducted in Malaysia from 2017 to 2019, the results of which had been published separately. The parameters measured included post-bronchodilator FEV1 (PB-FEV1), exacerbations, and scores of modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George’s Respiratory Questionnaire for COPD (SGRQ-c). Descriptive, association, and correlation statistics were used. Results Three hundred seventy-four patients were included in the analysis. The PB-FEV1 predicted was < 30% in 85 (22.7%), 30–49% in 142 (38.0%), 50–79% in 111 (29.7%), and ≥ 80% in 36 (9.6%) patients. Patients with PB-FEV1 < 30% predicted had significantly more COPD exacerbations than those with PB-FEV1 30–49% predicted (p < 0.001), 50–79% predicted (p < 0.001), and ≥ 80% predicted (p = 0.002). The scores of mMRC, CAT, and SGRQ-c were not significantly higher in patients with more severe airflow limitation based on PB-FEV1 (p = 0.121–0.271). The PB-FEV1 predicted had significant weak negative correlations with exacerbations (r = − 0.182, p < 0.001), mMRC (r = − 0.121, p = 0.020), and SGRQ-c scores (r = − 0.114, p = 0.028). There was a moderate positive correlation between COPD exacerbations and scores of mMRC, CAT, and SGRQ-c (r = 0.407–0.482, all p < 0.001). There were significant strong positive correlations between mMRC score with CAT (r = 0.727) and SGRQ-c scores (r = 0.847), and CAT score with SGRQ-c score (r = 0.851) (all p < 0.001). Conclusions In COPD patients, different severity of airflow limitation was not associated with significant differences in the mMRC, CAT, and SGRQ-c scores. Exacerbations were significantly more frequent in patients with very severe airflow limitation only. The correlation between airflow limitation with exacerbations, mMRC, and SGRQ-c was wea

Evaluating the Impact of Drug Dispensing Systems on the Safety and Efficiency in a Singapore Outpatient Pharmacy

Purpose: Automation of pharmacy workflow can reduce medication errors as well as improve efficiency of the medication picking, packing and labeling process. Since September 2012, two drug dispensing systems (DDS) began operations in the Singapore General Hospital Specialist Outpatient Clinic Pharmacy. This study sought to evaluate the impact of the DDS on safety and efficiency in the pharmacy. Methods: The primary outcome was the rate of prevented dispensing incidents contributed by DDS or manual picking of medications defined as the number of prevented dispensing incidents per 1000 medications picked. The secondary outcome was the productivity of each full time equivalent (FTE) when assigned to either the DDS or manual picking stations. Data pertaining to the primary and secondary outcomes between January and December 2013 were collected and analyzed. The rate of prevented dispensing incidents was expressed in median (interquartile range) and compared using Mann-Whitney U test. Other continuous variables were expressed in mean ± standard deviation and compared using independent samples t-test. Results: An average of 59494 medications was picked every month in the pharmacy. DDS accounted for 21.1 percent while manual picking accounted for 78.9 percent of all the medications picked. The median rate of prevented dispensing incidents per month committed by manual picking (2.73) was significantly higher than the DDS (0.00). DDS had greater productivity with each FTE in the DDS having an average of 6175 picks per month which was significantly higher than each FTE in the manual picking stations which had an average of 4867 picks per month. Conclusion: Installation of DDS in an outpatient pharmacy improved safety of the pharmacy workflow by automating the medication picking, packing and labeling process and minimizing human errors. Efficiency of the medication picking, packing and labeling process was also improved by the DDS as there were continuous efforts to boost their productivity as well as being more reliable and better able to handle fluctuations in patient load. &nbsp; Type:&nbsp;Original Researc

Quality Of Life Of Patients With Chronic Obstructive Pulmonary Disease Based On Clinical Phenotypes

Background and Aims: Spanish chronic obstructive pulmonary disease (COPD) guideline classifies COPD into 4 clinical phenotypes: nonexacerbator (A), asthma-COPD overlap (B), exacerbator with emphysema(C) and exacerbator with bronchitis (D). Methods: A cross-sectional study of quality of life (QOL) based on COPD phenotypes utilizing St George’s Respiratory Questionnaire (SGRQ-c) conducted in University Malaya Medical Center from 1 June 2017 – 31 May 2018. Results: Of 220 patients, 189 patients with post bronchodilator force expiratory volume in 1 second (FEV1)/force vital capacity (FVC) of <0.70 were recruited. Their demographic, clinical characteristics and SGRQ-c score are as shown in Table 1. Patients with phenotype C and D had poorer modified medical research center (MMRC) performance status and global initiative for COPD (GOLD) class based on FEV1. Nevertheless, only patients with phenotype D had significant higher total SGRQ-c score than others. They also scored significant higher in sub-components of COPD symptoms, activities and impacts. Patients with phenotypes B had numerically higher SGRQ-c total and symptoms score than those with phenotype A and C. The total and sub-components SGRQ-c score of patients with phenotype A and C were almost similar. Conclusion: Patients with phenotype D had poorest QOL, followed by phenotype B. These groups of patients need additional medical attention, in terms of pharmacology treatment, physiotherapy and rehabilitation

Comparison of pattern of disease progression and prevalence of acquired T790M mutation in Malaysia patients with EGFR mutant lung adenocarcinoma upon failure of first-line afatinib, gefitinib and erlotinib

Abstract Background Patients receiving first-line afatinib, gefitinib or erlotinib for epidermal growth factor receptor (EGFR) mutant advanced non-small cell lung cancer develop progression of disease (PD) after an average of 9-13 months. Methods A retrospective analysis of PD pattern and prevalence of acquired T790M mutation among patients failing first-line afatinib versus gefitinib or erlotinib at University Malaya Medical Centre from 1st January 2015 to 31th December 2018. Results Of 87 patients who developed PD while on first-line EGFR-tyrosine kinase inhibitor (TKI) treatment, 19 (21.8%) were on afatinib, 49 (56.3%) were on gefitinib, and 19 (21.8%) were on erlotinib. The median progression-free survival (mPFS) of these patients is as shown in the table. Of 20 patients (23.0%) who developed new symptomatic brain metastases, one (5.0%) had new leptomeningeal metastases, three (15.0%) had both new leptomeningeal metastases and solid brain metastases, and the remaining 16 (80.0%) had new solid brain metastases only. New leptomeningeal metastases occurred in one patient treated with afatinib and three patients treated with gefitinib. Forty-nine patients (56.3%) were investigated for acquired T790M mutation either by plasma biopsy or tissue biopsy or both. The prevalence of acquired T790M mutation was 61.2%. There was no difference in the pattern of PD or prevalence of acquired T790M mutation among patients treated with afatinib, gefitinib or erlotinib. Conclusions New leptomeningeal metastases were uncommon in patients receiving first-line EGFR-TKI. The choice of first-line first- or second generation EGFR-TKI did not influence the pattern of PD and prevalence of acquired T790M mutation. However, patients receiving afatinib appeared to have longer mPFS than those on gefitinib or erlotinib