Publications by authors named "Mafauzy Mohamed"

18 Publications

  • Page 1 of 1

Retracted: Western pacific consensus proposals for management of prediabetes.

Int J Clin Pract 2021 Jan 22:e14019. Epub 2021 Jan 22.

Vietnamese Association of Diabetes and Endocrinology, Hochiminh, Vietnam.

Prediabetes and diabetes burden become the strong challenge in the Western Pacific region. Prediabetes with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and the mixed status (IFG + IGT) are considered as risk factors for the development of diabetes. Effective early intervention for prediabetes can significantly delay the progression of the onset of diabetes, even if reverse blood glucose to normal. Increasing evidence shows that without targeted intervention, the progression from prediabetes to diabetes occurs more frequently in Asians compared with Caucasians. Consequently, it is essential to timely detect the populations at higher risk and effectively implement intervention and management to prevent diabetes. Significant evidence also supports the effectiveness of adjusting lifestyle in combination with medication to delay the onset of diabetes. A working group of Western Pacific expertise in diabetes conducted to develop evidence-based consensus recommendations to guide the management of patients with prediabetes. These consensual recommendations are intended to provide a clear and concise approach to the management of individuals with prediabetes.
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http://dx.doi.org/10.1111/ijcp.14019DOI Listing
January 2021

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study.

Diagnostics (Basel) 2020 Dec 11;10(12). Epub 2020 Dec 11.

Endocrine Unit, Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia.

Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases ( = 64, hyperthyroid; = 53 euthyroid; = 18, hypothyroid) and healthy controls ( = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm). The results showed that the mean serum vitamin D Levels of all groups was low (<50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD.
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http://dx.doi.org/10.3390/diagnostics10121075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763871PMC
December 2020

Efficacy and Safety of Pioglitazone Monotherapy in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Sci Rep 2019 03 29;9(1):5389. Epub 2019 Mar 29.

School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.

Pioglitazone, the only thiazolidinedione drug in clinical practice is under scrutiny due to reported adverse effects, it's unique insulin sensitising action provides rationale to remain as a therapeutic option for managing type 2 diabetes mellitus (T2DM). We conducted a systematic review and meta-analysis comparing pioglitazone monotherapy with monotherapies of other oral antidiabetic drugs for assessing its efficacy and safety in T2DM patients. Mean changes in glycated haemoglobin (HbA1c), and mean changes in fasting blood sugar (FBS) level, body weight (BW) and homeostasis model assessment-insulin resistance (HOMA-IR) were primary and secondary outcomes, respectively. Safety outcomes were changes in lipid parameters, blood pressure and incidences of adverse events. Metafor package of R software and RevMan software based on random-effects model were used for analyses. We included 16 randomised controlled trials. Pioglitazone monotherapy showed equivalent efficacy as comparators in reducing HbA1c by 0.05% (95% CI: -0.21 to 0.11) and greater efficacy in reducing FBS level by 0.24 mmol/l (95% CI: -0.48 to -0.01). Pioglitazone showed similar efficacy as comparators in reducing HOMA-IR (WMD: 0.05, 95% CI: -0.49 to 0.59) and increasing high-density lipoprotein level (WMD: 0.02 mmol/l, 95% CI: -0.06 to 0.10). Improved blood pressure (WMD: -1.05 mmHg, 95% CI: -4.29 to 2.19) and triglycerides level (WMD: -0.71 mmol/l, 95% CI: -1.70 to 0.28) were also observed with pioglitazone monotherapy. There was a significant association of pioglitazone with increased BW (WMD: 2.06 kg, 95% CI: 1.11 to 3.01) and risk of oedema (RR: 2.21, 95% CI: 1.48 to 3.31), though the risk of hypoglycaemia was absolutely lower (RR: 0.51, 95% CI: 0.33 to 0.80). Meta-analysis supported pioglitazone as an effective treatment option for T2DM patients to ameliorate hyperglycaemia, adverse lipid metabolism and blood pressure. Pioglitazone is suggested to prescribe following individual patient's needs. It can be a choice of drug for insulin resistant T2DM patients having dyslipidaemia, hypertension or history of cardiovascular disease.
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http://dx.doi.org/10.1038/s41598-019-41854-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441028PMC
March 2019

Efficacy of Rosuvastatin in Children With Homozygous Familial Hypercholesterolemia and Association With Underlying Genetic Mutations.

J Am Coll Cardiol 2017 Aug;70(9):1162-1170

Department of Paediatrics and Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Background: Homozygous familial hypercholesterolemia (HoFH), a rare genetic disorder, is characterized by extremely elevated levels of low-density lipoprotein cholesterol (LDL-C) and accelerated atherosclerotic cardiovascular disease. Statin treatment starts at diagnosis, but no statin has been formally evaluated in, or approved for, HoFH children.

Objectives: The authors sought to assess the LDL-C efficacy of rosuvastatin versus placebo in HoFH children, and the relationship with underlying genetic mutations.

Methods: This was a randomized, double-blind, 12-week, crossover study of rosuvastatin 20 mg versus placebo, followed by 12 weeks of open-label rosuvastatin. Patients discontinued all lipid-lowering treatment except ezetimibe and/or apheresis. Clinical and laboratory assessments were performed every 6 weeks. The relationship between LDL-C response and genetic mutations was assessed by adding children and adults from a prior HoFH rosuvastatin trial.

Results: Twenty patients were screened, 14 randomized, and 13 completed the study. The mean age was 10.9 years; 8 patients were on ezetimibe and 7 on apheresis. Mean LDL-C was 481 mg/dl (range: 229 to 742 mg/dl) on placebo and 396 mg/dl (range: 130 to 700 mg/dl) on rosuvastatin, producing a mean 85.4 mg/dl (22.3%) difference (p = 0.005). Efficacy was similar regardless of age or use of ezetimibe or apheresis, and was maintained for 12 weeks. Adverse events were few and not serious. Patients with 2 defective versus 2 negative LDL receptor mutations had mean LDL-C reductions of 23.5% (p = 0.0044) and 14% (p = 0.038), respectively.

Conclusions: This first-ever pediatric HoFH statin trial demonstrated safe and effective LDL-C reduction with rosuvastatin 20 mg alone or added to ezetimibe and/or apheresis. The LDL-C response in children and adults was related to underlying genetic mutations. (A Study to Evaluate the Efficacy and Safety of Rosuvastatin in Children and Adolescents With Homozygous Familial Hypercholesterolemia [HYDRA]; NCT02226198).
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http://dx.doi.org/10.1016/j.jacc.2017.06.058DOI Listing
August 2017

Choice of Insulin in Type 2 Diabetes: A Southeast Asian Perspective.

Indian J Endocrinol Metab 2017 May-Jun;21(3):478-481

Center of Diabetes, Mahosot Hospital, Vientiane, Laos.

Southeast Asia faces a diabetes epidemic, which has created significant challenges for health care. The unique Asian diabetes phenotype, coupled with peculiar lifestyle, diet, and healthcare-seeking behavior, makes it imperative to develop clinical pathways and guidelines which address local needs and requirements. From an insulin-centric viewpoint, the preparations prescribed in such pathways should be effective, safe, well tolerated, nonintrusive, and suitable for the use in multiple clinical situations including initiation and intensification. This brief communication describes the utility of premixed or dual action insulin in such clinical pathways and guidelines.
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http://dx.doi.org/10.4103/ijem.IJEM_82_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434737PMC
May 2017

A Consensus of Key Opinion Leaders on the Management of Pre-diabetes in the Asia-Pacific Region.

J ASEAN Fed Endocr Soc 2017 5;32(1):6-12. Epub 2017 May 5.

National Institute of Diabetes and Endocrinology, Dow University of Health Sciences, Pakistan.

The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in this region. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance (IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment are urgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestyle modification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importance of lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting, experts from the Asian region convened to develop consensus recommendations to guide clinicians in the management of Asian patients with pre-diabetes. These consensus recommendations provide a clear and concise approach to the management of individuals with IGT based on the available evidence and current best clinical practice.
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http://dx.doi.org/10.15605/jafes.032.01.02DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784241PMC
May 2017

DNA Methylation: An Epigenetic Insight into Type 2 Diabetes Mellitus.

Curr Pharm Des 2016 ;22(28):4398-419

Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

DNA methylation, a major regulator of epigenetic modifications has been shown to alter the expression of genes that are involved in aspects of glucose metabolism such as glucose intolerance, insulin resistance, β-cell dysfunction and other conditions, and it ultimately leads to the pathogenesis of type 2 diabetes mellitus (T2DM). Current evidences indicate an association of DNA methylation with T2DM. This review provides an overview of how various factors play crucial roles in T2DM pathogenesis and how DNA methylation interacts with these factors. Additionally, an update on current techniques of DNA methylation analysis with their pros and cons is provided as a basis for the adoption of suitable techniques in future DNA methylation research towards better management of T2DM. To elucidate the mechanistic relationship between vital environmental factors and the development of T2DM, a better understanding of the changes in gene expression associated with DNA methylation at the molecular level is still needed.
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http://dx.doi.org/10.2174/1381612822666160527111152DOI Listing
March 2018

Safety and effectiveness of insulin detemir in type 2 diabetes: results from the ASEAN cohort of the A₁chieve study.

Diabetes Res Clin Pract 2013 Apr;100 Suppl 1:S10-6

University of Indonesia, Cipto Mangunkusomo Hospital, Jakarta, Indonesia.

Aim: To determine the safety and effectiveness of insulin detemir (IDet) in type 2 diabetes patients from the ASEAN cohort of the A1chieve study.

Methods: Patients from Indonesia, Malaysia, Philippines and Singapore prescribed IDet at the discretion of their physicians were included. The primary outcome was the incidence of serious adverse drug reactions including major hypoglycaemia over 24 weeks. Secondary endpoints included changes in the frequency of hypoglycaemia, serious adverse events and effectiveness assessments.

Results: This sub-analysis included 1540 patients (insulin-naive, 1239; insulin-experienced, 301) with mean age ± SD 56.4 ± 10.9 years, BMI 25.4 ± 4.6 kg/m(2) and diabetes duration 6.9 ± 5.3 years. Insulin-naive patients received a baseline IDet dose of 0.24 ± 0.11 U/kg titrated up to 0.37 ± 0.21 U/kg by Week 24. The pre-study insulin dose in insulin-experienced patients was 0.41 ± 0.25 U/kg and baseline IDet dose was 0.31 ± 0.24 U/kg titrated up to 0.40 ± 0.20 U/kg by Week 24. Overall hypoglycaemia decreased from 1.73 to 0.46 events/patient-year from baseline to Week 24 (change in proportion of patients affected, p < 0.0001). At Week 24, 1 major hypoglycaemic event was reported in 1 insulin-experienced patient. IDet significantly improved glucose control (p < 0.001) at Week 24. The lipid profile and systolic blood pressure improved (p < 0.001) and body weight did not change significantly. Quality of life was positively impacted (p < 0.001).

Conclusion: IDet was well-tolerated and improved glycaemic control without increasing the risk of hypoglycaemia or weight gain.
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http://dx.doi.org/10.1016/S0168-8227(13)70004-4DOI Listing
April 2013

The impact of a disease management program (COACH) on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study): a randomised controlled trial.

BMC Fam Pract 2012 Oct 10;13:97. Epub 2012 Oct 10.

Eli Lilly (M) Sdn Bhd, Cameron Highlands, Petaling Jaya, Malaysia.

Background: To evaluate the efficacy of Counselling and Advisory Care for Health (COACH) programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm) and primary care physicians assisted by nurse educators (PCP-NE arm).

Methods: This was a multi-centre, open label, randomised trial of a disease management programme (COACH) among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE) and 148 to care provided by primary care physicians (PCP) alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio), Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36.

Results: Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS) mean change from baseline LDL-C were -30.09% and -27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288), with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had ended).

Conclusion: Patients who received coaching and advice from primary care physicians (with or without the assistance by nurse educators) showed improvement in LDL-cholesterol. Disease management services delivered by PCP-NE demonstrated a trend towards add-on improvements in cholesterol control compared to care delivered by physicians alone; however, the improvements were not maintained when the services were withdrawn.

Trial Registration: National Medical Research Registration (NMRR) Number: NMRR-08-287-1442Trial Registration Number (ClinicalTrials.gov Identifier): NCT00708370.
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http://dx.doi.org/10.1186/1471-2296-13-97DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539990PMC
October 2012

Variation in the prevalence, awareness, and control of diabetes in a multiethnic population: a nationwide population study in Malaysia.

Asia Pac J Public Health 2010 Apr 14;22(2):194-202. Epub 2009 May 14.

University of Malaya, Kuala Lumpur, Malaysia.

The purpose of this study was to determine the association between different ethnic groups and the prevalence, awareness, and control of diabetes in Malaysia. A population-based cross-sectional study using multistage sampling was conducted in Malaysia. Diabetes is defined as having a fasting blood glucose > or =7 mmol/L or a self-reported diabetic on treatment. Among the 7683 respondents aged > or =30 years, the prevalence of diabetes mellitus was 15.2% (95% CI = 14.1, 16.4). Multivariate analysis showed that compared with Malays, Chinese had lower odds (adjusted odds ratio [aOR] 0.71; 95% CI = 0.56, 0.91) and Indians had higher odds of having diabetes (aOR 1.54; 95% CI = 1.20, 1.98). The odds of diabetes increased with age, family history of diabetes, body mass index, and lower education levels. Among those with diabetes mellitus, 45.0% were aware and 42.7% were under treatment. Among treated diabetics, 25.1% had their fasting blood sugar under control. There is a significant association between prevalence of diabetes and different ethnic groups.
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http://dx.doi.org/10.1177/1010539509334816DOI Listing
April 2010

MJMS and the challenges of a research university.

Authors:
Mafauzy Mohamed

Malays J Med Sci 2008 Oct;15(4)

Campus Director, Universiti Sains Malaysia Health Campus, Kubang Kerian, 16150, Kota Bharu, Kelantan, Malaysia.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341915PMC
October 2008

An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies.

Curr Med Res Opin 2008 Feb;24(2):507-14

Health Campus, Universiti Sains Malaysia, Malaysia.

Objective: To collect information on diabetes management, including psychosocial aspects, in patients managed by specialists 5 years after they were first surveyed in 1998.

Methods: Data on demography, diabetes status, management and complications were collected via medical records, interview and laboratory assessments. HbA(1c) was analysed by a central laboratory prospectively.

Results: Patient profile was similar in the 1998 (N = 21,838) and 2003 cohorts (N = 15,549): 95% were diagnosed as type 2 diabetes mellitus and were obese (BMI approximately 25 kg/m(2)). Glycaemic control was unsatisfactory in many patients (mean HbA(1c) approximately 8%; fasting glucose approximately 9 mmol/L). Lipids were well-controlled but hypertension was not. The incidence of neuropathy ( approximately 33%) and cataract ( approximately 27%) were high. The majority ( approximately 71%) of patients in both cohorts were treated with oral antidiabetic drug (OAD) monotherapy; approximately 24% were on insulin therapy. Approximately half of the 2003 cohort reported a healthy state of well-being. Quality of life did not appear to have suffered as a result of having diabetes. However, many patients were worried about hypoglycaemic risk (53.9%) or worsening of diabetes (45.8%) and insulin initiation (64.5%).

Conclusions: Although both cohorts were separate cross-sectional studies of diabetes management status in Asia, the results showed that the demography profile, glycaemic control and cardiovascular risk factors were remarkably similar in both cohorts 5 years after the first survey. More concerted efforts are needed to increase diabetes awareness and education.
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http://dx.doi.org/10.1185/030079908x261131DOI Listing
February 2008

Comparisons of the outcomes on control, type of management and complications status in early onset and late onset type 2 diabetes in Asia.

Diabetes Res Clin Pract 2006 Feb 6;71(2):146-55. Epub 2005 Jul 6.

Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.

Objective: To describe the clinical characteristics and chronic diabetic complications in early (EOD) and late onset type 2 diabetes mellitus (LOD) in Asia.

Research Design And Methods: Retrospective collection of information (basic patient data, treatment received for diabetes, hypertension, dyslipidaemia, clinical measurements, complications, life-style management, etc.) on paper form and prospective collection of blood samples for HbA(1c) assessment were performed. Means, proportions and associated factors were analyzed using non-parametric and logistic regression.

Results: The frequency of EOD (<30 years) varies in different Asian countries (0.4-5.3%). Overweight (BMI>or=23 kg/m2) was common in both EOD (60%) and LOD (66%). EOD was characterized by significantly higher levels of HbA(1c) (median 8.9% versus 7.9%) and FPG (median 9.8 mmol/L versus 8.3 mmol/L) but hypertension was less common (43% versus 59%). Lipid profiles (cholesterol and triglycerides) were similar between both groups of patients. Cataract was more common in LOD and was associated with onset age and diabetes duration whereas an increase in frequency of advanced eye disease, retinopathy and history of photocoagulation was found in EOD cohort.

Conclusions: In addition to diabetic control and duration of the disease, the onset age conferred risk to certain subsets of chronic complications in type 2 diabetes population.
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http://dx.doi.org/10.1016/j.diabres.2005.05.007DOI Listing
February 2006

A Prelimenary Result of the Cardiovascular Risk factors Intervention Study (Pikom Study): Diabetes Mellitus, Hypertension and their Associated Factors.

Malays J Med Sci 2005 Jan;12(1):20-5

School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Cardiovascular disease (CVD) has been the number one cause of death since the last three decades in Malaysia and diabetes mellitus and hypertension are considered as major risk factors. A study to reduce risk factors for cardiovascular diseases in the community (PIKOM) through education and lifestyle changes was undertaken. The study population was from four different areas in Peninsular Malaysia - Kota Bharu and Bachok in Kelantan ; Raub in Pahang; Gunung Besout in Perak and Felda Palong in Negri Sembilan. The subjects invited to participate in this study ware aged between 30 - 65 years, did not have any debilitating illnesses and no known history of diabetes mellitus, hypertension or cardiovascular disease. Subjects were asked to come to the local clinic in a fasting state and after physical examination, blood was taken for plasma glucose and lipids. Oral glucose tolerance test (OGTT) was then performed. A total of 4,121 subjects participated in the study. The proportion of subjects with diabetes mellitus was highest in Felda Palong area (20.3%) and lowest in Raub area (7.1%). The proportion of subjects with hypertension was also highest in Felda Palong area (38.6%) and lowest in Raub area (29.1%). This could be attributable to the subjects in Felda Palong having the highest mean Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR). There were significant associations between diabetes and hypertension with age and obesity. Subjects with diabetes mellitus and hypertension also had the highest mean age, BMI, WHR and plasma cholesterol.In conclusion, the proportion of patients with risk factors for CVD was high and intervention studies through education and lifestyle changes were being carried out to see their effectiveness.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349409PMC
January 2005

Open label clinical trial to study adverse effects and tolerance to dry powder of the aerial part of andrographis paniculata in patients type 2 with diabetes mellitus.

Malays J Med Sci 2005 Jan;12(1):13-9

Department of Pharmacology.

Adverse effects and tolerance to dry powder of aerial part of Andrographis paniculata (Burm.f.) Nees were studied in 20 patients with type 2 diabetes mellitus for a period of 12 weeks. Patients were given powdered A. paniculata starting with 600 mg daily, gradually increasing to a maximum of 1.8 gm daily. Parameters monitored included body weight, blood pressure, liver function tests, renal function tests, cardiac enzymes, haemogram, serum electrolytes, fasting blood glucose, HbA1c, blood cholesterol, serum triglycerides and blood hormone levels (triiodotyronine, thyroxine, thyrotropin, insulin, fasting cortisol). None of the above mentioned parameters showed significant change during the study period except for a fall in HbA1c by 5.46% (p<0.01) and fasting S. insulin by 20.93% (p<0.003). In conclusion, A. paniculata powder did not induced significant adverse events based on parameters observed in our study but significantly lowered HbA1c and fasting serum insulin in patients with type 2 diabetes.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349408PMC
January 2005

Dyslipidaemic pattern of patients with type 2 diabetes mellitus.

Malays J Med Sci 2004 Jan;11(1):44-51

Department of Chemical Pathology.

The aim of the study was to define dyslipidaemic pattern among type 2 diabetic patients using American Diabetes Association guidelines for the classification of lipoprotein concentrations into CVD risk categories. The total number screened was 211 type 2 diabetic patients who were on treatment between 2001 - 2002 for diabetes at the Outpatient Diabetes Clinic in HUSM Kubang Kerian. Fasting venous blood samples were analysed for plasma glucose, glycated hemoglobin and serum lipids. Type 2 diabetic patients with high, borderline, and low risk LDL cholesterol level were 62 %, 25 %, and 10 %, respectively. There were 26 % patients in the high risk HDL cholesterol group, 31 % were in the borderline risk group, and 43 % were in the low risk group. Only 3 % and 25 % of patients had triglycerides concentration in the high and borderline risk categories, respectively, but 72 % had low risk triglycerides levels. More female and younger subjects than men and older subjects had HDL cholesterol in high and borderline risk categories. The percentages of patients with triglycerides values at high and borderline high risk category were higher in poor and acceptable glycaemic control groups than good glycaemic control group. The most prevalent dyslipidaemia pattern was an isolated LDL cholesterol increase, which was observed in 35 % of the patients. The second most common pattern of dyslipidaemia was a combination of LDL cholesterol above goal with HDL cholesterol below target, which was observed in 30 % patients. Patients with established dyslipidaemia will require advice regarding diet, exercise and improvement in glycaemic control. An active strategy of early detection and drug treatment for dyslipidaemia is needed for type 2 diabetic patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438150PMC
January 2004

Medical schools : the supply and availability of qualified human resources - challenges and opportunities.

Authors:
Mafauzy Mohamed

Malays J Med Sci 2003 Jan;10(1):1-3

Health Campus, Universiti Sains Malaysia, Health Campus 16150 Kubang Kerian, Kelantan, Malaysia.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557103PMC
January 2003
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