Search

Vitamin E is an established antioxidant. However, the effect of vitamin E on healthspan, which deteriorates during ageing, has not been determined because most related studies have emphasized its effects on lifespan. Therefore, the purpose of this study was to determine the effect of palm tocotrienol-rich fraction (TRF) on the lifespan, locomotion and thermotolerance of Caenorhabditis elegans, which share many common gene sequences with humans. The nematodes were treated with different concentrations of TRF (0 - 200 μg/mL), and the number of surviving nematodes at each concentration (N=30, duplicate) was counted daily under a light microscope to determine the optimal dose of treatment. The nematodes were divided into 3 groups, namely; control, Tween-80 (vehicle) and TRF-treated. Locomotion and thermotolerance were determined on day 4 and 12 of treatment in adult nematodes. ImageJ was used for locomotion analysis, and thermotolerance was determined based on nematode survivals after exposure to 37 °C. TRF-treated C. elegans had significantly longer lifespans compared to controls (P = 0.003). The TRF group (50 μg/mL) had the longest mean lifespan (23.5 days), which was significantly longer compared to controls, (18.5 days; (P = 0.002). However, locomotion was similar between all groups. In the thermotolerance assay, the survival determined on day 4 and day 12 of TRF-treatment was higher compared to controls (P= 0.046). Interestingly, the Tween- 80-treated group showed similar results as the TRF-treated group compared to controls. The findings indicate that TRF prolongs the lifespan and increases the thermotolerance of C. elegans but does not improve the locomotion of the worms as they age.

Objective: The study objective was to determine the feasibility and selection criteria for discharge within 24 h posttotal laparoscopic hysterectomy with or without bilateral salpingo-oophorectomy (TLH with or without BSO) in Hospital Putrajaya. Materials and Methods: A total of thirty patients among all gynecology inpatients who were planned for TLH with or without BSO with controlled medical diseases, normal preoperative investigations, and uncomplicated surgery were recruited from January 2014 to December 2016. Data were collected from electronic medical records. Postoperatively, patients who fulfilled the selection criteria were discharged within 24 h and were followed up at 6 weeks and 3 months postsurgery. The results were presented as frequency with percentage and mean standard deviation. Results: All patients who had uncomplicated surgery and blood loss

Due to the health benefits such as anti-diabetic, antioxidant, and anti-inflammatory agents, the extraction of bioactive compounds from natural plants becomes significant. One of the favored extraction processes is supercritical carbon dioxide (SC-CO2). SC-CO2 is known as a green method with a high-selectivity process. Therefore, this study aims to determine the best parameters and mass transfer process to extract the bioactive compounds, viz. sinensetin, isosinensetin, and rosmarinic acid, in the leaves of Orthosiphon stamineus using the SC-CO2 extraction technique. Response surface methodology was applied to optimize the operating temperature and pressure of 40–80 °C and 10–30 MPa, respectively. Meanwhile, to quantify the concentration of sinensetin, isosinensetin, and rosmarinic acid, a high-performance liquid chromatography was used. Results showed that the level of sinensetin, isosinensetin, and rosmarinic acid varied significantly at each extraction condition from 122.98 to 469.54 mg/kg sample, 50.60 to 419.07 mg/kg sample, and 17.43 to 931.44 mg/kg, respectively. Based on the optimization study, the optimum pressure and temperature were 10 MPa and 80 °C, respectively, with 440.3 mg/g sinensetin, 392.9 mg/g isosinensetin, and 752.0 mg/g of rosmarinic acid concentration obtained. Meanwhile, the single-sphere model showed a significant correlation with sinensetin, isosinensetin, and rosmarinic acid extraction, with an average AARD of 12.31%, 13.72%, and 18.90%, respectively. The range of diffusivity coefficient, De, of sinensetin, isosinensetin, and rosmarinic acid was 5.47E−13–1.81E−12 m2/s, 8.26E−13–1.89E−12 m2/s, and 2.64E−13–2.28E−12 m2/s, respectively.

Objectives: While the issue of aerosolization of virus from the blood occurs during usage of energy sources scare practitioners, there have been no reported instances of healthcare workers (HCWs) being infected. COVID-19 virus is primarily transmitted via respiratory droplets and contact routes. Therefore, the ultimate decision for surgery, should be based on which is the safest, quickest route and concurrently ensuring that HCWs are protected during these surgeries. During the time of crisis, HCWs need to concentrate and channel resources to the care of those affected by the coronavirus hence judicious allocation of resources is mandatory. We present the guidelines and recommendations on gynecological laparoscopic surgery during this COVID-19 outbreak in Malaysia. Materials and Methods: Thorough search of articles and recommendations were done to look into the characteristics of the virus in terms of transmission and risks during surgery. Smoke plume characteristics, composition and risk of viral transmission were also studied. Search includes The WHO Library, Cochrane Library and electronic databases (PubMed, Google scholar and Science Direct). Conclusion: We concluded that there is no scientific basis of shunning laparoscopic approach in surgical intervention. Ultimately, the guiding principles would be of reducing the anesthetic and surgical duration, the availability of full protective gear for HCWs during the surgery and the status of the patient. It is mandatory for viral swab tests to be done within the shortest window period possible, for all cases planned for surgery.

Study Objective: This study aimed to investigate the morbidity of laparoscopic myomectomy (LM) versus open myomectomy (OM), including intraoperative blood loss, duration of surgery, hospital stay, and complications and to evaluate the criteria for selection of cases suitable for LM. Design: This was a retrospective study. Setting: This study was conducted at tertiary hospital. Participants: The records of 67 women who underwent LM, 22 women who underwent OM, and 14 women who had laparo-conversion from January 2010 to November 2014 were reviewed. Measurement and Main Results: Fibroids up to 10 cm were removed by LM, while most fibroids more than 10 cm were managed through OM. The number and weight of myomas are significantly associated with laparo-conversion, with a rate of 17%. Mean blood loss was significantly reduced in LM group than the OM and laparo-conversion groups. Duration of hospital stay was also significantly less in LM (2 ± 1 days) compared to both OM and laparo-conversion groups (3 ± 1 days). Most women underwent LM (88%) had no postoperative complications compared to OM (50%) and laparo-conversion (57.1%). The number of fibroids removed and duration of surgery was positively correlated with blood loss in the women who underwent myomectomy. Conclusion: LM is an ideal surgical approach for removal of fibroids which are up to 10 cm diameter and 10 cm), and deeply located fibroids. Preoperative evaluation of the size and number of myomas is necessary to avoid laparo-conversion and to reduce intraoperative and postoperative complications.

Study objective: To evaluate the safety and maternal fetal outcome of laparoscopic surgery in the management of ovarian mass in pregnant women and the usage of analgesia in postoperative period. Materials and methods: This is a retrospective cross-sectional study which was carried out at department of O&G, Putrajaya Hospital. A total of 120 cases of ovarian mass in pregnancy between Jan 2000âDecember 2014 were evaluated. 115 patients had undergone laparoscopy cystectomy/salpingo-oophorectomy. Women's age, parity, gestational age, surgical technique, operative findings and time, estimated blood loss, postoperative hospital stay, post operative pain score, usage of analgesia, complications of surgery, outcome of the pregnancy and histopathology reports were evaluated. Measurement and main results: Outcome of the pregnancy and post operative pain score and usage of analgesic were evaluated. The mean gestational week at the time of surgery was 14 weeks 1 day (±2 weeks 1 day). The duration of surgery was 87.4 mins (±34.8 mins) with average blood loss of 110.3 ml (±32.0). Median size of ovarian cyst was 6 cm (IQR 2 cm). 2 cases converted to laparotomy. Only 2 cases were reported with second trimester loss which was diagnosed after 4 weeks and 10 weeks respectively. 5 women received tocolytic agent post operatively, all of them delivered at term.The mean length of hospitalization was 1.51 day (±0.597). The average gestational age of delivery was 37.78 (±3.42) mean birth weight 2.97 kg (±0.65 kg). There was one intrauterine growth restriction baby with birth weight of 1.89 kg at 35 weeks of gestation and another baby with bladder exstrophy with ambiguous genitalia which was not related to surgery. The mean of pain score was 1.5 (±1.6) over 10. 87.9% of the women had mild pain which only 64.6% require paracetamol or no analgesia. Conclusion: Majority of women with ovarian masses in pregnancy can be treated with ensured safety and reduced morbidity using the endoscopic approach. Keywords: laparoscopic cystectomy, maternal fetal outcome, ovarian cyst in pregnancy, safety, usage of analgesia

Background: Malignant melanoma of the uterus is a very rare disease entity bearing potentially serious consequences with an unpredictable and poor prognosis. Case: A 64-year-old woman who had a longstanding, slow-growing blackish mass of the right big toe for more than a decade, presented with postmenopausal bleeding. Histopathologic examination confirmed the diagnosis of a likely secondary malignant melanoma of the uterus. Results: She was treated successfully without any complications via total laparoscopic hysterectomy and bilateral salpingo-oophorectomy (TLHBSO). Even though malignant melanoma of the uterus has a poor prognosis, the patient was alive and disease-free at a 1-year regular follow-up. Conclusions: A malignant melanoma of the uterus is very rare and has a poor prognosis. However, laparoscopic excision of the uterus and adjacent organs in selected patients could be a superior option, especially in terms of rapid recovery and minimal tumor spillage. A combined multidisciplinary appr...

Cornual pregnancy happens when implantation occurs in the cavity of a rudimentary horn of the uterus, which may or may not be communicating with the uterine cavity. The diagnosis of cornual pregnancy remains challenging, and rupture of a cornual pregnancy usually causes massive bleeding. Early diagnosis and treatment, therefore, are very crucial and key to prevent mortality. Historically, the management of cornual pregnancies included wedge resection through open surgery or even hysterectomy. In this case report, we would like to highlight a case of late second trimester cornual pregnancy, at 19-week and 3-day gestation, which was managed laparoscopically.

Study Objective: The objective of the study was to evaluate the prevalence of interstitial ectopic pregnancy and to compare the surgical outcomes of laparoscopic cornuotomy (LC) and laparotomy (open) cornuotomy (OC) of cornual ectopic pregnancy and to analyze its associated factors. Materials and Methods: A cross-sectional study was conducted involving cases of interstitial ectopic in Hospital Putrajaya, Putrajaya, Malaysia, over a 10-year period (2005–2014). Data on sociodemographic, clinical profile, perioperative, and postoperative were obtained from the electronic medical records. Measurement and Main Results: The prevalence of cornual pregnancy was 4.0% (n = 14) out of total 347 cases of all ectopic pregnancies in Putrajaya Hospital. The mean ± standard deviation age of patient in the LC group and OC group was 29.3 ± 5.9 years and 31.4 ± 7.3 years, respectively. The duration of hospitalization and mean operating time were both significantly shorter in the LC group than in the OC group (1.43 ± 0.54 versus 2.57 ± 0.79 and 61.4 ± 15.7 min versus 97.1 ± 38.2 min, respectively, P < 0.05).There were no statistically significant differences between both groups for the estimated blood loss, requirement of blood transfusion, complications, and future fertility. Conclusion: Laparoscopic cornual resection (cornuotomy) is a safe and less invasive procedure with a comparable complication rate. It has shown that it is feasibility and should be considered as initial treatment in managing those cases in trained hand surgeons.

Peanut skin is a waste of peanut industries especially peanut butter industries. Peanut skin contain high antioxidant and high nutritional values. The objective of this study was to optimize the effect of parameters to obtain high extract yield and high antioxidant activity by using supercritical carbon dioxide and co-solvent ethanol. A Box-Behnken design (BBD) was used to optimize the extraction process at the condition temperature (40, 55 and 70 ºC), rate of co-solvent ethanol (2.5, 5, and 7.5 % Vethanol/Vtotal), and extraction pressure (10, 20 and 30 MPa). The extraction time was 3 hours. The optimum condition to obtain yield of extraction and antioxidant activity 22.05 MPa, 62.76 °C and 6.03 %(Vethanol/Vsolvent) with 15.404 % yield extract and 94.040 % antioxidant activity.

Objective: The objective of the study is to assess the efficacy of laparoscopy compared with laparotomy in extrafascial hysterectomy and lymphadenectomy for endometrial cancer. Design: This was a retrospective study of small cases over a 5-year period. Setting: This study was conducted in Putrajaya Hospital, a district hospital with consultant care level in obstetrics and gynecology. Sample: Forty women presented with confirmed cases of endometrial cancer based on histopathology result and underwent extrafascial hysterectomy with or without lymphadenectomy between January 2010 and December 2014. Materials and Methods: Patient outcomes were compared between 26 women who underwent laparoscopic total hysterectomy with or without lymphadenectomy and 14 women who underwent open laparotomy extrafascial hysterectomy with or without lymphadenectomy. Data were collected using electronic medical records. Main Outcome Measures: Postoperative outcomes, operative time, total intraoperative blood loss, number of lymph nodes harvested, and total days of postoperative stay were obtained. Results: There was a significant reduction in operative blood loss in the laparoscopic group with mean 262.50 ± 47.87 and laparotomy group with mean 381.82 ± 138.33, 95% confidence interval, P < 0.05. Postoperative hospital stay was also significantly reduced in the laparoscopic group, where the mean postoperative stay in laparoscopic group was 2.5 ± 2.0 days and laparotomy 5.0 ± 3.6 days. There was no significant difference in mean operative time (the mean operative time: 256 ± 76.40 for laparotomy and 288.75 ± 43.66 for the laparoscopic approach). More number of lymph nodes were harvested laparoscopically (29.75 ± 16.59) than laparotomy (23.0 ± 12.62); however, this was not significant. Conclusions: Laparoscopic surgery had significant lesser blood loss and it is comparable to laparotomy in the surgical management of endometrial cancer. Experienced surgeon will be able to perform hysterectomy and lymphadenectomy as equally good to laparotomy with adequate tumor excision and complete staging.