Institut Perubatan & Pergigian Termaju - Tesis

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Browsing Institut Perubatan & Pergigian Termaju - Tesis by Subject "2023"

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    Characteristics Of Intravenous Immunoglobin Demand In Adult And Paediatric Patients In Hospital Universiti Sains Malaysia
    (2023-11)
    Wan Naim, Wan Ahmad Ashraf
    Introduction: Intravenous immunoglobulin (IVIG) is a plasma-derived medicinal product (PDMP) used to treat various immune and non-immunological diseases. The characteristics and indications for IVIG demand among patients at Hospital Universiti Sains Malaysia were the main focus of this study. Methods: A retrospective cross-sectional study was performed on 218 patients who were prescribed IVIG in Hospital USM. Data were obtained from the list of requests for IVIG filed within the Department of Pharmacy and the patients’ case notes were reviewed. T test analysis and Chi-squared test were employed for statistical analysis and a p-value of <0.05 was considered significant. Results: 218 patients were prescribed IVIG in Hospital USM from January 2019 until December 2020 of which 111 (50.9%) were males and 107 (49.1%) were females. The median age was 7 years old (IQR 0.00–45.25). The most common labelled IVIG indication was immune thrombocytopenia in 15 (32.6%) patients, whereas IVIG was given commonly as off-label in neonatal jaundice in 52 (30.2%) patients. In the adult cohort, IVIG was commonly given for myasthenia gravis, 26 (42.6%) patients, while the paediatric cohort received IVIG commonly for neonatal jaundice, 52 (46.8%) patients. There were significant differences between labelled and off-label IVIG usage (p = 0.039) and its frequency (p <0.001) in adult and paediatric populations. Race (p = 0.011) and clinical category in adults (p = 0.002) had significant correlations with the status of IVIG usage. Conclusion: There were significant differences between labelled and off-label usage of IVIG among all Hospital USM patients. A local guideline for IVIG usage should be developed to help clinicians in giving appropriate IVIG prescriptions.
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    Pilot Study On Microbiota Profiling In Female Patient With Autoimmune Connective Tissue Disease From Hospital Putrajaya
    (2023-08)
    Wasdewa, Soonali
    An autoimmune disease occur in human body when the immune system could not differentiate or recognise between foreign antigen and own cells and thus, attacks and destroys healthy cells and tissues in the own body. Autoimmune connective tissue disease (CTD) is a disease when the immune system affect the function and structure of connective tissues, such as joints, skin, eyes, gastrointestinal track, heart, and lungs mostly in female body. Gut micro biota play ab important role in human immune system by providing protection against pathibionts. However, imbalance of gnt microbiota occur in autoimmune patients resulting in curiosity whether the microbiome in the gut cause autoimmunity in the body or vice versa. This study therefore aimed to profile presence of gut microbiota in healthy versus autoimmune connective tissue disease (CTD) female patients. The stool samples and blood samples were collected from healthy and autoimmune patients and the DNA were extracted from stool samples using QIAamp PowerFecal Pro DNA kits. Furthermore, the extracted DNA was sequenced using 16S rRNA next generation sequencing (NGS). The produced sequences was aligned and analysed using Basic Local Alignment Search Tool (BLAST) and the identified microbes was profiled using MicrobiomeAnalyst webserver and produced heatrnaps of healthy control and autoimmune patients. The comparison of heatrnaps between the healthy control and patients showed both category have high abundance of Blautia argi (prevalence 1.0) which indicate the patients does not have imbalance of Blautia argi and also it does not cause the autoimmunity in the patients body. Furthermore, compared to healthy control, patients have high abundance of Bifidobacterium, and unclassified Lachnospiraceae genera (prevalence 1.0) which is abnormal and may contribute to autoimmunity. High abundance in Streptococcus genera also found in patients samples that have molecular mimicry ability in producing II homologous proteins similar to human proteins which may contribute to development of autoimmunity. The current study showed only the heatrnaps that indicate the imbalance of gut microbiome in the patients samples, but, it does not provide the understanding or evidence of causes of imbalance, causes of autoimmunity or influence of gut microbes in immune system. Thus, gut microbiota in CTD patients from Hospital Putrajaya and healthy control have been profiled and it serve as fundamental to establish the correlation between autoimmune and gut dysbiosis among Malaysian population.
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    Study Of Goniothalamin And Bioactive Glass 45s5 (Gtn-bg) On Osteosarcoma Saos-2 And Breast Adenocarcinoma Mcf-7 Cells
    (2023-08)
    Abu Bakar, Siti Aishah
    Developing alternative cancer treatment is crucial due to the limitations of conventional chemotherapy, which can harm healthy cells while targeting cancer cells. Plant-derived natural products, with their diverse mechanisms and low toxicity, hold promise as cancer treatments, and their combination with bioactive materials may improve treatment effectiveness. In this study, the cytotoxic activity of a plant styryl lactone, goniothalamin (GTN) was screened first in several human cancer cell lines and was found to possess a substantial range of cytotoxicity against osteosarcoma (Saos-2), breast adenocarcinoma (MCF-7), breast carcinoma (UACC-732), adenocarcinoma alveolar basal epithelial (A549) and colorectal adenocarcinoma (HT29) cells, but less toxicity towards human bone marrow-derived mesenchymal stem (HMSC) cells. GTN demonstrated selective toxicity towards cancer cells with a high SI value (>2) for each examined cancer cell line compared to doxorubicin (DOX). The potential enhancement of GTN's anticancer effects was explored by combining it with a sol-gel-derived bioactive glass 45S5 (BG 45S5) that possesses bioactive, biocompatible, and biodegradable properties. The combination of GTN-BG was found more potent than GTN in inhibiting the proliferation of Saos-2 and MCF-7 cells due to a better microenvironment provided with the release of ionic dissolution products such as Ca2+, Na+ and Mg2+ ions from the BG. For both GTN and GTN-BG treatments, several apoptotic features were detected when observed under a phase microscope, including cell shrinkage, rounded cells, and membrane blebbing. It was found that apoptosis was triggered through the extrinsic death receptor pathway as the activation of caspase 8 was mainly detected and significantly higher in GTN-BG compared to GTN. The binding of a death ligand triggers the activation of caspase 8, which later activates the effector’s caspase 3/7. These results were supported by transcriptome profiling. Several TNFRSF members, including TNFRSF1A, TNFRSF16, and TNFRSF14 genes, were upregulated in Saos-2 cells treated with GTN-BG. GTN-BG treatment also induced the expression of DUSP4, DUSP6, PLK5 and CHOP genes that may contribute to cell cycle arrest at the G2/M phase, subsequently resulted in apoptosis. To conclude, the antiproliferative and apoptotic activities of GTN were enhanced with the combination of BG.