Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. Previously, this rare virus was limited to sporadic cases in Africa and Asia until its emergence in Brazil, South America in 2015, where it rapidly spread throughout the world. Recently, a high number of cases were reported in Singapore and other Southeast Asia countries. A combination of factors explains the current Zika virus outbreak although it is highly likely that the changes in the climate and high frequency of travelling contribute to the spread of Aedes vector carrying the Zika virus mainly to the tropical climate countries such as the Southeast Asia. The Zika virus is known to cause mild clinical symptoms similar to those of dengue and chikungunya and transmitted by different species of Aedes mosquitoes. However, neurological complications such as Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a serious concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Therefore, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.
Colorectal cancer (CRC) remains one of the major leading causes of cancer related morbidity and mortality. Apart from the conventional anti-neoplastic agents, metformin, a biguanide anti-diabetic agent, has recently found to have anti-cancer property. Several studies observed the effect of metformin towards its anti-cancer effect on colon or colorectal cancer in diabetic patients. However, only a few studies showed its effect on colorectal cancer in relation to the non-diabetic status. The present review aimed to highlight the insight into the molecular pathway of metformin towards colorectal cancer in the absence of diabetes mellitus. In CRC-independent of diabetes mellitus, highly deregulation of PI3K/AKT pathway is found which activates the downstream mammalian target of rapamycin (mTOR). Metformin inhibits cancer growth in colon by suppressing the colonic epithelial proliferation by inhibiting the mTOR pathway. Metformin exerts its anti-neoplastic effects by acting on tumour suppressor pathway via activating the adenosine monophosphate.activated protein kinase (AMPK) signaling pathway. Metformin interrupts the glucose metabolism by activating the AMPK. Metformin reduces tumour cell growth and metastasis by activating the p53 tumour suppressor gene. In addition to its therapeutic benefits, metformin is easily accessible, cost effective with better tolerance to the patients compared to the chemotherapeutic agents. This review summarised modern findings on the therapeutic applications of metformin on the colorectal cancer with no evidences of diabetes mellitus.
Herbal products have gained popularity over the past few decades. The reasons attributed to the rise in popularity are cheaper costs, easy availability, patient compliance and fewer side effects. However, liver toxicity following consumption of herbal remedies is on the increase. Thus, there is an urgent need to understand the mechanism of action of the herbal supplements on the liver. Occasionally, herbal supplements may also interact with conventional drugs. The present review focusses on a few herbs such as Aloe barbadensis, Atractylis gummifera, Centella asiatica, Mitragyna speciosa, Morinda citrifolia, Larea tridentata, Symphytum officinale, Teucrium chamaedrys and Xanthium strumarium, which are reported to cause hepatotoxicity in humans and animals. Prior knowledge on hepatotoxicity caused by herbs may be beneficial for clinicians and medical practitioners.
Introduction: Anatomy is perceived to be an onerous subject as it contains complex information that necessitates three-dimensional visualization to comprehend. During COVID-19 pandemic, there was a paradigm shift to online distance learning including practical sessions. Innovative instructional techniques of learning anatomy are clearly needed.Methods: An e-Anatomy kit composing of 5 components: i) pre-recorded cadaveric demonstrations, ii) Complete Anatomy application, iii) interactive diagram labelling, iv) schematic diagram and v) mnemonics were designed to improve the Respiratory Module virtual practical experience of medical students from Faculty of Medicine, Universiti Teknologi MARA, Malaysia. The students were divided into 2 groups: the control group had regular discussion and the experimental group received an e-Anatomy kit. Pre- and post-test containing Anatomy questions as well as questionnaires regarding student perceptions were also given to the students. Results: There was significant difference between the means of pre- and post-test assessment in both control and e-Anatomy kit groups. There were no differences of post-test assessments between the control and e-Anatomy kit groups. However, in post-test assessments, the mean percentage difference of the e-Anatomy kit group is higher (15.8%) in comparison to the control group (10.3%). The students perceived the e-Anatomy kit as engaging, interesting and effective. Conclusion: e-Anatomy kit is an efficient and engaging approach as an alternative or adjunct to face-to-face anatomy teaching, especially under COVID-19 pandemic.
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