Introduction: The ability to proliferate progressively is a crucial characteristic of cancer cells. A number of natural products including prophetic food were demonstrated to have an anti-proliferative effect on cancer cells. Trigona honey has received much attention for its anti-microbial and anti-oxidant properties. The anti-proliferative effect of this honey on cancer cells however, is yet to be discovered. Objective: The aim of this study is to investigate the anti-proliferative effect of Trigona honey on MCF-7 cells. Materials & Methods: MCF-7 cells were cultured in basal medium DMEM-F12, containing 10% fetal bovine serum, 1% antibiotic antimycotic and 1% glutamax. Upon 80% confluence in 96 well plate, used media were replaced with basal media enriched with different concentrations (v/v) of Trigona itama honey; 0, 0.049, 0.195, 0.78, 3.125, 12.5 and 25. Proliferation of MCF-7 cells after 24 and 72 hours were measured by WST assay. Higher absorbance reading denotes higher proliferation rate. Results: MCF-7 cells treated with Trigona honey-enriched media showed consistent reduction in cell proliferation after 24 and 72 hours. Discussion & Conclusion: These preliminary findings show a promising effect of Trigona honey as an anti-cancer agent through its anti-proliferative effect.

Introduction: Iron deficiency anaemia (IDA) is a global health problem. It is common in poverty areas and indicates poor nutrition and health. According to Islamic beliefs, dates and goat milk are considered as superfood for preservation of health. Therefore, this study aimed to determine the beneficial effects of dates and goat milk on IDA. Materials & Methods: A cross-sectional study was conducted among 57 female adults with IDA. They were assigned to 5 groups with different feeding protocol (normal diet, dates, goat milk, both dates and goat milk and ferrous fumarate). Full blood count and iron profile were assessed at the beginning of the study and repeated at weeks 4, 8 and 12. Results: There was significant improvement in reticulocyte count and haemoglobin level in all three groups supplemented with dates and goat milk. The group supplemented with dates also showed increased in packed cell volume (p<0.005) while group supplemented with goat milk showed raised red cell count (p<0.005). The iron profile (ferritin and transferrin level) improved in all three groups supplemented with dates and goat milk (p<0.005). Discussion: Dates and goat milk improved the haematopoietic and iron profile in IDA subjects in accordance with previous reports on animal model. This may be contributed by the high iron content in dates and presence of biochemical components in dates and goat milk that enhanced iron bioavailability. Therefore, inclusion of dates and goat milk may be considered as a supplementary diet in IDA subjects.

Introduction: Triploidy is one of the commonest chromosomal aberrations in first trimester spontaneous miscarriages. We describe a case of Triploidy Syndrome diagnosed in the second trimester. Case report: A 32-year-old lady in her second pregnancy at 15 weeks gestation was noted to have oligohydramnios and a fetus that was small for gestational age. Detailed ultrasound showed a male fetus with several abnormalities which include micrognathia, frontal bossing, bilateral mild ventriculomegaly, clawed hands, bilateral talipes, constricted chest, small stomach and a small bladder. At 19 weeks an intrauterine death was confirmed. At autopsy the fetus was macerated and the parameters corresponded to a 16-week-old gestation. Additional features noted were hypertelorism, microphthalmia, malformed low set ears, small mouth, short nasion and micropenis. The limbs abnormalities include bilateral syndactyly of third and fourth fingers, syndactyly of third and fourth digits of right foot, rocker bottom feet and bilateral talipes equinovarus. There was hypoplasia of the right lower limb with thinning at the middle anterior part of the thigh. On internal examination there were hypoplastic alobar lungs, stenosed ductus arteriosus, pulmonary trunk hypoplasia and adrenal hypoplasia. The placenta showed no evidence of hydatidiform mole. Fetal DNA analysis following amniocentesis revealed a Triploidy Syndrome containing XXY chromosome. Discussion & conclusion: Triplody can be classified into diandric or digynic types. The former reflects extra haploid set of chromosomes of paternal origin and associated with partial hydatidiform mole. The digynic type represents extra haploid set of maternal origin and is more likely to live into second trimester which was demonstrated in our case.

Introduction: Chronic histiocytic intervillositis (CHI) is a rare placental lesion strongly associated with recurrent miscarriages and fetal losses. It requires histopathological diagnosis and can only be made after delivery of the products of conception (POC). We describe a case of CHI in a 41-yearold lady with a 16-year history of thirteen recurrent consecutive first trimester miscarriages. Case report: The patient is a 41-year-old lady who suffered first trimester miscarriages in all her thirteen pregnancies. The relevant clinical investigations revealed neither significant nor helpful findings in determining the cause of recurrent miscarriages. Histological findings in each except one of the submitted conceptual tissue showed similar features of histiocytic aggregates primarily within the intervillous spaces, a characteristic description of CHI. One of the samples showed degenerative changes. Discussion: Practicing pathologists are not familiar with the histological features of CHI and this may be a potential pitfall in routine examination of POCs. Recognising this entity allows for accurate diagnosis and hence better management. The aetiology remains unclear, although an immunopathological basis are being explored.

Mesenchymal stem cells population has been successfully isolated from the matrix and characterised for its stemness properties. Endothelial cells from the vein of the umbilical cord which are usually termed as HUVEC are also of interest to researchers as it can be manipulated in vitro to study endothelial cells behaviour and vascular-associated diseases. Immunophenotyping for positive and negative markers of mesenchymal stem cells was performed on HUVEC and compared to the closest stem cells that were isolated from the umbilical cord matrix which is termed as HUCMSC in this study. The expressions of a set of stemness genes were also detected using qPCR. The results showed that HUVEC strongly expressed hematopoietic and mesenchymal stem cells markers (CD31, CD34, CD9, CD44, CD73 and CD90) while HUCMSC possess mesenchymal stem cells properties with strong expression of CD9, CD44, CD73 and CD90. Interestingly, the expression of stemness genes is detected higher in HUVEC compared to HUCMSC with possibilities of having neural properties as evidenced by the high expression of FGF4, FZD9, Nestin and SOX2. Thus, it is suggested that HUVEC exhibited some stem cells characteristics and could be further investigated for possible application in research as well as in future cells therapy. � 2018 Pharmascope Publications. All rights reserved.

Purpose: We hypothesized that low estrogen levels aggravate obesity-related complications. Diet-induced obesity can cause distinct pathologies, including impaired glucose tolerance, inflammation, and organ injury that leads to fatty liver and chronic kidney diseases. To test this hypothesis, ovariectomized (OVX) rats were fed a high-fat style diet (HFSD), and we examined structural changes and inflammatory response in the kidney and liver. Methods: Sprague-Dawley female rats were ovariectomized or sham-operated and divided into four groups: sham-operated rats fed a normal diet (ND); ovariectomized rats fed a normal diet (OVX-ND); sham-operated rats fed a HFSD; ovariectomized rats fed a high-fat style diet (OVX-HFSD). Mean blood pressure and fasting blood glucose were measured on weeks 0 and 10. The rats were sacrificed 10 weeks after initiation of ND or HFSD, the kidney and liver were harvested for histological, immunohistochemical and immunofluorescence studies. Results: HFSD-fed rats presented a significantly greater adiposity index compared to their ND counterparts. Liver index, fasting blood glucose and mean blood pressure was increased in OVX-HFSD rats compared to HFSD rats at study terminal. Histological and morphometric studies showed focal interstitial mononuclear cell infiltration in the kidney of HFSD rats with mesangial expansion being greater in the OVX-HFSD rats. Both HFSD fed groups showed increased expressions of renal inflammatory markers, namely TNF-alpha, IL-6 and MCP-1, and infiltrating M1 macrophages with some influence of ovarian hormonal status. HFSD-feeding also caused hepatocellular steatosis which was aggravated in ovariectomized rats fed the same diet. Furthermore, hepatocellular ballooning was observed only in the OVX-HFSD rats. Similarly, HFSD-fed rats showed increased expressions of the inflammatory markers and M1 macrophage infiltration in the liver; however, only IL-6 expression was magnified in the OVX-HFSD. Conclusion: Our data suggest that some of the structural changes and inflammatory response in the kidney and liver of rats fed a HFSD are exacerbated by ovariectomy.

Introduction: Examination of placenta provides an insight into the aetiology of stillbirth. Obstetricians and general pathologists have tendency to underestimate the significance of placental examination. We report a case of a perinatal death, where the placenta was retrieved from the burial site and was in fact the cause of death in the stillborn. Case Report: A 26-year-old lady, G2P1 at 28 weeks gestation, was investigated for persistent sudden left upper limb pain and numbness associated with bluish discoloration of the fingers. Further investigations revealed a left ulnar artery stenosis and she was suspected to have microvascular/connective tissue disease. During her admission, a fetal assessment performed showed absence of fetal heart activity. Her first child was born 2 years ago at 35 weeks with low birth weight of 1.28 kg. She subsequently underwent induction of labour and delivered a macerated stillborn. After a small focal sampling of the placenta in the labour room for histopathological examination, it was handed over to the parents for burial purposes. A consent for autopsy was obtained afterwards. Upon request by the pathologists and with the consent of the parents, the placenta disc was immediately retrieved from the burial site within 24 hours. On thorough examination of the placenta, there was a significant area of infarction within the placental disc. Microscopically, there was decidual spiral arterioles vasculopathy. Both the macroscopic and microscopic changes were not seen in the initial tissue sampling. These underlying uteroplacental insufficiency were supportive evidences to the hypoxic mode of death identified at autopsy. Learning Points: Placental examination remains necessary as part of investigations in any stillbirth. In instances where a consent for autopsy cannot be obtained, the placenta may provide the answer to the cause of the perinatal death.

Introduction: Stem cells and cancer cells are known to excrete pro – angiogenic factors such as vascular endothelial growth factor (VEGF). These factors promote angiogenesis of normal as well as cancerous tissues. Objective: The aim of this study is to compare the expressions of growth factors and Human umbilical vein endothelial cells (HUVECs) count in tumoural and non-tumoural angiogenesis model co-cultured with Wharton’s jelly-derived mesenchymal stem cells (WJMSC). Materials & Methods: Different angiogenesis models were prepared as follows; 1) Non-tumoural angiogenesis model, NTAM (indirect co-culture of WJMSCs and HUVECs), 2) Tumoural angiogenesis model, TAM (indirect co-culture of MCF7 and HUVECs) and 3) Stem cells in tumoural angiogenesis model, STAM (indirect co-culture of WJMSCs, MCF7 and HUVECs). Culture of HUVECs alone was prepared as control. The difference in HUVECs count and VEGF concentration were compared between models on day 3 and 6. Results: HUVECs count and VEGF were reduced in STAM compared to TAM with p-value of 0.014 and 0.021, respectively. In contrast, HUVECs count in NTAM was significantly increased compared to control with p-value of 0.018. Conclusion: WJMSCs promote HUVECs proliferation and the up-regulation of pro-angiogenic factors in NTAM. While in STAM, the presence of stem cells with MCF7 seems to inhibit HUVECs proliferation and eventually down regulate the pro-angiogenic factors. Hence, it is suggested that the involvement of WJMSCs in STAM offers an anti-tumour property.

Introduction: Massive chronic intervillositis (MCV) or currently known as chronic intervillositis of unknown aetiology is a rare poorly understood placental lesion. MCV is strongly associated with recurrent spontaneous miscarriages, IUGR and fetal demise. We described a case of MCV in a lady with consecutive recurrent miscarriages. Case report: The patient was a 37-year-old lady who had ten consecutive recurrent first trimester miscarriages within the last 13 years. She has no living child and the relevant blood investigations were not helpful in determining the cause of recurrent miscarriages. Histopathological examination of the conception tissues showed abundant aggregates of CD 68 positive histiocytes primarily within the intervillous spaces associated with increased perivillous fibrin deposition. No significant villitis were seen. The findings were consistent with massive chronic intervillositis. Discussion & conclusion: MCV is associated with high recurrence rate of spontaneous miscarriages. In general, practicing pathologist are unfamiliar with MCV. The histiocytes may be missed during a routine reporting of tissue from products of conception if important clinical informations are not being highlighted to the pathologists. Chronic intervillositis of infectious etiology should be excluded. However the etiology of MCV remains unclear. The histiocytes are maternal in origin which led to the hypothesis of a possible abnormal maternal immune reaction towards the placental tissue in the pathogenesis of MCV. Obstetricians and pathologists should be made aware of this entity. Until today, no proven effective treatment has been proposed to prevent recurrences. Further studies are required in the understanding of this entity and in the prevention of recurrent pregnancy losses.

Iron deficiency anemia (IDA) is a medical condition characterized by insufficient iron levels in the body, resulting in a reduced ability to produce hemoglobin (Hb), a critical component of red blood cells. IDA is often associated with chronic fatigue, impaired cognitive function, and diminished well-being. Transferrin (Tf) is one of the major proteins in iron homeostasis, responsible for transporting iron through the blood to various tissues, while its carrier protein, transferrin receptor (TfR), mediates the cellular uptake of transferrin-bound iron into the cell. This study aims to evaluate the expression of TfR mRNA and protein in the small intestine following intervention with date palm and goat milk in IDA-induced rats. Twenty-four male Wistar rats were induced with IDA for 2 weeks using a low-iron diet. Following IDA detection, rats were supplemented with date palm and goat milk, singly and in combination. After four weeks, the rats were sacrificed, and the expression of TfR mRNA and protein in the small intestine was assessed using qPCR and immunohistochemistry, respectively. Data were analyzed using SPSS 24.0, with a significance level set at p<0.05. Results demonstrated that date palm and goat milk significantly improved Hb, serum iron, Tf saturation levels, and modulated the expression of TfR mRNA in the IDA-induced rats. Expression of TfR on the crypt region and brush border membrane of the small intestine was normalized following intervention. The findingsindicate that supplementation of date palm and goat milk improved Hb and Tf saturation levels and significantly modulated duodenal TfR expression in IDA-induced rats.

Introduction: Excess bodyweight or adiposity is an epidemic health problem that increases the risk of various types of cancer. Adipose tissue produces hormones known as adipocytokines, which participate in carcinogenesis in many solid tumours. Leptin was shown to have mitogenic effects in cancer cell lines thus promoting the malignant behavior of cancer. Adiponectin has a significant anti-inflammatory effect and showed an inverse relation with solid tumours risk. It was hypothesized that adiponectin provides protection against carcinogenesis. However, the knowledge on the relation of adiposity and adipocytokines with haematological malignancies is limited and the findings were not consistent. Materials and Methods: We studied this feature in newly diagnosed haematological malignancy cases in Malaysia. Diagnosis was made according to World Health Organization (WHO) guidelines or the French-American-Britain (FAB) classification. The body mass index (BMI), waist hip ratio, adipocytokines levels (leptin and adiponectin) were measured in subjects (n=29) and healthy control (n=18). Results: There was no significant difference in the mean BMI of control and subjects. However, the mean waist hip ratio in subjects were significantly higher (0.91) compared to control (0.82) with p=0.04. The mean level of leptin was markedly raised in subjects compared to control (1.80 vs 17.41) with p=0.00. The mean adiponectin level was significantly suppressed in subjects (6.54 vs 0.15) with p=0.00. Discussion: This study supports the evidence that adiposity and adipocytokines are related to haematological malignancy similar to that of solid tumours. We also concluded that waist hip ratio is a better index of adiposity compared to BMI.

Obesity is a global health problem. Adipocytes produce adipocytokines, which participate in carcinogenesis of many solid tumours. However, reports on the effects in haematological malignancies are limited. We studied this feature in haematological malignancies. The body mass index (BMI), waist:hip ratio and serum adipocytokines levels (leptin and adiponectin) were measured in subjects (n=29) and healthy control (n=18). There was no significant difference in the mean BMI of control and subjects. However, the mean waist:hip ratio in subjects were significantly higher (0.91) compared to control (0.82); p=0.04. The mean level of leptin was raised in subjects compared to control (1.80 vs 17.41); p=0.00. The mean adiponectin level was suppressed in subjects (6.54 vs 0.15); p=0.00. The leptin:adiponectin ratio was also suppressed (0.01 vs 3.93); p=0.000. Subjects with good and poor initial clinical outcome did not show any significant difference in the adiposity index and the serum adipocytokines levels. This study supports the evidence that adiposity and adipocytokines are related to haematological malignancy similar to that reported in solid tumours. Leptin:adiponectin ratio may have the potential as a biomarker of obesity related malignancy. We also concluded that waist:hip ratio is a better index of adiposity compared to BMI. However, there is no significant relation of these parameters with the prognosis.