Complementary and alternative medicine (CAM) practices and dietary patterns in children with inflammatory bowel disease in Singapore and Malaysia.

BACKGROUND: The use of complementary and alternative medicine (CAM) has been associated with adverse effects and self-imposed dietary restrictions. The prevalence of its use in Asian children with inflammatory bowel disease (IBD) is unknown. We aimed to determine the prevalence, types, and factors associated with the use of CAM among children with IBD from Singapore and Malaysia, and to ascertain if dietary restriction was prevalent in patients who used CAM. METHODS: A cross-sectional study was conducted in which parents of children with IBD attending two tertiary pediatric IBD referral centres in Singapore and Malaysia were interviewed. Data about demographics, conventional treatment, complementary therapies and dietary patterns were collected in a questionnaire. RESULTS: Of 64 children with IBD interviewed, 83% (n = 53) reported the use of CAM (Singapore [90%] vs. Malaysia [76%]; p = 0.152). The median number of CAM agents used was two (range 1-10). The three most common types of CAM used were probiotics (64%), vitamin and mineral supplements (55%), and food-based therapies (36%). Among individual CAM categories, the use of food-based therapies was correlated significantly with nationality (r = 0.497, p < 0.001), history of weight loss due to IBD (r = 0.340, p = 0.013) and avoidance of certain foods to prevent a relapse (r = 0.289, p = 0.036). Parents who rated their child's disease activity as more severe were less likely to use CAM (r = -0.257, p = 0.041). Fifty-nine percent of CAM users reported physician awareness of their CAM use. The overall self-perceived efficacy of CAM in improving IBD symptoms was 34%. Of the dietary patterns explored, only intake of dairy products was associated with CAM use (r = 0.306, p = 0.019). CONCLUSION: Use of CAM is prevalent in children with IBD in Malaysia and Singapore. Further studies to elucidate reasons influencing CAM use, dietary patterns and efficacy of commonly used CAM would be required.

Characterization of Matured Vermicompost Derived from Valorization of Palm Oil Mill Byproduct.

The valorization process involves transforming low-value materials such as wastes into high-value-added products. The current study aims to determine the potential of using a valorization process such as vermicomposting technology to convert palm oil mill byproduct, namely, decanter cake (DC), into organic fertilizer or vermicompost. The maturity of the vermicompost was characterized through various chemical and instrumental characterization to ensure the end product was safe and beneficial for agricultural application. The vermicomposting of DC showed significantly higher nutrient recovery and decreases in C:N ratio in comparison with the controls, particularly in the treatment with 2 parts DC and 1 part rice straw (w/w) (2DC:1RS). 2DC:1RS vermicompost had a final C:N ratio of 9.03 ± 0.12 and reasonably high levels of calcium (1.13 ± 0.05 g/kg), potassium (25.47 ± 0.32 g/kg), magnesium (4.87 ± 0.19 g/kg), sodium (7.40 ± 0.03 g/kg), and phosphorus (3.62 ± 0.27 g/kg). In addition, instrumental characterization also revealed a higher degree of maturity in the vermicompost. Ratios of 2921:1633 and DTG2:DTG3 also showed significant linear correlations with the C:N ratio, implying that those ratios could be used to characterize the progression of vermicompost maturity during the valorization process of DC.

Nutrition intervention approaches to reduce malnutrition in oncology patients: a systematic review.

PURPOSE: Malnutrition is a very common problem in oncology patients and is associated with many negative consequences including poorer prognosis, quality of life and survival. However, malnutrition in oncology patients is often overlooked although there is growing evidence showing that it can be prevented or reduced through nutrition intervention. This paper aims to provide an updated review on the effectiveness of different nutrition intervention approaches on nutrition status outcomes in oncology patients. METHODS: Randomised controlled trials (RCTs) published between 1994 and 2014 which examined the effects of nutrition intervention approaches--in particular, nutrition counselling (NC), oral nutrition supplements (ONS) and tube feeding (TF)--on nutrition status outcomes of oncology patients were identified and reviewed. RESULTS: Thirteen papers from 11 RCTs with a total of 1077 participants were included. The intervention approaches included NC (four studies), NC + ONS (five studies), ONS (three studies) and TF (three studies). The various results suggest that NC with or without ONS was associated with consistent improvements in several nutrition status outcomes. On the other hand, ONS and TF were associated with inconsistent improvements in few aspects of nutrition status outcomes. CONCLUSIONS: The referral of oncology patients for NC is recommended given the strong evidence of its beneficial effects on the prevention and reduction of malnutrition. Other forms of nutrition support including ONS and TF may then be included if deemed suitable and necessary for the individual.

Growth inhibition of Candida species by Wickerhamomyces anomalus mycocin and a lactone compound of Aureobasidium pullulans.

BACKGROUND: The increasing resistance of Candida yeasts towards antifungal compounds and the limited choice of therapeutic drugs have spurred great interest amongst the scientific community to search for alternative anti-Candida compounds. Mycocins and fungal metabolites have been reported to have the potential for treatment of fungal infections. In this study, the growth inhibition of Candida species by a mycocin produced by Wickerhamomyces anomalus and a lactone compound from Aureobasidium pullulans were investigated. METHODS: Mycocin was purified from the culture supernatant of an environmental isolate of W. anomalus using Sephadex G-75 gel filtration column chromatography. The mycocin preparation was subjected to SDS-PAGE analysis followed by MALDI TOF/TOF mass spectrometry analysis. The thermal and temperature stability of the mycocin were determined. The glucanase activity of the mycocin was investigated by substrate staining of the mycocin with 4-methyl-umbelliferyl-ß-D-glucoside (MUG). Gas chromatography mass spectrometry (GCMS) analysis was used to identify anti-Candida metabolite in the culture supernatant of an environmental isolate of Aureobasidium pullulans. The inhibitory effects of the anti-Candida compound against planktonic and biofilm cultures of various Candida species were determined using broth microdilution and biofilm quantitation methods. RESULTS: A mycocin active against Candida mesorugosa but not C. albicans, C. parapsilosis and C. krusei was isolated from the culture supernatant of W. anomalus in this study. The mycocin, identified as exo-ß-1,3 glucanase by MALDI TOF/TOF mass spectrometry, was stable at pH 3-6 and temperature ranging from 4-37°C. The glucanase activity of the mycocin was confirmed by substrate staining with MUG. 5-hydroxy-2-decenoic acid lactone (HDCL) was identified from the culture supernatant of A. pullulans. Using a commercial source of HDCL, the planktonic and biofilm MICs of HDCL against various Candida species were determined in this study. CONCLUSIONS: W. anomalus mycocin demonstrated a narrow spectrum of activity targeting only against C. mesorugosa, while HDCL demonstrated a broad spectrum of inhibitory action against multiple Candida species. The growth inhibition of W. anomalus mycocin and the lactone compound from A. pullulans against Candida yeasts should be further explored for therapeutic potentials against candidiasis.

Clinical and economic outcomes of nutrition interventions across the continuum of care.

Optimal nutrition across the continuum of care plays a key role in the short- and long-term clinical and economic outcomes of patients. Worldwide, an estimated one-quarter to one-half of patients admitted to hospitals each year are malnourished. Malnutrition can increase healthcare costs by delaying patient recovery and rehabilitation and increasing the risk of medical complications. Nutrition interventions have the potential to provide cost-effective preventive care and treatment measures. However, limited data exist on the economics and impact evaluations of these interventions. In this report, nutrition and health system researchers, clinicians, economists, and policymakers discuss emerging global research on nutrition health economics, the role of nutrition interventions across the continuum of care, and how nutrition can affect healthcare costs in the context of hospital malnutrition.

Treatment and biotransformation of highly polluted agro-industrial wastewater from a palm oil mill into vermicompost using earthworms.

In this laboratory-scale study, earthworms were introduced as biodegraders of palm oil mill effluent (POME), which is a wastewater produced from the wet process of palm oil milling. POME was absorbed into amendments (soil or rice straw) in different ratios as feedstocks for the earthworm, Eudrilus eugeniae. The presence of earthworms led to significant increases in pH, electrical conductivity, and nutrient content but decreases in the C/N ratio (0.687-75.8%), soluble chemical oxygen demand (19.7-87.9%), and volatile solids (0.687-52.7%). However, earthworm growth was reduced in all treatments by the end of the treatment process. Rice straw was a better amendment/absorbent relative to soil, with a higher nutrient content and greater reduction in soluble chemical oxygen demand with a lower C/N ratio in the vermicompost. Among all treatments investigated, the treatment with 1 part rice straw and 3 parts POME (w/v) (RS1:3) produced the best quality vermicompost with high nutritional status.

Sustainable reuse of rice residues as feedstocks in vermicomposting for organic fertilizer production.

Over the past decade, rice (Oryza sativa or Oryza glaberrima) cultivation has increased in many rice-growing countries due to the increasing export demand and population growth and led to a copious amount of rice residues, consisting mainly of rice straw (RS) and rice husk (RH), being generated during and after harvesting. In this study, Eudrilus eugeniae was used to decompose rice residues alone and rice residues amended with cow dung (CD) for bio-transformation of wastes into organic fertilizer. Generally, the final vermicomposts showed increases in macronutrients, namely, calcium (11.4-34.2%), magnesium (1.3-40.8%), phosphorus (1.2-57.3%), and potassium (1.1-345.6%) and a decrease in C/N ratio (26.8-80.0%) as well as increases in heavy metal content for iron (17-108%), copper (14-120%), and manganese (6-60%) after 60 days of vermicomposting. RS as a feedstock was observed to support healthier growth and reproduction of earthworms as compared to RH, with maximum adult worm biomass of 0.66 g/worm (RS) at 60 days, 31 cocoons (1RS:2CD), and 23 hatchlings (1RS:1CD). Vermicomposting of RS yielded better results than RH among all of the treatments investigated. RS that was mixed with two parts of CD (1RS:2CD) showed the best combination of nutrient results as well as the growth of E. eugeniae. In conclusion, vermicomposting could be used as a green technology to bio-convert rice residues into nutrient-rich organic fertilizers if the residues are mixed with CD in the appropriate ratio.

The potential reuse of soybean husk as feedstock of Eudrilus eugeniae in vermicomposting.

BACKGROUND: Soybean (Glycine max L.) is one the most commonly consumed legumes worldwide, with 200 million metric tons produced per year. However, the inedible soy husk would usually be removed during the process and the continuous generation of soybean husk may represent a major disposal problem for soybean processing industries. Thus, the main aim of the present study was to investigate the possibility to convert soybean husk (S) amended with market-rejected papaya (P) into vermicompost using Eudrilus eugeniae. RESULTS: Soybean husk was mixed with market-rejected papaya in different ratios to produce five different treatments (1P:1S, 2P:1S, 1P:2S, S only and P only) for laboratory screening of solid wastes. Generally, the application of E. eugeniae permitted a significant increase in Ca (42.3-91.6%), K (93.8-235%), Mg (25.4-84.6%) and P (37.1-129%) but a decrease in the C:N ratio (21.4-52.8%) after 9 weeks of vermicomposting. Among all the treatments investigated, soybean husk which was mixed with an equal amount of market-rejected papaya (1P:1S) showed superior quality vermicompost. Waste mixtures also encouraged the growth of E. eugeniae except the treatments with soybean husk alone as well as soybean husk which was mixed with market-rejected papaya in 1P:2S ratio. CONCLUSION: Vermicomposting could be used as an efficient technology to convert soybean husk into nutrient-rich organic fertiliser if it was mixed with market-rejected papaya in appropriate ratio.