A systematic review of task-sharing interventions for substance use and substance use disorder in low- and middle-income countries.

INTRODUCTION: Substance use (SU) and substance use disorders (SUDs) are associated with adverse health and socio-economic consequences. Due to the shortage of specialist healthcare providers, people with SUDs in low- and middle-income countries (LMICs) have limited access to adequate treatment. Task-sharing with non-specialist health workers (NSHWs) has the potential to improve treatment accessibility for these individuals. This review synthesizes the evidence on the effectiveness of task-sharing interventions for SU and SUDs outcomes in LMICs. METHODS: PsycINFO, MEDLINE, EMBASE, Global Health and CENTRAL databases were searched to identify eligible studies. Quality assessment was conducted using the Cochrane risk of bias (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. A narrative synthesis was undertaken to analyze the data. RESULTS: Nineteen RCTs and two quasi-experimental studies met the eligibility criteria, and the majority had a low risk of bias rating. NSHW-delivered interventions significantly impact SU and SUDs outcomes, particularly in reducing alcohol and other substance use, cessation of smoking, and use of opioids. Multiple sessions delivered via face-to-face interactions was the most utilized method for intervention delivery. There were variations in terms of components of the intervention across studies; however, the most common intervention strategies used were a) personalized feedback, b) psychoeducation, c) motivational enhancement, d) problem-solving, and e) coping skills. CONCLUSION: Our review highlights the growing interests in leveraging NSHWs to provide interventions to people with SU and SUDs in LMICs where access to treatment is limited. However, additional research is necessary to explore the effectiveness of these interventions and identify the specific active components linked to enhancing treatment outcomes on a broader scale.

Artificial Intelligence-Driven Serious Games in Health Care: Scoping Review.

BACKGROUND: Artificial intelligence (AI)-driven serious games have been used in health care to offer a customizable and immersive experience. Summarizing the features of the current AI-driven serious games is very important to explore how they have been developed and used and their current state to plan on how to leverage them in the current and future health care needs. OBJECTIVE: This study aimed to explore the features of AI-driven serious games in health care as reported by previous research. METHODS: We conducted a scoping review to achieve the abovementioned objective. The most popular databases in the information technology and health fields (ie, MEDLINE, PsycInfo, Embase, CINAHL, IEEE Xplore, ACM Digital Library, and Google Scholar) were searched using keywords related to serious games and AI. Two reviewers independently performed the study selection process. Three reviewers independently extracted data from the included studies. A narrative approach was used for data synthesis. RESULTS: The search process returned 1470 records. Of these 1470 records, 46 (31.29%) met all eligibility criteria. A total of 64 different serious games were found in the included studies. Motor impairment was the most common health condition targeted by these serious games. Serious games were used for rehabilitation in most of the studies. The most common genres of serious games were role-playing games, puzzle games, and platform games. Unity was the most prominent game engine used to develop serious games. PCs were the most common platform used to play serious games. The most common algorithm used in the included studies was support vector machine. The most common purposes of AI were the detection of disease and the evaluation of user performance. The size of the data set ranged from 36 to 795,600. The most common validation techniques used in the included studies were k-fold cross-validation and training-test split validation. Accuracy was the most commonly used metric for evaluating the performance of AI models. CONCLUSIONS: The last decade witnessed an increase in the development of AI-driven serious games for health care purposes, targeting various health conditions, and leveraging multiple AI algorithms; this rising trend is expected to continue for years to come. Although the evidence uncovered in this study shows promising applications of AI-driven serious games, larger and more rigorous, diverse, and robust studies may be needed to examine the efficacy and effectiveness of AI-driven serious games in different populations with different health conditions.

Effectiveness of Serious Games for Language Processing Amongst Elderly Population with Cognitive Impairment: A Systematic Review and Meta-Analysis.

This article intended to carry out a systematic review on the effectiveness of serious games for language processing among older adults with cognitive impairment. Out of 548 retrieved records, six randomized controlled trials (RCTs) eventually met the eligibility criteria. A meta-analysis of four studies showed that serious games are more effective than no/passive interventions in enhancing language processing among older adults with cognitive impairment (p=0.008). Further, a statistically significant effect of serious games on language processing when compared with conventional cognitive activities and conventional exercises was reported in two RCTs. Other RCTs found that exergames are as effective as computerized cognitive training games in improving language processing. Serious games should be offered or used as complementary (i.e., not a substitute) to the current interventions. For there to be definitive conclusions about the efficacy of serious games on language processing more trials are needed.

Effectiveness of Serious Games for Visuospatial Abilities in Elderly Population with Cognitive Impairment: A Systematic Review and Meta-Analysis.

We explore the effectiveness of serious games for visuospatial abilities among older adults with cognitive impairment by conducting a systematic review. Out of 548 identified publications, seven randomized controlled trials (RCTs) were included in this review. According to a meta-analysis of four RCTs, there is no statistically significant difference (p=0.28) in visuospatial abilities between serious game and control groups. Further, the included RCTs noted no statistically significant difference in the visuospatial ability when comparing serious games to conventional exercise (one study) and other serious games (two studies). One RCT demonstrated a statistically significant effect of serious games on the visuospatial ability when compared with conventional cognitive training. This review could not prove the effectiveness of serious games in enhancing visuospatial abilities for older adults with cognitive impairment. Thus, serious games should not be offered or used for enhancing visuospatial abilities amongst the elderly population with cognitive impairment. More robust RCTs are needed to make firm conclusions on the efficacy of serious games.

Thematic Analysis on User Reviews for Depression and Anxiety Chatbot Apps: Machine Learning Approach.

BACKGROUND: Anxiety and depression are among the most commonly prevalent mental health disorders worldwide. Chatbot apps can play an important role in relieving anxiety and depression. Users' reviews of chatbot apps are considered an important source of data for exploring users' opinions and satisfaction. OBJECTIVE: This study aims to explore users' opinions, satisfaction, and attitudes toward anxiety and depression chatbot apps by conducting a thematic analysis of users' reviews of 11 anxiety and depression chatbot apps collected from the Google Play Store and Apple App Store. In addition, we propose a workflow to provide a methodological approach for future analysis of app review comments. METHODS: We analyzed 205,581 user review comments from chatbots designed for users with anxiety and depression symptoms. Using scraper tools and Google Play Scraper and App Store Scraper Python libraries, we extracted the text and metadata. The reviews were divided into positive and negative meta-themes based on users' rating per review. We analyzed the reviews using word frequencies of bigrams and words in pairs. A topic modeling technique, latent Dirichlet allocation, was applied to identify topics in the reviews and analyzed to detect themes and subthemes. RESULTS: Thematic analysis was conducted on 5 topics for each sentimental set. Reviews were categorized as positive or negative. For positive reviews, the main themes were confidence and affirmation building, adequate analysis, and consultation, caring as a friend, and ease of use. For negative reviews, the results revealed the following themes: usability issues, update issues, privacy, and noncreative conversations. CONCLUSIONS: Using a machine learning approach, we were able to analyze ≥200,000 comments and categorize them into themes, allowing us to observe users' expectations effectively despite some negative factors. A methodological workflow is provided for the future analysis of review comments.

Contribution of Artificial Intelligence in Pregnancy: A Scoping Review.

For the past ten years, the healthcare sector and industry has witnessed a surge in Artificial Intelligence (AI) technologies being used in many different medical specialties. Recently, AI-driven technologies have been utilized in medical care for pregnancy. In this work, we present a scoping review that explores the features of AI-driven technologies used in caring for pregnant patients. This review was conducted using the Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews. Our analysis revealed that AI techniques were used in predicting pregnancy disorders such as preeclampsia and gestational diabetes, along with managing and treating ectopic pregnancies. We also found that AI technologies were used to assess risk factors and safety surveillance of pregnant women. We believe that AI-driven technologies have the potential to improve the healthcare provided to pregnant women.

A Scoping Review of Effective Teaching Strategies in Surface Anatomy.

To become skilled physicians, medical students must master surface anatomy. However, the study of surface anatomy is less emphasized in medical and allied health science curricula, and the time devoted to direct engagement with the human body is limited. This scoping review was designed to answer one research question: "What are the elements and strategies that are effective in teaching surface anatomy?" The review was performed using a five-stage scoping review framework, including research question identification, relevant study identification, study selection, data charting, and result collating and reporting. Three databases were searched using two search terms combined with a Boolean operator: "teaching" and "surface anatomy." The initial pool of 3,294 sources was assessed for duplication, and study eligibility was evaluated using inclusion and exclusion criteria. Data were abstracted from 26 original articles by one researcher and verified by two other researchers. A thematic analysis was performed, and several elements of effective teaching strategies for surface anatomy were identified, namely contextualized teaching, embracing experiential learning, and learning facilitation. This review revealed that a multimodal approach was most commonly used in surface anatomy instruction. Hence, future research should explore the effectiveness of multimodal teaching strategies that adopt the three aforementioned primary elements of effective teaching in an authentic learning environment. It is pertinent to clarify the effectiveness of these teaching strategies by evaluating their impact on student learning, organizational changes, and benefits to other stakeholders.

Anatomy Education Environment Measurement Inventory (AEEMI): a cross-validation study in Malaysian medical schools.

BACKGROUND: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia. METHODS: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses. RESULTS: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P < 0.001, χ 2/df = 1.965, Root Mean Square of Error Approximation (RMSEA) = 0.018, Goodness-of-fit Index (GFI) = 0.929, Comparative Fit Index (CFI) = 0.962, Normed Fit Index (NFI) = 0.927, Tucker-Lewis Index (TLI) = 0.956) with Cronbach's alpha values ranging from 0.621 to 0.927. Findings of the cross-validation across institutions and phases of medical training indicated that the AEEMI measures nearly the same constructs as the previously validated version with several modifications to the item placement within each factor. CONCLUSIONS: These results confirmed that variability exists within factors of the anatomy education environment among institutions. Hence, with modifications to the internal structure, the proposed model of the AEEMI can be considered universally applicable in the Malaysian context and thus can be used as one of the tools for auditing and benchmarking the anatomy curriculum.

The benefits and threats of blockchain technology in healthcare: A scoping review.

BACKGROUND: The application of blockchain technology is being explored to improve the interoperability of patient health information between healthcare organisations while maintaining the privacy and security of data. OBJECTIVES: The objective of this scoping review is to explore and categorise the benefits and threats of blockchain technology application in a healthcare system. METHODS: Databases such as PubMed, CINAHL, IEEE, Springer, and ScienceDirect were searched using a combination of terms related to blockchain, healthcare, benefits and threats. Backward-reference list checking was conducted to identify other relevant references. Study selection process was performed in three steps based on PRISMA flow diagram. Extracted data were synthesised and presented narratively using tables and figures. RESULTS: The search resulted in 84 relevant studies that have been conducted of which only 37 unique studies were included in this review. Eight benefits of blockchain were categorised in either patient related-benefits (security and authorisation, personalised healthcare, patients' health data tracking, and patient's health status monitoring) or organisational-related benefits (health information exchange, pharmaceutical supply chain, clinical trials, and medical insurance management). Meanwhile, eight threats of blockchain were categorised into three groups: organisational threats (installation and transaction costs, interoperability issues, and lack of technical skills), social threats (social acceptance and regulations issues), and technological threats (scalability issues, authorisation and security issues, high energy consumption, and slow processing speeds). CONCLUSION: Blockchain is a viable technology that can improve the healthcare data sharing and storing system owing to its decentralisation, immutability, transparency and traceability features. However, many healthcare organisations remain hesitant to adopt blockchain technology due to threats such as security and authorisation issues, interoperability issues and lack of technical skills related to blockchain technology.

Mid-Gut Carcinoid Tumour Presenting as Suspected Orbital Metastasis.

Although metastasis of carcinoid tumours of the intestine is rare, it has been reported in several organs, mainly in the lungs, the liver and less commonly in the orbits. We report a 50-year-old male patient who presented at Hamad General Hospital, Doha, Qatar, in 2016 with central abdominal pain, distention, nausea and vomiting for the previous four days. The patient had unilateral right-sided exophthalmos for two years prior to presentation. Following an abdominal computed tomography (CT) scan and an ultrasound guided biopsy, the patient was diagnosed with extensive multi-focal metastatic carcinoid tumour of the small bowel and mesentery; histopathology confirmed the diagnosis. Subsequently, the patient underwent a laparotomy and small bowel resection and was administered somatostatin therapy. One week postoperatively, the patient developed an acute increase in his right eye exophthalmos. CT, magnetic resonance imaging and scintigraphy scans revealed an orbital metastatic lesion, which probably originated from the previously diagnosed carcinoid tumour. The orbital metastasis was treated with somatostatin therapy and the patient was lost to follow-up when he left the country.

Dietary Supplement Intake and Associated Factors Among Gym Users in a University Community.

Dietary supplement intake and associated factors among gym users in a university community in Sharjah, United Arab Emirates (UAE), were assessed using a structured, self-administered questionnaire in this cross-sectional study. Adults (N = 320) from five gyms in the University City of Sharjah participated in this cross-sectional study. The prevalence of dietary supplement intake was 43.8%. Statistically significant associations were found between the use of dietary supplements and sex (47.7% males, 28.1% females; p = .006), as well as weight lifting (88.6% taking supplements vs. 11.4% not taking supplements; p < .001), favoring male gym users. The reasons attributed to the use of dietary supplements varied between the sexes. Male exercisers used supplements to increase or maintain muscles mass, strength, and power and to boost exercise recovery. Females mainly used dietary supplements to increase energy, maintain their health, and prevent nutrition deficiency. Overall, protein supplements (whey proteins [48.6%] and protein powder [45.7%]) were among the most-consumed dietary supplements, followed by multivitamins (38.6%), branched-chain amino acids (36.4%), caffeine (35.0%), and creatine (29.3%). A widespread use of Internet-driven, self-prescribed dietary supplement intake was reported among gym users (60.7%). Only 12.8% of dietary supplement users sought information from dietitians. Practical implications suggest that gym instructors and coaches should be sufficiently trained to be able to provide accurate and scientifically sound information on dietary supplements to the exercisers in gyms in the university environment.

Creating an engaging and stimulating anatomy lecture environment using the Cognitive Load Theory-based Lecture Model: Students' experiences.

OBJECTIVE: There is a need to create a standard interactive anatomy lecture that can engage students in their learning process. This study investigated the impact of a new lecturing guideline, the Cognitive Load Theory-based Lecture Model (CLT-bLM), on students' cognitive engagement and motivation. METHODS: A randomised controlled trial involving 197 participants from three institutions was conducted. The control group attended a freestyle lecture on the gross anatomy of the heart, delivered by a qualified anatomist from each institution. The intervention group attended a CLT-bLM-based lecture on a similar topic, delivered by the same lecturer, three weeks thereafter. The lecturers had attended a CLT-bLM workshop that allowed them to prepare for the CLT-bLM-based lecture over the course of three weeks. The students' ratings on their cognitive engagement and internal motivation were evaluated immediately after the lecture using a validated Learners' Engagement and Motivation Questionnaire. The differences between variables were analysed and the results were triangulated with the focus group discussion findings that explored students' experience while attending the lecture. RESULTS: The intervention group has a significantly higher level of cognitive engagement than the control group; however, no significant difference in internal motivation score was found. In addition, the intervention group reported having a good learning experience from the lectures. CONCLUSION: The guideline successfully stimulated students' cognitive engagement and learning experience, which indicates a successful stimulation of students' germane resources. Stimulation of these cognitive resources is essential for successful cognitive processing, especially when learning a difficult subject such as anatomy.

Anatomy education environment measurement inventory: A valid tool to measure the anatomy learning environment.

Students' perceptions of the education environment influence their learning. Ever since the major medical curriculum reform, anatomy education has undergone several changes in terms of its curriculum, teaching modalities, learning resources, and assessment methods. By measuring students' perceptions concerning anatomy education environment, valuable information can be obtained to facilitate improvements in teaching and learning. Hence, it is important to use a valid inventory that specifically measures attributes of the anatomy education environment. In this study, a new 11-factor, 132-items Anatomy Education Environment Measurement Inventory (AEEMI) was developed using Delphi technique and was validated in a Malaysian public medical school. The inventory was found to have satisfactory content evidence (scale-level content validity index [total] = 0.646); good response process evidence (scale-level face validity index [total] = 0.867); and acceptable to high internal consistency, with the Raykov composite reliability estimates of the six factors are in the range of 0.604-0.876. The best fit model of the AEEMI is achieved with six domains and 25 items (X2 = 415.67, P < 0.001, ChiSq/df = 1.63, RMSEA = 0.045, GFI = 0.905, CFI = 0.937, NFI = 0.854, TLI = 0.926). Hence, AEEMI was proven to have good psychometric properties, and thus could be used to measure the anatomy education environment in Malaysia. A concerted collaboration should be initiated toward developing a valid universal tool that, using the methods outlined in this study, measures the anatomy education environment across different institutions and countries. Anat Sci Educ 10: 423-432. © 2017 American Association of Anatomists.

Evaluation of diabetes awareness among general population of Bahawalpur, Pakistan.

AIMS: To evaluate diabetes awareness among general population of Bahawalpur, Pakistan. METHODS: A questionnaire based descriptive cross sectional study was performed during 2014. Descriptive and inferential statistics were applied using the IBM Statistical Package for Social Sciences version 20. RESULTS: Total 383 respondents participated in this study giving a response rate of about 88%. Mean age of the participants was 33±13.3 years and the majority of the participants were females (50.4%). Mean scores of the participants were 20.77±6.65 out of 34 and only one participant scored 34/34 marks. Kruskal-Wallis and Mann-Whitney U test revealed that females scored significantly higher diabetes awareness score than males (p<0.05). Moreover, urban residential status, better education and higher socioeconomic status were significantly associated with higher diabetes awareness. CONCLUSIONS: Majority of our study population had adequate awareness regarding diabetes. However, lack of awareness was observed among illiterate, poor and rural participants that indicated the immediate need of diabetes awareness programs for these participants.

A Bilayer Engineered Skin Substitute for Wound Repair in an Irradiation-Impeded Healing Model on Rat.

Objective: An engineered skin substitute is produced to accelerate wound healing by increasing the mechanical strength of the skin wound via high production of collagen bundles. During the remodeling stage of wound healing, collagen deposition is the most important event. The collagen deposition process may be altered by nutritional deficiency, diabetes mellitus, microbial infection, or radiation exposure, leading to impaired healing. This study describes the fabrication of an engineered bilayer skin substitute and evaluates its effectiveness for the production of collagen bundles in an impaired healing model. Approach: Rats were exposed to 10 Gy of radiation. Two months postirradiation, the wounds were excised and treated with one of three skin replacement products: bilayer engineered skin substitutes, chitosan skin templates, or duoderm©. The collagen deposition was analyzed by hematoxylin and eosin staining. Results: On day 21 postwound, the irradiated wounds displayed increased collagen bundle deposition after treatment using bilayer engineered skin substitutes (3.4±0.25) and chitosan skin templates (3.2±0.58) compared with duoderm (2.0±0.63). Innovation: We provide the first report on the fabrication of bilayer engineered skin substitutes using high density human dermal fibroblasts cocultured with HFSCs on chitosan skin templates. Conclusion: The high density of fibroblasts significantly increases the penetration of cells into chitosan skin templates, contributing to the fabrication of bilayer engineered skin substitute.

Potential Role of Honey in Learning and Memory.

The composition and physicochemical properties of honey are variable depending on its floral source and often named according to the geographical location. The potential medicinal benefits of Tualang honey, a multifloral jungle honey found in Malaysia, have recently been attracting attention because of its reported beneficial effects in various diseases. This paper reviews the effects of honey, particularly Tualang honey, on learning and memory. Information regarding the effects of Tualang honey on learning and memory in human as well as animal models is gleaned to hypothesize its underlying mechanisms. These studies show that Tualang honey improves morphology of memory-related brain areas, reduces brain oxidative stress, increases brain-derived neurotrophic factor (BDNF) and acetylcholine (ACh) concentrations, and reduces acetylcholinesterase (AChE) in the brain homogenates. Its anti-inflammatory roles in reducing inflammatory trigger and microglial activation have yet to be investigated. It is hypothesized that the improvement in learning and memory following Tualang honey supplementation is due to the significant improvement in brain morphology and enhancement of brain cholinergic system secondary to reduction in brain oxidative damage and/or upregulation of BDNF concentration. Further studies are imperative to elucidate the molecular mechanism of actions.

Effect of Ajuga bracteosa on systemic T-cell immunity in Balb/C mice: dual Th1/Th2 immunostimulatory effects.

Ajuga bracteosa (AB) has been widely used in folk medicine in Asian countries against gout, hepatitis, pneumonia, rheumatism, and various neuro inflammatory disorders. The aim of this study was to investigate the possible immunoregulatory effects of the ethanolic extract of Ajuga bracteosa (ABEE) on systemic Th1/Th2 immunity in SRBC immunized Balb/C mice. Animals were orally administered with graded doses of ABEE from 6.25 mg/kg to 100 mg/kg. Post sub-cutaneous immunization with SRBCs and circulating antibody titers, DTH responses and splenocyte proliferation was monitored as markers of Th2 and Th1 responses. Cyclophosphamide and levamisole were used as controls. Lymphocyte immunophenotying (CD4/CD8 cell counts) and intracellular Th1/Th2 cytokine concentrations were determined using flow cytometry. Treatment with ABEE demonstrated significant biphasic immunostimulation of effector T-helper immunity. ABEE at 50 mg/kg dose resulted in maximal increase in antibody titers, DTH responses and CD4+/CD8+ T-cell percentages indicating maximal activation and proliferation of T and B lymphocytes at this dose. ABEE, at the same dose, also showed maximal up regulation of LPS and CON A stimulated splenocyte proliferation and also maximal up-regulation of both Th1 (IL-2, IFN-γ) and Th2 (IL-4) cytokines which suggest its mixed Th1/Th2 immunostimulatory activity. Comparatively at higher doses (100 mg/kg), significant down regulation of all these effector T-helper (Th) immune responses was observed. The study therefore suggests mixed biphasic immunostimulatory Th1/Th2 activity of ABEE that could support its immunoadjuvant potential.

Enhancement of BDNF concentration and restoration of the hypothalamic-pituitary-adrenal axis accompany reduced depressive-like behaviour in stressed ovariectomised rats treated with either Tualang honey or estrogen.

A possible interaction between glucocorticoids and estrogen-induced increases in brain-derived-neurotrophic factor (BDNF) expression in enhancing depressive-like behaviour has been documented. Here we evaluated the effects of Tualang honey, a phytoestrogen, and 17 ß -estradiol (E2) on the depressive-like behaviour, stress hormones, and BDNF concentration in stressed ovariectomised (OVX) rats. The animals were divided into six groups: (i) nonstressed sham-operated control, (ii) stressed sham-operated control, (iii) nonstressed OVX, (iv) stressed OVX, (v) stressed OVX treated with E2 (20 µg daily, sc), and (vi) stressed OVX treated with Tualang honey (0.2 g/kg body weight daily, orally). Two months after surgery, the animals were subjected to social instability stress procedure followed by forced swimming test. Struggling time, immobility time, and swimming time were scored. Serum adrenocorticotropic hormone (ACTH) and corticosterone levels, and the BDNF concentration were determined using commercially available ELISA kits. Stressed OVX rats displayed increased depressive-like behaviour with significantly increased serum ACTH and corticosterone levels, while the BDNF concentration was significantly decreased compared to other experimental groups. These changes were notably reversed by both E2 and Tualang honey. In conclusion, both Tualang honey and E2 mediate antidepressive-like effects in stressed OVX rats, possibly acting via restoration of hypothalamic-pituitary-adrenal axis and enhancement of the BDNF concentration.

Tualang honey supplement improves memory performance and hippocampal morphology in stressed ovariectomized rats.

Recently, our research team has reported that Tualang honey was able to improve immediate memory in postmenopausal women comparable with that of estrogen progestin therapy. Therefore the aim of the present study was to examine the effects of Tualang honey supplement on hippocampal morphology and memory performance in ovariectomized (OVX) rats exposed to social instability stress. Female Sprague-Dawley rats were divided into six groups: (i) sham-operated controls, (ii) stressed sham-operated controls, (iii) OVX rats, (iv) stressed OVX rats, (v) stressed OVX rats treated with 17ß-estradiol (E2), and (vi) stressed OVX rats treated with Tualang honey. These rats were subjected to social instability stress procedure followed by novel object recognition (NOR) test. Right brain hemispheres were subjected to Nissl staining. The number and arrangement of pyramidal neurons in regions of CA1, CA2, CA3 and the dentate gyrus (DG) were recorded. Two-way ANOVA analyses showed significant interactions between stress and OVX in both STM and LTM test as well as number of Nissl-positive cells in all hippocampal regions. Both E2 and Tualang honey treatments improved both short-term and long-term memory and enhanced the neuronal proliferation of hippocampal CA2, CA3 and DG regions compared to that of untreated stressed OVX rats.

Protective Effects of Tualang Honey against Oxidative Stress and Anxiety-Like Behaviour in Stressed Ovariectomized Rats.

The present study aims to evaluate the antioxidant and anxiolytic-like effect of Tualang honey in stressed ovariectomized (OVX) rats. The animals were divided into; (i) nonstressed sham-operated control rats, (ii) sham-operated control rats exposed to stress, (iii) nonstressed OVX rats, (iv) OVX rats exposed to stress, (v) OVX rats exposed to stress and treated with 17 ß-oestradiol (E2) (20 µg daily, sc), and (vi) OVX rats exposed to stress and treated with Tualang honey (0.2 g/kg body weight, orally). The open field test was used to evaluate the anxiety-like behaviour and ELISA kits were used to measure oxidant/antioxidant status of the brain homogenates. The result showed that anxiety-like behavior was significantly increased in stressed OVX compared to other groups, and administering either E2 or Tualang honey significantly decreased anxiety-like behaviour in stressed OVX rats. The levels of malondialdehyde (MDA) and protein carbonyl (PCO) were significantly decreased while the levels/activities of superoxide dismutase (SOD), glutathione S-transferases (GST), glutathione peroxidase (GPx), and glutathione reductase (GR) were significantly increased in the brain homogenates of treated stressed OVX groups compared to untreated stressed OVX. In conclusion, Tualang honey has protective effects against brain oxidative stress and may be useful alternative anxiolytic agent especially for postmenopausal women.