Epsom College Medical Review Society Issue 1 (June 2021) ECIM

BRINGING INNOVATION TO LIGHT

Medical REVIEW JOURNAL

20 21

Issue 1 - June 2021

FEATURED JOURNALS

"Development of Parkinson Disease in the ageing society" - Ong Paul Sherng

"An Overview of the Amyotrophic Lateral Sclerosis (ALS) " -Tiffany Cheah "Importance of Microbiome" - Justin Kim

"Introduction to Superfoods!"

- Hirotsugu Takami

Share your research Bringing Discovery to Light : Demonstrate Passion in Science & Medicine Unlock Unrealised Skills & Values Future Collaboration

Medical REVIEW JOURNAL

story

Medical REVIEW JOURNAL BRINGING INNOVATION TO LIGHT 5

Parkinson Disease in Ageing Society

by Paul Sherng

6

Overview of Amyotrophic Lateral Sclerosis 8

by Tiffany Importance of Microbiome

by Justin Kim

10

Introduction to Superfoods!

by Hiro

12

Activities Conducted from February 2021 to May 2021 by MRS

14

Committee Hierarchy 2021

18

Graphic Designer of 1st Issue : Ong Paul Sherng Content Writer: Ong Paul Sherng (Main) Kim Dohyun Tiffany Cheah Hirotsugu Takami Contact info: Ong Paul Sherng (paul.ong21@epsomcollege.edu.my)

Contents

Welcome Message from Medical Review

editor's desk

Welcome to the June 2021 Edition of

Medical REVIEW JOURNAL

Welcome to our 1st Issue of the Medical Review Journal.

We are gratified to bring you the latest findings in medicine, technology, and social sciences discovered by our Medical Review Society members. It is stimulating to learn how researchers are evolving creative approaches to track and treat cancer, diabetes, HIV and even the flu. Equally as intriguing are the advances in computing power, nanotechnology and gene editing enabling these new tools and potential therapies.

Looking forward, we are thrilled to unveil our next issue of the Medical Review Journal, a series of webinars and peer discussions.

We are excited that our platform is evoking students’ interests in the medical & technology field through a series of activities that will be conducted.

Join the Medical Review community and enrich the society with exciting research developments in the medical field!

Medical Review Team

Parkinson Disease Parkinson disease is a neurodegenerative disorder associated with dopamine depletion in the basal ganglia. Although best known as a movement disorder, non‐motor symptoms, such as depression and cognitive impairment, are also frequent.

Diagnosis Parkinson disease is defined by the presence of motor symptoms, including bradykinesia (a slowness of movement) and one or more additional cardinal motor feature (rigidity or rest tremor).

EVOLUTION OF PARKINSON DISEASE OVER TIME

Mechanism The motor symptoms associated with Parkinson disease result from loss of dopaminergic neurons in the substantia nigra, which ultimately inhibits neuronal output from the basal ganglia to the thalamus.

Motor Symptoms Diagnosis

Prodr omal

Ear

ly S

Damage to dopaminergic neurons is essentially caused by a complex interplay between toxic α-synuclein aggregates (due to impaired protein degradation), oxidative stress, impaired intracellular calcium, homeostasis & neuroinflammation.

tage

!

Several non-motor symptoms (including REM sleep behaviour disorder, constipation and loss of smell) antedate motor symptoms by years.

Loss of dopaminergic neurons in the substantia nigra

α-Synuclein depositions

Healthy

Parkinson

!

Combined loss of specific neurons & widespread, intracellular α- synuclein aggregations are the pathophysiological hallmarks of Parkinson disease.

in ageing society

REVIEW JOURNAL

Epidemiology

In addition to the motor symptoms, patients show persistent and new nonmotor symptoms, such as cognitive impairment, disorders of mood and autonomic dysfunction (e.g. hypotension).

Parkinson disease is the second-most common neurodegenerative disorder. The incidence of the disease sharply increases with age.

Indeed, the global prevalence across all age groups is estimated at 0.3%, whereas levels increase to 2–3% in the population ≥65 years of age. Parkinson disease is more common in men than in women.

The incidence varies depending on ethnicity, environmental factors (such as exposure to organic pollutants), lifestyle factors (for example, smoking and caffeine intake) and genetic factors.

Outlook

Mi dS tag e

Late Stage In addition to clinical evaluation, diagnostic tests are mainly based on imaging, for example, of striatal dopamine levels.

The identification of markers for prodromal disease & the development and optimization of curative treatments remain considerable challenges. New treatments might involve gene therapy, stem cell treatment, fetal cell transplantation, or new disease‐modifying drugs.

Author: Ong Paul Sherng President & Founder of Medical Review

Amyotrophic Lateral Amyotrophic Lateral Sclerosis (ALS), which is also known as Lou Gehrig’s Disease. It is a progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control, resulting in paralysis.

Treatment There isn’t any cure for this disease. However, there are treatments that could help control the symptoms, making life easier for the patients. One of the most commonly used treatments is the drug riluzole (Rilutek) and edaravone (Radicava). Riluzole is believed to reduce damage to motor neurons by decreasing the levels of glutamate*. It is expensive, but it appears to be the most effective. Physicians can also prescribe medication to help manage the symptoms of ALS, which includes muscle cramps, stiffness, excess saliva and phlegm, and the pseudobulbar affect*.

Patients could also go to physical therapy to help strengthen unaffected muscles and improve cardiovascular health. Physical therapists would help them carry out gentle, low-impact exercises, e.g. walking, swimming, stationary cycling, etc. These activities can help fight fatigue as well as reduce depression.

Speech therapy is also greatly recommended as the therapist would teach them adaptive strategies to speak more loudly and clearly. By going to therapy, the ability to communicate could be maintained as ALS progresses

.

Glutamate - transports messages between nerve cells and motor neurons The pseudobulbar affect - involuntary or uncontrollable episodes of crying, laughing, or other emotional displays

Medical REVIEW JOURNAL

Sclerosis Fun Fact Up to 50% of patients develop cognitive and/or behavioural impairments during the course of the disease

Diagnosis It is fairly difficult to diagnose ALS as there isn’t any medical test for it. Since many neurological diseases have similar symptoms, these other conditions should be ruled out first by running a few medical tests and clinical examinations. The test and procedures used for diagnosis: Electrodiagnostic tests Blood and urine studies Spinal tap

X-ray / MRI CT scan Muscle/ nerve biopsy

Symptoms The signs and symptoms vary from person to person, but here are a few examples of what may occur to patients diagnosed with this disease: Fascicuations (muscles twitching) Muscle cramps Tight and stiff muscles (spasticity) Difficulty walking

Slurred speech or difficulty swallowing Cognitive changes Fatigue Shortness of breath or difficulty breathing

ALS usually starts in the limbs, hands, or feet. As the disease develops, and more nerve cells are destroyed, the symptoms will advance to the rest of the body. No pain would be experienced in the early stages of ALS, it is also uncommon in the later stages. Some patients may have problems with decision-making and memory, which eventually leads to a form of dementia called frontotemporal dementia*.

Frontotemporal dementia - a group of uncommon brain disorders that primarily affect the frontal and temporal lobes of the brain NIV - breathing support that delivers oxygen through a mask over the nose or mouth

Author: Tiffany Cheah

The Importance of

Microbiome Types of Microbiome Most diseases in our bodies are genetically predetermined at birth.

However, if we keep Microbiome well, we can live longer and have a healthy body even we are in our old age.

Ruminococcaceae, Lachnospiraceae, and Bacteroidales representative bacteria beneficial to our body.

are

Ruminococcaceae lowers levels of inflammatory bowel disease and colorectal cancer and is commonly known as probiotics.

Bacteroidales is a typical intestinal microorganism in mammals, including humans, which is necessary to digest carbohydrates and serves to eliminate Firmicutes which is usually known for obese bacteria.

Importance (Real life Example) We can identify the importance of microbiomes as an example of a Heterocephalus glaber(naked mole rat). The maximum life span of ordinary mice is only three to four years, while the slightly larger Heterocephalus glaber is known to be more than 30 years, which is ten times larger. Unlike other mice, this Heterocephalus glaber had a significant number of intestinal beneficial bacteria, and it was found that Heterocephalus often eats root foods such as sweet potatoes, ginseng, and potatoes.

How Intestinal Harmful Bacteria proliferate & Ways to prevent it.

1

Lectin

Lectin is a protein in plants that contain grains, beans, potatoes, brown rice, and so on. When a lot of lectin builds up, it inhibits bacteria that are beneficial to our body and leaks intestinal walls. It then spreads harmful bacteria through the bloodstream. Diseases induced by this include thyroid cancer, obesity, diabetes, and irritable bowel syndrome. Interestingly, many people eat brown rice instead of rice for their health these days.

Brown rice is much more effective than rice in breaking down sugar, but it has more lectin than rice. Thus, we should eat rice that suits our body rather than eating brown rice.

2 Antibiotics

3 Sugar & Artificial Sweeter

Antibiotics have contributed greatly to preventing and developing human extinction through bacterial infections in our human history. However, when taken frequently or strongly, beneficial intestinal bacteria cannot withstand and worsen the intestinal environment.

These do not directly affect beneficial bacteria but are the best food source for fungi, including bad bacteria. Eating too much sugar causes inflammation to occur in our bodies and damages not only our intestines but also other parts of our bodies.

Author: Kim Dohyun

What are Superfoods?

At the moment there is not a specific (official) definition of what superfoods are, however, scientists define them as foods with rich nutrients. This is not imaginative food!

When you go to a supermarket or even online shopping and find ‘superfoods’ you can get a variety of foods and drinks as well, for example, dark leafy greens, berries, eggs, green tea etc. When you compare them with the normal ones you will notice that superfoods are slightly more expensive. This is because they tend to grow in a fully controlled environment by humans.

Usually, superfoods contain a large percentage of vitamins, minerals, enzymes, amino acids and antioxidants which prevent damage to cells. Unlike other ‘healthy’ foods which contain 2 or 3 nutrients on average, superfoods have 12 or even more! Nowadays, you not only can purchase superfoods anywhere but you can make them yourself too.

Berries This includes all kinds of berries such as blueberries, raspberries, strawberries etc. Most of the berries are high in vitamin C which is essential to protect cells and keeps skin, blood vessels, bones and cartilage healthy. Some berries like blueberries have iron, potassium and manganese too! If you ask me, I love to blend it with soy milk as a drink before I start off my day

Seeds Soley eating superfoods does not lead to a healthier lifestyle. You still need to take in other factors like exercises, enough sleep etc.

Remember to consume a variety of superfoods to ensure balanced nutrients are being consumed!

Chlorella

Just like berries, there are many types of seeds you can find such as pumpkin seeds, chia seeds (you can get this from Tealive) etc. My most favourite one is the hemp seeds which contain omega-3 (ω-3) and omega-6 (ω-6) fatty acids These two are needed for blood pressure regulation and inflammatory responses. Scientists recently found out that protecting against fatal heart disease is one of the hidden functions too!

For your information, Hemp seeds also contain minerals such as calcium, magnesium, sulphur, copper, potassium and phosphorus. However, I recommend you to get raw hemp seeds as they contain more nutrients. You will get more nutrients if you get raw hemp seeds.

In my opinion, this is probably the strongest superfood. Having a similar powderly form to Matcha powder, chlorella is a type of single-celled green algae. Nowadays, you can purchase them in a form of a capsule, powder, tablet or take them as snacks. Now, why I said this is the strongest superfood? This is because it has all the nutrients you should obtain daily. Therefore, taking chlorella on a daily basis will lead to a healthier life by preventing sickness. However, there is a big concern when buying chlorella. Becoming extremely popular in times, ‘fake’ chlorella products are commonly found in the market. So, make sure you check the label carefully before making any purchase!

Author: Hirotsugu Takami

Medical REVIEW JOURNAL Activities Conducted from February 2021 to May 2021

Initiate Medical Review Journal

February

1st Peer Discussion on the "Should animals be used in laboratory experimentations?"

March

1st Webinar on Pathway to Top Tier Medical Schools

April

May

2nd Webinar on Life as a Medic Student @ Cambridge University

Medical REVIEW JOURNAL

Speaker's Biography: Dr. Ricky Tavares is an MBBS holder from University College London and furthered his studies in the Medical Science field at Oxford University. He was used to be a Medical Doctor in NHS and is currently the CoFounder of Career Portal.

Attendance: Approximately 45 participants

Topics that were discussed: 1) How to be an outstanding applicant for UK Top Medical Schools?

2) How to excel in BMAT & UCAT tests?

3) The overall pathway from GCSE to A-Levels & to Medical Universities.

4) Tips for excelling in interviews & draft an unique personal statement.

Medical REVIEW JOURNAL

Introduction to Dylan Birk: Dylan Birk is a fifth-year medical student at The University of Cambridge with a BSc Degree in Viral Immunology. He is currently working in the Teenage & Young Adult Cancer Unit at Addenbrookes Hospital. Alongside his medical studies, he is a clinical supervisor for junior students and has created his own teaching scheme for international medical graduates.

Moreover, Dylan was the summer medical tutor for Epsom's Medical Review Society's President, Ong Paul Sherng, where they met at Cambridge University. He is also completing some research on Tribunal Success Rates for Psychiatric Inpatients. Outside of medicine, he enjoys spending time in nature and is a member of the University Officer Training Corps.

Medical REVIEW JOURNAL 1st Peer Discussion - 1st of May

Should animals be used in the laboratory for biological experiments?

EPSOM COLLEGE IN MALAYSIA

Presented by: Ong Paul Sherng

Replacement

The 3

Rs

Reduction Refinement

Do the positives associated with using animal models outweigh the negatives?

YES

NO

The use of animals in research is essential for enabling researchers to develop new drugs and treatments

It is expensive to use model organisms as the animals must be purchased and then fed, housed and cared for.

Animal models help ensure the effectiveness and safety of new treatments.

Some people will consider using animals in the lab to be immoral.

Should the use of animals in research be a mandatory part of modern progressive science?

It's Time to Brainstorm ideas!

Medical REVIEW JOURNAL

President & Founder Ong Paul Sherng Secretary Team

Vice President

Bernie Tan Wai Ling (Chief) Sonya Lim

Muhammad Wafi Badrul Hisham

Journal Department

Event & Program Coordination Team

Advertising & Public Relation Department

Journal Editors

Chief of Graphic Designing

Kim do hyun Ashley Lim Xin Ling Goh Narita Sora Shanker Darshinie

Benjamin Lim An Yi

Core Action Leader Hirotsugu Takami

Chief of Public Relations Tan Yee Lim

Core Action Members

Deputy Chief Aloysious Ng Kar Foon

Tiffany Cheah Wong Zi Ming

Members Cadence Ong Jing Han Carmin Ooi

Medical REVIEW JOURNAL

Join us via medicalreview@epsomcollege.edu.my