Transcript The Effect of Mangrove Crab Soup on Improvement of

“The Effect of Mangrove Crab
Soup on Improvement of
Clinical Symptoms and Platelet
Level in Dengue Patient-A Pilot
Study”
Irfan Mohamad (Otorhinolaryngology)
Wan Yus Haniff (Internal Medicine)
Rosline Hassan (Hematology)
Nutritionist / Dietitian
Pharmacology / Biology
Malaysia
• In 2007, 48,185 dengue cases were reported,
with 98 deaths
• In 2008, during the 1st week, 734 cases
including 3 deaths were reported In the 37th
week (7-13 September 2008), 837 cases
reported (with 3 deaths)
• Source : Disease Control Division, Ministry of
Health Malaysia, epid Week 1& 37, 2008
Globally…
• More than 500,000 people — mostly children
and infants — contract this more severe form of
dengue, which kills 20,000 every year, making it
a leading cause of childhood death in many
countries. And the numbers are increasing.
• Dengue fever climbs the social ladder.
Nature 448, 734 - 735 (2007) .
doi:10.1038/448734a
•
1.
2.
3.
4.
Actions by Ministry of Health include :
Compound
Aerosol spray/fogging
Notification
Health Education
•
1.
2.
3.
4.
5.
Treatment is mainly supportive
Hydration
Platelet monitoring
Transfusion
Antipyretics
Many still under trials
Promising?
• Several vaccine developers have utilized
live-attenuated live tetravalent vaccines
and two of them have already completed
phase two trials. However, the risk of
antibody-dependent enhancement
infection is not well elucidated.
• Morita K. Dengue vaccines. Nippon Rinsho. 2008
Oct;66(10):1999-2003.
• Strains of each of the 4 DV serotypes,
attenuated by passage in tissue culture or
by recombinant DNA technology, have
been formulated into tetravalent vaccines
and have entered successful phase 1 and
2 clinical trials in the United States and
Southeast Asia.
• For the first time in 60 years, the pipeline
of dengue vaccines looks promising.
• A protective tetravalent vaccine must be
licensed soon if dengue is to be brought
under control.
• Edelmen R. Dengue vaccines approach
the finish line. Clin Infect Dis. 2007 Jul
15;45 Suppl 1:S56-60.
Why using crab?
No published data to show the effect of taking crab meat on any disease
Nutritive value of crabs described
Old generation people believe that taking crab meat soup is very helpful in
treating some illnesses including dengue
Nutritive value
• The crab showed higher protein content
(78.50%) when compared to the mussel
(63.75%) and the oyster (40.14%).
• As to wet weight basis, the lipid contents
were quite low ranging from 0.25 to
1.19%.
• Carbohydrate content ranged from 2.26 %
(crab) to 4.60% (mussel).
• These shellfishes represent a good source
of minerals satisfying from 7.6 to 100% the
highest requirements suggested by The
Food and Nutrition Board, Institute of
Medicine (2002).
• Caravalho AF, Farias DF, Barroso CX et al. Nutritive
value of three organisms from mangrove ecosystem:
Ucides cordatus (Linnaeus, 1763), Mytella sp. (SootRyen, 1955) and Crassostrea rhizophorae (Guilding,
1828). Braz J Biol. 2007 Nov;67(4):787-8.
Objectives
• General
1. To demonstrate the effect of taking
mangrove crab soup meal on the
improvement of dengue patient condition
• Specific
1. To evaluate the pletelet count
2. To evaluate the clinical symptom*
Clinical symptom
•
•
•
•
Headache
Myalgia& athralgia
Fever
Rash
• Ryan KJ, Ray CG (editors) (2004). Sherris Medical
Microbiology (4th ed. ed.), McGraw Hill. pp. 592. ISBN
0838585299.
Methodology
• Patient clinically diagnosed dengue admitted
• Patients randomized into two groups(sex, age
matched)
• Baseline blood investigation taken
• Supportive treatment commenced
• One will received mangrove crab soup as the
first meal since admission
• Platelet monitored from the usual BD/QID blood
investigation
• Temperature, symptoms, length of stay recorded
Patient selection
Inclusion criteria
1. All patient admitted clinically diagnosed
as dengue
2. Age 18 years old & above
Exclusion criteria
1. Allergy to seafood
2. Patient in shock / intubated
Sample Size
• A Pilot Study
• 30 patients required for each group
(Central Limit Theorem-for normal curve
distribution)
• Age, sex matched
The soup
• Using Mangrove crab
• Prepared in the form of soup
• Steps of preparation will be standardized
(after discussion with dietitian/nutritionist)
• Served as the first meal and completed
until three doses
• Each meal contains 500 ml, to be taken
with the ordinary meal served by hospital
The crab
• Mud Crab (Scylla serrata) is also known
as Mangrove Crab. It is commonly farmed
in Southeast Asia.
• Is it halal? Is it the same with ketam batu?
Hukum Memakan Ketam Nipah
menurut Mazhab Syafie (terbitan
Panel Kemusykilan Agama,JAKIM)
• Ketam Nipah bukanlah daripada jenis reptilia dan amfibia, tetapi ia
adalah dari jenis rustasia iaitu sama golongan dengan udang dan
kerang. Keseluruhan edaran hidupnya adalah di dalam air dan
mempunyai sistem pernafasan melalui insang dan bukan paru-paru.
Ia bernafas menggunakan oksigen dalam air sebagai pelarut.
Kehidupan ketam Nipah di darat hanya dalam tempoh masa yang
singkat sahaja iaitu lebih kurang 2 atau 3 hari, kerana dalam
insangnya mempunyai satu ruang pintu yang boleh ditutup dan
mengandungi sedikit air. Ia menggunakan air tersebut untuk
pernafasan dan sekiranya air itu kering ia akan mati.
• Oleh itu dari segi hukum Ketam Nipah adalah binatang yang boleh
dimakan..
• Ketam Nipah or scientifically called as
scylla serrata is indeed a real crab that
lives in water, got gills for respiration and
what differentiate it with Ketam Batu is the
Flipping Leg. The last rear legs are meant
for swimming.
• The Ketam Batu, all the legs are sharp
pointed, mainly for walking, therefore
HARAM
Outcome
• New supportive measure to expedite
recovery of dengue patient
• Reduce the load of platelet usage for
transfusion
• Shorten the hospital stay
• Improve quality of life
• Treating nature’s disease using nature’s
gift
Thank you