13 Previous studies also selleck chemical Abiraterone showed that treatment with Piper sarmentosum extract and GCA had reduced bone resorption markers.4,9,18 Apart from that, the expression of 11β-HSD1 enzyme in the bones of dexamethasone-treated rats supplemented with Piper sarmentosum extract significantly decrease. This could be explained by the fact that 11β-HSD1 synthesis is glucocorticoid-dependant.13 There is a possibility that Piper sarmentosum extract might have inhibited the synthesis of 11β-HSD1 Inhibitors,research,lifescience,medical in the bones. Such an effects, however, was not seen in the groups supplemented with GCA. This could be due to repetitive stress, during which the inhibition of the 11β-HSD

1 synthesis is overcome, and return to basal level.28 Despite that, GCA is a known 11β-HSD1 inhibitor, was able to completely block 11β-HSD1 reductase activity,15 and caused to Inhibitors,research,lifescience,medical switch the enzyme activity from reductase to dehydrogenase. It would be interesting to look for the active component(s) of the Piper sarmentosum extract that has the inhibitory effect on the

activity and expression of 11β-HSD 1 enzyme. Conclusion From the results obtained, it can be concluded that Piper sarmentosum water extract is a potential 11β-HSD1 inhibitor that was able to switch the 11β-HSD1 action from reductase to dehydrogenase activity. This subsequently reduced the Inhibitors,research,lifescience,medical local availability of active glucocorticoids in the femur bone. As a potential inhibitor of 11β-HSD1 synthesis in the bone, Piper sarmentosum extract has the potential to act as a protective agent against glucocorticoid-induced osteoporosis. Acknowledgment This work was supported by a Research Grant (FF-03-FRGS0010-2007) from the Malaysian Ministry of Higher Education. The Inhibitors,research,lifescience,medical authors gratefully Inhibitors,research,lifescience,medical acknowledge the technical assistance of the staff of Anatomy and Pharmacology Department of Universiti

Kebangsaan Malaysia, especially Mrs Azizah Othman, Mrs Mazlidiyana and Mr Rafizul. Conflict of Interest: None declared
To provide effective health services, it is important to distinguish populations of people with Drug_discovery and without diseases. Accurate diagnosis of diseases is important for delivering the appropriate treatments, implementing preventive programs in the community, and finding the causes and etiology of diseases.1 Therefore, a special attention should be paid to the quality of diagnostic tests. Instead of reporting positive and negative results, a number of diagnostic tests report the values of measured variables. Thus, the determination of a twice cut-off point, which distinguishes patients and healthy individuals, is necessary. Cut-off point is an important and attractive issue in medical research. Since cut-off point has a great impact on decision making by clinicians, studies for the determination of cut-off points should be designed under special methodological considerations.