As A Biotherapeutic Agent In

Clinical Nutrition

As A Biotherapeutic Agent In

Clinical Nutrition

Microbial Cell PreparationMicrobial Cell Preparation

Efficacy EstablishedEfficacy Established

Scientifically Proven Safe For ConsumptionScientifically Proven Safe For Consumption

Palatable FlavourPalatable Flavour

No Reported Side EffectNo Reported Side Effect

Registered With National Pharmaceutical Registered With National Pharmaceutical

Control BureauControl Bureau

ABSORPTIONABSORPTION ABSORPTIONABSORPTION

CLINICALCLINICAL

NUTRITIONNUTRITIONCLINICALCLINICAL

NUTRITIONNUTRITION

IMPROVEIMPROVE

QOLQOLIMPROVEIMPROVE

QOLQOL

& Constipation

Pathophysiology ofPathophysiology ofConstipationConstipation

Aged Population

PregnantMothers

BedRiddenPatients

Premature Babies

Vulnerable Vulnerable GroupsGroups

Travelling Individual

Medication

Stress

Laxative Abuse

• Hemorrhoids • Anal fissure • Diarrhea • Fecal incontinence • Rectal bleeding

• Rectal prolapse • Rectal hernia• Fecal impaction • Uterine hernia • Uterine prolapse

Prolonged Constipation Prolonged Constipation

May Lead To:May Lead To:

www.wrongdiagnosis.com

Prolong Constipation:Prolong Constipation:HemorrhoidsHemorrhoids

Prolong Constipation:Prolong Constipation:HemorrhoidsHemorrhoids

Rectal ProlapseRectal ProlapseRectal ProlapseRectal Prolapse Rectal BleedingRectal BleedingRectal BleedingRectal Bleeding

Anal FissureAnal FissureAnal FissureAnal Fissure Uterine ProlapseUterine ProlapseUterine ProlapseUterine Prolapse

Hexbio Improves Chronic Constipation

Number of patients according to gender

The study of “Efficacy of in Improving Chronic Constipation” was conducted in 12 patients consisting of 5 males and 7 females. Figure shows the total of patients (N)

involved in the study according to gender.

The study of “Efficacy of in Improving Chronic Constipation” was conducted in 12 patients consisting of 5 males and 7 females. Figure shows the total of patients (N)

involved in the study according to gender.

Years of constipation

Age of patients

22 83

2 31

Chart shows the age of the patients ranging from 22 to 83 years old and the years each patients suffer from constipation ranging from 2 to 31 years.

Age of patients and years of constipation

years 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85

Results

Above graph shows the frequency of stools during the study period of 7 days. According to the results, stool frequency increased from 1.4 time a week before treatment to 4.3 a week after treatment. This indicates the efficacy of in increasing patients’ bowel

movement and reduces constipation.

Above graph shows the frequency of stools during the study period of 7 days. According to the results, stool frequency increased from 1.4 time a week before treatment to 4.3 a week after treatment. This indicates the efficacy of in increasing patients’ bowel

movement and reduces constipation.

Stool frequency per week

p = 0.001

Stool frequency

Role of Probiotic Mixture In Treatment Of Role of Probiotic Mixture In Treatment Of Childhood ConstipationChildhood Constipation

The probiotic mixture was contained Bifidobacterium and lactobacillus. Frequency of Bowel Movement (BM) per week in 20 children we tested. According to the chart, the

frequency of BMs in overall children increased in each week showing that the administration of probiotic mixture had a positive effect on frequency of BM.

The probiotic mixture was contained Bifidobacterium and lactobacillus. Frequency of Bowel Movement (BM) per week in 20 children we tested. According to the chart, the

frequency of BMs in overall children increased in each week showing that the administration of probiotic mixture had a positive effect on frequency of BM.

The role of probiotics mixture in the treatment of childhood constipation : a pilot study. Noor-L-Huada Bekkali, Marloes EJ Bongers, Maartje M Van den Berg, Olivia Liem and Marc A Benniga. Netherlands. Published in 4 August 2007.

2.0

4. 2 3.8

Frequency of Bowel MovementFrequency of Bowel Movement

A study to determine the prevalence of IBS and to assess the symptoms subgroups in young adult Malaysians was done. The results obtained had been categorized into few subgroups of symptoms as shown above. As conclusion, within the IBS population, the

majority (77.4%) was of the constipation-predominant IBS subgroup.

A study to determine the prevalence of IBS and to assess the symptoms subgroups in young adult Malaysians was done. The results obtained had been categorized into few subgroups of symptoms as shown above. As conclusion, within the IBS population, the

majority (77.4%) was of the constipation-predominant IBS subgroup.

Prevalence of irritable bowel syndrome in young adult Malaysians: A survey among medical students. Tan, Yan-mei; Goh, Khean L; Muhidayah, Raja; Ooi, Chee L; Salem, Omar. Department of Medicine, Faculty of Medicine, University of Malaya.

Prevalence of Irritable Bowel Syndrome on young adult. Prevalence of Irritable Bowel Syndrome on young adult. Malaysian: A survey among Medical StudentsMalaysian: A survey among Medical Students

HOW HELPCONSTIPATION???

Bekkali et. al. (2007). The role of probiotics mixture in the treatment of childhood constipation: a pilot study. Nutrition Journal 6: 17.

Secretes organic acids, maintaining acidic environment that induce peristalsis.

Regularize bowel movement and shortens the Colonic Transit Time.

Mechanism Mechanism of Actionof Action

Provide Provide AcidicAcidic

EnvironmentEnvironment

ShortenShortenColonic Transit Colonic Transit

TimeTime

Induce Induce PeristalsisPeristalsis

Increase Increase Bowel MovementBowel Movement

FrequencyFrequency

FacilitateFacilitateSmootherSmootherDefecationDefecation

& Diarrhea

Is Like A Storm Is Like A Storm Raging Inside Raging Inside

You & Its You & Its Shows Up At Shows Up At

The Most The Most Unexpected Unexpected

Time Time

Diarrhea

Frequent loose or liquid bowel movements, often due to disruption of water absorption in the colon

Defense Mechanism

In the event of pathogenic infection, diarrhea functions as an evolved expulsion defense mechanism.

The appendix serves as a safe house for the good bacteria, protecting it from contamination and facilitating a re-start of the system once the contaminating organisms has been eliminated.

Type Condition Caused Efficacy, HEXBIO®

Secretory Secretory DiarrheaDiarrhea

Increase secretion activity or inhibition of absorption.

1. Cholera toxin N.A.

Osmotic Osmotic DiarrheaDiarrhea

Too much of water is drawn into the bowel, maldigestion.

1. Osmotic laxatives2. Malabsorption3. Lactose

intolerance

Selective

Motility-Related Motility-Related DiarrheaDiarrhea

Rapid movement of food through the intestines (hypermotility).

1. Menstruation2. Hyperthyroidism

N.A.

Inflammatory Inflammatory DiarrheaDiarrhea

Damage to the mucosal lining, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids.

1. Bacterial/ viral/ parasitic infection

2. Inflammatory bowel disease

3. Antibiotic treatment

4. Colon cancer

Most

Types of DiarrheaTypes of Diarrhea

Treatment of Acute Gastroenteritis in Infants Treatment of Acute Gastroenteritis in Infants (6-12 months)(6-12 months)

Raanan Shamir et. al, Evaluation of a diet containing probiotics for the treatment of mild diarrheal illness in children younger than one year of age, American College of Nutrition 2005; 24(Suppl. 5):370-375

From the study, 65 young children aged 6-12 months, suffering from acute gastroenteritis were From the study, 65 young children aged 6-12 months, suffering from acute gastroenteritis were treated daily until diarrhea resolution. As showed in the result, the feeding of microbial cell treated daily until diarrhea resolution. As showed in the result, the feeding of microbial cell

preparation reduced the severity and duration of acute gastroenteritis in young children.preparation reduced the severity and duration of acute gastroenteritis in young children.

From the study, 65 young children aged 6-12 months, suffering from acute gastroenteritis were From the study, 65 young children aged 6-12 months, suffering from acute gastroenteritis were treated daily until diarrhea resolution. As showed in the result, the feeding of microbial cell treated daily until diarrhea resolution. As showed in the result, the feeding of microbial cell

preparation reduced the severity and duration of acute gastroenteritis in young children.preparation reduced the severity and duration of acute gastroenteritis in young children.

61 children that tested positive for rotavirus were treated with microbial cell 61 children that tested positive for rotavirus were treated with microbial cell preparation/placebo for 6 days. Stools were collected and examined again after 6 days of preparation/placebo for 6 days. Stools were collected and examined again after 6 days of treatment. In conclusion, oral administration of microbial cell preparation is effective in treatment. In conclusion, oral administration of microbial cell preparation is effective in

reducing the duration of rotavirus excretion. reducing the duration of rotavirus excretion.

61 children that tested positive for rotavirus were treated with microbial cell 61 children that tested positive for rotavirus were treated with microbial cell preparation/placebo for 6 days. Stools were collected and examined again after 6 days of preparation/placebo for 6 days. Stools were collected and examined again after 6 days of treatment. In conclusion, oral administration of microbial cell preparation is effective in treatment. In conclusion, oral administration of microbial cell preparation is effective in

reducing the duration of rotavirus excretion. reducing the duration of rotavirus excretion.

Guarino A et. al, Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea,Department of Pediatrics, University Federico II of Naples, Italy

The largest meta-analysis to evaluate 34 different clinical trials involving 4844 patients. 

Result:Reduced the likelihood of developing antibiotic-associated diarrhea by 52%.

Reduce Incidence of Reduce Incidence of Antibiotic Associated DiarrheaAntibiotic Associated Diarrhea

Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomized, placebo-controlled trials. Lancet Infect Dis. 2006;6:374-382.

Conclusion:

The benefits were most pronounced among children. 

An analysis to evaluate 34 different clinical trials involving 4844 patients. 

Result:Reduced the incidence of acute diarrhea by 34%. 

Review:In 12 pediatric studies included in this analysis, it reduced the likelihood of acute diarrhea in children by 57% (p<0.001)

Reduce Incidence of Acute DiarrheaReduce Incidence of Acute Diarrhea

Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomized, placebo-controlled trials. Lancet Infect Dis. 2006;6:374-382.

Conclusion:

The benefits were most pronounced among children. 

Combined Treatment (with ORS) of acute diarrhea in children

37 children aged 3 to 24 months received ORS as a form of rehydration, and were treated to microbial cell preparation at 12-hours interval until the resolution of diarrhea.

In conclusion, addition of microbial cell preparation to ORS was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea.

37 children aged 3 to 24 months received ORS as a form of rehydration, and were treated to microbial cell preparation at 12-hours interval until the resolution of diarrhea.

In conclusion, addition of microbial cell preparation to ORS was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea.

Simakachorn N. et. al, Clinical evaluation of the addition of lyophilized Lactobacillus LB to oral rehydration therapy in the treatment of acute diarrhea in children, Journal of Pediatric Gastroenterology and Nutrition 0277-2116

Hexbio® + ORS

Gilliland et. al. (2001). Health and nutritional properties of probiotics in foods including powder milk with live Lactic Acid Bacteria, WHO/FAO

HOW HELPDIARRHEA???

Mechanism of Action

Produce anti-microbial substances

Secretes lactase enzyme

Neutralize enterotoxins

from pathogen

Facilitate digestion of

lactose

Reduce rotavirus shedding

Suppress the replication of

virus

Neutralize enterotoxins from pathogens. Produce anti-microbial substances to

suppress the growth of pathogens. Reduce rotavirus shedding.

& Immunity

Common Cold – upper respiratory Common Cold – upper respiratory tract infection caused by either tract infection caused by either rhinoviruses or coronaviruses. rhinoviruses or coronaviruses.

Flu – infectious disease caused by Flu – infectious disease caused by Influenza viruses.Influenza viruses.

Cold and FluCold and Flu

HOW HELPto induce immunity???

Induces secretion of Immunoglobin A. Increase level of T-Lymphocyte cells as well as other

helper immune cells. Activate the human myeloid dendrite cell (MDC) to

induce immune response.

Mechanism of Action

Immunostimulation of mucosalmembrane

Increase Synthesis

of IgA

Increase Increase

T-LymphocytesT-LymphocytesActivate MDCActivate MDC

Stimulation of T-Lymphocyte LevelStimulation of T-Lymphocyte Level

125

90

0

20

40

60

80

100

120

140

T-Lymphocyte Level/10 pilli

Treatment Group Control Group

G. Perdigon et. al, Symposium: Probiotic bacteria for humans: Clinical systems for evaluation of effectiveness, Journal of Dairy Science

1995 78:1597-1606

Consumption of microbial cell preparation able to stimulate the level of T-Lymphocyte cells.

Reduction of Cold and Flu SymptomsReduction of Cold and Flu Symptoms

For 6 months, 326 children, aged 3 to 5 were For 6 months, 326 children, aged 3 to 5 were treated twice a day.treated twice a day.

Results:Results:

Probiotic Effects on cold and influenza-like symptom incidence and duration in children. American Academy of Pediatrics

Symptoms Incidence Rate

Treatment Group

Control Group

Cough 29.5% 83.7%

Fever 16.1% 63.5%

Microbial cell preparation reduces the incidence and severity of cold and flu symptoms in children.

& Other Diseases

STROKE

Chart shows the overall rates of complications in the Asian region. Among the non-neurologic complications, the most commonly encountered were chest infections, constipation and urinary retention with a rate of 19%, 15% and 11% respectively.

Chart shows the overall rates of complications in the Asian region. Among the non-neurologic complications, the most commonly encountered were chest infections, constipation and urinary retention with a rate of 19%, 15% and 11% respectively.

Complication of Acute Stroke : A study in Ten Asian countries. Jose C.Navvaro MD MSc et.al, Neurology Asia 2008; 13:33-39. University of Santo Thomas, Espana, Manila, Phillipines.

DIABETES

• Gastrointestinal Symptoms associated to Diabetic Complications.• Scientist state that 76% of DM patients undergo at least one

gastrointestinal problem and the majority of them suffer from constipation.• The percentage are as shown below:-

DIABETES

TYPE 1TYPE 1 Is a failure

of the pancreas to produce insulin

TYPE 2TYPE 2 Is insulin resistance

or impaired glucose tolerance

Diabetes Related GIT Symptoms

• Irritable Bowel Syndrome• Constipation• Dyschezia (Painful Defecation) • Diarrhea• Fecal incontinence• Dyspepsia

(Upset Stomach, Indigestion)• Nausea /vomiting• Heartburn

The chart pie above shows the prevalence of GI tract symptoms among patients The chart pie above shows the prevalence of GI tract symptoms among patients with DM type 1 compared to respective control. As showed above, the highest with DM type 1 compared to respective control. As showed above, the highest symptom stand of peripheral neuropathy for muscle numbness, continued by symptom stand of peripheral neuropathy for muscle numbness, continued by

dyspepsia and constipation which holds the third place with percentage of 16.7%.dyspepsia and constipation which holds the third place with percentage of 16.7%.

The chart pie above shows the prevalence of GI tract symptoms among patients The chart pie above shows the prevalence of GI tract symptoms among patients with DM type 1 compared to respective control. As showed above, the highest with DM type 1 compared to respective control. As showed above, the highest symptom stand of peripheral neuropathy for muscle numbness, continued by symptom stand of peripheral neuropathy for muscle numbness, continued by

dyspepsia and constipation which holds the third place with percentage of 16.7%.dyspepsia and constipation which holds the third place with percentage of 16.7%.

The chart pie above shows the prevalence of GI tract symptoms among patients The chart pie above shows the prevalence of GI tract symptoms among patients with DM type 2 compared to respective control. As showed above, the highest with DM type 2 compared to respective control. As showed above, the highest symptom is peripheral neuropathy with 51.6%, continued by heartburn 19.8%, symptom is peripheral neuropathy with 51.6%, continued by heartburn 19.8%,

dyspepsia 13.4% and constipation 10.1%.dyspepsia 13.4% and constipation 10.1%.

The chart pie above shows the prevalence of GI tract symptoms among patients The chart pie above shows the prevalence of GI tract symptoms among patients with DM type 2 compared to respective control. As showed above, the highest with DM type 2 compared to respective control. As showed above, the highest symptom is peripheral neuropathy with 51.6%, continued by heartburn 19.8%, symptom is peripheral neuropathy with 51.6%, continued by heartburn 19.8%,

dyspepsia 13.4% and constipation 10.1%.dyspepsia 13.4% and constipation 10.1%.

COLON CANCER

DEFECATION.. Is not evaluated

according to HOW MANY times

we defecate..

It is evaluated according to the

TYPES of stool that been eliminated..

Types of Stool

Evaluation Of Stool

Constipation

Normal

Diarrhea

Bristol Stool Chart

Bowel Movement (BM) Frequency and Risk of Colorectal Cancer in a Large Cohort Study of Japanese Men and Women

IRR

BM

Above chart shows the average Incidence Rate Ratios (IRR) for colorectal and colon cancer according Above chart shows the average Incidence Rate Ratios (IRR) for colorectal and colon cancer according to BM frequency. As shown, it is the best to have BM every 2-3 days as it shows the lowest IRR. Too to BM frequency. As shown, it is the best to have BM every 2-3 days as it shows the lowest IRR. Too often of BM per day can cause higher risk of colon and colorectal cancer. This is the same with BM often of BM per day can cause higher risk of colon and colorectal cancer. This is the same with BM

every 6 days or less which has IRR of 1.81 average for both men and women.every 6 days or less which has IRR of 1.81 average for both men and women.

Above chart shows the average Incidence Rate Ratios (IRR) for colorectal and colon cancer according Above chart shows the average Incidence Rate Ratios (IRR) for colorectal and colon cancer according to BM frequency. As shown, it is the best to have BM every 2-3 days as it shows the lowest IRR. Too to BM frequency. As shown, it is the best to have BM every 2-3 days as it shows the lowest IRR. Too often of BM per day can cause higher risk of colon and colorectal cancer. This is the same with BM often of BM per day can cause higher risk of colon and colorectal cancer. This is the same with BM

every 6 days or less which has IRR of 1.81 average for both men and women.every 6 days or less which has IRR of 1.81 average for both men and women.

British Journal of Cancer (2004) 90, 1397-1401

Colon CancerColon Cancer

SafetySafety

Acute Oral Toxicity Test for Hexbio was done in TÜV SÜD PSB Singapore to find out the Adverse Effect of Hexbio.

Necropsy Result shows there is no weight & colour change of the liver.

SafetySafetySafetySafety

Nutrition Fact

Content Unit

Protein gram per sachet 0.16

Fat gram per sachet 0

Fiber gram per sachet 0

Carbohydrate gram per sachet 2.7

Calories gram per sachet 11.6

* Hexbio* Hexbio®® is safe for all type of patients’ consumption since the Carbohydrate and the Calories are in the safe range for everybody

SleepingSleeping

ActivityActivity

AppetiteAppetite

PsychologyPsychology

Hexbio In Balancing QOLHexbio In Balancing QOL

When there is Constipation; Diarrhea; Cold or FluWhen there is Constipation; Diarrhea; Cold or Flu

Our normal daily activities (as mentioned) will be disturbed.Our normal daily activities (as mentioned) will be disturbed.

Hexbio is here to overcome the symptoms and improve the Quality of Life!Hexbio is here to overcome the symptoms and improve the Quality of Life!

HOW TO USE ?HOW TO USE ?

WHEN TO USE ?WHEN TO USE ?

Consume:1 sachet during each meal

• Breakfast Breakfast • DinnerDinner

As a good treatment; For good absorption of nutrients;

and for faster recovery

Hexbio can function at BOTH small intestine & large intestine

2. Liquid Dose

1 sachet (3g) to 5ml water/juices/energy drinks/milk

Pour 1 sachet into 5ml water

Stir to mix Feed using syringe

1. Oral Dose

Consume 2 sachets during Breakfast & Dinner eachby directly pour into the mouth

DosageDosage

Before any patient

been discharged, it

is very important

for a Medical

Practitioner to

ensure that the

patient’s bowel

movement is

smooth and able to

have good

absorption of

nutrient, for a

promising

RECOVERY!

Thank You!Thank You!

B-CROBES MARKETING (M) SDN. BHD.B-CROBES MARKETING (M) SDN. BHD.