Browse publications by year: 2016

  1. Norhalini Hamzah, Majdiah Syahirah Nasir, Mohd Basri Mat Nor, Azrina Md Ralib
    MyJurnal
    Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid
    balance in critically ill patients. The postulated mechanism of harm is the development of interstitial
    oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positive fluid
    balance within the first 48 hours on mortality in our local ICU population. Methods: This was a secondary
    analysis of a single centre, prospective observational study. All ICU patients more than 18 years were
    screened for inclusion in the study. Admission of less than 48 hours, post-elective surgery and ICU
    readmission were excluded. Cumulative fluid balance either as volume or percentage of body weight from
    admission was calculated over 6, 24 and 48 hour period from ICU admission. Results: A total of 143 patients
    were recruited, of these 33 died. There were higher cumulative fluid balances at 6, 24 and 48 hours in nonsurvivors
    compared to survivors. However, after adjusted for severity of illness, APACHE II Score, they were
    not predictive of mortality. Sensitivity analysis on sub-cohort of patients with acute kidney injury (AKI)
    showed only an actual 48-hour cumulative fluid balance was independently predictive of mortality (1.21
    (1.03 to 1.42)). Conclusions: Cumulative fluid balance was not independently predictive of mortality in a
    heterogenous group of critically ill patients. However, in subcohort of patients with AKI, a 48-hour
    cumulative fluid balance was independently predictive of mortality. An additional tile is thus added to the
    mosaic of findings on the impact of fluid balance in a hetergenous group of critically ill patients, and in subcohort
    of AKI patients.
    MeSH terms: Body Weight; Edema; Humans; Intensive Care Units; Patient Readmission; Prospective Studies; Water-Electrolyte Balance; Critical Illness; Survivors; APACHE; Acute Kidney Injury
  2. Zahari M, Lee DS, Darlow BA
    J Clin Monit Comput, 2016 Oct;30(5):669-78.
    PMID: 26282827 DOI: 10.1007/s10877-015-9752-1
    The displayed readings of Masimo pulse oximeters used in the Benefits Of Oxygen Saturation Targeting (BOOST) II and related trials in very preterm babies were influenced by trial-imposed offsets and an artefact in the calibration software. A study was undertaken to implement new algorithms that eliminate the effects of offsets and artefact. In the BOOST-New Zealand trial, oxygen saturations were averaged and stored every 10 s up to 36 weeks' post-menstrual age. Two-hundred and fifty-seven of 340 babies enrolled in the trial had at least two weeks of stored data. Oxygen saturation distribution patterns corresponding with a +3 % or -3 % offset in the 85-95 % range were identified together with that due to the calibration artefact. Algorithms involving linear and quadratic interpolations were developed, implemented on each baby of the dataset and validated using the data of a UK preterm baby, as recorded from Masimo oximeters with the original software and a non-offset Siemens oximeter. Saturation distributions obtained were compared for both groups. There were a flat region at saturations 85-87 % and a peak at 96 % from the lower saturation target oximeters, and at 93-95 and 84 % respectively from the higher saturation target oximeters. The algorithms lowered the peaks and redistributed the accumulated frequencies to the flat regions and artefact at 87-90 %. The resulting distributions were very close to those obtained from the Siemens oximeter. The artefact and offsets of the Masimo oximeter's software had been addressed to determine the true saturation readings through the use of novel algorithms. The implementation would enable New Zealand data be included in the meta-analysis of BOOST II trials, and be used in neonatal oxygen studies.
    MeSH terms: Algorithms*; Calibration; Female; Humans; Infant, Newborn; Infant, Premature; Male; New Zealand; Oximetry/methods*; Oxygen/metabolism; Retinopathy of Prematurity/metabolism*; Software; Reproducibility of Results; Linear Models; Artifacts
  3. Azizan A, Justine M
    J Gerontol Nurs, 2016 Feb;42(2):45-54.
    PMID: 26651863 DOI: 10.3928/00989134-20151124-01
    Sedentary behavior and low participation in exercise among older adults can lead to depression and low quality of life (QOL). The current study investigated the effects of behavioral and exercise programs on depression severity and QOL among Malaysian community-dwelling older adults. A controlled, quasi-experimental, pre-posttest design was used. A total of 63 participants were divided into three groups: (a) exercise and behavior group (EBG), (b) exercise only group (EG), and (c) control group (CG). Results showed a significant difference in depression among groups (F(2,58) = 33.49, p < 0.01, η(2) = 0.54; mean, EBG < EG < CG) and in physical (F(2,58) = 5.33, p < 0.01, η(2)= 0.16; mean, EBG > EG > CG) and mental (F(2,58) = 4.08, p < 0.01, η(2) = 0.12; mean, EBG > CG > EG) scores of QOL. A combination of behavioral and exercise programs has superior effects on depression and QOL of older adults. [Journal of Gerontological Nursing, 42(2), 45-54.].
    MeSH terms: Aged; Behavior Therapy*; Depression/prevention & control*; Humans; Malaysia; Quality of Life*; Exercise*
  4. Dianawati D, Mishra V, Shah NP
    J Food Sci, 2016 Jun;81(6):M1472-9.
    PMID: 27145163 DOI: 10.1111/1750-3841.13313
    Production of probiotic food supplements that are shelf-stable at room temperature has been developed for consumer's convenience, but information on the stability in acid and bile environment is still scarce. Viability and acid and bile tolerance of microencapsulated Bifidobacterium spp. and Lactobacillus acidophilus and 4 commercial probiotic supplements were evaluated. Bifidobacterium and L. acidophilus were encapsulated with casein-based emulsion using spray drying. Water activity (aw ) of the microspheres containing Bifidobacterium or L. acidophilus (SD GM product) was adjusted to 0.07 followed by storage at 25 °C for 10 wk. Encapsulated Bifidobacterium spp. and Lactobacillus acidophilus and 4 commercial probiotic supplement products (AL, GH, RE, and BM) were tested. Since commercial probiotic products contained mixed bacteria, selective media MRS-LP (containing L-cysteine and Na-propionate) and MRS-clindamycin agar were used to grow Bifidobacterium spp. or L. acidophilus, respectively, and to inhibit the growth of other strains. The results showed that aw had a strong negative correlation with the viability of dehydrated probiotics of the 6 products. Viable counts of Bifidobacterium spp. and L. acidophilus of SD GM, AL, and GH were between 8.3 and 9.2 log CFU/g, whereas that of BM and RE were between 6.7 and 7.3 log CFU/g. Bifidobacterium in SD GM, in AL, and in GH products and L. acidophilus in SD GM, in AL, and in BM products demonstrated high tolerance to acid. Most of dehydrated probiotic bacteria were able to survive in bile environment except L. acidophilus in RE product. Exposure to gastric juice influenced bacterial survivability in subsequent bile environment.
    MeSH terms: Agar; Bifidobacterium/drug effects; Bifidobacterium/growth & development*; Bile*; Bile Acids and Salts/pharmacology; Commerce; Desiccation/methods*; Drug Compounding; Drug Storage; Gastric Juice; Humans; Lactobacillus acidophilus/drug effects; Lactobacillus acidophilus/growth & development*; Temperature*; Water; Probiotics*; Gastrointestinal Tract*
  5. Khayi S, Cigna J, Chong TM, Quêtu-Laurent A, Chan KG, Hélias V, et al.
    Int J Syst Evol Microbiol, 2016 Dec;66(12):5379-5383.
    PMID: 27692046 DOI: 10.1099/ijsem.0.001524
    Pectobacterium wasabiae was originally isolated from Japanese horseradish (Eutrema wasabi), but recently some Pectobacterium isolates collected from potato plants and tubers displaying blackleg and soft rot symptoms were also assigned to P. wasabiae. Here, combining genomic and phenotypical data, we re-evaluated their taxonomic position. PacBio and Illumina technologies were used to complete the genome sequences of P. wasabiae CFBP 3304T and RNS 08-42-1A. Multi-locus sequence analysis showed that the P. wasabiae strains RNS 08-42-1A, SCC3193, CFIA1002 and WPP163, which were collected from potato plant environment, constituted a separate clade from the original Japanese horseradish P. wasabiae. The taxonomic position of these strains was also supported by calculation of the in-silico DNA-DNA hybridization, genome average nucleotide indentity, alignment fraction and average nucleotide indentity values. In addition, they were phenotypically distinguished from P. wasabiae strains by producing acids from (+)-raffinose, α-d(+)-α-lactose, d(+)-galactose and (+)-melibiose but not from methyl α-d-glycopyranoside, (+)-maltose or malonic acid. The name Pectobacterium parmentieri sp. nov. is proposed for this taxon; the type strain is RNS 08-42-1AT (=CFBP 8475T=LMG 29774T).
    MeSH terms: DNA, Bacterial/genetics; Genes, Bacterial; Nucleic Acid Hybridization; Phylogeny*; Plant Diseases/microbiology*; Solanum tuberosum/microbiology*; Bacterial Typing Techniques; Pectobacterium/classification*
  6. Nhu TT, Schaubroeck T, Henriksson PJG, Bosma R, Sorgeloos P, Dewulf J
    Environ Pollut, 2016 Dec;219:156-165.
    PMID: 27814531 DOI: 10.1016/j.envpol.2016.10.006
    Pangasius production in Vietnam is widely known as a success story in aquaculture, the fastest growing global food system because of its tremendous expansion by volume, value and the number of international markets to which Pangasius has been exported in recent years. While certification schemes are becoming significant features of international fish trade and marketing, an increasing number of Pangasius producers have followed at least one of the certification schemes recognised by international markets to incorporate environmental and social sustainability practices in aquaculture, typically the Pangasius Aquaculture Dialogue (PAD) scheme certified by the Aquaculture Stewardship Council (ASC). An assessment of the environmental benefit of applying certification schemes on Pangasius production, however, is still needed. This article compared the environmental impact of ASC-certified versus non-ASC certified intensive Pangasius aquaculture, using a statistically supported LCA. We focused on both resource-related (water, land and total resources) and emissions-related (global warming, acidification, freshwater and marine eutrophication) categories. The ASC certification scheme was shown to be a good approach for determining adequate environmental sustainability, especially concerning emissions-related categories, in Pangasius production. However, the non-ASC certified farms, due to the large spread, the impact (e.g., water resources and freshwater eutrophication) was possibly lower for a certain farm. However, this result was not generally prominent. Further improvements in intensive Pangasius production to inspire certification schemes are proposed, e.g., making the implementation of certification schemes more affordable, well-oriented and facilitated; reducing consumed feed amounts and of the incorporated share in fishmeal, especially domestic fishmeal, etc. However, their implementation should be vetted with key stakeholders to assess their feasibility.
    MeSH terms: Animals; Animal Feed; Catfishes; Certification; Environment*; Environmental Exposure; Eutrophication; Fisheries/standards*; Fresh Water/chemistry; Hydrogen-Ion Concentration; Legislation, Food/trends*; Vietnam; Water Pollutants, Chemical/adverse effects; Water Pollutants, Chemical/toxicity*; Seafood; Uncertainty; Global Warming; Waste Water/chemistry
  7. Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Nurul F, Kanagasingam S, Franklin D, et al.
    J Forensic Leg Med, 2016 Nov;44:178-182.
    PMID: 27821308 DOI: 10.1016/j.jflm.2016.10.013
    Different non-invasive methods have been proposed for dental age estimation in adults, with the Kvaal et al. method as one of the more frequently tested in different populations. The purpose of this study was to apply the Kvaal et al. method for dental age estimation on modern volumetric data from 3D digital systems. To this end, 101 CBCT images from a Malaysian population were used. Fifty-five per cent were female (n = 55), and forty-five percent were male (n = 46), with a median age of 31 years for both sexes. As tomographs allow the observer to obtain a sagittal and coronal view of the teeth, the Kvaal pulp/root width measurements and ratios were calculated in the bucco-lingual and mesio-distal aspects of the tooth. From these data different linear regression models and formulae were built. The most accurate models for estimating age were obtained from a diverse combination of measurements (SEE ±10.58 years), and for the mesio-distal measurements of the central incisor at level A (SEE ±12.84 years). This accuracy, however is outside an acceptable range in for forensic application (SEE ±10.00 years), and is also more time consuming than the original approach based on dental radiographs.
    MeSH terms: Adolescent; Adult; Age Determination by Teeth/methods*; Aged; Female; Humans; Male; Maxilla; Middle Aged; Odontometry; Linear Models; Imaging, Three-Dimensional; Cone-Beam Computed Tomography*; Young Adult
  8. Tey NP, Lai SL, Teh JK
    Maturitas, 2016 Dec;94:39-45.
    PMID: 27823743 DOI: 10.1016/j.maturitas.2016.08.016
    OBJECTIVES: The aims of this study were to assess the current sharp rise in chronic diseases and disabilities with advancing age, and to examine the debilitating effects of chronic diseases among the oldest old in China.

    STUDY DESIGN AND OUTCOME VARIABLES: This study used data from four waves of the Chinese Longitudinal Health and Longevity Survey (CLHLS) conducted in 2002, 2005, 2008 and 2011. The sample comprised 2137 older adults who were interviewed in 2002 and re-interviewed in the following waves. Cross-tabulations were run to show the rise in chronic disease and disability with age. Ordinal logistic regression was run to examine the debilitating effects of these diseases in terms of the ability of the oldest old to perform activities of daily living.

    RESULTS: The prevalence of chronic diseases rose sharply with age. The prevalence rate of six major diseases increased between 38% (respiratory diseases) and 533% (neurological disorder) among respondents who were re-interviewed nine years later. Cardiovascular diseases were the most common. Neurological disorder and cancer were less common, but had the most debilitating effects on patients. Overall, 10.0%, 3.1% and 3.1% of the respondents were disabled by cardiovascular, musculoskeletal and sensorial diseases, respectively. Ordinal logistic regression showed that neurological disorder had the strongest debilitating effects, followed by musculoskeletal and cardiovascular diseases among 2137 older persons who had survived and were followed up from the base year (2002) through 2011.

    CONCLUSION: The rapid rise in chronic diseases has resulted in an increased burden of disability among the oldest old in China. There is a need to improve health care systems for the prevention and management of chronic diseases.

    MeSH terms: Activities of Daily Living*; Aged; Aged, 80 and over; China/epidemiology; Chronic Disease/epidemiology*; Disability Evaluation; Female; Disabled Persons/statistics & numerical data; Health Surveys; Humans; Longevity*; Longitudinal Studies; Male; Middle Aged; Prevalence
  9. Law JX, Liau LL, Aminuddin BS, Ruszymah BH
    Int J Pediatr Otorhinolaryngol, 2016 Dec;91:55-63.
    PMID: 27863642 DOI: 10.1016/j.ijporl.2016.10.012
    Tracheal replacement is performed after resection of a portion of the trachea that was impossible to reconnect via direct anastomosis. A tissue-engineered trachea is one of the available options that offer many advantages compared to other types of graft. Fabrication of a functional tissue-engineered trachea for grafting is very challenging, as it is a complex organ with important components, including cartilage, epithelium and vasculature. A number of studies have been reported on the preparation of a graftable trachea. A laterally rigid but longitudinally flexible hollow cylindrical scaffold which supports cartilage and epithelial tissue formation is the key element. The scaffold can be prepared via decellularization of an allograft or fabricated using biodegradable or non-biodegradable biomaterials. Commonly, the scaffold is seeded with chondrocytes and epithelial cells at the outer and luminal surfaces, respectively, to hasten tissue formation and improve functionality. To date, several clinical trials of tracheal replacement with tissue-engineered trachea have been performed. This article reviews the formation of cartilage tissue, epithelium and neovascularization of tissue-engineered trachea, together with the obstacles, possible solutions and future. Furthermore, the role of the bioreactor for in vitro tracheal graft formation and recently reported clinical applications of tracheal graft were also discussed. Generally, although encouraging results have been achieved, however, some obstacles remain to be resolved before the tissue-engineered trachea can be widely used in clinical settings.
    MeSH terms: Animals; Biocompatible Materials; Cartilage/physiology*; Epithelial Cells/transplantation*; Humans; Neovascularization, Physiologic; Chondrocytes/transplantation*; Respiratory Mucosa/physiology*; Tissue Engineering/methods*; Tissue Culture Techniques; Tissue Scaffolds
  10. Wan Hassan WN, Othman SA, Chan CS, Ahmad R, Ali SN, Abd Rohim A
    Am J Orthod Dentofacial Orthop, 2016 Nov;150(5):886-895.
    PMID: 27871715 DOI: 10.1016/j.ajodo.2016.04.021
    INTRODUCTION: In this study we aimed to compare measurements on plaster models using a digital caliper, and on 3-dimensional (3D) digital models, produced using a structured-light scanner, using 3D software.

    METHODS: Fifty digital models were scanned from the same plaster models. Arch and tooth size measurements were made by 2 operators, twice. Calibration was done on 10 sets of models and checked using the Pearson correlation coefficient. Data were analyzed by error variances, repeatability coefficient, repeated-measures analysis of variance, and Bland-Altman plots.

    RESULTS: Error variances ranged between 0.001 and 0.044 mm for the digital caliper method, and between 0.002 and 0.054 mm for the 3D software method. Repeated-measures analysis of variance showed small but statistically significant differences (P <0.05) between the repeated measurements in the arch and buccolingual planes (0.011 and 0.008 mm, respectively). There were no statistically significant differences between methods and between operators. Bland-Altman plots showed that the mean biases were close to zero, and the 95% limits of agreement were within ±0.50 mm. Repeatability coefficients for all measurements were similar.

    CONCLUSIONS: Measurements made on models scanned by the 3D structured-light scanner were in good agreement with those made on conventional plaster models and were, therefore, clinically acceptable.

    MeSH terms: Computer Simulation*; Dental Arch/anatomy & histology; Dental Models*; Humans; Odontometry/instrumentation; Software; Tooth/anatomy & histology; Imaging, Three-Dimensional; Cone-Beam Computed Tomography
  11. Ng CW, How CH, Ng YP
    Singapore Med J, 2016 Nov;57(11):591-597.
    PMID: 27872937 DOI: 10.11622/smedj.2016174
    Major depression is a common condition seen in the primary care setting, often presenting with somatic symptoms. It is potentially a chronic illness with considerable morbidity, and a high rate of relapse and recurrence. Major depression has a bidirectional relationship with chronic diseases, and a strong association with increased age and coexisting mental illnesses (e.g. anxiety disorders). Screening can be performed using clinical tools for major depression, such as the Patient Health Questionaire-2, Patient Health Questionaire-9 and Beck Depression Inventory, so that timely treatment can be initiated. An accurate diagnosis of major depression and its severity is essential for prompt treatment to reduce morbidity and mortality. This is the first of a series of articles that illustrates the approach to the management of major depression in primary care. Our next articles will cover suicide risk assessment in a depressed patient and outline the basic principles of management and treatment modalities.
    MeSH terms: Chronic Disease; Depressive Disorder, Major/complications*; Depressive Disorder, Major/diagnosis*; Disabled Persons; Humans; Mass Screening; Primary Health Care/methods*; Psychometrics; Surveys and Questionnaires; Recurrence; Suicide/prevention & control; Risk Assessment
  12. Iversen OE, Miranda MJ, Ulied A, Soerdal T, Lazarus E, Chokephaibulkit K, et al.
    JAMA, 2016 12 13;316(22):2411-2421.
    PMID: 27893068 DOI: 10.1001/jama.2016.17615
    Human papillomavirus (HPV) infections cause anogenital cancers and warts. The 9-valent HPV vaccine provides protection against 7 high-risk types of HPV responsible for 90% of cervical cancers and 2 other HPV types accounting for 90% of genital warts.
    MeSH terms: Adolescent; Adult; Age Factors; Antibody Specificity; Child; Female; Genotype; Humans; Immunization Schedule*; Male; Sex Factors; Time Factors; Cohort Studies; Papillomaviridae/genetics; Papillomaviridae/immunology; Papillomavirus Infections/prevention & control*; Papillomavirus Vaccines/administration & dosage*; Papillomavirus Vaccines/adverse effects; Papillomavirus Vaccines/immunology*; Young Adult; Elder Nutritional Physiological Phenomena
  13. Suhaimi MZ, Sanip Z, Jan HJ, Yusoff HM
    Ann Saudi Med, 2016;36(6):404-408.
    PMID: 27920412
    BACKGROUND: Exposure to nicotine via tobacco smoking may influence leptin release and decrease food intake among smokers. However, the effect of nicotine exposure on leptin and food intake among different nicotine dependent groups is unclear.

    OBJECTIVE: We aimed to measure leptin and calorie intake among different nicotine dependent groups.

    DESIGN: Cross-sectional study.

    SETTING: Research department in school of medical sciences.

    PATIENTS AND METHODS: Subjects were selected by purposive (non-probability) sampling and categorized as having low, moderate and high nicotine dependency based on the Fagerstrom Test for Nicotine Dependence (FTND) score. Diet was recorded by interview. Anthropometry, blood pressure, body composition, lipid profile, and physical activity level were measured accordingly. Fasting serum leptin was measured using a commercial ELISA kit.

    MAIN OUTCOME MEASURE(S): Nicotine dependency, 24-hour diet, clinical anthropometric and clinical measurements.

    RESULTS: In 107 Malay male smokers leptin concentration was inversely correlated with nicotine dependence. However, body weight, smoking period, blood pressure, body composition, lipid profile and physical activity level were not significantly different among low, moderately and highly dependent smoking groups. Leptin concentration and total calorie intake were also not significantly different among these groups.

    CONCLUSION: Leptin concentration was inversely correlated with nicotine dependence, but leptin concentration and total calorie intake status were not significantly different among our different nicotine dependency subjects.

    LIMITATIONS: Purposive sampling for subject recruitment and inaccurate information in the self-administered questionnaire.

    MeSH terms: Adult; Anthropometry; Blood Pressure; Body Composition/drug effects; Energy Intake/drug effects*; Cross-Sectional Studies; Female; Humans; Lipids/blood; Male; Middle Aged; Nicotine/adverse effects*; Smoking/blood; Smoking/physiopathology; Tobacco Use Disorder/blood*; Tobacco Use Disorder/physiopathology; Exercise; Leptin/administration & dosage*; Leptin/blood
  14. Eachempati P, Kiran Kumar KS, Sumanth KN
    Indian J Pharmacol, 2016 Oct;48(Suppl 1):S25-S28.
    PMID: 28031603 DOI: 10.4103/0253-7613.193315
    OBJECTIVES: Blended learning has become the method of choice in educational institutions because of its systematic integration of traditional classroom teaching and online components. This study aims to analyze student's reflection regarding blended learning in dental pharmacology.

    SUBJECTS AND METHODS: A cross-sectional study was conducted in Faculty of Dentistry, Melaka-Manipal Medical College among 3(rd) and 4(th) year BDS students. A total of 145 dental students, who consented, participate in the study. Students were divided into 14 groups. Nine online sessions followed by nine face-to-face discussions were held. Each session addressed topics related to oral lesions and orofacial pain with pharmacological applications. After each week, students were asked to reflect on blended learning. On completion of 9 weeks, reflections were collected and analyzed.

    STATISTICAL ANALYSIS: Qualitative analysis was done using thematic analysis model suggested by Braun and Clarke.

    RESULTS: The four main themes were identified, namely, merits of blended learning, skill in writing prescription for oral diseases, dosages of drugs, and identification of strengths and weakness. In general, the participants had a positive feedback regarding blended learning. Students felt more confident in drug selection and prescription writing. They could recollect the doses better after the online and face-to-face sessions. Most interestingly, the students reflected that they are able to identify their strength and weakness after the blended learning sessions.

    CONCLUSIONS: Blended learning module was successfully implemented for reinforcing dental pharmacology. The results obtained in this study enable us to plan future comparative studies to know the effectiveness of blended learning in dental pharmacology.

    MeSH terms: Education, Dental/methods*; Facial Pain/drug therapy; Humans; Learning*; Online Systems; Pharmacology, Clinical/education*; Drug Prescriptions; Students, Dental*; Oral Ulcer/drug therapy
  15. Shankar PR, Herz BL, Dubey AK, Hassali MA
    Indian J Pharmacol, 2016 Oct;48(Suppl 1):S29-S32.
    PMID: 28031604 DOI: 10.4103/0253-7613.193309
    OBJECTIVE: Use of generic medicines is important to reduce rising health-care costs. Proper knowledge and perception of medical students and doctors toward generic medicines are important. Xavier University School of Medicine in Aruba admits students from the United States, Canada, and other countries to the undergraduate medical (MD) program. The present study was conducted to study the knowledge and perception about generic medicines among basic science MD students.

    MATERIALS AND METHODS: The cross-sectional study was conducted among first to fifth semester students during February 2015. A previously developed instrument was used. Basic demographic information was collected. Respondent's agreement with a set of statements was noted using a Likert-type scale. The calculated total score was compared among subgroups of respondents. One sample Kolmogorov-Smirnov test was used to study the normality of distribution, Independent samples t-test to compare the total score for dichotomous variables, and analysis of variance for others were used for statistical analysis.

    RESULTS: Fifty-six of the 85 students (65.8%) participated. Around 55% of respondents were between 20 and 25 years of age and of American nationality. Only three respondents (5.3%) provided the correct value of the regulatory bioequivalence limits. The mean total score was 43.41 (maximum 60). There was no significant difference in scores among subgroups.

    CONCLUSIONS: There was a significant knowledge gap with regard to the regulatory bioequivalence limits for generic medicines. Respondents' level of knowledge about other aspects of generic medicines was good but could be improved. Studies among clinical students in the institution and in other Caribbean medical schools are required. Deficiencies were noted and we have strengthened learning about generic medicines during the basic science years.

    MeSH terms: Adult; Education, Medical, Undergraduate; Female; Humans; Health Knowledge, Attitudes, Practice*; Male; Netherlands; Perception; Students, Medical*; Drugs, Generic*; Young Adult
  16. Gubbiyappa KS, Barua A, Das B, Vasudeva Murthy CR, Baloch HZ
    Indian J Pharmacol, 2016 Oct;48(Suppl 1):S41-S46.
    PMID: 28031607 DOI: 10.4103/0253-7613.193313
    OBJECTIVES: Flipped classroom (FC) is a pedagogical model to engage students in learning process by replacing the didactic lectures. Using technology, lectures are moved out of the classroom and delivered online as means to provide interaction and collaboration. Poll Everywhere is an audience response system (ARS) which can be used in an FC to make the activities more interesting, engaging, and interactive. This study aims to study the perception of undergraduate pharmacy students on FC activity using Poll Everywhere ARS and to study the effectiveness of FC activity as a teaching-learning tool for delivering complementary medicine module in the undergraduate pharmacy program.

    MATERIALS AND METHODS: In this nonrandomized trial on interrupted time series study, flipped class was conducted on group of 112 students of bachelor of pharmacy semester V. The topic selected was popular herbal remedies of the complementary medicine module. Flipped class was conducted with audio and video presentation in the form of a quiz using ten one-best-answer type of multiple-choice questions covering the learning objectives. Audience response was captured using web-based interaction with Poll Everywhere. Feedback was obtained from participants at the end of FC activity and debriefing was done.

    RESULTS: Randomly selected 112 complete responses were included in the final analysis. There were 47 (42%) male and 65 (58%) female respondents. The overall Cronbach's alpha of feedback questionnaire was 0.912. The central tendencies and dispersions of items in the questionnaire indicated the effectiveness of FC. The low or middle achievers of quiz session (pretest) during the FC activity were three times (95% confidence interval [CI] = 1.1-8.9) at the risk of providing neutral or negative feedback than high achievers (P = 0.040). Those who gave neutral or negative feedback on FC activity were 3.9 times (95% CI = 1.3-11.8) at the risk of becoming low or middle achievers during the end of semester examination (P = 0.013). The multivariate analysis of "Agree" or "Disagree" and "Agree" or "Strongly Agree" was statistically significant.

    CONCLUSION: This study provides insight on how the pharmacy students learn and develop their cognitive functions. The results revealed that the FC activity with Poll Everywhere is an effective teaching-learning method.

    MeSH terms: Cognition; Education, Pharmacy/methods*; Educational Measurement; Female; Humans; Male; Perception; Surveys and Questionnaires*; Software*; Students, Pharmacy; Teaching; Herbal Medicine/education
  17. Sahoo HB, Sagar R, Kumar A, Bhaiji A, Bhattamishra SK
    Biomed J, 2016 Dec;39(6):376-381.
    PMID: 28043416 DOI: 10.1016/j.bj.2016.11.003
    BACKGROUND: Apium leptophyllum (Pers.) is an annual herb with traditional appreciation for various pharmacological properties; however, the scientific information on this herb is insufficient. The aim of the present investigation was undertaken to evaluate flavonoidal fraction of A. leptophyllum fruit (FFALF) against diarrhoea on albino rats.

    METHODS: The antidiarrhoeal study was conducted by castor oil induce diarrhoea, prostaglandin E2 (PGE2) induced enteropooling and intestinal transit by charcoal meal test. The rats were divided into five groups (six/group). Group I served as control and received orally 2% acacia suspension; Group II served as standard and received orally loperamide (3 mg/kg) or atropine sulphate (5 mg/kg); Group III, IV and V served as test groups and received the FFALF at doses of 5, 10 and 20 mg/kg orally, respectively.

    RESULTS: In castor oil-induced diarrhoeal model, the FFALF significantly (p 

    MeSH terms: Sodium-Potassium-Exchanging ATPase/metabolism*; Animals; Antidiarrheals/therapeutic use*; Diarrhea/chemically induced; Diarrhea/drug therapy*; Disease Models, Animal; Female; Gastrointestinal Motility/drug effects*; Male; Nitrous Oxide/metabolism; Plant Extracts/therapeutic use*; Apiaceae/chemistry*; Rats
  18. Hanizah N, Affirul CA, Farah NA, Shamila MA, Ridzuan MI
    Clin Ter, 2016 Nov-Dec;167(6):182-184.
    PMID: 28051822 DOI: 10.7417/CT.2016.1969
    Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Early recognition and timely intervention with the correct treatment are crucial particularly preventing airway obstruction. New disease specific treatment including plasma derived or recombinant C1-INH, ecallantide and icatibant have recently emerged and its appropriate use can reduce HAE-associated mortality and morbidity. However due to its costs, these disease specific treatments have yet to reach Malaysia. Despite that no randomized clinical trial on FFP has been performed, its efficacy in treating acute attacks of HAE is only demonstrated in case studies. This case report illustrates the successful treatment of acute HAE episode with FFP in a Malaysian government hospital setting.
    MeSH terms: Blood Coagulation/drug effects; Bradykinin/administration & dosage; Bradykinin/analogs & derivatives*; Cold Temperature; Humans; Malaysia; Peptides/administration & dosage*; Cryopreservation*; Disease Management; Angioedemas, Hereditary/drug therapy*
  19. Seong CL, Shanmuganathan M
    Indian J Pharmacol, 2016 Nov-Dec;48(6):739-740.
    PMID: 28066119 DOI: 10.4103/0253-7613.194848
    Ibuprofen is a nonsteroidal anti-inflammatory drug that is used widely in treating pain, fever, and inflammation. Its side effects are mainly due to acute renal impairment and gastric discomfort. We hereby report a rare case of Henoch-Schönlein purpura nephritis secondary to ibuprofen consumption which has not been reported in literature before.
    MeSH terms: Anti-Inflammatory Agents, Non-Steroidal/adverse effects*; Female; Humans; Ibuprofen/adverse effects*; Middle Aged; Nephritis/chemically induced*; Nephritis/complications; Nephritis/diagnosis*; Purpura, Schoenlein-Henoch/chemically induced*; Purpura, Schoenlein-Henoch/complications; Purpura, Schoenlein-Henoch/diagnosis*
  20. Selvaratnam C, Thevarajoo S, Goh KM, Chan KG, Chong CS
    Int J Syst Evol Microbiol, 2016 Dec;66(12):5537-5543.
    PMID: 28077207 DOI: 10.1099/ijsem.0.001553
    The genus Roseivirga currently includes five species: Roseivirga ehrenbergii, R. echinicomitans, R. spongicola, R. marina and R. maritima. Marinicola seohaensis SW-152T was renamed as Roseivirgaseohaensis SW-152T and then reclassified again as a later heterotypic synonym of R. ehrenbergii KMM 6017T. In this study, based on average nucleotide identity and digital DNA-DNA hybridization values obtained from in silico methods, together with fatty acid analyses and biochemical tests, we propose to reclassify R. ehrenbergii SW-152 as Roseivirga seohaensis comb. nov. (type strain SW-152T=KCTC 1231T=JCM 12600T). In this work, a Gram-negative, rod-shaped, aerobic and pink-pigmented strain designated as D-25T was isolated from seawater (Desaru Beach, Johor, Malaysia). The 16S rRNA gene analysis revealed that strain D-25T was related to the genus Roseivirga. Strain D-25T was found most closely related to R. seohaensis SW-152T based on average nucleotide identity and digital DNA-DNA hybridization values, phenotypic and chemotaxonomic analyses, indicating that these strains belong to the same species. Thus, it is proposed to split the species R.oseivirga seohaensis into two novel subspecies, Roseivirga seohaensissubsp. seohaensis subsp. nov. (type strain SW-152T=KCTC 12312T=JCM 12600T) and Roseivirga seohaensissubsp. aquiponti subsp. nov. (type strain D-25T=KCTC 42709T=DSM 101709T) and to emend the description of the genus Roseivirga.
    MeSH terms: Base Composition; DNA, Bacterial/genetics; Fatty Acids/chemistry; Malaysia; Nucleic Acid Hybridization; Phosphatidylethanolamines/chemistry; Phylogeny*; Pigmentation; RNA, Ribosomal, 16S/genetics; Seawater/microbiology*; Bacterial Typing Techniques; Sequence Analysis, DNA; Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry; Bacteroidetes/classification*; Bacteroidetes/genetics; Bacteroidetes/isolation & purification
External Links