Browse publications by year: 2017

  1. Saw PS, Nissen L, Freeman C, Wong PS, Mak V
    Pharm Pract (Granada), 2017 Jul-Sep;15(3):971.
    PMID: 28943979 DOI: 10.18549/PharmPract.2017.03.971
    BACKGROUND: Private general practitioners in Malaysia largely operates as solo practices - prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists.
    OBJECTIVE: To explore pharmacists' views in integrating pharmacists into private GP clinics in Malaysia.
    METHODS: A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10.
    RESULTS: Four major themes were identified: (1) Limited potential to expand pharmacists' roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs' responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists' in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines.
    CONCLUSION: Findings from the study provided a better understanding to help ascertain pharmacists' views on their readiness and acceptance in a potential new model of practice.
  2. Dawood OT, Hassali MA, Saleem F, Ibrahim IR, Abdulameer AH, Jasim HH
    Pharm Pract (Granada), 2017 Jul-Sep;15(3):991.
    PMID: 28943981 DOI: 10.18549/PharmPract.2017.03.991
    BACKGROUND: Patients' behaviour in making decisions regarding health is currently changing from passive recipients to recipients who play an active role in taking action to control their health and taking self-care initiatives.
    OBJECTIVES: This study was conducted to evaluate the health seeking behaviour among general public and its associated factors; and to evaluate the medicine taking behaviour in public and the practice of self-medication.
    METHODS: A cross-sectional study was undertaken among general public in Penang Island, Malaysia. A convenience sampling of 888 participants successfully completed the survey. Self-administered questionnaires were distributed among the residents in the north east of Penang Island.
    RESULTS: This study showed that most of the participants chose to consult the physician when they experience any health problems (66.7%), followed by self-medication (20.9%). The first action for consulting the physician was significantly predicted by Malay respondents and retired people (OR 3.05, 95% CI 1.04-8.89). The prevalence of self-medication was 54%. The practice of self-medication was significantly associated with Chinese participants, educated people, people with alone living status and people with more self-care orientation.
    CONCLUSION: Increasing the awareness of the public about the rational choice of getting medical assistance is a very important issue to control their health. A health education program is needed to increase the awareness about the use of medicines among the general public and to enable them to make the right decisions relating to health problems.
    MeSH terms: Choice Behavior; Cross-Sectional Studies; Health Education; Humans; Malaysia; Surveys and Questionnaires; Self Care; Self Medication; Prevalence; Islands
  3. Thevi T, Godinho MA
    Int J Ophthalmol, 2017;10(9):1452-1459.
    PMID: 28944207 DOI: 10.18240/ijo.2017.09.19
    AIM: To explore the associations between various characteristics of Malaysian cataract patients and their management, and their post-operative visual outcomes, to inform relevant bodies to reduce cataract-related blindness.

    METHODS: We conducted a descriptive secondary data analysis of cataract surgery patients in Melaka Hospital, from 2007 to 2014 using the National Eye Database (NED). Patient-related factors (demographic features, systemic and ocular comorbidities) and management-related factors (surgical duration, type of surgery, type of lens) were analysed for their association with visual outcome (acuity).

    RESULTS: Most patients were Malays (48.23%) and Chinese (38.55%) aged 60-79y (range 0-100y). Hypertension (58.61%) and diabetes (44.89%) were major systemic comorbidities. Glaucoma (6.71%) and diabetic retinopathy (10.12%) were the main ocular comorbidities. Other comorbidities were age-related macular degeneration, pterygium, corneal opacities, macula diseases, vitreous haemorrhage, retinal detachment and pseudoexfoliation (0.70%-1.60%). Preoperatively 7150 (55.03%) eyes presented with poor vision. Uncomplicated phacoemulsification performed quickly with foldable lenses gave good results.

    CONCLUSION: Primary care physicians should initiate early detection to prevent late presentation of cataracts causing poor vision and should discuss the risks and benefits of cataract surgery while emphasizing the role of pre-existing comorbidities which may affect the visual outcomes. For good results, phacoemulsification should be done within 30min, without complications, using foldable posterior chamber intraocular lens.
    MeSH terms: Cataract; Cataract Extraction; Corneal Opacity; Demography; Diabetic Retinopathy; Eye; Glaucoma; Humans; Hypertension; Lens, Crystalline; Lenses, Intraocular; Macular Degeneration; Malaysia; Pterygium; Retinal Detachment; Vitreous Hemorrhage; Comorbidity; Risk Assessment; Phacoemulsification; Physicians, Primary Care
  4. Omar R, Kuan YM, Zuhairi NA, Manan FA, Knight VF
    Int J Ophthalmol, 2017;10(9):1460-1464.
    PMID: 28944208 DOI: 10.18240/ijo.2017.09.20
    AIM: To compare visual efficiency, specifically accom-modation, vergence, and oculomotor functions among athletes and non-athletes.

    METHODS: A cross-sectional study on sports vision screening was used to evaluate the visual skills of 214 elementary students (107 athletes, 107 non-athletes), aged between 13 and 16y. The visual screening assessed visual parameters such as ocular motor alignment, accommodation, and vergence functions.

    RESULTS: Mean visual parameters were compared between age-group matched athletes (mean age 14.82±0.98y) and non-athletes (mean age 15.00±1.04y). The refractive errors of all participants were corrected to maximal attainable best corrected visual acuity of logMAR 0.0. Accommodation function assessment evaluated amplitude of accommodation and accommodation facility. Vergence functions measured the near point of convergence, vergence facility, and distance fusional vergence at break and recovery point. Ocular motor alignment was not statistically significant between both groups. Athletes had a statistically significant amplitude of accommodation for both the right eye (t=2.30, P=0.02) and the left eye (t=1.99, P=0.05). Conversely, non-athletes had better accommodation facility (t=-2.54, P=0.01) and near point of convergence (t=4.39, P<0.001) when compared to athletes. Vergence facility was found to be better among athletes (t=2.47, P=0.01). Nevertheless, non-athletes were significantly better for both distance negative and positive fusional vergence.

    CONCLUSION: Although the findings are still inconclusive as to whether athletes had superior visual skills as compared to non-athletes, it remains important to identify and elucidate the key visual skills needed by athletes in order for them to achieve higher performance in their sports.

  5. James CA, Hayes M, Willmott AGB, Gibson OR, Flouris AD, Schlader ZJ, et al.
    Temperature (Austin), 2017;4(3):314-329.
    PMID: 28944273 DOI: 10.1080/23328940.2017.1333189
    In cool conditions, physiologic markers accurately predict endurance performance, but it is unclear whether thermal strain and perceived thermal strain modify the strength of these relationships. This study examined the relationships between traditional determinants of endurance performance and time to complete a 5-km time trial in the heat. Seventeen club runners completed graded exercise tests (GXT) in hot (GXTHOT; 32°C, 60% RH, 27.2°C WBGT) and cool conditions (GXTCOOL; 13°C, 50% RH, 9.3°C WBGT) to determine maximal oxygen uptake (V̇O2max), running economy (RE), velocity at V̇O2max (vV̇O2max), and running speeds corresponding to the lactate threshold (LT, 2 mmol.l(-1)) and lactate turnpoint (LTP, 4 mmol.l(-1)). Simultaneous multiple linear regression was used to predict 5 km time, using these determinants, indicating neither GXTHOT (R(2) = 0.72) nor GXTCOOL (R(2) = 0.86) predicted performance in the heat as strongly has previously been reported in cool conditions. vV̇O2max was the strongest individual predictor of performance, both when assessed in GXTHOT (r = -0.83) and GXTCOOL (r = -0.90). The GXTs revealed the following correlations for individual predictors in GXTHOT; V̇O2maxr = -0.7, RE r = 0.36, LT r = -0.77, LTP r = -0.78 and in GXTCOOL; V̇O2maxr = -0.67, RE r = 0.62, LT r = -0.79, LTP r = -0.8. These data indicate (i) GXTHOT does not predict 5 km running performance in the heat as strongly as a GXTCOOL, (ii) as in cool conditions, vV̇O2max may best predict running performance in the heat.
  6. Shariffa YN, Tan TB, Uthumporn U, Abas F, Mirhosseini H, Nehdi IA, et al.
    Food Res Int, 2017 11;101:165-172.
    PMID: 28941679 DOI: 10.1016/j.foodres.2017.09.005
    The aim of this study was to develop formulations to produce lycopene nanodispersions and to investigate the effects of the homogenization pressure on the physicochemical properties of the lycopene nanodispersion. The samples were prepared by using emulsification-evaporation technique. The best formulation was achieved by dispersing an organic phase (0.3% w/v lycopene dissolved in dichloromethane) in an aqueous phase (0.3% w/v Tween 20 dissolved in deionized water) at a ratio of 1:9 by using homogenization process. The increased level of homogenization pressure to 500bar reduced the particle size and lycopene concentration significantly (p<0.05). Excessive homogenization pressure (700-900bar) resulted in large particle sizes with high dispersibility. The zeta potential and turbidity of the lycopene nanodispersion were significantly influenced by the homogenization pressure. The results from this study provided useful information for producing small-sized lycopene nanodispersions with a narrow PDI and good stability for application in beverage products.
    MeSH terms: Beverages; Emulsions/chemistry; Food Additives/chemistry; Methylene Chloride/chemistry; Particle Size; Polysorbates; Pressure*; Solubility; Phase Transition; Emulsifying Agents; Nanostructures/chemistry*; Chemical Phenomena*
  7. Kumaran SK, Bakar MFA, Mohd-Padil H, Mat-Sharani S, Sakinah S, Poorani K, et al.
    Acta Trop, 2017 Dec;176:433-439.
    PMID: 28941729 DOI: 10.1016/j.actatropica.2017.09.011
    Leptospirosis is a widespread zoonotic disease caused by pathogenic Leptospira species (Leptospiraceae). LipL32 is an abundant lipoprotein from the outer membrane proteins (OMPs) group, highly conserved among pathogenic and intermediate Leptospira species. Several studies used LipL32 as a specific gene to identify the presence of leptospires. This research was aimed to study the characteristics of LipL32 protein gene code, to fill the knowledge gap concerning the most appropriate gene that can be used as antigen to detect the Leptospira. Here, we investigated the features of LipL32 in fourteen Leptospira pathogenic strains based on comparative analyses of their primary, secondary structures and 3D modeling using a bioinformatics approach. Furthermore, the physicochemical properties of LipL32 in different strains were studied, shedding light on the identity of signal peptides, as well as on the secondary and tertiary structure of the LipL32 protein, supported by 3D modelling assays. The results showed that the LipL32 gene was present in all the fourteen pathogenic Leptospira strains used in this study, with limited diversity in terms of sequence conservation, hydrophobic group, hydrophilic group and number of turns (random coil). Overall, these results add basic knowledge to the characteristics of LipL32 protein, contributing to the identification of potential antigen candidates in future research, in order to ensure prompt and reliable detection of pathogenic Leptospira species.
    MeSH terms: Antigens, Bacterial/immunology; Antigens, Bacterial/chemistry*; Bacterial Outer Membrane Proteins/immunology; Bacterial Outer Membrane Proteins/chemistry*; Leptospira/genetics; Leptospira/immunology*; Leptospirosis/immunology*; Lipoproteins/immunology; Lipoproteins/chemistry*; Models, Molecular*; Computational Biology
  8. Yaacob R, Zainal Mokhtar A, Abang Jamari DZH, Jaafar N
    BMJ Case Rep, 2017 Sep 23;2017.
    PMID: 28942402 DOI: 10.1136/bcr-2017-220801
    Fetus-in-fetu (FIF) is a rare entity in which malformed parasitic twin grows inside the body of its twin. It is most commonly presented with mass in the abdomen. We present a case of a 15-year-old boy who presented with abdominal mass since infancy. Radiological investigations are suggestive of FIF. Intraoperatively, malformed fetus in a sac was found and excised. Postoperatively the patient recovers well and was put on follow-up.
    MeSH terms: Abdomen/abnormalities; Abdomen/surgery; Congenital Abnormalities/surgery; Adolescent; Diagnosis, Differential; Fetus/abnormalities*; Humans; Male; Twins, Conjoined*
  9. Tan HJR
    BMJ Case Rep, 2017 Sep 23;2017.
    PMID: 28942410 DOI: 10.1136/bcr-2017-221518
    This was about a case of a patient requiring admission to psychiatry ward twice a year for relapse schizophrenia due to medication non-compliance. Medication adherence was previously monitored by her husband. However, following the death of her husband, she stopped treatment. The lack of insight and poor family support further contributed to her relapse. She presented with positive and negative symptoms of schizophrenia during her relapse, neglecting her hygiene and oral intake. She was also found to have anaemia as a result of poor diet when she was in relapse. Community psychiatry services had attempted to ensure compliance with postdischarge plan but failed as patient was not present every home visits. Supervised treatment in outpatient for schizophrenia (STOPS) provided an alternative method to ensure compliance in this patient. Patient has remained in remission for 1 year since the use of STOPS.
    MeSH terms: Adult; Diagnosis, Differential; Female; Humans; Outpatients*; Patient Care Team*; Schizophrenia/diagnosis*; Schizophrenia/drug therapy; Schizophrenic Psychology; Antipsychotic Agents/administration & dosage; Antipsychotic Agents/therapeutic use*; Medication Adherence
  10. Lu WC
    Environ Sci Pollut Res Int, 2017 Nov;24(33):26006-26015.
    PMID: 28942473 DOI: 10.1007/s11356-017-0259-9
    This article aims to investigate the relationship among renewable energy consumption, carbon dioxide (CO2) emissions, and GDP using panel data for 24 Asian countries between 1990 and 2012. Panel cross-sectional dependence tests and unit root test, which considers cross-sectional dependence across countries, are used to ensure that the empirical results are correct. Using the panel cointegration model, the vector error correction model, and the Granger causality test, this paper finds that a long-run equilibrium exists among renewable energy consumption, carbon emission, and GDP. CO2 emissions have a positive effect on renewable energy consumption in the Philippines, Pakistan, China, Iraq, Yemen, and Saudi Arabia. A 1% increase in GDP will increase renewable energy by 0.64%. Renewable energy is significantly determined by GDP in India, Sri Lanka, the Philippines, Thailand, Turkey, Malaysia, Jordan, United Arab Emirates, Saudi Arabia, and Mongolia. A unidirectional causality runs from GDP to CO2 emissions, and two bidirectional causal relationships were found between CO2 emissions and renewable energy consumption and between renewable energy consumption and GDP. The findings can assist governments in curbing pollution from air pollutants, execute energy conservation policy, and reduce unnecessary wastage of energy.
    MeSH terms: Asia; Carbon Dioxide/analysis*; Conservation of Energy Resources; Cross-Sectional Studies; Environmental Pollution/prevention & control; Humans; Models, Statistical*; Economic Development/trends; Economic Development/statistics & numerical data*; Gross Domestic Product/trends; Gross Domestic Product/statistics & numerical data; Renewable Energy/statistics & numerical data*
  11. Ayoib A, Hashim U, Gopinath SCB, Md Arshad MK
    Appl Microbiol Biotechnol, 2017 Nov;101(22):8077-8088.
    PMID: 28942548 DOI: 10.1007/s00253-017-8493-0
    This review covers a developmental progression on early to modern taxonomy at cellular level following the advent of electron microscopy and the advancement in deoxyribonucleic acid (DNA) extraction for expatiation of biological classification at DNA level. Here, we discuss the fundamental values of conventional chemical methods of DNA extraction using liquid/liquid extraction (LLE) followed by development of solid-phase extraction (SPE) methods, as well as recent advances in microfluidics device-based system for DNA extraction on-chip. We also discuss the importance of DNA extraction as well as the advantages over conventional chemical methods, and how Lab-on-a-Chip (LOC) system plays a crucial role for the future achievements.
    MeSH terms: DNA/genetics; DNA/isolation & purification*; Humans; Molecular Biology/methods; Oligonucleotide Array Sequence Analysis*; Microfluidics/methods; Solid Phase Extraction/methods; Liquid-Liquid Extraction
  12. Shee-Chai C, Liam CK, Mun KS
    J Thorac Oncol, 2017 10;12(10):e171-e173.
    PMID: 28939153 DOI: 10.1016/j.jtho.2017.06.068
    MeSH terms: Adult; Carcinoma, Non-Small-Cell Lung/drug therapy*; Carcinoma, Non-Small-Cell Lung/pathology; Humans; Lung Neoplasms/drug therapy*; Lung Neoplasms/pathology; Male; Mutation; Receptor, Epidermal Growth Factor/genetics*; Drug Resistance, Neoplasm/genetics; Protein Kinase Inhibitors/pharmacology; Protein Kinase Inhibitors/therapeutic use
  13. Nadarajah G, Ratnalingam VH, Mohd Isa H
    Cornea, 2017 Apr;36(4):452-456.
    PMID: 27941383 DOI: 10.1097/ICO.0000000000001106
    PURPOSE: To evaluate graft stability and recurrence rate between fibrin glue and autologous blood in pterygium conjunctival autograft surgery.

    METHODS: A prospective, randomized, single-blinded clinical trial to assess the efficacy of autologous blood in place of fibrin glue in pterygium surgery. A total of 120 eyes of 111 patients were randomized according to pterygium morphology, to undergo pterygium surgery with autografting using either autologous blood or fibrin glue. All patients were operated by a single surgeon; 58 eyes were operated using fibrin glue and 62 eyes had a conjunctival autograft with autologous blood. Patients were seen on postoperative day 1, 1 week, 1 month, 6 months, and 1 year after surgery. Graft stability and pterygium recurrence were graded by an independent observer who was masked to the method of treatment.

    RESULTS: All 120 eyes completed the 1-year follow-up. Graft loss was seen only in the autologous blood group. Of the 62 eyes in this group, a total of 15 (24.2%) grafts dislodged. Recurrence was calculated after excluding grafts that were dislodged. Of the 105 patients, there were a total of 7 recurrences, 2 (3.4%) from the fibrin adhesive method and 5 (10.6%) from the autologous blood method. This was not statistically significant (P = 0.238).

    CONCLUSIONS: Autologous blood does not exhibit similar graft stability seen with fibrin glue. Although the recurrence rate may not be significant, careful patient selection and a standard method needs to be laid out before the use of this method is widely accepted.

    MeSH terms: Blood*; Conjunctiva/transplantation*; Female; Follow-Up Studies; Graft Survival/drug effects*; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Pterygium/physiopathology; Pterygium/surgery*; Recurrence; Tissue Adhesives/therapeutic use*; Transplantation, Autologous; Visual Acuity/physiology; Fibrin Tissue Adhesive/therapeutic use*; Single-Blind Method; Autografts
  14. Susanto TAK, Bhattacharyya R
    J Pediatr Hematol Oncol, 2017 Jul;39(5):408-409.
    PMID: 28644307 DOI: 10.1097/MPH.0000000000000814
    Dimorphism in peripheral blood film was noted in a 16 year old Malay boy with anemia who was eventually diagnosed with X-linked sideroblastic anemia. A mutation in ALAS2 S568G was identified which has not been described previously in a Malay ethnic group.
    MeSH terms: Adolescent; 5-Aminolevulinate Synthetase/genetics*; Anemia, Sideroblastic/diagnosis*; Anemia, Sideroblastic/drug therapy; Anemia, Sideroblastic/ethnology; Anemia, Sideroblastic/genetics; Hemoglobins/analysis; Humans; Malaysia; Male; Mutation*; Pyridoxine/therapeutic use; Sex Characteristics; Genetic Diseases, X-Linked/diagnosis*; Genetic Diseases, X-Linked/drug therapy; Genetic Diseases, X-Linked/ethnology; Genetic Diseases, X-Linked/genetics
  15. Chan YY, Lim KK, Lim KH, Teh CH, Kee CC, Cheong SM, et al.
    BMC Public Health, 2017 Sep 21;17(1):733.
    PMID: 28934939 DOI: 10.1186/s12889-017-4772-z
    BACKGROUND: Overweight and obesity are growing health problems both worldwide and in Malaysia due to such lifestyle changes as decreased physical activity (PA), increased sedentary behavior and unhealthy eating habits. This study examined the levels and patterns of PA among normal-weight and overweight/obese adults and to investigate the association between PA level and overweight/obesity in Malaysian adults.

    METHODS: This study used data from the 2015 National Health and Morbidity Survey (NHMS), a nationwide cross-sectional survey that implemented a two-stage stratified random sampling design. Respondents aged 18 years and above (n = 17,261) were included in the analysis. The short version of International Physical Activity Questionnaire (IPAQ) was administered to assess the respondents' PA levels. The respondents' height and weight were objectively measured and body mass index (BMI) was calculated. The respondents were categorized according to BMI as either normal-weight (18.5-24.9 kg/m2) or overweight/obese (≥ 25 kg/m2). Descriptive and complex sample logistic regression analyses were employed as appropriate.

    RESULTS: Overall, approximately 1 in 2 respondents (51.2%) were overweight/obese, even though the majority (69.0%) reporting at least a moderate level of PA (total PA ≥ 10 MET-hours/week). In both normal-weight and overweight/obese groups, a significantly higher prevalence of high PA (total PA ≥ 50 MET-hours/week) was observed among men than women (p 

    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Female; Health Surveys; Humans; Malaysia/epidemiology; Male; Middle Aged; Obesity/epidemiology*; Risk Factors; Exercise*; Body Mass Index; Prevalence; Overweight/epidemiology*; Young Adult
  16. Shahadat M, Khan MZ, Rupani PF, Embrandiri A, Sultana S, Ahammad SZ, et al.
    Adv Colloid Interface Sci, 2017 Nov;249:2-16.
    PMID: 28935100 DOI: 10.1016/j.cis.2017.08.006
    Among the various electrically conducting polymers, polyaniline (PANI) has gained attentions due to its unique properties and doping chemistry. A number of electrically conducting biodegradable polymers has been synthesized by incorporating a biodegradable content of cellulose, chitin, chitosan, etc. in the matrix of PANI. The hybrid materials are also employed as photocatalysts, antibacterial agents, sensors, fuel cells and as materials in biomedical applications. Furthermore, these biodegradable and biocompatible conducting polymers are employed in tissue engineering, dental implants and targeted drug delivery. This review presents state of the art of PANI based biodegradable polymers along with their synthesis routes and unique applications in diverse fields. In future, the synthesis of PANI-grafted biodegradable nanocomposite material is expected to open innovative ways for their outstanding applications.
  17. Malakahmad A, Abualqumboz MS, Kutty SRM, Abunama TJ
    Waste Manag, 2017 Dec;70:282-292.
    PMID: 28935377 DOI: 10.1016/j.wasman.2017.08.044
    Malaysian authorities has planned to minimize and stop when applicable unsanitary dumping of waste as it puts human health and the environment at elevated risk. Cost, energy and revenue are mostly adopted to draw the blueprint of upgrading municipal solid waste management system, while the carbon footprint emissions criterion rarely acts asa crucial factor. This study aims to alert Malaysian stakeholders on the uneven danger of carbon footprint emissions of waste technologies. Hence, three scenarios have been proposed and assessed mainly on the carbon footprint emissions using the 2006 IPCC methodology. The first scenario is waste dumping in sanitary landfills equipped with gas recovery system, while the second scenario includes anaerobic digestion of organics and recycling of recyclable wastes such as plastic, glass and textile wastes. The third scenario is waste incineration. Besides the carbon footprint emissions criterion, other environmental concerns were also examined. The results showed that the second scenario recorded the lowest carbon footprint emissions of 0.251t CO2 eq./t MSW while the third scenario had the highest emissions of 0.646t CO2 eq./t MSW. Additionally, the integration between anaerobic digestion and recycling techniques caused the highest avoided CO2 eq. emissions of 0.74t CO2 eq./t MSW. The net CO2 eq. emissions of the second scenario equaled -0.489t CO2 eq./t MSW due to energy recovery from the biogas and because of recycled plastic, glass and textile wastes that could replace usage of raw material. The outcomes also showed that the first scenario generates huge amount of leachate and hazardous air constituents. The study estimated that a ton of dumped waste inside the landfills generates approximately 0.88m3 of trace risky compounds and 0.188m3 of leachate. As for energy production, the results showed that the third scenario is capable of generating 639kWh/t MSW followed by the second scenario with 387.59kWh/t MSW. The first scenario produced 296.79kWh/t MSW. In conclusion, the outcomes of this study recommend an integrated scenario of anaerobic digestion and recycling techniques to be employed in Malaysia.
    MeSH terms: Anaerobiosis; Carbon Dioxide; Humans; Malaysia; Plastics; Textiles; Incineration; Biofuels; Carbon Footprint; Recycling; Solid Waste; Waste Disposal Facilities
  18. Lye HS, Kato T, Low WY, Taylor TD, Prakash T, Lew LC, et al.
    J Biotechnol, 2017 Sep 19.
    PMID: 28935567 DOI: 10.1016/j.jbiotec.2017.09.007
    In this study, hypercholesterolemic mice fed with Lactobacillus fermentum FTDC 8312 after a seven-week feeding trial showed a reduction in serum total cholesterol (TC) levels, accompanied by a decrease in serum low-density lipoprotein cholesterol (LDL-C) levels, an increase in serum high-density lipoprotein cholesterol (HDL-C) levels, and a decreased ratio of apoB100:apoA1 when compared to those fed with control or a type strain, L. fermentum JCM 1173. These have contributed to a decrease in atherogenic indices (TC/HDL-C) of mice on the FTDC 8312 diet. Serum triglyceride (TG) levels of mice fed with FTDC 8312 and JCM 1173 were comparable to those of the controls. A decreased ratio of cholesterol and phospholipids (C/P) was also observed for mice fed with FTDC 8312, leading to a decreased number of spur red blood cells (RBC) formation in mice. Additionally, there was an increase in fecal TC, TG, and total bile acid levels in mice on FTDC 8312 diet compared to those with JCM 1173 and controls. The administration of FTDC 8312 also altered the gut microbiota population such as an increase in the members of genera Akkermansia and Oscillospira, affecting lipid metabolism and fecal bile excretion in the mice. Overall, we demonstrated that FTDC 8312 exerted a cholesterol lowering effect that may be attributed to gut microbiota modulation.
    MeSH terms: Gastrointestinal Microbiome; Animals; Bile; Diet; Erythrocytes; Lipoproteins, HDL; Cholesterol, LDL; Phospholipids; Triglycerides; Apolipoprotein A-I; Lipid Metabolism; Mice; Lactobacillus fermentum; Apolipoprotein B-100
  19. Vinodh VP, Harun R, Sellamuthu P, Kandasamy R
    J Neurosci Rural Pract, 2017 Aug;8(Suppl 1):S111-S113.
    PMID: 28936084 DOI: 10.4103/jnrp.jnrp_165_17
    We report a rare case of a young female with primary brain fibrosarcoma, and to the best of our knowledge, we believe that only <50 cases have been reported or described worldwide so far. Fibrosarcoma is a malignant neoplasm, in which histologically the predominant cells are fibroblasts that divide excessively without cellular control and they can invade local tissues or metastasize. Primary central nervous system fibrosarcomas are very aggressive neoplasms and generally have a poor prognosis. This tumor is either from sarcomatous transformation of a meningioma or arises de novo within the brain parenchyma. Our patient, a 48-year-old woman, who presented with progressive speech disorder over the period of 4 months, showed a left temporoparietal lesion with surrounding edema and local mass effect. Total surgical resection was achieved. Histopathology revealed classical fibrosarcoma features and secondary screening revealed no other distant lesion as diagnosis of primary brain fibrosarcoma was established. This case is deemed to be extremely rare because most reports claim that recurrence is within 6 months with poor prognosis; however, this patient is currently recurrence-free at 3 years. This would suggest of the possibility for a relook into this disease's course and recurrence rate when complete excision is achieved. Due to extreme rarity of these tumors, more comparative studies will be needed to improve the disease outcome.
    MeSH terms: Brain; Edema; Female; Fibroblasts; Fibrosarcoma; Humans; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Sarcoma; Speech Disorders
  20. Emeka PM, Mukalaf AA, Helal HA, Khan TM, Almukalf MA
    Int J Health Sci (Qassim), 2017 Jul-Sep;11(3):38-44.
    PMID: 28936150
    OBJECTIVES: To assess drug use pattern and the effect on glycemic and blood pressure (BP) control in type 2 diabetes mellitus (T2DM) and hypertensive patients. Furthermore, to evaluate the duration of drug use and antecedence in diagnosis.
    METHODOLOGY: A cross-sectional study design, comprising interview/questionnaire targeting outpatients attending primary health centers in Al Ahsa was adopted. During the interview, their fasting blood glucose, weight, and height were measured, along with their BP. Time and duration of drug use were recorded. The history, sociodemographic data and the presence of any other disease conditions were also documented.
    RESULTS: The highest number of uncontrolled BP and poor glycemic control was among the age group of 45 and 49 years. Significant number of the patients (92.9%) had body mass index >30 kg/m(2). The prevalence of developing hypertension before T2DM among participants was 59.9%. A significant number (84%) had uncontrolled hypertension, and 67.3% had uncontrolled T2DM. Drug use pattern revealed single or combinations according to clinical guidelines initially but did not follow through in meeting targets. Majority received angiotensin converting enzyme inhibitors, amlodipine or atenolol for BP control and metformin for T2DM. Patients diagnosed between 1 and 5 years displayed significant poor glycemic and BP control. Significantly, most patients appeared to have been on same prescriptions for a longer time without review.
    CONCLUSION: Poor glycemic and BP controls observed in this study could be due to deficient treatment strategy among others. Patients were, however, not adequately managed in line with prescribed clinical guidelines.
    MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Diabetes Mellitus*; Humans; Hypertension*; Saudi Arabia; Prevalence
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