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  1. Lactobacilli reduce recurrences of vaginal candidiasis in pregnant women: a randomized, double-blind, placebo-controlled study
    Ang XY, Chung FY, Lee BK, Azhar SNA, Sany S, Roslan NS, et al.
    J Appl Microbiol, 2021 May 22.
    PMID: 34022103 DOI: 10.1111/jam.15158
    AIMS: The aim of this study was to investigate the effects of lactobacilli strains in preventing the recurrences of vaginal candidiasis (VC) in 78 pregnant women with VC (lactobacilli, n = 39; placebo, n = 39) and the potential benefits on quality of life.

    METHODS AND RESULTS: The lactobacilli putative probiotic (SynForU-HerCare; two capsules/day of 9·5 log CFU per capsule) or placebo was administered for 8-weeks in a randomized, double-blind, placebo-controlled study. Subjects were assessed for vaginal and gut health conditions at baseline, week-4 and week-8 via questionnaires. The vulvovaginal symptom questionnaire not only covered aspects pertaining to vulvovaginal symptoms but also the quality of life impacts such as emotional, social and sexual. The administration of lactobacilli reduced symptoms of irritation (P = 0·023) and discharge (P = 0·011) starting week-4 and continued after week-8 (P 

  2. Fulltext Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia
    Anwar M, Sulaiman SA, Ahmadi K, Khan TM
    BMC Public Health, 2010;10:47.
    PMID: 20113511 DOI: 10.1186/1471-2458-10-47
    BACKGROUND: Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.
    METHODS: Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.
    RESULTS: Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 +/- 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).
    CONCLUSIONS: It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.
  3. A survey evaluating nurses' perception and expectations towards the role of pharmacist in Pakistan's healthcare system
    Azhar S, Hassali MA, Mohamed Ibrahim MI, Saleem F, Siow Yen L
    J Adv Nurs, 2012 Jan;68(1):199-205.
    PMID: 21658097 DOI: 10.1111/j.1365-2648.2011.05728.x
    This paper is a report of a study of nurses' perception towards the role of pharmacist in Pakistan healthcare setup.
  4. Fulltext The role of pharmacists in developing countries: the current scenario in Pakistan
    Azhar S, Hassali MA, Ibrahim MI, Ahmad M, Masood I, Shafie AA
    Hum Resour Health, 2009;7:54.
    PMID: 19594916 DOI: 10.1186/1478-4491-7-54
    During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in Pakistan. The paper draws on the literature related to the socioeconomic and health status of Pakistan's population, along with background on the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in Pakistan. It concludes that although the pharmacy profession in Pakistan is continuously evolving, the health care system of Pakistan has yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in Pakistan are concerned about their present professional role in the health care system. The main problem they are facing is the shortage of pharmacists in pharmacies. Moreover, their services are focused towards management more than towards customers. For these reasons, the pharmacist's role as a health care professional is not familiar to the public.
  5. Fulltext Navigated Percutaneous Sacroiliac Screw Fixation in Unstable Pelvic Ring Fracture
    Azhar S, Syafiq S, Arif NK, Mohamed Khalil AF, Muhamad Ariffin MH
    Cureus, 2022 Oct;14(10):e29897.
    PMID: 36348881 DOI: 10.7759/cureus.29897
    Since the late 1990s, navigation systems have been widely used in a variety of orthopaedic surgical procedures, with the majority of these procedures being complex arthroplasty surgeries and the correction of spinal abnormalities. Navigation systems are, however, infrequently used in trauma cases, especially in unstable pelvic ring fractures. The conventional method of percutaneous sacroiliac screw fixation typically used fluoroscopic image intensifiers to fix unstable pelvic ring fractures. We will examine how navigation systems can be used in trauma situations, particularly those involving unstable posterior pelvic ring fractures and focus on the advantages and disadvantages that we experienced during management.
  6. WALANT technique for percutaneous pinning of distal radioulnar joint
    Azhar S, Abdullah S, Soh E
    J Hand Surg Eur Vol, 2023 Mar;48(3):279-281.
    PMID: 36691295 DOI: 10.1177/17531934221148115
  7. Fulltext Biochemical aspirin resistance in stroke patients - a cross-sectional single centre study
    Azmin S, Sahathevan R, Rabani R, Nafisah WY, Tan HJ, Raymond AA, et al.
    EXCLI J, 2013;12:907-15.
    PMID: 27092036
    BACKGROUND: Aspirin use is known to reduce the recurrence of stroke. However, the clinical response to aspirin has been mixed. The rate of stroke recurrence whilst on aspirin treatment is still unacceptably high. A plausible explanation for this may be resistance to the effects of aspirin. The causes of aspirin resistance are manifold and multi-factorial. We conducted a study to investigate the prevalence rate of biochemical aspirin resistance in a cohort of aspirin-naïve stroke patients. We also sought to determine the inherent factors that may predispose towards the development of aspirin resistance.
    METHOD: This was a cross-sectional, observational study conducted on patients admitted to our centre with an acute stroke who were aspirin-naïve. The diagnosis of an acute stroke was confirmed by clinical history and brain imaging. Fifty consecutive patients were prospectively enrolled. Socio-demographic data were collected and baseline blood investigations were performed. Patients were tested for biochemical aspirin resistance using Multiplate platelet analyser (Dynabyte, Munich, Germany) after 5 doses of aspirin, corresponding to a total dose of 900 mg.
    RESULTS: The median age of patients was 65.5 years and 54 % of patients were female. There were 11 smokers; of these 10 were male. Twenty-six (52 %) patients were Chinese, 21 (41 %) were Malay and 3 (6.0 %) were Indian. Aspirin resistance was present in 14 % of our patients. There was an inverse relationship between the presence of aspirin resistance and plasma HDL levels (r = -0.394; p = 0.005). There was no relationship observed between aspirin resistance and total cholesterol, triglycerides, LDL, HbA1c, ALT, ALP, urea and creatinine levels. There were no significant differences in demographic profiles or smoking status between the aspirin resistant and non-aspirin resistant groups. We did not find any link between ethnicity and aspirin resistance.
    CONCLUSIONS: Our results indicate that a lower HDL level is associated with biochemical aspirin resistance. This may increase platelet aggregation and consequently increase the risk of a recurrent stroke. The clinical implications for aspirin resistance are far reaching. Any evidence that correctable factors may negatively influence the action of aspirin warrants further investigation. The prevalence rate of biochemical aspirin resistance in our study is comparable to the findings in other studies performed in an Asian population. Further research is required to determine how our findings translate into clinical aspirin resistance and stroke recurrence.
    KEYWORDS: Asia; antiplatelet therapy; aspirin; aspirin resistance; developing countries; ischaemic stroke; risk factors
  8. Fulltext Prevalence of complementary alternative medicine use among patients with type II diabetes in Negeri Sembilan, Malaysia
    Baharom N, Shamsul Azhar S, Rotina AB
    Medicine & Health, 2016;11(2):257-266.
    MyJurnal
    The uses of Complementary and Alternative Medicine (CAM) among patients with chronic diseases are becoming increasingly popular. This was a descriptive cross-sectional study conducted in 45 government health clinics across Negeri Sembilan. Respondents at diabetes clinics were selected via systematic random sampling and interviewed using structured questionnaire. CAM usage was divided into three groups; CAM use for diabetes (CAM-DM), CAM use for general health (CAM-G) and Non CAM user. The prevalent use of CAM among type II diabetes mellitus patients in Negeri Sembilan was 58.5% (CAM-DM: 40.6% and CAM-G: 17.9%). For CAM-DM group, bitter gourd (Momordica charantia) was the most popular CAM consumed to help control diabetes, while supplement milk was the most popular choice for the CAM-G group. In conclusion, the use of CAM among type II diabetes mellitus patients in Negeri Sembilan was common. Natural products are the main choice of CAM modality used to help with the management of diabetes. Majority of CAM users never informed their healthcare providers about their CAM use.
    Study site: 45 klinik kesihatan, Negeri Sembilan, Malaysia
  9. Fulltext Pomegranate peels waste hydrolyzate optimization by Response Surface Methodology for Bioethanol production
    Chaudhary A, Hussain Z, Aihetasham A, El-Sharnouby M, Abdul Rehman R, Azmat Ullah Khan M, et al.
    Saudi J Biol Sci, 2021 Sep;28(9):4867-4875.
    PMID: 34466060 DOI: 10.1016/j.sjbs.2021.06.081
    Unwanted agricultural waste is largely comprised of lignocellulosic substrate which could be transformed into sugars. The production of bioethanol from garbage manifested an agreeable proposal towards waste management as well as energy causation. The goal of this work is to optimize parameters for generation of bioethanol through fermentation by different yeast strains while Saccharomyces cerevisiae used as standard strain. The low cost fermentable sugars from pomegranate peels waste (PPW) were obtained by hydrolysis with HNO3 (1 to 5%). The optimum levels of hydrolysis time and temperature were elucidated via RSM (CCD) ranging from 30 to 60 min and 50 to 100 °C respectively. The result shows that optimum values (g/L) for reducing sugars was 61.45 ± 0.01 while for total carbohydrates was 236 ± 0.01. These values were found when PPW was hydrolyzed with 3% HNO3, at 75 °C for one hour. The hydrolyzates obtained from the dilute HNO3 pretreated PPW yielded a maximum of 0.43 ± 0.04, 0.41 ± 0.03 g ethanol per g of reducing sugars by both Metchnikowia sp. Y31 and M. cibodasensis Y34 at day 7 of ethanologenic experiment. The current study exhibited that by fermentation of dilute HNO3 hydrolyzates of PPW could develop copious amount of ethanol by optimized conditions.
  10. Fulltext Factors Associated with Self-Medication during the COVID-19 Pandemic: A Cross-Sectional Study in Pakistan
    Chaudhry B, Azhar S, Jamshed S, Ahmed J, Khan LU, Saeed Z, et al.
    Trop Med Infect Dis, 2022 Oct 25;7(11).
    PMID: 36355873 DOI: 10.3390/tropicalmed7110330
    Self-medication (SM) is characterized by the procurement and use of medicines by bypassing primary healthcare services and without consulting a physician, usually to manage acute symptoms of self-diagnosed illnesses. Due to the limited availability of primary healthcare services and the anxiety associated with the COVID-19 pandemic, the compulsion to SM by the public has increased considerably. The study aimed to assess the characteristics, practices, and associated factors of SM by the public during the COVID-19 pandemic in Sargodha, Pakistan. χ2-tests and univariable analyses were conducted to explore the identification of characteristics and the potential contributing factors for SM during COVID-19, while multivariable logistic regression models were run to study the effect of variables that maintained a significant association. The study was performed during July−September 2021, with n = 460 questionnaires returned overall (response rate: 99.5%). The majority of respondents were males (58.7%, n = 270) who live in the periphery of the town (63.9%, n = 294), and most of the respondents belonged to the age group of 18−28 years (73.3%, n = 339). A large number, 46.1% (n = 212), of the participants were tested for COVID-19 during the pandemic, and among them, 34.3% (n = 158) practiced SM during the pandemic; the most common source of obtaining medicines was requesting them directly from a pharmacy (25.0%; n = 127). The chances of practicing SM for medical health professionals were 1.482 (p-value = 0.046) times greater than for non-medical health personnel. The likelihood of practicing SM in participants whose COVID-19 test was positive was 7.688 (p-value < 0.001) times more than who did not test for COVID-19. Allopathic medicines, acetaminophen (23.6%), azithromycin (14,9%), and cough syrups (13%), and over the counter (OTC) pharmaceuticals, vitamin oral supplements, such as Vitamin C (39.1%), folic acid (23.5%), and calcium (22.6%), were the most commonly consumed medicines and supplements, respectively; being a healthcare professional or having a COVID-test prior showed a significant association with the usage of Vitamin C (p < 0.05 in all cases). Respondents who mentioned unavailability of the physician and difficulty in travelling/reaching healthcare professionals were found 2.062-times (p-value = 0.004) and 1.862-times (p-value = 0.021) more likely to practice SM, respectively; SM due to fear of COVID was more common in individuals who had received COVID-tests prior (p = 0.004). Practices of SM were observed at alarming levels among our participants. Consciousness and understanding about the possible adverse effects of SM must be established and validated on a continuous level; in addition, on a commercial level, collaboration from pharmacists not to sell products (especially prescription-only medicines) without a certified prescription must be developed and implemented.
  11. Fulltext The use of complementary and alternative medicine among malaysian chronic kidney disease patients
    Muhammad Yusuf, A.S., Abdul Halim, A.G., Shamsul Azhar, S.
    Medicine & Health, 2019;14(2):219-234.
    MyJurnal
    Many of our chronic kidney disease (CKD) patients venture into complementary and alternative medicine (CAM) to seek a cure for the disease beyond conventional management. The objective of this study was to determine the prevalence and pattern of CAM usage; and its association with the progression of CKD in our population. This was a cross-sectional survey recruited CKD patients from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Data was collected via interview using questionnaires which explore the demographics, type and pattern of CAM use. Patients’ comorbidities and serum creatinine were extracted from the medical notes to assess the association between progression of CKD and usage of CAM. Chi-square, Independent Samples t-test, Mann-Whitney U test and logistic regression were used to evaluate for an association. Three hundred and seventy two eligible patients were recruited. The prevalence of CAM use was 29% in the past year. Younger age, higher education and higher income level were associated with significantly more usage of CAM. Natural products were the commonest type of CAM used (86.1%). The belief in the effectiveness of CAM was the main reason for its uptake and about 57.8% revealed their practice to their physician. We found that the use of CAM in Malaysian CKD patients did not influence the progression of the disease.
  12. Fulltext Assessment of potential drug-drug interactions and its associated factors in the hospitalized cardiac patients
    Murtaza G, Khan MY, Azhar S, Khan SA, Khan TM
    Saudi Pharm J, 2016 Mar;24(2):220-5.
    PMID: 27013915 DOI: 10.1016/j.jsps.2015.03.009
    Drug-drug interactions (DDIs) may result in the alteration of therapeutic response. Sometimes they may increase the untoward effects of many drugs. Hospitalized cardiac patients need more attention regarding drug-drug interactions due to complexity of their disease and therapeutic regimen. This research was performed to find out types, prevalence and association between various predictors of potential drug-drug interactions (pDDIs) in the Department of Cardiology and to report common interactions. This study was performed in the hospitalized cardiac patients at Ayub Teaching Hospital, Abbottabad, Pakistan. Patient charts of 2342 patients were assessed for pDDIs using Micromedex® Drug Information. Logistic regression was applied to find predictors of pDDIs. The main outcome measure in the study was the association of the potential drug-drug interactions with various factors such as age, gender, polypharmacy, and hospital stay of the patients. We identified 53 interacting-combinations that were present in total 5109 pDDIs with median number of 02 pDDIs per patient. Overall, 91.6% patients had at least one pDDI; 86.3% were having at least one major pDDI, and 84.5% patients had at least one moderate pDDI. Among 5109 identified pDDIs, most were of moderate (55%) or major severity (45%); established (24.2%), theoretical (18.8%) or probable (57%) type of scientific evidence. Top 10 common pDDIs included 3 major and 7 moderate interactions. Results obtained by multivariate logistic regression revealed a significant association of the occurrence of pDDIs in patient with age of 60 years or more (p 
  13. Fulltext COVID-19 and sustainable development goals: A bibliometric analysis and SWOT analysis in Malaysian context
    Nilashi M, Ali Abumalloh R, Mohd S, Nurlaili Farhana Syed Azhar S, Samad S, Hang Thi H, et al.
    Telemat Inform, 2023 Jan;76:101923.
    PMID: 36510580 DOI: 10.1016/j.tele.2022.101923
    The COVID-19 crisis has been a core threat to the lives of billions of individuals over the world. The COVID-19 crisis has influenced governments' aims to meet UN Sustainable Development Goals (SDGs); leading to exceptional conditions of fragility, poverty, job loss, and hunger all over the world. This study aims to investigate the current studies that concentrate on the COVID-19 crisis and its implications on SDGs using a bibliometric analysis approach. The study also deployed the Strengths, Weaknesses, Opportunities, and Threats (SWOT) approach to perform a systematic analysis of the SDGs, with an emphasis on the COVID-19 crisis impact on Malaysia. The results of the study indicated the unprecedented obstacles faced by countries to meet the UN's SDGs in terms of implementation, coordination, trade-off decisions, and regional issues. The study also stressed the impact of COVID-19 on the implementation of the SDGs focusing on the income, education, and health aspects. The outcomes highlighted the emerging opportunities of the crisis that include an improvement in the health sector, the adoption of online modes in education, the swift digital transformation, and the global focus on environmental issues. Our study demonstrated that, in the post-crisis time, the ratio of citizens in poverty could grow up more than the current national stated values. We stressed the need to design an international agreement to reconsider the implementation of SDGs, among which, are strategic schemes to identify vital and appropriate policies.
  14. Fulltext Parental concerns and control in feeding of 9 to 12-year-old children in a primary school in Kuala Lumpur, Malaysia
    Noor AM, Muthupalaniappen L, Shamsul AS, Hizlinda T, Khairani O, Fatimah A
    Malays J Nutr, 2012 Apr;18(1):47-55.
    PMID: 23713229 MyJurnal
    Body weight of children is affected by many factors including food habits which are influenced by their parents. Studies in the West have shown that parents tend to control child feeding in response to their child's weight status. The aim of this study was to assess Malaysian parental concerns about child weight and the control they exert on child feeding.
  15. Fulltext Religious personality and smoking among form two students in rural schools in Malacca, Malaysia
    Nor Afiah, M.Z., Rahmah, M.A., Salmiah, M.S., Fazilah, I., Shamsul Azhar, S.
    International Medical Journal Malaysia, 2012;11(2):39-44.
    MyJurnal
    Introduction: There is an increasing trend in smoking among rural adolescents compared to urban adolescents in Malaysia. This study was to determine the relationship between religious personality and smoking among form two students from the rural schools in Malacca. Methods: This was an unmatched case-control study conducted from May 2010 to August 2010 among form two school children from rural area in Malacca. There were 484 cases, and 444 controls selected using randomized cluster sampling. The dependent variable was smoking, and the independent factors were religious personality. Validated and reliability-tested questionnaires were used for data collection. Results: The mean age (year) at which smoking was first tried among the cases was 11.39 + 2.107. There were eleven out of twenty three significant differences between religious personality statements in the cases and control group. Those were: reciting the Quran/Holy book/Scriptures even when busy, making efforts to deepen the understanding of the religion, trying to understand the teachings of the religion in the Holy book/Quran, inviting others to perform solat/prayer/religious service, making sure all the family members are following the teachings according to the religion, referring to the learned people when feeling uncertain about the rulings/teachings of the religion, performing work duties enthusiastically because of the religion/God, making efforts to remember death and afterlife often, making efforts to internalize the ethical conduct of the religion in daily life, setting aside money every year for religious purposes and looking for opportunities to give charity. Conclusion: Religious personality is an important factor which may influence adolescents volved in smoking.
  16. Fulltext Smoking behaviour among adolescents in rural schools in Malacca, Malaysia - a case-control study
    Nor Afiah, M.Z., Rahmah, M. A., Salmiah, M.S., Lye, M.S., Shamsul Azhar, S., Fazilah, I.
    Pertanika Journal of Science & Technology, 2015;23(1):13-28.
    MyJurnal
    Smoking among rural adolescents in Malaysia is on the rise with a significant difference seen between urban and rural youths. Therefore, this study was carried out to determine a predictive model of smoking among the rural-school adolescents population in Malacca, Malaysia. An unmatched case-control study was conducted in 2010 involving 484 cases and 444 controls of Form Two students in Malacca, Malaysia, using cluster sampling. Smoking was the dependent factor of this study while the independent factors were individual, family, school and environment. Data were obtained through a self-administered questionnaire. The response rate of the study was 100% whereas the smoking prevalence was 20.9%. Binary logistic regression was used to determine the smoking predictive model. Strong predictors of smoking behaviour were: influenced by artistes who smoke (Adjusted OR=8.67, 95% CI 5.53-13.58); the male gender (Adjusted OR=6.7, 95% CI 4.14-10.83); Muslim (Adjusted OR=4.46, 95% CI 2.36-8.44); and the belief that smoking is not dangerous when the teacher is seen smoking as well (Adjusted OR=3.95, 95% CI 2.19-7.10). Other predictors were: being offered cigarettes by friends (Adjusted OR=2.81, 95% CI 1.79-4.42); the belief that smoking will relax the mind (Adjusted OR=2.45, 95% CI 1.33-4.51); having friends who smoke (Adjusted OR=2.32, 95% CI 1.29-4.81); forced by friends to smoke (Adjusted OR=2.17, 95% CI 1.15-4.12); have heard of the national No-Smoking Campaign (Adjusted OR=1.89, 95% CI 1.06-3.37); have problems with the school management (Adjusted OR=1.75, 95% CI 1.07-2.88); parental consent to watch sexual activities, drug use or violence on television or at the cinema (Adjusted OR=1.73, 95% CI 1.06-2.83); and have lunch in school (Adjusted OR=1.58, 95% CI 1.04-2.41). This paper ends with the recognition of the need for intervention in dismantling the predictors that can lead to the development of smoking among Malaysian adolescents in rural schools. of different pathological entities.
  17. Fulltext Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre
    Nurul Iman, P., Ramliza, R., Wan Fariza, W.J., Shamsul Azhar, S., Nor Azimah, I., S. Fadilah, A.W.
    Medicine & Health, 2019;14(2):60-76.
    MyJurnal
    Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aim of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients, within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.
  18. Fulltext Digitization of natural history collections: A guideline and nationwide capacity building workshop in Malaysia
    Ong SQ, Mat Jalaluddin NS, Yong KT, Ong SP, Lim KF, Azhar S
    Ecol Evol, 2023 Jun;13(6):e10212.
    PMID: 37325726 DOI: 10.1002/ece3.10212
    Natural history museum collections are the most important sources of information on the present and past biodiversity of our planet. Most of the information is primarily stored in analogue form, and digitization of the collections can provide further open access to the images and specimen data to address the many global challenges. However, many museums do not digitize their collections because of constraints on budgets, human resources, and technologies. To encourage the digitization process, we present a guideline that offers low-cost and technical knowledge solutions yet balances the quality of the work and outcomes. The guideline describes three phases of digitization, namely preproduction, production, and postproduction. The preproduction phase includes human resource planning and selecting the highest priority collections for digitization. In the preproduction phase, a worksheet is provided for the digitizer to document the metadata, as well as a list of equipment needed to set up a digitizer station to image the specimens and associated labels. In the production phase, we place special emphasis on the light and color calibrations, as well as the guidelines for ISO/shutter speed/aperture to ensure a satisfactory quality of the digitized output. Once the specimen and labels have been imaged in the production phase, we demonstrate an end-to-end pipeline that uses optical character recognition (OCR) to transfer the physical text on the labels into a digital form and document it in a worksheet cell. A nationwide capacity workshop is then conducted to impart the guideline, and pre- and postcourse surveys were conducted to assess the confidence and skills acquired by the participants. This paper also discusses the challenges and future work that need to be taken forward for proper digital biodiversity data management.
  19. Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia
    Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.
    Med J Malaysia, 2009 Sep;64(3):197-204.
    PMID: 20527267 MyJurnal
    A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.
  20. Fulltext Isolation and characterization of pulp from sugarcane bagasse and rice straw
    Saiful Azhar, S., Suhardy, D., Kasim, F.H., Nazry Saleh, M.
    Journal of Nuclear and Related Technologies, 2007;2007(1):109-114.
    MyJurnal
    The amount of sugarcane bagasse and rice straw in the state of Perlis (Malaysia) is abundant while its utilization is still limited. One of the alternatives for the bagasse and straw utilization is as pulp raw material. This paper reviews on pulp from sugarcane bagasse and rice straw and its suitability for paper production. In this study, the pulp was extracted by the Soxhlet extraction method. The objective of this study was to investigate the cellulose, lignin and silica content of the pulp from sugarcane bagasse and rice straw. For rice straw, the presence of large amount of pentosanes in the pulp and black liquors, which also contain silica were decreased the using of straw in the paper industry. Therefore, formic acid pulping and NaOH treatment are studied to reduce or prevent silica. The isolated pulp samples were further characterized by Scanning Electron Microscope (SEM) to investigate their fiber dimensions.
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