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Fulltext The relationship between bacterial sources and genotype to the antimicrobial resistance pattern of Burkholderia pseudomallei

Sadiq MA, Hassan L, Aziz SA, Zakaria Z, Musa HI, Amin MM

Vet World, 2018 Nov;11(10):1404-1408.
PMID: 30532493 DOI: 10.14202/vetworld.2018.1404-1408

Background: Melioidosis is a fatal emerging infectious disease of both man and animal caused by bacteria Burkholderia pseudomallei. Variations were suggested to have existed among the different B. pseudomallei clinical strains/genotypes which may implicate bacterial susceptibility and resistance toward antibiotics.
Aim: This study was designed to determine whether the phenotypic antibiotic resistance pattern of B. pseudomallei is associated with the source of isolates and the genotype.
Materials and Methods: A collection of 111 B. pseudomallei isolates from veterinary cases of melioidosis and the environments (soil and water) were obtained from stock cultures of previous studies and were phylogenetically characterized by multilocus sequence typing (ST). The susceptibility to five antibiotics, namely meropenem (MEM), imipenem, ceftazidime (CAZ), cotrimoxazole (SXT), and co-amoxiclav (AMC), recommended in both acute and eradication phases of melioidosis treatment were tested using minimum inhibitory concentration antibiotics susceptibility test.
Results: Majority of isolates were susceptible to all antibiotics tested while few resistant strains to MEM, SXT, CAZ, and AMC were observed. Statistically significant association was found between resistance to MEM and the veterinary clinical isolates (p<0.05). The likelihood of resistance to MEM was significantly higher among the novel ST 1130 isolates found in veterinary cases as compared to others.
Conclusion: The resistance to MEM and SXT appeared to be higher among veterinary isolates, and the novel ST 1130 was more likely to be resistant to MEM as compared to others.
Phylogenetic Diversity of Burkholderia pseudomallei isolated from veterinary cases and the environments in Peninsular Malaysia

Sadiq MA, Hassan L, Aziz SA, Zakaria Z, Musa HI, Amin MM, et al.

Vet Anim Sci, 2018 Dec;6:21-28.
PMID: 32734049 DOI: 10.1016/j.vas.2018.07.004

This study was designed to determine the genotype and the phylogeny of Burkholderia pseudomallei isolated from veterinary cases and from the animal environments in Peninsular Malaysia. The Malaysian B. pseudomallei population were then compared to those found elsewhere. A total of 113 isolates from veterinary cases (35) and the environment (56 from soil and 22 from water) were characterized using multilocus sequence typing (MLST). Two novel alleles, allele 97 and 69 of the gene locus ace and lepA respectively were recovered. Isolates were resolved into 12 distinct sequence types (STs) out of which five were novel, namely ST1130, ST1131, ST1338, ST1339 and ST1367. The isolates from veterinary cases co-clustered with those from the environment. B. pseudomallei isolates in this study were highly clonal and have descended from a common ancestor clonal complex (CC) 48 found in Southeast Asia. This study shows that veterinary case isolates are often caused by similar STs, with similar populations found in the direct animal environment and those previously reported to cause human infections in Malaysia and elsewhere. Isolates of B. pseudomallei from human infections have been given more attention, with a comparatively lower focus on isolates from animals and the farm environment. This study highlighted the genotype and phylogeny of B. pseudomallei isolated from animals and the environment and their relations to the isolates from human cases reported in Malaysia and elsewhere. Most STs reported in this study, from veterinary cases and animal environment are similar to those previously reported as causing human infections in Malaysia and elsewhere. Therefore, even though direct zoonosis is uncommon, monitoring melioidosis occurrences in animals can provide insights on the bacterial strains infecting humans.
Occurrence of Campylobacter species from broiler chickens and chicken meat in Malaysia

Sinulingga TS, Aziz SA, Bitrus AA, Zunita Z, Abu J

Trop Anim Health Prod, 2020 Jan;52(1):151-157.
PMID: 31273582 DOI: 10.1007/s11250-019-01995-y

Campylobacter is reported as a major cause of foodborne illness worldwide. Consumption of contaminated chicken meat is considered a significant risk factor of Campylobacter infection in humans. This study investigated the occurrence of non-Campylobacter jejuni-Campylobacter coli, in broiler chickens (n = 210) and chicken meat (n = 109). The samples were collected from seven broiler chicken farms (n = 210 cloacal swabs), 11 markets (n = 84 chicken meat), and 5 supermarkets (n = 25 chicken meat) located in different districts of Selangor State. Campylobacter were isolated from cloacal swabs using the Cape Town Protocol and from meat samples using the method of Duffy et al. (2007) with some modifications for Campylobacter isolations which were reported effective in the isolation of non-C. jejuni-C. coli Campylobacter species. The isolates were identified by Gram staining for cellular morphology, wet mount for motility and biochemical tests. Confirmation of presumed Campylobacter isolates was carried out using multiplex PCR (mPCR). One hundred seven (107/210) or 50.9% and twenty-nine (29/109) or 26.6% of chickens and chicken meat samples respectively were positive for Campylobacter species. Among the Campylobacter isolates from chickens, C. jejuni was the most predominantly isolated species (69.5%), followed by C. coli (16.2%). Campylobacter fetus and C. upsaliensis were the non-C. jejuni-C. coli Campylobacter species isolated in this study, at 9.3% and 2.5% respectively. Overall, the findings indicated broiler chickens were colonized not only by the common Campylobacter species but also by other Campylobacter species. We found the Cape Town Protocol useful to detect the occurrence of non-C. jejuni-C. coli isolates in chickens.
Fulltext Effectiveness of antihypertensive drugs in hypertensive patients with end stage renal failure

Kumolosasi E, Ng WB, Abdul Aziz SA

Med J Malaysia, 2012 Aug;67(4):379-85.
PMID: 23082445 MyJurnal

Hypertension has been identified as one of the causes for end stage renal failure (ESRF) and is likely to worsen kidney function. This retrospective study was carried out at a tertiary hospital in Malaysia with the objective of determining the effectiveness of combination antihypertensive drugs in hypertensive patients with ESRF admitted between 2006 and 2008. Patients with incomplete data and who were on monotherapy were excluded from this study. Although six different combinations gave significant reductions in systolic blood pressure (SBP) (13.38 +/- 9.11 mmHg, p < 0.05) and diastolic blood pressure (DBP) (6.03 +/- 11.39 mmHg, p < 0.05), 69.16% patients did not achieve target blood pressure (BP) (< or = 130/80 mmHg). Combination of beta blocker (BB) with calcium channel blocker (CCB) was the most commonly used. The CCB-diuretic regimen achieved highest percentage of BP control compared to others (40%). Comparison of blood pressure reduction between different combinations of antihypertensive drugs were not significant (p > 0.05) except for CCB-diuretics and BB-CCB-alpha blocker. The findings suggested better BP control with CCB-diuretic relative to other combinations used.
Fulltext Cutaneous vasculitis: a review of aetiology and clinical manifestations in 85 patients in Malaysia

Muthupalaniappen L, Aziz SA, Gangaram HB, Hussein SH

Med J Malaysia, 2009 Sep;64(3):210-2.
PMID: 20527269 MyJurnal

Cutaneous vasculitis presents with a variety of clinical morphologies and causes significant morbidity. A total of 85 patients with cutaneous vasculitis at Hospital Kuala Lumpur were retrospectively reviewed. Palpable purpura was seen in 49.4% and frequently involved the lower limbs (50.6%). Identifiable causes include drugs (28.2%), infections (20.0%) and connective tissue disorders (16.5%). Non steroidal antiinflammatory were the commonest group of drugs responsible for 25% of cases while B-haemolytic streptococci was the leading infectious cause (64.7%).
Fulltext MH17: the Malaysian experience

Khoo LS, Hasmi AH, Abdul Ghani Aziz SA, Ibrahim MA, Mahmood MS

Malays J Pathol, 2016 Apr;38(1):1-10.
PMID: 27126658 MyJurnal

A disaster is a natural or man-made (or technological) hazard resulting in an event of substantial extent causing significant physical damage or destruction, loss of life, or drastic change to the environment. It is a phenomenon that can cause damage to life and property and destroy the economic, social and cultural life of the people; and overwhelms the capacity of the community to cope with the event. The recent tragic aviation accidents in 2014 involving Malaysia Airlines flights MH370 and MH17 shocked the world in an unprecedented manner. This paper focuses on the Malaysian experience in the MH17 mission in Ukraine as well as the first ever international Disaster Victim Identification (DVI) operation for the Malaysian DVI team. The DVI operations in Hilversum, the Netherlands were well described in stages. The Netherlands' Landelijk Team Forensische Opsporing as the lead DVI team in Hilversum operated systematically, ensuring the success of the whole mission. This paper discusses the lessons learned by the Malaysian team on proper DVI structure, inter- and intra-agency cooperation, facilities planning and set up, logistics and health and safety aspects, as well as effective communication and collaboration with other international delegates. Several issues and challenges faced by the Malaysian team were also documented. In addition, the authors shared views, opinions and recommendations for a more comprehensive DVI operation in the future.
Fulltext In vitro effects of plantago major extract on urolithiasis

Aziz SA, See TL, Khuay LY, Osman K, Abu Bakar MA

Malays J Med Sci, 2005 Jul;12(2):22-6.
PMID: 22605954

The study was carried out to determine the in vitro effect of Plantago major extract on calcium oxalate crystals and to compare the effects of Plantago major extract with clinically used drugs like allopurinol and potassium citrate (positive controls). Modified Schneider slide gel method was used for the in vitro study and the crystals formed were measured by Image Analyser system KS 300, 3.0 Carl Zeiss. The concentrations of Plantago major extract used were from 100ppm to 350ppm. Plantago major extract at concentrations in the range of (100ppm-350ppm) significantly inhibited the size of calcium oxate crystals (dihydrate variety) against negative control (p<0.05) and against positive controls (p<0.05). However the inhibition concentration 50 (IC(50)) values on the size of calcium oxalate crystal for the extract, potassium citrate and allopurinol were 300ppm, 350ppm and 450ppm respectively. Extract of Plantago major also has inhibition effect on the number of crystals but it was not significant. In conclusion extract of Plantago major was better than allopurinol and potassium citrate in inhibiting the size of the calcium oxalate crystal in-vitro.
Evaluation of mean glandular dose and modulation transfer function for different tube potentials and target-filter combinations in computed radiography mammography

Abdul Aziz SA, Mohd Saparudin AK, Harun AZ

Malays J Med Sci, 2013 May;20(3):23-30.
PMID: 23966821 MyJurnal

BACKGROUND: Different target-filter combinations in computed radiography have different impacts on the dose and image quality in digital radiography. This study aims to evaluate the mean glandular dose (MGD) and modulation transfer function (MTF) of various target-filter combinations by investigating the signal intensities of X-ray beams.
METHODS: General Electric (GE) Senographe DMR Plus mammography unit was used for MGD and MTF evaluation. The measured MGD was compared with the dose reference level (DRL), whereas the MTF was evaluated using ImageJ 1.46o software. A modified Mammography Accreditation Phantom RMI 156 was exposed using different target-filter combinations of molybdenum-molybdenum (Mo-Mo), molybdenum-rhodium (Mo-Rh) and rhodium-rhodium (Rh-Rh) at two different tube voltages, 26 kV and 32 kV with 50 mAs.
RESULTS: In the MGD evaluations, all target-filters gave an MGD value of < 1.5 mGy. The one-way ANOVA test showed a highly significant interaction between the MGD and the kilovoltage and target-filter material used (26 kV: F (2,12) = 49,234, P = 0.001;32 kV: F (2,12) = 89,972, P = 0.001). A Tukey post-hoc test revealed that the MGD for 26 kV and 32 kV was highly affected by the target-filter combinations. The test of homogeneity of variances indicates that the MGD varies significantly for 26 kV and 32 kV images (0.045 and 0.030 (P < 0.05), respectively). However, the one-way ANOVA for the MTF shows that no significant difference exists between the target-filter combinations used with 26 kV and 32 kV images either in parallel or perpendicular to the chest wall side F (2,189) = 0.26, P > 0.05).
CONCLUSION: Higher tube voltage and atomic number target-filter yield higher MGD values. However, the MTF is independent of the X-ray energy and the type of target-filter combinations used.
Evaluation of Methadone Treatment in Malaysia: Findings from the Malaysian Methadone Treatment Outcome Study (MyTOS)

Ali N, Aziz SA, Nordin S, Mi NC, Abdullah N, Paranthaman V, et al.

Subst Use Misuse, 2018 01 28;53(2):239-248.
PMID: 29116878 DOI: 10.1080/10826084.2017.1385630

BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005.
OBJECTIVE: To evaluate the effectiveness of MMT.
METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20.
RESULTS: There were 3254 respondents (93.6% response rate); of these 17.5% (n = 570) transferred to another treatment center, 8.6% (n = 280) died, 29.2% (n = 950) defaulted, and 7.6% (n = 247) were terminated for various reasons. Hence, 1233 (37%) respondents' baseline and follow-up data were further analyzed. Respondents had a mean age of 39.2 years old and were mainly male, Malay, Muslim, married (51.1%, n = 617), and currently employed. Few showed viral seroconversion after they started MMT (HIV: 0.5%, n = 6; Hepatitis B: 0.3%, n = 4; Hepatitis C: 2.7%, n = 29). There were significant reductions in opioid use, HIV risk-taking score (p < 0.01), social functioning (p < 0.01), crime (p < 0.01), and health (p < 0.01). However, there were significant improvements in quality of life in the physical, psychological, social, and environmental domains. Factors associated with change were being married, employed, consuming alcohol, and high criminality at baseline. Lower methadone dosage was significantly associated with improvements in the physical, psychological, and environmental domains.
Conclusion/Importance: The MMT program was found to be successful; hence, it should be expanded.
Fulltext Dual Properties of Polyvinyl Alcohol-Based Magnetorheological Plastomer with Different Ratio of DMSO/Water

Hapipi NM, Mazlan SA, Ubaidillah U, Abdul Aziz SA, Choi SB, Nordin NA, et al.

Sensors (Basel), 2021 Nov 22;21(22).
PMID: 34833835 DOI: 10.3390/s21227758

Polyvinyl alcohol (PVA)-based magnetorheological plastomer (MRP) possesses excellent magnetically dependent mechanical properties such as the magnetorheological effect (MR effect) when exposed to an external magnetic field. PVA-based MRP also shows a shear stiffening (ST) effect, which is very beneficial in fabricating pressure sensor. Thus, it can automatically respond to external stimuli such as shear force without the magnetic field. The dual properties of PVA-based MRP mainly on the ST and MR effect are rarely reported. Therefore, this work empirically investigates the dual properties of this smart material under the influence of different solvent compositions (20:80, 40:60, 60:40, and 80:20) by varying the ratios of binary solvent mixture (dimethyl sulfoxide (DMSO) to water). Upon applying a shear stress with excitation frequencies from 0.01 to 10 Hz, the storage modulus (G') for PVA-based MRP with DMSO to water ratio of 20:40 increases from 6.62 × 10-5 to 0.035 MPa. This result demonstrates an excellent ST effect with the relative shear stiffening effect (RSTE) up to 52,827%. In addition, both the ST and MR effect show a downward trend with increasing DMSO content to water. Notably, the physical state of hydrogel MRP could be changed with different solvent ratios either in the liquid-like or solid-like state. On the other hand, a transient stepwise experiment showed that the solvent's composition had a positive effect on the arrangement of CIPs within the matrix as a function of the external magnetic field. Therefore, the solvent ratio (DMSO/water) can influence both ST and MR effects of hydrogel MRP, which need to be emphasized in the fabrication of hydrogel MRP for appropriate applications primarily with soft sensors and actuators for dynamic motion control.
Fulltext The effect of salt water ageing on the mechanical and rheological properties of magnetorheological elastomer

Ahmad Khairi MH, Mazlan SA, Ubaidillah U, Khaidir REM, Nordin NA, Johari MAF, et al.

Sci Rep, 2023 Apr 10;13(1):5810.
PMID: 37037883 DOI: 10.1038/s41598-023-33171-6

This paper aims to investigate the mechanical and rheological properties of magnetorheological elastomer (MRE) in marine ecosystems. The prepared samples comprised silicone rubber (SR) and 70 wt% micron-sized carbonyl iron particles (CIPs), immersed in an artificial marine ecosystem using salt water (Natrium Chloride) for 30 days. The mechanical properties of MRE samples were evaluated using hardness and quasi-static tensile tests. While the rheometer was used to investigate the rheological properties of their storage modulus condition with magnetic field stimulation. Further analysis of the defects and damages caused by salt water ageing was done through morphological observation using scanning electron microscope (SEM) technology. The results showed that the hardness and tensile strength of MRE samples that were soaked in salt water were affected over time. Lower values of hardness and tensile strength were obtained after 30 days due to the presence of Na+ and Cl-, which acted as an accelerator to the hydrolyzation process of the MRE. The process then, enhanced the water ingress capability into the matrix to cause the molecular changes. Interestingly, for rheological properties, 30 days of salt water ageing allowed the water molecules to move the MRE matrix molecular chains apart, a process known as plasticization and thus increasing the MR effect. Furthermore, morphological evidence was established to determine the MRE changes during salt water ageing. The research findings should greatly contribute to a better understanding of the effect of salt water on the performance of MRE.
Morphological features of magnetorheological elastomer degradation under a natural weathering environment

Johari MAF, Mazlan SA, Abdul Aziz SA, Zaini N, Nordin NA, Ubaidillah U, et al.

Sci Rep, 2024 Jan 12;14(1):1155.
PMID: 38212384 DOI: 10.1038/s41598-024-51736-x

It is well known in the field of materials science that a substance's longevity is significantly influenced by its environment. Everything begins with the initial contact on a material's surface. This influence will then deteriorate and have an extended negative impact on the strength of the material. In this study, the effect of natural weathering in tropical climates on magnetorheological elastomer (MRE) was investigated through microstructural evaluation to understand the aging behavior of the environmentally exposed MRE. To understand and elucidate the process, MREs made of silicone rubber and 70 wt% micron-sized carbonyl iron particles were prepared and exposed to the natural weathering of a tropical climate for 90 days. The MRE samples were then mechanically tensile tested, which revealed that Young's modulus increased, while elongation at break decreased. Surface degradation due to weathering was suspected to be the primary cause of this condition. Using scanning electron microscopy (SEM), the degradation of MRE was investigated as a function of morphological evidence. Upon examination through SEM, it was noted that the weathering effects on the morphology of the exposed samples showed distinct characteristics on the degraded surfaces of the MRE, including numerous microvoids, cavities, and microcracks. While these features were not prominent for the MRE itself, they bear resemblance to the effects observed in similar materials like rubber and elastomer. An atomic force microscope (AFM) is used to investigate the surface topography and local degradation conditions. This observation revealed a distinctive degradation characteristic of the MRE in connection to natural weathering in tropical climates. The surface damage of the MRE samples became severe and inhomogeneous during the environmental aging process, and degradation began from the exposed MRE surface, causing the mechanical characteristics of the MRE to significantly change.
Immunophenotyping analysis of lymph node biopsies by flow cytometry

Raja-Sabudin RZ, Hamid AA, Yusof N, Alauddin H, Aziz SA, Kulaveerasingam S, et al.

Saudi Med J, 2012 Oct;33(10):1131-3.
PMID: 23047221
Fulltext Physicomechanical Properties of Rice Husk/Coco Peat Reinforced Acrylonitrile Butadiene Styrene Blend Composites

Norhasnan NHA, Hassan MZ, Nor AFM, Zaki SA, Dolah R, Jamaludin KR, et al.

Polymers (Basel), 2021 Apr 06;13(7).
PMID: 33917337 DOI: 10.3390/polym13071171

Utilizing agro-waste material such as rice husk (RH) and coco peat (CP) reinforced with thermoplastic resin to produce low-cost green composites is a fascinating discovery. In this study, the effectiveness of these blended biocomposites was evaluated for their physical, mechanical, and thermal properties. Initially, the samples were fabricated by using a combination of melt blend internal mixer and injection molding techniques. Increasing in RH content increased the coupons density. However, it reduced the water vapor kinetics sorption of the biocomposite. Moisture absorption studies disclosed that water uptake was significantly increased with the increase of coco peat (CP) filler. It showed that the mechanical properties, including tensile modulus, flexural modulus, and impact strength of the 15% RH-5% CP reinforced acrylonitrile-butadiene-styrene (ABS), gave the highest value. Results also revealed that all RH/CP filled composites exhibited a brittle fracture manner. Observation on the tensile morphology surfaces by using a scanning electron microscope (SEM) affirmed the above finding to be satisfactory. Therefore, it can be concluded that blend-agriculture waste reinforced ABS biocomposite can be exploited as a biodegradable material for short life engineering application where good mechanical and thermal properties are paramount.
Fulltext Recent Progress of Rice Husk Reinforced Polymer Composites: A Review

Suhot MA, Hassan MZ, Aziz SA, Md Daud MY

Polymers (Basel), 2021 Jul 21;13(15).
PMID: 34371993 DOI: 10.3390/polym13152391

Recently, because of the rising population, carbon overloading, and environmental distress, human beings have needed to increase awareness and responsibility for the reduction of agricultural waste. The utilization of agricultural waste as a filler material in reinforced polymers is a fascinating discovery. This review paper attempts to study the physical, mechanical, and thermal behavior of rice husk (RH) as a fiber for reinforcing various synthetic polymers, based on recent studies, conducted between 2017 and 2021. It also highlights that advanced modification techniques could further improve the performance of composites by tailoring the physical and chemical substances of the fiber or matrix. The thermal properties, including flame-retardance and thermal behavior, are also discussed. The characteristics of the fiber-matrix interaction between RH and the polymer matrix provide essential insights into the future-ready applications of this agricultural waste fiber. The way forward in researching RH polymer composites is finally reviewed.
Fulltext Chemically Reduced Graphene Oxide-Reinforced Poly(Lactic Acid)/Poly(Ethylene Glycol) Nanocomposites: Preparation, Characterization, and Applications in Electromagnetic Interference Shielding

Ahmad AF, Aziz SA, Abbas Z, Obaiys SJ, Matori KA, Zaid MHM, et al.

Polymers (Basel), 2019 Apr 11;11(4).
PMID: 30978935 DOI: 10.3390/polym11040661

In this study, a nanocomposite of reduced graphene oxide (RGO) nanofiller-reinforcement poly(lactic acid) (PLA)/poly(ethylene glycol) (PEG) matrix was prepared via the melt blending method. The flexibility of PLA was improved by blending the polymer with a PEG plasticizer as a second polymer. To enhance the electromagnetic interference shielding properties of the nanocomposite, different RGO wt % were combined with the PLA/PEG blend. Using Fourier-transform infrared (FT-IR) spectroscopy, field emission scanning electron microscopy (FE-SEM) and X-ray diffraction, the structural, microstructure, and morphological properties of the polymer and the RGO/PLA/PEG nanocomposites were examined. These studies showed that the RGO addition did not considerably affect the crystallinity of the resulting nanomaterials. Thermal analysis (TGA) reveals that the addition of RGO highly improved the thermal stability of PLA/PEG nanocomposites. The dielectric properties and electromagnetic interference shielding effectiveness of the synthesized nanocomposites were calculated and showed a higher SE total value than the target value (20 dB). On the other hand, the results showed an increased power loss by increasing the frequency and conversely decreased with an increased percentage of filler.
Fulltext Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia

Lim LM, McStea M, Chung WW, Nor Azmi N, Abdul Aziz SA, Alwi S, et al.

PLoS One, 2017;12(3):e0173466.
PMID: 28273128 DOI: 10.1371/journal.pone.0173466

BACKGROUND: Polypharmacy has been associated with increased morbidity and mortality in the older population.
OBJECTIVES: The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia.
METHODS: This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models.
RESULTS: A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation.
CONCLUSION: A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.
Fulltext Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians

Yunus RM, Wazid SW, Hairi NN, Choo WY, Hairi FM, Sooryanarayana R, et al.

PLoS One, 2017;12(7):e0180222.
PMID: 28686603 DOI: 10.1371/journal.pone.0180222

OBJECTIVES: To examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI).
DESIGN: This study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome.
SETTING: Kuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia.
PARTICIPANTS: 1648 community-dwelling older Malaysians.
RESULTS: The Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach's Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for "no abuse", "1 type of abuse" and "2 types or more". Generalized linear models revealed six variables as significant determinants of sleep quality-abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep.
CONCLUSION: The Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed.
Fulltext Evaluation of six decontamination procedures for isolation of Mycobacterium avium complex from avian feces

Sattar A, Zakaria Z, Abu J, Aziz SA, Gabriel RP

PLoS One, 2018;13(8):e0202034.
PMID: 30096205 DOI: 10.1371/journal.pone.0202034

Culture is considered the gold standard for definitive diagnosis of mycobacterial infections. However, consensus about the most suitable culture procedure for isolation of nontuberculous mycobacteria is lacking. The study compared the recoveries of mycobacteria after decontamination of spiked and fresh avian feces with 4% sodium hydroxide (NaOH), 12% sulfuric acid (H2SO4), or 1% cetylperidinium chloride (CPC), with and without mixture of three antibiotics, namely vancomycin (VAN, 100 μg/ml), nalidixic acid (NAL, 100 μg/ml), and amphotericin B (AMB, 100 μg/ml). The antibiotic mixture was referred to as VNA. Decontamination procedures were evaluated using two (n = 2) avian fecal samples spiked with 106, 104, and 102 CFU/ml of Mycobacterium avium subsp. avium (ATCC 15769) and fresh avian feces (n = 42). M. avium subsp. avium was detected on the culture media from spiked samples (106 and 104 CFU/ml) decontaminated with NaOH, NaOH-VNA, H2SO4, and H2SO4 -VNA for 2-6 weeks. These bacteria were detected in 2-4 weeks when using CPC and CPC-VNA. M. avium subsp. avium cannot be isolated on culture media from spiked samples (102 CFU/ml) decontaminated with any decontaminating agent. Two mycobacterial isolates, namely, Mycobacterium terrae and M. engbaekii, were isolated from field samples decontaminated with NaOH and CPC-VNA. With regard to the contamination rate, the use of CPC-VNA showed lower contamination rates (5.5% and 19.0%) from spiked and field samples than those of the other methods (NaOH: 22.2% and 59.5%, NaOH-VNA: 16.7% and 21.4%, H2SO4: 11.1% and 40.5%, H2SO4-VNA: 5.5% and 21.4%, and CPC: 66.7% and 50%). In conclusion, the decontamination of fecal samples following a two-step procedure with 1% CPC and VNA can ensure high recovery rate of many mycobacteria with the lowest contamination in cultures.
Fulltext Elucidating the diet of the island flying fox (Pteropus hypomelanus) in Peninsular Malaysia through Illumina Next-Generation Sequencing

Aziz SA, Clements GR, Peng LY, Campos-Arceiz A, McConkey KR, Forget PM, et al.

PeerJ, 2017;5:e3176.
PMID: 28413729 DOI: 10.7717/peerj.3176

There is an urgent need to identify and understand the ecosystem services of pollination and seed dispersal provided by threatened mammals such as flying foxes. The first step towards this is to obtain comprehensive data on their diet. However, the volant and nocturnal nature of bats presents a particularly challenging situation, and conventional microhistological approaches to studying their diet can be laborious and time-consuming, and provide incomplete information. We used Illumina Next-Generation Sequencing (NGS) as a novel, non-invasive method for analysing the diet of the island flying fox (Pteropus hypomelanus) on Tioman Island, Peninsular Malaysia. Through DNA metabarcoding of plants in flying fox droppings, using primers targeting the rbcL gene, we identified at least 29 Operationally Taxonomic Units (OTUs) comprising the diet of this giant pteropodid. OTU sequences matched at least four genera and 14 plant families from online reference databases based on a conservative Least Common Ancestor approach, and eight species from our site-specific plant reference collection. NGS was just as successful as conventional microhistological analysis in detecting plant taxa from droppings, but also uncovered six additional plant taxa. The island flying fox's diet appeared to be dominated by figs (Ficus sp.), which was the most abundant plant taxon detected in the droppings every single month. Our study has shown that NGS can add value to the conventional microhistological approach in identifying food plant species from flying fox droppings. At this point in time, more accurate genus- and species-level identification of OTUs not only requires support from databases with more representative sequences of relevant plant DNA, but probably necessitates in situ collection of plant specimens to create a reference collection. Although this method cannot be used to quantify true abundance or proportion of plant species, nor plant parts consumed, it ultimately provides a very important first step towards identifying plant taxa and spatio-temporal patterns in flying fox diets.

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