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Master's program in clinical pharmacy at a Malaysian pharmacy school

Ab Rahman AF, Bahari MB

Am J Health Syst Pharm, 2004 Dec 15;61(24):2687-9.
PMID: 15646704
Fulltext Iraqi parents' views of barriers to childhood immunization

Al-Lela OQ, Bahari MB, Al-Abbassi MG, Salih MR, Basher AY

East Mediterr Health J, 2013 Mar;19(3):295-7.
PMID: 23879083

Deficiencies in knowledge about immunization among parents often leads to poor utake or errors in immunization dosage and timing. The aims of this study were to determine Iraqi parents' views of barriers to immunization and beliefs about ways to promote immunization. A questionnaire survey was carried out among 528 Iraqi parents with children who had incomplete immunization status. The main barriers to immunization agreed by the parents were lack of vaccine availability (51.5% of parents) and parents' lack of education (42.4%), while 88.4% of parents thought that lack of funding was not an important barrier. More than 60% of the parents suggested promoting childhood immunization via the media, and 77.5% thought that an increase in funding would not remove barriers to childhood immunization. Better vaccine availability in public health clinics and improving parents' literacy might enhance immunization uptake in Iraq.
Estimation of immunization providers' activities cost, medication cost, and immunization dose errors cost in Iraq

Al-lela OQ, Bahari MB, Al-abbassi MG, Salih MR, Basher AY

Vaccine, 2012 Jun 6;30(26):3862-6.
PMID: 22521848 DOI: 10.1016/j.vaccine.2012.04.014

The immunization status of children is improved by interventions that increase community demand for compulsory and non-compulsory vaccines, one of the most important interventions related to immunization providers. The aim of this study is to evaluate the activities of immunization providers in terms of activities time and cost, to calculate the immunization doses cost, and to determine the immunization dose errors cost. Time-motion and cost analysis study design was used. Five public health clinics in Mosul-Iraq participated in the study. Fifty (50) vaccine doses were required to estimate activities time and cost. Micro-costing method was used; time and cost data were collected for each immunization-related activity performed by the clinic staff. A stopwatch was used to measure the duration of activity interactions between the parents and clinic staff. The immunization service cost was calculated by multiplying the average salary/min by activity time per minute. 528 immunization cards of Iraqi children were scanned to determine the number and the cost of immunization doses errors (extraimmunization doses and invalid doses). The average time for child registration was 6.7 min per each immunization dose, and the physician spent more than 10 min per dose. Nurses needed more than 5 min to complete child vaccination. The total cost of immunization activities was 1.67 US$ per each immunization dose. Measles vaccine (fifth dose) has a lower price (0.42 US$) than all other immunization doses. The cost of a total of 288 invalid doses was 744.55 US$ and the cost of a total of 195 extra immunization doses was 503.85 US$. The time spent on physicians' activities was longer than that spent on registrars' and nurses' activities. Physician total cost was higher than registrar cost and nurse cost. The total immunization cost will increase by about 13.3% owing to dose errors.
Fulltext Incorporating an immunization course in the pharmacy curriculum: Malaysian experience

Al-lela OQ, Bahari MB, Elkalmi RM, Jawad Awadh AI

Am J Pharm Educ, 2012 Dec 12;76(10):206.
PMID: 23275671 DOI: 10.5688/ajpe7610206
Fulltext Profitable Fischer Tropsch realization via CO2-CH4 reforming; an overview of nickel-promoter-support interactions

Alhassan M, Jalil AA, Bahari MB, Owgi AHK, Nabgan W, Hassan NS, et al.

RSC Adv, 2023 Jan 06;13(3):1711-1726.
PMID: 36712622 DOI: 10.1039/d2ra06773k

Environmental pollution, climate change, and fossil fuel extinction have aroused serious global interest in the search for alternative energy sources. The dry reforming of methane (DRM) could be a good technique to harness syngas, a starting material for the FT energy process from greenhouse gases. Noble metal DRM catalysts are effective for the syngas generation but costly. Therefore, they inevitably, must be replaced by their Ni-based contemporaries for economic reasons. However, coking remains a strong challenge that impedes the industrialization of the FT process. This article explains the secondary reactions that lead to the production of detrimental graphitic coke deposition on the surface of active nickel catalyst. The influence of nickel particle size, impact of extra surface oxygen species, interaction of Ni catalysts with metal oxide supports/promoters, and larger fraction of exposed nickel active sites were addressed in this review. Size of active metal determines the conversion, surface area, metal dispersion, surface reactions, interior diffusion effects, activity, and yield. The influence of oxygen vacancy and coke deposition on highly reported metal oxide supports/promoters (Al2O3, MgO and La2O3) was postulated after studying CIFs (crystallographic information files) obtained from the Crystallography open database (COD) on VESTA software. Thus, overcoming excessive coking by La2O3 promotion is strongly advised in light of the orientation of the crystal lattice characteristics and the metal-support interaction can be used to enhance activity and stability in hydrogen reforming systems.
CuO improved energy band of AgO/fibrous SiO2-ZrO2 for optimized simultaneous photocatalytic redox of chromium (VI) and p-cresol using response surface methodology

Aziz FFA, Jalil AA, Hassan NS, Fauzi AA, Khusnun NF, Ali MW, et al.

Environ Res, 2023 Mar 01;220:115151.
PMID: 36584845 DOI: 10.1016/j.envres.2022.115151

Ternary CuO/AgO/FSZr photocatalysts were fabricated via the hydrothermal and electrochemical methods with three different CuO loading (1, 3 and 5 wt%), indicated as 1CuO/AgO/FSZr, 3CuO/AgO/FSZr and 5CuO/AgO/FSZr. The photocatalytic reaction was tested towards simultaneous chromium (VI) photoreduction and p-cresol photooxidation and the performance in order as follow: 3CuO/AgO/FSZr > 5CuO/AgO/FSZr > 1CuO/AgO/FSZr > AgO/FSZr > FSZr. CuO/AgO/FSZr photocatalysts showed an improvement in photocatalytic activity compared to AgO/FSZr and FSZr due to the reduction potential of chromium (VI) aligned closer to the conduction band of CuO and provided abundant free active electrons (e-) and holes (h+) with efficient transportation and migration. Interestingly, the 3CuO/AgO/FSZr was established as the best photocatalyst with 98% reduction of chromium (VI) and 83% oxidation of p-cresol simultaneously, owing to its strong corporation between the metal oxides and support and higher total pore volume. The Langmuir-Hinshelwood model were employed for kinetics which followed the pseudo-first-order kinetics model well. Based on the simultaneous photocatalytic mechanism, chromium (VI) and p-cresol were directly reduced and oxidized by e- and h+, respectively. The response surface methodology (RSM) discovered that the quadratic term initial concentration of chromium (VI) is the main significant factor in photocatalytic performance. The optimum parameters for simultaneous photoredox of chromium (VI) and p-cresol predicted from RSM are 9.6 mg L-1 of chromium (VI) concentration, 9.8 mg L-1 of p-cresol concentration and 0.32 g L-1 of catalyst dosage. Under these conditions the error between the predicted and experimental values is only 3.7%. The 3CuO/AgO/FSZr sustained the photocatalytic performance after reused for five cycles and could oxidized various organic pollutants as well as reduced chromium (VI) simultaneously.
Fulltext A knowledge of asthma in school children: a survey among primary school teachers

Bahari MB, Nur NM, Rahman AF

Singapore Med J, 2003 Mar;44(3):131-5.
PMID: 12953726

A survey was carried out among primary school teachers in the district of Kota Bharu, Malaysia to assess the level of knowledge on asthma and its management. Our findings revealed that primary school teachers were less informed about the management and treatment of asthma. They were relatively more knowledgeable about the causes and symptomatology of asthma. The majority of respondents had misunderstanding regarding the effect of rain, smoking and cold weather on asthma. It is important that teachers should be able to recognise symptoms of an asthmatic attack or take the necessary precautions to avoid such an attack. Many teachers agreed on the need to have an asthma education programme in their teaching curriculum.
Effects of pre and post-treatments with dipyridamole in gentamicin-induced acute nephrotoxicity in the rat

Balakumar P, WitnessKoe WE, Gan YS, JemayPuah SM, Kuganesswari S, Prajapati SK, et al.

Regul Toxicol Pharmacol, 2017 Mar;84:35-44.
PMID: 27993652 DOI: 10.1016/j.yrtph.2016.12.007

This study investigated the pretreatment and post-treatment effects of dipyridamole (20 mg/kg/day, p.o.) in gentamicin-induced acute nephrotoxicity in rats. Rats were administered gentamicin (100 mg/kg/day, i.p.) for 8 days. Gentamicin-administered rats exhibited renal structural and functional changes as assessed in terms of a significant increase in serum creatinine and urea and kidney weight to body weight ratio as compared to normal rats. Renal histopathological studies revealed a marked incidence of acute tubular necrosis in gentamicin-administered rats. These renal structural and functional abnormalities in gentamicin-administered rats were accompanied with elevated serum uric acid level, and renal inflammation as assessed in terms of decrease in interleukin-10 levels. Dipyridamole pretreatment in gentamicin-administered rats afforded a noticeable renoprotection by markedly preventing renal structural and functional abnormalities, renal inflammation and serum uric acid elevation. On the other hand, dipyridamole post-treatment did not significantly prevent uric acid elevation and renal inflammation, and resulted in comparatively less protection on renal function although it markedly reduced the incidence of tubular necrosis. In conclusion, uric acid elevation and renal inflammation could play key roles in gentamicin-nephrotoxicity. Dipyridamole pretreatment markedly prevented gentamicin-induced acute nephrotoxicity, while its post-treatment resulted in comparatively less renal functional protection.
Exploring community pharmacists' views on generic medicines: a nationwide study from Malaysia

Chong CP, Hassali MA, Bahari MB, Shafie AA

Int J Clin Pharm, 2011 Feb;33(1):124-31.
PMID: 21365404 DOI: 10.1007/s11096-010-9470-1

OBJECTIVE: To evaluate the Malaysian community pharmacists' views on generic medicines.
SETTING: A sample of 1419 Malaysian community pharmacies with resident pharmacists.
METHOD: A cross-sectional nationwide survey using a self-completed mailing questionnaire.
MAIN OUTCOME MEASURE: Pharmacists' views on generic medicines including issues surrounding efficacy, safety, quality and bioequivalence.
RESULTS: Responses were received from 219 pharmacies (response rate 15.4%). Only 50.2% of the surveyed pharmacists agreed that all products that are approved as generic equivalents can be considered therapeutically equivalent with the innovator medicines. Around 76% of respondents indicated that generic substitution of narrow therapeutic index medicines is inappropriate. The majority of the pharmacists understood that a generic medicine must contain the same amount of active ingredient (84.5%) and must be in the same dosage form as the innovator brand (71.7%). About 21% of respondents though that generic medicines are of inferior quality compared to innovator medicines. Most of the pharmacists (61.6%) disagreed that generic medicines produce more side-effects than innovator brand. Pharmacists graduated from Malaysian universities, twinning program and overseas universities were not differed significantly in their views on generic medicines. Additionally, the respondents appeared to have difficulty in ascertaining the bioequivalent status of the marketed generic products in Malaysia.
CONCLUSION: The Malaysian pharmacists' have lack of information and/or trust in the generic manufacturing and/or approval system in Malaysia. This issue should be addressed by pharmacy educators and relevant government agencies.
A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance

Chong CP, March G, Clark A, Gilbert A, Hassali MA, Bahari MB

Health Policy, 2011 Feb;99(2):139-48.
PMID: 20732723 DOI: 10.1016/j.healthpol.2010.08.002

This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution.
Evaluating community pharmacists' perceptions of future generic substitution policy implementation: a national survey from Malaysia

Chong CP, Hassali MA, Bahari MB, Shafie AA

Health Policy, 2010 Jan;94(1):68-75.
PMID: 19762106 DOI: 10.1016/j.healthpol.2009.08.011

This study aims to provide baseline data to support the implementation of generic substitution policy in Malaysia by evaluating the community pharmacists' perceptions and opinions on generic substitution and current substitution practices.
Fulltext Antiepileptic drug utilisation and seizure outcome among paediatric patients in a Malaysian public hospital

Hasan SS, Bahari MB, Babar ZU, Ganesan V

Singapore Med J, 2010 Jan;51(1):21-7.
PMID: 20200771

INTRODUCTION: The primary purpose of this study was to evaluate the utilisation pattern and seizure outcome of newer and older antiepileptic drugs in paediatric clinical practice in a Malaysian hospital setting.
METHODS: Over a two-month period, all paediatric epilepsy patients from Penang General Hospital, Malaysia who were diagnosed according to the classification of the International League Against Epilepsy were followed up prospectively, and the patients' information was gathered with the help of a validated data collection form. This included demographic characteristics, monotherapy and polytherapy of antiepileptic drugs, as well as the number of seizures experienced.
RESULTS: Partial seizures, including complex and simple partial seizures (47.2 percent), followed by generalised seizures (40 percent), were the most common seizure types found in this study. An average of 1.51 antiepileptic drugs per patient was prescribed, with 54.3 percent of the patients on monotherapy and 45.7 percent on polytherapy. Overall, sodium valproate was the most frequently prescribed antiepileptic drug (36.8 percent), followed by carbamazepine (30.2 percent) and lamotrigine (10.4 percent). Carbamazepine was the most frequently prescribed monotherapy (28.6 percent), followed by sodium valproate (17.1 percent). The newer antiepileptic drugs were also found to be used as monotherapy in 7.2 percent of the cases. Moreover, a significant difference was observed between the older and newer antiepileptic drugs in terms of the number of seizures experienced (p=0.027). Most (75 percent) of the seizure-free patients were on carbamazepine monotherapy.
CONCLUSION: Monotherapy was the most frequently used remedy in all forms of epilepsy. Overall, sodium valproate was the most commonly used drug, while carbamazepine was found to be more frequently used as monotherapy. There was a significant difference found between the older and newer antiepileptic drugs, with 87.5 percent of seizure-free patients on older antiepileptic drugs.

Study site: all paediatric epilepsy patients from Penang General Hospital
Extra-modification of zirconium dioxide for potential photocatalytic applications towards environmental remediation: A critical review

Hassan NS, Jalil AA, Khusnun NF, Bahari MB, Hussain I, Firmansyah ML, et al.

J Environ Manage, 2023 Feb 01;327:116869.
PMID: 36455446 DOI: 10.1016/j.jenvman.2022.116869

Photocatalytic degradation is a valuable direction for eliminating organic pollutants in the environment because of its exceptional catalytic activity and low energy requirements. As one of the prospective photocatalysts, zirconium dioxide (ZrO2) is a promising candidate for photoactivity due to its favorable redox potential and higher chemical stability. ZrO2 has a high rate of electron-hole recombination and poor light-harvesting capabilities. Still, modification has demonstrated enhancements, especially extra-modification, and is therefore worthy of investigation. This present review provides a comprehensive overview of the extra-modifications of ZrO2 for enhanced photocatalytic performance, including coupling with other semiconductors, doping with metal, non-metal, and co-doping with metal and non-metal. The extra-modified ZrO2 showed superior performance in degrading the organic pollutant, particularly dyes and phenolic compounds. Interestingly, this review also briefly highlighted the probable mechanisms of the extra-modification of ZrO2 such as p-n heterojunction, type II heterojunction, and Z-scheme heterojunction. The latter heterojunction with excellent electron-hole space separation improved the photoactivity. Extensive research on ZrO2's photocatalytic potential is presented, including the removal of heavy metals, the redox of heavy metals and organic pollutants, and the evolution of hydrogen. Modified ZrO2's photocatalytic effectiveness depends on its band position, oxygen vacancy concentration, and metal defect sites. The opportunities and future problems of the extra-modified ZrO2 photocatalyst are also discussed. This review aims to share knowledge regarding extra-modified ZrO2 photocatalysts and inspire new environmental remediation applications.
A comprehensive review on zeolite-based mixed matrix membranes for CO2/CH4 separation

Hassan NS, Jalil AA, Bahari MB, Khusnun NF, Aldeen EMS, Mim RS, et al.

Chemosphere, 2023 Feb;314:137709.
PMID: 36592833 DOI: 10.1016/j.chemosphere.2022.137709

Biogas consisting of carbon dioxide/methane (CO2/CH4) gas mixtures has emerged as an alternative renewable fuel to natural gas. The presence of CO2 can decrease the calorific value and generate greenhouse gas. Hence, separating CO2 from CH4 is a vital step in enhancing the use of biogas. Zeolite and zeolite-based mixed matrix membrane (MMM) is considered an auspicious candidate for CO2/CH4 separation due to thermal and chemical stability. This review initially addresses the development of zeolite and zeolite-based MMM for the CO2/CH4 separation. The highest performance in terms of CO2 permeance and CO2/CH4 selectivity was achieved using zeolite and zeolite-based MMM, which exhibited CO2 permeance in the range of 2.0 × 10- 7-7.0 × 10- 6 mol m- 2 s- 1 Pa- 1 with CO2/CH4 selectivity ranging from 3 to 300. Current trends directed toward improving CO2/CH4 selectivity via modification methods including post-treatment, ion-exchanged, amino silane-grafted, and ionic liquid encapsulated of zeolite-based MMM. Those modification methods improved the defect-free and interfacial adhesions between zeolite particulates and polymer matrices and subsequently enhanced the CO2/CH4 selectivity. The modifications via ionic liquid and silane methods more influenced the CO2/CH4 selectivity with 90 and 660, respectively. This review also focuses on the possible applications of zeolite-based MMM, which include the purification and treatment of water as well as biomedical applications. Lastly, future advances and opportunities for gas separation applications are also briefly discussed. This review aims to share knowledge regarding zeolite-based MMM and inspire new industrial applications.
Vanadia as an electron-hole recombination inhibitor on fibrous silica-titania for selective hole oxidation of ciprofloxacin and Congo red photodegradation

Hassan NS, Jalil AA, Fei ICM, Razak MTA, Khusnun NF, Bahari MB, et al.

Chemosphere, 2023 Oct;338:139502.
PMID: 37453521 DOI: 10.1016/j.chemosphere.2023.139502

Vanadia (V2O5)-incorporated fibrous silica-titania (V/FST) catalysts, which were successfully synthesized using a hydrothermal method followed by the impregnation of V2O5. The catalysts were then characterized using numerous techniques, including X-ray diffraction, field emission scanning electron microscopy, transmission electron microscopy, nitrogen adsorption-desorption analyses, ultraviolet-visible diffuse reflectance spectroscopy, Fourier-transform infrared, X-ray photoelectron spectroscopy, and photoluminescence (PL) analyses. The study found that varying the amount of V2O5 (1-10 wt%) had a significant impact on the physicochemical properties of the FST, which in turn improved the photodegradation efficiency of two organic compounds, ciprofloxacin (CIP) and congo red (CR). 5V/FST demonstrated the best performance in degrading 10 mg L-1 of CIP (83%) and CR (100%) at pH 3 using 0.375 g L-1 catalyst under visible light irradiation within 180 min. The highest photoactivity of 5V/FST is mainly due to higher crystallinity and the highest number of V2O5-FST interactions. Furthermore, as demonstrated by PL analysis, the 5V/FST catalyst has the most significant impact on interfacial charge transfer and reduces electron-hole recombination. The photodegradation of both contaminants follows the Langmuir-Hinshelwood pseudo-first-order model, according to the kinetic study. The scavenger investigation demonstrated that hydroxyl radicals and holes dominated species in the system, indicating that the catalyst effectively generated reactive species for pollutant degradation. A possible mechanism was also identified for FST and 5V/FST. Interestingly, V2O5 acts as an electron-hole recombination inhibitor on FST for selective hole oxidation of ciprofloxacin and congo red photodegradation. Finally, the degradation efficiency of the catalyst remained relatively stable even after five cyclic experiments, indicating its potential for long-term use in environmental remediation.
Fulltext Health-Related Quality of Life Among Tuberculosis Patients in Pakistan: A Cross Sectional Study Using WHOQOL-BREF

Iqbal MS, Iqbal MW, Bahari MB, Iqbal MZ

Value Health, 2014 Nov;17(7):A601-2.
PMID: 27202073 DOI: 10.1016/j.jval.2014.08.2086
Fulltext A Pharmacoeconomic Care Analysis of Tuberculosis Control in Pakistan

Iqbal MS, Iqbal MW, Bahari MB, Khalid SH, Iqbal MZ

Value Health, 2014 Nov;17(7):A594.
PMID: 27202039 DOI: 10.1016/j.jval.2014.08.2044
Fulltext The Economic Impact Of Hypertension In Health Care System Of Pakistan

Iqbal MS, Iqbal MW, Bahari MB, Iqbal MZ

Value Health, 2014 Nov;17(7):A485.
PMID: 27201430 DOI: 10.1016/j.jval.2014.08.1415
An RP-HPLC-UV method with SPE for cefotaxime in all-in-one total parenteral nutritional admixtures: application to stability studies

Iqbal MS, Bahari MB, Darwis Y, Iqbal MZ, Hayat A, Venkatesh G

J AOAC Int, 2013 6 19;96(2):290-4.
PMID: 23767352

A simple and selective RP-HPLC-UV method with SPE was developed and validated for the quantification of cefotaxime in all-in-one total parenteral nutrition (AIO-TPN) admixtures. Chromatographic separation was achieved on a 5 pm particle size C18 DB column (250 x 4.6 mm id) using the mobile phase ammonium acetate (25 mM, pH 4.0)-50% acetonitrile in methanol (80 + 20, v/v). The flow rate was 0.9 mL/min and the detection wavelength was 254 nm. The analyte was extracted from AIO-TPN admixtures by means of an SPE method. The cefotaxime calibration curve was linear over a concentration range of 100-1400 microg/mL with a correlation coefficient of > or = 0.9994. The intraday accuracy and precision for cefotaxime were < or = -3.15 and < or = 3.08%, respectively, whereas the interday accuracy and precision were < or = -2.48 and < or = 2.25%, respectively. The method was successfully applied to stability studies of cefotaxime in the presence of micronutrients together with low and high concentrations of macronutrients in AIO-TPN admixtures. Cefotaxime was degraded by 13.00 and 26.05% at room temperature (25 +/- 2 degrees C) after 72 h in low and high macronutrient concentration formulations of AIO-TPN admixtures, respectively. The values of cefotaxime degradation rates for low and high macronutrient concentration formulations of AIO-TPN admixtures were -0.164 and -0.353, respectively. These results indicated that there was a higher rate of degradation in the AIO-TPN admixture formulations containing high concentrations of macronutrients.
Complementary and alternative medicines (CAM) among diabetes patients: a prospective study from Pakistan [Abstract]

Iqbal MS, Iqbal MZ, Iqbal MW, Bahari MB

Value Health, 2015 Nov;18(7):A620.
PMID: 26533480 DOI: 10.1016/j.jval.2015.09.2170

Objectives: To evaluate the prevalence and patterns of CAM use among diabetes patients in Pakistan. In addition, the study also focused on the perceived effectiveness of CAM over conventional therapies, information seeking behavior and CAM disclosure to healthcare providers.
Methods: A prospective, cross-sectional and self-administered questionnaire based study was conducted in tertiary care public hospitals in Pakistan. A prevalence based sample of 350 diabetes patients attending the tertiary hospital in Punjab, Pakistan were selected for the study. All obtained data were analyzed using descriptive and inferential statistics.
Results: Overall, 327 questionnaires were completed and included in the analysis, showing that 52.8% of diabetics had used CAM, with most (62.4%) believing that CAM therapies assist body’s natural forces to heal. CAM usage was significantly associated with gender (P=0.001), level of education (P=0.001), employment status (P=0.03) and monthly income (P<0.001).
Conclusions: Diabetes treatment and management requires compliance to effective therapies at early stages. Healthcare providers should engage diabetics in an open non-judgmental dialogue to ascertain better understanding of diabetes and its management options.

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