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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.
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.
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.
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.
Synthesis and catalytic properties of calcium oxide obtained from organic ash over a titanium nanocatalyst for biodiesel production from dairy scum

Nabgan W, Nabgan B, Ikram M, Jadhav AH, Ali MW, Ul-Hamid A, et al.

Chemosphere, 2022 Mar;290:133296.
PMID: 34914962 DOI: 10.1016/j.chemosphere.2021.133296

The fatty acid methyl ester (FAME) production from dairy effluent scum as a sustainable energy source using CaO obtained from organic ash over titanium dioxide nanoparticles (TNPs) as the transesterification nano-catalyst has been studied. The physical and chemical properties of the synthesized catalysts were characterized, and the effect of different experimental factors on the biodiesel yield was studied. It was revealed that the CaO-TiO2 nano-catalyst displayed bifunctional properties, has both basic and acid phases, and leads to various effects on the catalyst activity in the transesterification process. These bifunctional properties are critical for achieving simultaneous transesterification of dairy scum oil feedstock. According to the reaction results, the catalyst without and with a low ratio of TNPs showed a low catalytic activity. In contrast, the 3Ca-3Ti nano-catalyst had the highest catalytic activity and a strong potential for reusability, producing a maximum biodiesel yield of 97.2% for a 3 wt% catalyst, 1:20 oil to methanol molar ratio for the dairy scum, and a reaction temperature of 70 °C for a period of 120 min under a 300 kPa pressure. The physical properties of the produced biodiesel are within the EN14214 standards.
Fulltext Knowledge, Attitude, and Practice about Mental Health Challenges among Healthcare Students of a Private University

Zahid Iqbal M, Rathi R, Prajapati SK, Zi Qing MS, Pheng TS, Wei Kee H, et al.

J Pharm Bioallied Sci, 2021;13(1):136-142.
PMID: 34084060 DOI: 10.4103/jpbs.JPBS_297_20

OBJECTIVE: The objective of this study was to evaluate the knowledge, attitude, and practice of healthcare students (Medicine, Pharmacy, and Dentistry) in a private university about mental health challenges (MHC).
MATERIALS AND METHODS: A research cross-sectional observational was conducted to evaluate the knowledge, attitude, and practice of students towards MHC at a private university in Malaysia. A validated questionnaire was distributed to 284 students studying in three different selected faculties, namely the Faculty of Medicine, Pharmacy, and Dentistry. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data.
RESULTS: Upon evaluation of knowledge, male students were having less-adequate knowledge than females (P = 0.006). Malay students were having adequate knowledge than other races about MHC. Faculty of Medicine was having adequate knowledge than other faculties (P ≤ 0.001). Regarding attitude, the Faculty of Pharmacy students had the highest positive attitudes (P = 0.001). Final year students were having a more positive attitude than pre-final year students. For the evaluation of practice, the Faculty of Dentistry students had the lowest practice compared with other faculties.
CONCLUSION: In conclusion, overall, good knowledge was seen among the students of the private medical university about MHC. The medical students had adequate knowledge when compared with other faculties in the university.
Fulltext Knowledge, Attitude, and Practice of Oral Hygiene Among Students of a Private University

Iqbal MZ, Rathi R, Prajapati SK, Omar K, Bahari MB, Rajan S, et al.

J Pharm Bioallied Sci, 2021;13(1):123-128.
PMID: 34084058 DOI: 10.4103/jpbs.JPBS_298_20

OBJECTIVE: The objective of the study was to evaluate the knowledge, attitude, and practice among pre-final and final year students of pharmacy, medicine, biotechnology, and business faculties about oral hygiene.
MATERIALS AND METHODS: A cross-sectional observational study was conducted to evaluate the knowledge, attitude, and practice of students towards oral hygiene at a private university in Malaysia. Validated questionnaires were distributed to a convenient stratified sample of 324 students studying in the different selected faculties, namely pharmacy, medicine, biotechnology, and business, respectively. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data.
RESULTS: With regard to knowledge, upon evaluation, it was seen that the students of the Faculty of Pharmacy had the highest percentage of adequate knowledge, which was statistically significant with a P-value of 0.001 and the effect size of 0.246. On the evaluation of attitudes, it was seen that the Faculty of Biotechnology had the highest positive attitudes. According to race, Malay students had the highest positive attitude among all the races that participated in the study, which showed a P-value of 0.037 with the effect size of 0.034. Regarding practice, the Faculty of Pharmacy had the lowest practice compared with the other faculties. This variable had a P-value of 0.001 and showed to have significance against the practice with an effect size of 0.193.
CONCLUSION: Overall, a good attitude was seen amongst the students on their oral hygiene. It was also observed that the attitude, knowledge, and practice of the students in a private university increased with an increasing level of education.
Fulltext Immunogenicity and protective efficacy of a live, oral cholera vaccine formulation stored outside-the-cold-chain for 140 days

Xian TH, Sinniah K, Yean CY, Krishnamoorthy V, Bahari MB, Ravichandran M, et al.

BMC Immunol, 2020 05 25;21(1):29.
PMID: 32450807 DOI: 10.1186/s12865-020-00360-1

BACKGROUND: Cholera, an acute watery diarrhoeal disease caused by Vibrio cholerae serogroup O1 and O139 across the continents. Replacing the existing WHO licensed killed multiple-dose oral cholera vaccines that demand 'cold chain supply' at 2-8 °C with a live, single-dose and cold chain-free vaccine would relieve the significant bottlenecks and cost determinants in cholera vaccination campaigns. In this direction, a prototype cold chain-free live attenuated cholera vaccine formulation (LACV) was developed against the toxigenic wild-type (WT) V. cholerae O139 serogroup. LACV was found stable and retained its viability (5 × 106 CFU/mL), purity and potency at room temperature (25 °C ± 2 °C, and 60% ± 5% relative humidity) for 140 days in contrast to all the existing WHO licensed cold-chain supply (2-8 °C) dependent killed oral cholera vaccines.
RESULTS: The LACV was evaluated for its colonization potential, reactogenicity, immunogenicity and protective efficacy in animal models after its storage at room temperature for 140 days. In suckling mice colonization assay, the LACV recorded the highest recovery of (7.2 × 107 CFU/mL) compared to those of unformulated VCUSM14P (5.6 × 107 CFU/mL) and the WT O139 strain (3.5 × 107 CFU/mL). The LACV showed no reactogenicity even at an inoculation dose of 104-106 CFU/mL in a rabbit ileal loop model. The rabbits vaccinated with the LACV or unformulated VCUSM14P survived a challenge with WT O139 and showed no signs of diarrhoea or death in the reversible intestinal tie adult rabbit diarrhoea (RITARD) model. Vaccinated rabbits recorded a 275-fold increase in anti-CT IgG and a 15-fold increase in anti-CT IgA antibodies compared to those of rabbits vaccinated with unformulated VCUSM14P. Vibriocidal antibodies were increased by 31-fold with the LACV and 14-fold with unformulated VCUSM14P.
CONCLUSION: The vaccine formulation mimics a natural infection, is non-reactogenic and highly immunogenic in vivo and protects animals from lethal wild-type V. cholerae O139 challenge. The single dose LACV formulation was found to be stable at room temperature (25 ± 2 °C) for 140 days and it would result in significant cost savings during mass cholera vaccination campaigns.
Fulltext Phyto-Mediated Photo Catalysed Green Synthesis of Silver Nanoparticles Using Durio Zibethinus Seed Extract: Antimicrobial and Cytotoxic Activity and Photocatalytic Applications

Sumitha S, Vasanthi S, Shalini S, Chinni SV, Gopinath SCB, Anbu P, et al.

Molecules, 2018 Dec 13;23(12).
PMID: 30551671 DOI: 10.3390/molecules23123311

In the present study, we have developed a green approach for the synthesis of silver nanoparticles (DSAgNPs) using aqueous extract of Durio zibethinus seed and determined its antibacterial, photocatalytic and cytotoxic effects. Surface plasmon resonance confirmed the formation of DSAgNPs with a maximum absorbance (λmax) of 420 nm. SEM and TEM images revealed DSAgNPs were spherical and rod shaped, with a size range of 20 nm and 75 nm. The zeta potential was found to be -15.41 mV. XRD and EDX analyses confirmed the nature and presence of Ag and AgCl. DSAgNPs showed considerable antibacterial activity, exhibited better cytotoxicity against brine shrimp, and shown better photocatalytic activity against methylene blue. Based on the present research work, it can be concluded that DSAgNPs could be used in the field of water treatment, pharmaceuticals, biomedicine, biosensor and nanotechnology in near future.
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.
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.
Physicians' Prescribing Pattern For Tuberculosis: Evidences From Community Pharmacies In Punjab, Pakistan

Iqbal MS, Iqbal MZ, Iqbal MW, Bahari MB

Value Health, 2015 Nov;18(7):A507-8.
PMID: 26532843 DOI: 10.1016/j.jval.2015.09.1455
Knowledge, Attitude and Perception of Polio (Poliomyelitis) among General Public in Pakistan

Iqbal MS, Iqbal MW, Iqbal MZ, Bahari MB

Value Health, 2015 Nov;18(7):A591.
PMID: 26533322 DOI: 10.1016/j.jval.2015.09.1519
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.
Practices associated with serum antiepileptic drug level monitoring at a pediatric neurology clinic: a Malaysian experience

Salih MR, Bahari MB, Hassali MA, Shafie AA, Al-Lela OQ, Abd AY, et al.

J Pharm Pract, 2013 Jun;26(3):192-7.
PMID: 22797836 DOI: 10.1177/0897190012451926

OBJECTIVES: To assess the practices associated with the application of therapeutic drug monitoring (TDM) for antiepileptic drugs (AEDs) in the management of children with structural-metabolic epilepsy.
METHODS: It was a retrospective chart review and included children aged ≥2 years old with structural-metabolic epilepsy, treated with AEDs, and received TDM. The data were extracted from the medical records.
RESULTS: Thirty-two patients were identified with 50 TDM assays. In two thirds of the assays, "check level" and "recheck level" were the reasons behind the requesting of serum level monitoring of AEDs. Knowledge of serum AED levels led to alterations in the management in 60% of the assays. Thirty-two (76%) pediatrician's actions were consistent with the recommendation of TDM pharmacist. Forty-nine (98%) levels were appropriately indicated. In relation to the appropriateness of sampling time, 9 (18%) levels were not assessed due to missing data. Twenty-seven (54%) levels were appropriately sampled.
CONCLUSIONS: More studies should be designed to improve the component of the current TDM request form, especially in the reason section. By the same token, the number of pointless assays and the costs to the health care system can be reduced both by enhancing and improving the educational standards of the requesting neurologists.
KEYWORDS: Malaysia; epilepsy; neurology; pediatrics; therapeutic drug monitoring
Study site: Paediatric Neurology Clinic, Hospital Pulau Pinang, Malaysia
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.

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