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Fulltext Is the contact time between patient and health care personnel in Ministry of Health Hospitals Malaysia appropriate?

Roslinah, A., Azman, A.B., Roslan Johari, M.G., Noriah, B., Rohani, I., Faisal, S.

Malaysian Journal of Public Health Medicine, 2010;10(1):14-22.
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Contact time was defined as the time spent by health personnel with a patient. The study was conducted for four months in 2007 to assess the contact time and to determine the appropriate contact time as perceived by patients attending clinics of various clinical disciplines as well as Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals. This study was a cross-sectional study carried out on out-patients who came to the hospitals’ clinics for treatment. Information was gathered through self-administered questionnaires, distributed at twenty-one hospitals. The respondents were selected using stratified random sampling method. Out of 21,750 questionnaires distributed, 13,463 patients responded, a response rate of 61.9%. This study shows that the average contact time increases from small hospitals (8 minutes) to bigger hospitals (15 minutes). The contact time also varies between the clinics of various disciplines. Obstetrics and Gynecology (O&G) clinics and Pediatric clinics had the longest average contact time of 20 minutes and 15 minutes respectively. The percentage of patients who were satisfied with the contact time corresponded with the type of clinics and hospitals which had the longest contact time. Thus, it is suggested that clinics and hospitals, whenever possible try their best to follow the duration of contact time as perceived appropriate by the patients.

Study site: Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals (21)
Fulltext Coping With Diabetes During the COVID-19 Lockdown in Saudi Arabia: Lessons Learned in the Post-pandemic Era

Alharbi A, Alduribi A, Alghthami A, Elnaem M, Alsenani FS, Haseeb A, et al.

Cureus, 2022 Nov;14(11):e31522.
PMID: 36532936 DOI: 10.7759/cureus.31522

BACKGROUND: Uncontrolled diabetes has appeared as one of the major risk factors for morbidity and mortality in diabetic patients with coronavirus disease 2019 (COVID-19). Alterations in dietary habits, physical inactivity, and inability to take advice from the physician are some of the contributing factors. This study aimed to assess the impact of the COVID-19 lockdown in Saudi Arabia on medication accessibility, medication adherence, lifestyle, and quality of life of diabetes patients.
METHODS: A cross-sectional observational study was conducted among diabetic patients using a self-reported questionnaire developed on an online platform (SurveyMonkey®). The survey was distributed through social media platforms (WhatsApp, Telegram). For those who were digitally illiterate, responses were collected by family members. The targeted population was type 1, type 2 and gestational diabetes patients. The analysis of the data was done using IBM SPSS Statistics, version 26.
RESULTS: Four hundred forty-nine participants completed the survey. Most of the participants had type 2 diabetes (n=359; 79.8%) and were well educated (83.2%) with a high school degree and above. Complications from COVID-19 infection were reported in 12% (n=54) patients. During quarantine, 78.8% (n=354) of participants measured their blood glucose regularly. Results showed that during quarantine, 68.3% (n=311) participants skipped their scheduled follow-up whereas only 5.1% (n=23) of them took their medication inappropriately.
CONCLUSION: This study reported good levels of self-monitoring of blood glucose levels, whereas patients' accessibility to seek healthcare services seemed to be interrupted. Further efforts are needed in the post-pandemic era to empower patients' self-care behaviors and utilize telehealth models to facilitate timely access to medical care.
Fulltext HealthLock: Blockchain-Based Privacy Preservation Using Homomorphic Encryption in Internet of Things Healthcare Applications

Ali A, Al-Rimy BAS, Alsubaei FS, Almazroi AA, Almazroi AA

Sensors (Basel), 2023 Jul 28;23(15).
PMID: 37571545 DOI: 10.3390/s23156762

The swift advancement of the Internet of Things (IoT), coupled with the growing application of healthcare software in this area, has given rise to significant worries about the protection and confidentiality of critical health data. To address these challenges, blockchain technology has emerged as a promising solution, providing decentralized and immutable data storage and transparent transaction records. However, traditional blockchain systems still face limitations in terms of preserving data privacy. This paper proposes a novel approach to enhancing privacy preservation in IoT-based healthcare applications using homomorphic encryption techniques combined with blockchain technology. Homomorphic encryption facilitates the performance of calculations on encrypted data without requiring decryption, thus safeguarding the data's privacy throughout the computational process. The encrypted data can be processed and analyzed by authorized parties without revealing the actual contents, thereby protecting patient privacy. Furthermore, our approach incorporates smart contracts within the blockchain network to enforce access control and to define data-sharing policies. These smart contracts provide fine-grained permission settings, which ensure that only authorized entities can access and utilize the encrypted data. These settings protect the data from being viewed by unauthorized parties. In addition, our system generates an audit record of all data transactions, which improves both accountability and transparency. We have provided a comparative evaluation with the standard models, taking into account factors such as communication expense, transaction volume, and security. The findings of our experiments suggest that our strategy protects the confidentiality of the data while at the same time enabling effective data processing and analysis. In conclusion, the combination of homomorphic encryption and blockchain technology presents a solution that is both resilient and protective of users' privacy for healthcare applications integrated with IoT. This strategy offers a safe and open setting for the management and exchange of sensitive patient medical data, while simultaneously preserving the confidentiality of the patients involved.
Challenges associated with cellulose composite material: Facet engineering and prospective

Aziz T, Haq F, Farid A, Kiran M, Faisal S, Ullah A, et al.

Environ Res, 2023 Apr 15;223:115429.
PMID: 36746207 DOI: 10.1016/j.envres.2023.115429

Cellulose is the most abundant polysaccharide on earth. It has a large number of desirable properties. Its low toxicity makes it more useful for a variety of applications. Nowadays, its composites are used in most engineering fields. Composite consists of a polymer matrix and use as a reinforcing material. By reducing the cost of traditional fibers, it has an increasing demand for environment-friendly purposes. The use of these types of composites is inherent in moisture absorption with hindered natural fibers. This determines the reduction of polymer composite material. By appropriate chemical surface treatment of cellulose composite materials, the effect could be diminished. The most modern and advanced techniques and methods for the preparation of cellulose and polymer composites are discussed here. Cellulosic composites show a reinforcing effect on the polymer matrix as pointed out by mechanical characterization. Researchers tried their hard work to study different ways of converting various agricultural by-products into useful eco-friendly polymer composites for sustainable production. Cellulose plays building blocks, that are critical for polymer products and their engineering applications. The most common method used to prepare composites is in-situ polymerization. This help to increase the yields of cellulosic composites with a significant enhancement in thermal stability and mechanical properties. Recently, cellulose composites used as enhancing the incorporation of inorganic materials in multi-functional properties. Furthermore, we have summarized in this review the potential applications of cellulose composites in different fields like packaging, aerogels, hydrogels, and fibers.
Role of silica-based porous cellulose nanocrystals in improving water absorption and mechanical properties

Aziz T, Farid A, Haq F, Kiran M, Ullah N, Faisal S, et al.

Environ Res, 2023 Apr 01;222:115253.
PMID: 36702191 DOI: 10.1016/j.envres.2023.115253

Epoxy resins are important thermosetting polymers. They are widely used in many applications i.e., adhesives, plastics, coatings and sealers. Epoxy molding compounds have attained dominance among common materials due to their excellent mechanical properties. The sol-gel simple method was applied to distinguish the impact on the colloidal time. The properties were obtained with silica-based fillers to enable their mechanical and thermal improvement. The work which we have done here on epoxy-based nanocomposites was successfully modified. The purpose of this research was to look into the effects of cellulose nanocrystals (CNCs) on various properties and applications. CNCs have recently attracted a lot of interest in a variety of industries due to their high aspect ratio, and low density which makes them perfect candidates. Adding different amounts of silica-based nanocomposites to the epoxy system. Analyzed with different techniques such as Fourier-transformed infrared spectroscope (FTIR), thermogravimetric analysis (TGA) and scanning electronic microscopic (SEM) to investigate the morphological properties of modified composites. The various %-age of silica composite was prepared in the epoxy system. The 20% of silica was shown greater enhancement and improvement. They show a better result than D-400 epoxy. Increasing the silica, the transparency of the films decreased, because clustering appears. This shows that the broad use of CNCs in environmental engineering applications is possible, particularly for surface modification, which was evaluated for qualities such as absorption and chemical resistant behavior.
Fulltext Emergence of Polymeric Material Utilising Sustainable Radiation Curable Palm Oil-Based Products for Advanced Technology Applications

Tajau R, Rohani R, Alias MS, Mudri NH, Abdul Halim KA, Harun MH, et al.

Polymers (Basel), 2021 Jun 04;13(11).
PMID: 34199699 DOI: 10.3390/polym13111865

In countries that are rich with oil palm, the use of palm oil to produce bio-based acrylates and polyol can be the most eminent raw materials used for developing new and advanced natural polymeric materials involving radiation technique, like coating resins, nanoparticles, scaffold, nanocomposites, and lithography for different branches of the industry. The presence of hydrocarbon chains, carbon double bonds, and ester bonds in palm oil allows it to open up the possibility of fine-tuning its unique structures in the development of novel materials. Cross-linking, reversible addition-fragmentation chain transfer (RAFT), polymerization, grafting, and degradation are among the radiation mechanisms triggered by gamma, electron beam, ultraviolet, or laser irradiation sources. These radiation techniques are widely used in the development of polymeric materials because they are considered as the most versatile, inexpensive, easy, and effective methods. Therefore, this review summarized and emphasized on several recent studies that have reported on emerging radiation processing technologies for the production of radiation curable palm oil-based polymeric materials with a promising future in certain industries and biomedical applications. This review also discusses the rich potential of biopolymeric materials for advanced technology applications.
Fulltext Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes

Botto F, Alonso-Coello P, Chan MT, Villar JC, Xavier D, Srinathan S, et al.

Anesthesiology, 2014 Mar;120(3):564-78.
PMID: 24534856 DOI: 10.1097/ALN.0000000000000113

BACKGROUND: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study's four objectives were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS.
METHODS: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated "abnormal" laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria.
RESULTS: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors' diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96-5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6-41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom.
CONCLUSION: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.