Displaying publications 1 - 20 of 36 in total

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  1. Abdul-Hamid NA, Abas F, Ismail IS, Tham CL, Maulidiani M, Mediani A, et al.
    Food Res Int, 2019 11;125:108565.
    PMID: 31554083 DOI: 10.1016/j.foodres.2019.108565
    Inflammation has been revealed to play a central role in the onset and progression of many illnesses. Nuclear magnetic resonance (NMR) based metabolomics method was adopted to evaluate the effects of Phoenix dactylifera seeds, in particular the Algerian date variety of Deglet on the metabolome of the LPS-IFN-γ-induced RAW 264.7 cells. Variations in the extracellular and intracellular profiles emphasized the differences in the presence of tyrosine, phenylalanine, alanine, proline, asparagine, isocitrate, inosine and lysine. Principal component analysis (PCA) revealed noticeable clustering patterns between the treated and induced RAW cells based on the metabolic profile of the extracellular metabolites. However, the effects of treatment on the intracellular metabolites appears to be less distinct as suggested by the PCA and heatmap analyses. A clear group segregation was observed for the intracellular metabolites from the treated and induced cells based on the orthogonal partial least squares-discriminant analysis (OPLS-DA) score plot. Likewise, 11 of the metabolites in the treated cells were significantly different from those in the induced groups, including amino acids and succinate. The enrichment analysis demonstrated that treatment with Deglet seed extracts interfered with the energy and of amino acids metabolism. Overall, the obtained data reinforced the possible application of Deglet seeds as a functional food with anti-inflammatory properties.
  2. Hamdan NA, Hamid NA, Iman Leong Bin Abdullah MF
    Psychooncology, 2021 Oct 13.
    PMID: 34647392 DOI: 10.1002/pon.5835
    OBJECTIVES: Posttraumatic growth (PTG) may improve among cancer survivors, but a longitudinal study addressing head and neck cancer (HNC) is lacking. This longitudinal study examined PTG trends and determined the associations of physical symptoms and complications, as well as sociodemographic and tumor characteristics on PTG over time among HNC survivors.

    METHODS: Participants completed the European Organization of Research and Treatment of Cancer's "Quality of Life Questionnaire-Head and Neck 35" module (EORTC-QLQ-H&N-35) and "Posttraumatic Growth Inventory-Short Form" (PTGI-SF) during baseline (T1 ) and follow-up (T2 ; five to seven months post-baseline) assessments.

    RESULTS: In total, 200 HNC participants completed the study and 67.5% of them reported increasing PTG. Physical symptoms and complications that were significantly associated with lower PTG included problems with social contact and the senses. Meanwhile, sociodemographic variables that were significantly associated with PTG were gender (males had lower PTG than females) and religion (Muslims and Buddhists had higher PTG than participants of other religious faith).

    CONCLUSION: Our findings reveal the need to focus on the impact of sensory issues and reduced social contact following HNC on PTG which may be addressed by various restorative and supportive rehabilitation therapy. This article is protected by copyright. All rights reserved.

  3. Ganasegeran K, Hor CP, Jamil MFA, Loh HC, Noor JM, Hamid NA, et al.
    PMID: 32784771 DOI: 10.3390/ijerph17165723
    Diabetes causes significant disabilities, reduced quality of life and mortality that imposes huge economic burden on societies and governments worldwide. Malaysia suffers a high diabetes burden in Asia, but the magnitude of healthcare expenditures documented to aid national health policy decision-making is limited. This systematic review aimed to document the economic burden of diabetes in Malaysia, and identify the factors associated with cost burden and the methods used to evaluate costs. Studies conducted between 2000 and 2019 were retrieved using three international databases (PubMed, Scopus, EMBASE) and one local database (MyCite), as well as manual searches. Peer reviewed research articles in English and Malay on economic evaluations of adult type 2 diabetes conducted in Malaysia were included. The review was registered with PROSPERO (CRD42020151857), reported according to PRISMA and used a quality checklist adapted for cost of illness studies. Data were extracted using a data extraction sheet that included study characteristics, total costs, different costing methods and a scoring system to assess the quality of studies reviewed. The review identified twelve eligible studies that conducted cost evaluations of type 2 diabetes in Malaysia. Variation exists in the costs and methods used in these studies. For direct costs, four studies evaluated costs related to complications and drugs, and two studies were related to outpatient and inpatient costs each. Indirect and intangible costs were estimated in one study. Four studies estimated capital and recurrent costs. The estimated total annual cost of diabetes in Malaysia was approximately USD 600 million. Age, type of hospitals or health provider, length of inpatient stay and frequency of outpatient visits were significantly associated with costs. The most frequent epidemiological approach employed was prevalence-based (n = 10), while cost analysis was the most common costing approach used. The current review offers the first documented evidence on cost estimates of diabetes in Malaysia.
  4. Wong PL, Fauzi NA, Mohamed Yunus SN, Abdul Hamid NA, Abd Ghafar SZ, Azizan A, et al.
    Molecules, 2020 Jul 06;25(13).
    PMID: 32640504 DOI: 10.3390/molecules25133067
    Plants and plant-based products have been used for a long time for medicinal purposes. This study aimed to determine the antioxidant and anti-α-glucosidase activities of eight selected underutilized plants in Malaysia: Leucaena leucocephala, Muntingia calabura, Spondias dulcis, Annona squamosa, Ardisia elliptica, Cynometra cauliflora, Ficus auriculata, and Averrhoa bilimbi. This study showed that the 70% ethanolic extract of all plants exhibited total phenolic content (TPC) ranging from 51 to 344 mg gallic acid equivalent (GAE)/g dry weight. A. elliptica showed strong 2,2-diphenyl-1-picrylhydrazyl (DPPH) and nitric oxide (NO) scavenging activities, with half maximal inhibitory concentration (IC50) values of 2.17 and 49.43 μg/mL, respectively. Most of the tested plant extracts showed higher inhibition of α-glucosidase enzyme activity than the standard, quercetin, particularly A. elliptica, F. auriculata, and M. calabura extracts with IC50 values of 0.29, 0.36, and 0.51 μg/mL, respectively. A total of 62 metabolites including flavonoids, triterpenoids, benzoquinones, and fatty acids were tentatively identified in the most active plant, i.e., A. elliptica leaf extract, by using ultra-high-performance liquid chromatography (UHPLC)-electrospray ionization (ESI) Orbitrap MS. This study suggests a potential natural source of antioxidant and α-glucosidase inhibitors from A. elliptica.
  5. Abdul Hamid NA, Mediani A, Maulidiani M, Abas F, Park YS, Leontowicz H, et al.
    J Pharm Biomed Anal, 2017 May 10;138:80-91.
    PMID: 28189049 DOI: 10.1016/j.jpba.2017.01.046
    It is known from our previous studies that kiwifruits, which are used in common human diet, have preventive properties of coronary artery disease. This study describes a combination of (1)H NMR spectroscopy, multivariate data analyses and fluorescence measurements in differentiating of some kiwifruit varieties, their quenching and antioxidant properties. A total of 41 metabolites were identified by comparing with literature data Chenomx database and 2D NMR. The binding properties of the extracted polyphenols against HSA showed higher reactivity of studied two cultivars in comparison with the common Hayward. The results showed that the fluorescence of HSA was quenched by Bidan as much as twice than by other fruits. The correlation between the binding properties of polyphenols in the investigated fruits, their relative quantification and suggested metabolic pathway was established. These results can provide possible application of fruit extracts in pharmaceutical industry.
  6. Yusoff MM, Ibrahim H, Hamid NA
    Chem Biodivers, 2011 May;8(5):916-23.
    PMID: 21560240 DOI: 10.1002/cbdv.201000270
    Two poorly studied, morphologically allied Alpinia species endemic to Borneo, viz., A. ligulata and A. nieuwenhuizii, were investigated here for their rhizome essential oil. The oil compositions and antimicrobial activities were compared with those of A. galanga, a better known plant. A fair number of compounds were identified in the oils by GC-FID and GC/MS analyses, with large differences in the oil composition between the three species. The rhizome oil of A. galanga was rich in 1,8-cineole (29.8%), while those of A. ligulata and A. nieuwenhuizii were both found to be extremely rich in (E)-methyl cinnamate (36.4 and 67.8%, resp.). The three oils were screened for their antimicrobial activity against three Gram-positive and three Gram-negative bacteria and two fungal species. The efficiency of growth inhibition of Staphylococcus aureus var. aureus was found to decline in the order of A. nieuwenhuizii>A. ligulata ∼ A. galanga, while that of Escherichia coli decreased in the order of A. galanga>A. nieuwenhuzii ∼ A. ligulata. Only the A. galanga oil inhibited the other bacteria and the fungi tested.
  7. Mohd Azamai ES, Sulaiman S, Mohd Habib SH, Looi ML, Das S, Abdul Hamid NA, et al.
    J Zhejiang Univ Sci B, 2009 Jan;10(1):14-21.
    PMID: 19198018 DOI: 10.1631/jzus.B0820168
    Chlorella vulgaris (CV) has been reported to have antioxidant and anticancer properties. We evaluated the effect of CV on apoptotic regulator protein expression in liver cancer-induced rats. Male Wistar rats (200~250 g) were divided into eight groups: control group (normal diet), CDE group (choline deficient diet supplemented with ethionine in drinking water to induce hepatocarcinogenesis), CV groups with three different doses of CV (50, 150, and 300 mg/kg body weight), and CDE groups treated with different doses of CV (50, 150, and 300 mg/kg body weight). Rats were sacrificed at various weeks and liver tissues were embedded in paraffin blocks for immunohistochemistry studies. CV, at increasing doses, decreased the expression of anti-apoptotic protein, Bcl-2, but increased the expression of pro-apoptotic protein, caspase 8, in CDE rats, which was correlated with decreased hepatocytes proliferation and increased apoptosis as determined by bromodeoxy-uridine (BrdU) labeling and terminal deoxynucleotidyl transferase mediated dUTP nick-end labeling (TUNEL) assay, respectively. Our study shows that CV has definite chemopreventive effect by inducing apoptosis via decreasing the expression of Bcl-2 and increasing the expression of caspase 8 in hepatocarcinogenesis-induced rats.
  8. Rahman FA, Naidu J, Ngiu CS, Yaakob Y, Mohamed Z, Othman H, et al.
    Asian Pac J Cancer Prev, 2016;17(8):4037-41.
    PMID: 27644658
    BACKGROUND: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre.

    MATERIALS AND METHODS: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups.

    RESULTS: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were 4.9 ± 3.2 months and 8.3 ± 2.0 months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria.

    CONCLUSIONS: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.

  9. Sukeri S, Sulaiman Z, Hamid NA, Ibrahim SA
    Korean J Fam Med, 2024 Jan;45(1):27-36.
    PMID: 37848368 DOI: 10.4082/kjfm.23.0088
    BACKGROUND: Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV).

    METHODS: A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis.

    RESULTS: Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.

    CONCLUSION: The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.

  10. Abdul-Hamid NA, Mediani A, Maulidiani M, Abas F, Ismail IS, Shaari K, et al.
    Molecules, 2016 Oct 28;21(11).
    PMID: 27801841
    This study was aimed at examining the variations in the metabolite constituents of the different Ajwa grades and farm origins. It is also targeted at establishing the correlations between the metabolite contents and the grades and further to the nitric oxide (NO) inhibitory activity. Identification of the metabolites was generated using ¹H-NMR spectroscopy metabolomics analyses utilizing multivariate methods. The NO inhibitory activity was determined using a Griess assay. Multivariate data analysis, for both supervised and unsupervised approaches, showed clusters among different grades of Ajwa dates obtained from different farms. The compounds that contribute towards the observed separation between Ajwa samples were suggested to be phenolic compounds, ascorbic acid and phenylalanine. Ajwa dates were shown to have different metabolite compositions and exhibited a wide range of NO inhibitory activity. It is also revealed that Ajwa Grade 1 from the al-Aliah farm exhibited more than 90% NO inhibitory activity compared to the other grades and origins. Phenolic compounds were among the compounds that played a role towards the greater capacity of NO inhibitory activity shown by Ajwa Grade 1 from the al-Aliah farm.
  11. Abd-Hamid NA, Ahmad-Fauzi MI, Zainal Z, Ismail I
    Planta, 2020 Feb 18;251(3):68.
    PMID: 32072251 DOI: 10.1007/s00425-020-03356-8
    The SCF complex is a widely studied multi-subunit ring E3 ubiquitin ligase that tags targeted proteins with ubiquitin for protein degradation by the ubiquitin 26S-proteasome system (UPS). The UPS is an important system that generally keeps cellular events tightly regulated by purging misfolded or damaged proteins and selectively degrading important regulatory proteins. The specificity of this post-translational regulation is controlled by F-box proteins (FBPs) via selective recognition of a protein-protein interaction motif at the C-terminal domain. Hence, FBPs are pivotal proteins in determining the plant response in multiple scenarios. It is not surprising that the FBP family is one of the largest protein families in the plant kingdom. In this review, the roles of FBPs, specifically in plants, are compiled to provide insights into their involvement in secondary metabolites, plant stresses, phytohormone signalling, plant developmental processes and miRNA biogenesis.
  12. Abd Hamid NA, Hasrul MA, Ruzanna RJ, Ibrahim IA, Baruah PS, Mazlan M, et al.
    Nutr J, 2011;10:37.
    PMID: 21513540 DOI: 10.1186/1475-2891-10-37
    Exercise is beneficial to health, but during exercise the body generates reactive oxygen species (ROS) which are known to result in oxidative stress. The present study analysed the effects of vitamin E (Tri E®) on antioxidant enzymes; superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (Cat) activity and DNA damage in rats undergoing eight weeks exercise.
  13. Lin TS, Abd Latiff A, Abd Hamid NA, Wan Ngah WZ, Mazlan M
    PMID: 23097676 DOI: 10.1155/2012/491027
    Diabetes is a common cause of delayed wound healing. The aim of the study was to determine the effect of topical administration of tocopherol cream on the wound healing process in diabetic rats. The study was conducted using 18 male Sprague Dawley rats which were divided into three groups: (I) diabetic rats receiving control cream (n = 6), (II) diabetic rats receiving 0.06% tocopherol cream (n = 6), and (III) diabetic rats receiving 0.29% tocopherol cream (n = 6). Four cutaneous wounds were created at the dorsal region of the rats. Wound healing was assessed by total protein content, rate of wound closure estimation, and histological studies on the tenth day after wounding. Tocopherol treatment enhanced the wound healing process by increasing rate of wound closure and total protein content significantly (P < 0.05) compared to the control group. Histological observation also showed better organized epithelium and more collagen fibers in the tocopherol treated groups. Application of tocopherol cream enhances wound healing process in diabetic condition which is known to cause delay in wound healing.
  14. Ikhwan MI, Hamid NA, Nor Izwana H
    Med J Malaysia, 2022 Jan;77(1):47-52.
    PMID: 35086994
    INTRODUCTION: Tobacco smoking is one of major risk factor of non-communicable disease worldwide. As a prevention strategy, stop smoking services has been advocated at primary care. However, evidence suggests that worldwide there is high rate of unsuccessful quitters. In Malaysia, such evidence has come from small studies or single site study, and evidence on factors associated with failure to quit is scarce. This study aimed to identify the factors associated with unsuccessful quitters among smokers in Stop Smoking Services provided by government health clinics at North Peninsular of Malaysia.

    MATERIALS AND METHODS: This was a retrospective study record review using data from the Stop Smoking Services registry and patient file card between January 2017 and Jun 2019. Independent variables included in this analysis are sociodemographic data, comorbidity, number appointments attended, duration of smoking, age of starting smoking, previous attempt to quit, fagerstrom score and type of treatment. The outcome of interest, is unsuccessful quitters defined as those who continued to smoke at 6 months after attending the service. A total of 427 sample randomly cases selected from 490 eligible sample was analysed. Logistic regression was used to model factors associated with unsuccessful quitters.

    RESULTS: The study suggested that clients who attended 0-3 clinic sessions (AdjOR 6.57; 95% CI: 4.14, 10.43) and being single, unmarried (AdjOR: 2.78; 95%CI: 1.07, 7.18) was associated with increased risk of being unsuccessful quitters among smokers in Northern state of Malaysia CONCLUSION: The number of clinic sessions attended and marital status were factors associated with unsuccessful quitters among smokers in the State of Perlis, of Malaysia.

  15. Osman NH, Jailani RF, Rahman HA, Hamid NA
    Ann Coloproctol, 2021 Dec 03.
    PMID: 34856655 DOI: 10.3393/ac.2021.00584.0083
    Purpose: Intestinal fibrosis is a common complication of inflammatory bowel diseases. However, the possible involvement of epithelial-mesenchymal transition (EMT) has been scarcely investigated. This systematic review aims to search through research papers that are focusing on messenger RNA (mRNA) and protein expression profile in EMT in fistula or in intestinal fibrosis.

    Methods: Electronic exploration was performed until April 24, 2019 through PubMed, Ovid, Science Direct, and Scopus databases with the terms of "fistula" OR "intestinal fibrosis" AND "epithelial-mesenchymal transition". Two independent reviewers scrutinized the suitability of the title and abstract before examining the full text that met the inclusion criteria. For each study, the sample types that were used, methods for analysis, and genes expressed were identified. The list of genes was further analyzed using DAVID (Database for Annotation, Visualization, and Integrated Discovery) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway.

    Results: There were 896 citations found; however, only 3 studies fulfilled the requirements. Among the EMT-related genes, 5 were upregulated genes at mRNA level while 6 were at protein level. However, only 2 downregulated genes were found at each mRNA and protein level. Of the 4 inflammation-related genes found, 3 genes were upregulated at mRNA level and 1 at protein level. These genes were confirmed to be involved in the development of inflammatory induced fibrosis and fistula through EMT. Results from quantitative real-time polymerase chain reaction analysis were consistent with the process of EMT, confirmed by the western blot protein analysis.

    Conclusion: Many significant genes which are involved in the process of EMT in fistula and intestinal fibrosis have been identified. With high-end technology many more genes could be identified. These genes will be good molecular targets in the development of biomarkers for precision drug targeting in the future treatment of intestinal fibrosis and fistula.

  16. Habib SH, Makpol S, Abdul Hamid NA, Das S, Ngah WZ, Yusof YA
    Clinics (Sao Paulo), 2008 Dec;63(6):807-13.
    PMID: 19061005
    OBJECTIVE: To evaluate the effect of ginger extract on the expression of NFkappaB and TNF-alpha in liver cancer-induced rats.

    METHODS: Male Wistar rats were randomly divided into 5 groups based on diet: i) control (given normal rat chow), ii) olive oil, iii) ginger extract (100mg/kg body weight), iv) choline-deficient diet + 0.1% ethionine to induce liver cancer and v) choline-deficient diet + ginger extract (100mg/kg body weight). Tissue samples obtained at eight weeks were fixed with formalin and embedded in paraffin wax, followed by immunohistochemistry staining for NFkappaB and TNF-alpha.

    RESULTS: The expression of NFkappaB was detected in the choline-deficient diet group, with 88.3 +/- 1.83% of samples showing positive staining, while in the choline-deficient diet supplemented with ginger group, the expression of NFkappaB was significantly reduced, to 32.35 +/- 1.34% (p<0.05). In the choline-deficient diet group, 83.3 +/- 4.52% of samples showed positive staining of TNF-alpha, which was significantly reduced to 7.94 +/- 1.32% (p<0.05) when treated with ginger. There was a significant correlation demonstrated between NFkappaB and TNF-alpha in the choline-deficient diet group but not in the choline-deficient diet treated with ginger extract group.

    CONCLUSION: In conclusion, ginger extract significantly reduced the elevated expression of NFkappaB and TNF-alpha in rats with liver cancer. Ginger may act as an anti-cancer and anti-inflammatory agent by inactivating NFkappaB through the suppression of the pro-inflammatory TNF-alpha.

  17. Dehzangi A, Larki F, Hutagalung SD, Goodarz Naseri M, Majlis BY, Navasery M, et al.
    PLoS One, 2013;8(6):e65409.
    PMID: 23776479 DOI: 10.1371/journal.pone.0065409
    In this letter, we investigate the fabrication of Silicon nanostructure patterned on lightly doped (10(15) cm(-3)) p-type silicon-on-insulator by atomic force microscope nanolithography technique. The local anodic oxidation followed by two wet etching steps, potassium hydroxide etching for silicon removal and hydrofluoric etching for oxide removal, are implemented to reach the structures. The impact of contributing parameters in oxidation such as tip materials, applying voltage on the tip, relative humidity and exposure time are studied. The effect of the etchant concentration (10% to 30% wt) of potassium hydroxide and its mixture with isopropyl alcohol (10%vol. IPA ) at different temperatures on silicon surface are expressed. For different KOH concentrations, the effect of etching with the IPA admixture and the effect of the immersing time in the etching process on the structure are investigated. The etching processes are accurately optimized by 30%wt. KOH +10%vol. IPA in appropriate time, temperature, and humidity.
  18. Abdul-Hamid NA, Abas F, Ismail IS, Shaari K, Lajis NH
    J Food Sci, 2015 Nov;80(11):H2603-11.
    PMID: 26457883 DOI: 10.1111/1750-3841.13084
    This study aimed to examine the variation in the metabolite profiles and nitric oxide (NO) inhibitory activity of Ajwa dates that were subjected to 2 drying treatments and different extraction solvents. (1)H NMR coupled with multivariate data analysis was employed. A Griess assay was used to determine the inhibition of the production of NO in RAW 264.7 cells treated with LPS and interferon-γ. The oven dried (OD) samples demonstrated the absence of asparagine and ascorbic acid as compared to the freeze dried (FD) dates. The principal component analysis showed distinct clusters between the OD and FD dates by the second principal component. In respect of extraction solvents, chloroform extracts can be distinguished by the absence of arginine, glycine and asparagine compared to the methanol and 50% methanol extracts. The chloroform extracts can be clearly distinguished from the methanol and 50% methanol extracts by first principal component. Meanwhile, the loading score plot of partial least squares analysis suggested that beta glucose, alpha glucose, choline, ascorbic acid and glycine were among the metabolites that were contributing to higher biological activity displayed by FD and methanol extracts of Ajwa. The results highlight an alternative method of metabolomics approach for determination of the metabolites that contribute to NO inhibitory activity.
  19. Tan BE, Lim AL, Kan SL, Lim CH, Ng YF, Tng SLC, et al.
    Rheumatol Int, 2017 Jun;37(6):905-913.
    PMID: 28389855 DOI: 10.1007/s00296-017-3705-6
    To evaluate the achievement of treat-to-target (T2T) strategy in rheumatoid arthritis (RA) and identify factors associated with failed treatment target in a public rheumatology center. A cross-sectional study was conducted from June 2015 to February 2016. RA patients with disease duration greater than 2 years and under T2T for over a year were invited to the study. Demographic, clinical data, disease activity score of 28 joints (DAS28), and clinical disease activity index (CDAI) were collected in a single routine clinic visit. Treatment target was defined as DAS28 <3.2 or CDAI ≤10. Retrospective chart review was performed to determine reasons of failed treatment target. A total of 371 patients were recruited and 87.1% were female. Mean age and duration of RA were 53.5 years (SD 10.3) and 9.1 years (SD 6.6), respectively. Ethnic distribution was 49% Chinese, 27% Malay, and 24% Indian. T2T was achieved in 81.7% of the cohort. Non-Chinese ethnicity, positive rheumatoid factor, and treatment with three disease modifying anti-rheumatic drugs (DMARDs) were associated with failed treatment target. After controlling for covariates, Malay ethnicity (OR 2.96; 95% CI 1.47-5.96) and treatment with three DMARDs (OR 2.14; 95% CI 1.06-4.35) were associated with failed treatment target. There was no association between age, gender, duration of RA, BMI, smoking status, anti-citrulinated cyclic peptide, and achievement of T2T. The most common reasons of failed treatment target were inability to escalate DMARDs due to side effects (18.8%), lack of biologics fund (15.6%), and persistent disease despite optimum treatment (14.1%). T2T was successfully implemented. Malay patients need aggressive treatment adaptation to achieve optimal outcome.
  20. Saadatian-Elahi M, Alexander N, Möhlmann T, Langlois-Jacques C, Suer R, Ahmad NW, et al.
    Trials, 2021 May 30;22(1):374.
    PMID: 34053466 DOI: 10.1186/s13063-021-05298-2
    BACKGROUND: In common with many South East Asian countries, Malaysia is endemic for dengue. Dengue control in Malaysia is currently based on reactive vector management within 24 h of a dengue case being reported. Preventive rather than reactive vector control approaches, with combined interventions, are expected to improve the cost-effectiveness of dengue control programs. The principal objective of this cluster randomized controlled trial is to quantify the effectiveness of a preventive integrated vector management (IVM) strategy on the incidence of dengue as compared to routine vector control efforts.

    METHODS: The trial is conducted in randomly allocated clusters of low- and medium-cost housing located in the Federal Territory of Kuala Lumpur and Putrajaya. The IVM approach combines: targeted outdoor residual spraying with K-Othrine Polyzone, deployment of mosquito traps as auto-dissemination devices, and community engagement activities. The trial includes 300 clusters randomly allocated in a 1:1 ratio. The clusters receive either the preventive IVM in addition to the routine vector control activities or the routine vector control activities only. Epidemiological data from monthly confirmed dengue cases during the study period will be obtained from the Vector Borne Disease Sector, Malaysian Ministry of Health e-Dengue surveillance system. Entomological surveillance data will be collected in 12 clusters randomly selected from each arm. To measure the effectiveness of the IVM approach on dengue incidence, a negative binomial regression model will be used to compare the incidence between control and intervention clusters. To quantify the effect of the interventions on the main entomological outcome, ovitrap index, a modified ordinary least squares regression model using a robust standard error estimator will be used.

    DISCUSSION: Considering the ongoing expansion of dengue burden in Malaysia, setting up proactive control strategies is critical. Despite some limitations of the trial such as the use of passive surveillance to identify cases, the results will be informative for a better understanding of effectiveness of proactive IVM approach in the control of dengue. Evidence from this trial may help justify investment in preventive IVM approaches as preferred to reactive case management strategies.

    TRIAL REGISTRATION: ISRCTN ISRCTN81915073 . Retrospectively registered on 17 April 2020.

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