Displaying publications 1 - 20 of 91 in total

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  1. Synthesis, spectral characterization, self-assembly and biological studies of N-acyl-2-pyrazolines bearing long alkoxy side chains
    Abbas A, Nazir H, Naseer MM, Bolte M, Hussain S, Hafeez N, et al.
    Spectrochim Acta A Mol Biomol Spectrosc, 2014;120:176-84.
    PMID: 24177882 DOI: 10.1016/j.saa.2013.10.023
    A series of new pyrazoline derivatives (1b-4c) bearing N-acyl arms and nine to twelve carbon long alkoxy side chains was synthesized and characterized on the basis of spectroscopic data and microanalysis. The nature of self-assembly to understand the interplay of alkoxy chain crystallization and various supramolecular interactions was investigated using single crystal X-ray diffraction studies. Interesting self-assembled supramolecular structures of 1b and 4c were observed in the crystal lattice owing to various CH⋯O, H⋯H, CH⋯π, lonepair⋯π and π⋯π interactions. Further, all the synthesized compounds (1b-4c) were screened for their in vitro antifungal and anti-inflammatory activities. Compounds 2b, 3b, 2c and 3c showed significant to moderate antifungal activity against Microsporum canis whereas most of the other compounds were found inactive against all the five tested fungal strains. Good anti-inflammatory activity was observed for compounds 1b with IC50 value 331 μM compared to 273 μM for Indomethacine, a standard reference drug. The bio-activity data demonstrates the relationship between lipophilicity, solubility and bioavailability.
  2. Fulltext On solution existence of MHD Casson nanofluid transportation across an extending cylinder through porous media and evaluation of priori bounds
    Abdal S, Hussain S, Siddique I, Ahmadian A, Ferrara M
    Sci Rep, 2021 Apr 08;11(1):7799.
    PMID: 33833251 DOI: 10.1038/s41598-021-86953-1
    It is a theoretical exportation for mass transpiration and thermal transportation of Casson nanofluid over an extending cylindrical surface. The Stagnation point flow through porous matrix is influenced by magnetic field of uniform strength. Appropriate similarity functions are availed to yield the transmuted system of leading differential equations. Existence for the solution of momentum equation is proved for various values of Casson parameter [Formula: see text], magnetic parameter M, porosity parameter [Formula: see text] and Reynolds number Re in two situations of mass transpiration (suction/injuction). The core interest for this study aroused to address some analytical aspects. Therefore, existence of solution is proved and uniqueness of this results is discussed with evaluation of bounds for existence of solution. Results for skin friction factor are established to attain accuracy for large injection values. Thermal and concentration profiles are delineated numerically by applying Runge-Kutta method and shooting technique. The flow speed retards against M, [Formula: see text] and [Formula: see text] for both situations of mass injection and suction. The thermal boundary layer improves with Brownian and thermopherotic diffusions.
  3. IAPSO-AIRS: A novel improved machine learning-based system for wart disease treatment
    Abdar M, Wijayaningrum VN, Hussain S, Alizadehsani R, Plawiak P, Acharya UR, et al.
    J Med Syst, 2019 Jun 07;43(7):220.
    PMID: 31175462 DOI: 10.1007/s10916-019-1343-0
    Wart disease (WD) is a skin illness on the human body which is caused by the human papillomavirus (HPV). This study mainly concentrates on common and plantar warts. There are various treatment methods for this disease, including the popular immunotherapy and cryotherapy methods. Manual evaluation of the WD treatment response is challenging. Furthermore, traditional machine learning methods are not robust enough in WD classification as they cannot deal effectively with small number of attributes. This study proposes a new evolutionary-based computer-aided diagnosis (CAD) system using machine learning to classify the WD treatment response. The main architecture of our CAD system is based on the combination of improved adaptive particle swarm optimization (IAPSO) algorithm and artificial immune recognition system (AIRS). The cross-validation protocol was applied to test our machine learning-based classification system, including five different partition protocols (K2, K3, K4, K5 and K10). Our database consisted of 180 records taken from immunotherapy and cryotherapy databases. The best results were obtained using the K10 protocol that provided the precision, recall, F-measure and accuracy values of 0.8908, 0.8943, 0.8916 and 90%, respectively. Our IAPSO system showed the reliability of 98.68%. It was implemented in Java, while integrated development environment (IDE) was implemented using NetBeans. Our encouraging results suggest that the proposed IAPSO-AIRS system can be employed for the WD management in clinical environment.
  4. Fulltext Neonatal Outcomes of Pregnancies Complicated by Maternal Hyperthyroidism
    Abdullah AA, Ramli N, Yaacob NM, Hussain S
    J ASEAN Fed Endocr Soc, 2022;37(2):15-22.
    PMID: 36578895 DOI: 10.15605/jafes.037.02.03
    OBJECTIVE: This study aimed to determine the proportion, clinical characteristics, hormonal status, median time for normalization of serum thyroxine (FT4) and thyroid-stimulating hormone (TSH) and factors affecting time to thyroid function test (TFT) normalization of neonates born to mothers with maternal hyperthyroidism admitted in our institution.

    METHODOLOGY: This was a retrospective cohort study that included 170 newborns admitted to the Neonatal Intensive Care Unit (NICU) of Hospital Universiti Sains Malaysia (HUSM) with a history of maternal hyperthyroidism from January 2013 until December 2018. We analyzed their baseline demographic and clinical characteristics, maternal thyroid status and antibody levels. Finally, we analyzed newborn thyroid function and thyroid antibodies.

    RESULTS: The proportion of neonates born to mothers with maternal hyperthyroidism was 0.8% (170 of 20,198 neonates within the study period). Seven (4.1%) developed overt hyperthyroidism, while four (2.4%) had thyroid storm. The median time for thyroid function test normalization was 30 days (95% CI: 27.1 to 32.8). The median time for TFT normalization was longer among neonates of mothers with positive thyroid antibodies [46.6 days (95% CI, 20.6 to 39.4)] and of mothers who received anti-thyroid treatment [31.7 days (95% CI, 23.5 to 39.9)].

    CONCLUSION: Neonates born to mothers with hyperthyroidism is uncommon. These babies were observed to have a longer time for normalization of thyroid function tests if their mothers had thyroid antibodies or received anti-thyroid treatment.

  5. Fulltext The Impact of Temporomandibular Disorders on Orthodontic Management: A Systematic Review and Meta-Analysis
    Alam MK, Abutayyem H, Alzabni KMD, Almuhyi NHS, Alsabilah KAS, Alkubaydan FST, et al.
    Cureus, 2023 Aug;15(8):e44243.
    PMID: 37645665 DOI: 10.7759/cureus.44243
    The literature on the impact of temporomandibular disorders (TMDs) on orthodontic management or vice versa lacks clarity. This study presents a review that aims to evaluate the influence of TMDs on orthodontic management and explore the association between TMDs and various aspects of orthodontic treatment. A systematic search was conducted across multiple databases to identify relevant articles documenting the correlation between TMD incidence and orthodontic treatment to achieve the objectives. The selection process followed predefined criteria, and the selected studies underwent bias assessment using the AXIS tool and Cochrane risk of bias (RoB) tool. Among the articles identified, nine studies were deemed suitable for inclusion in the review. The findings from the subsequent meta-analysis indicated a significant overall effect, suggesting that orthodontic treatment may increase the risk of developing TMD. Furthermore, the analysis revealed that patients with TMD had higher odds of experiencing orthodontic issues than those without TMD. Subgroup analysis further demonstrated that orthodontic treatment could have a negative impact on the psychological well-being of TMD patients, while its effect on TMD incidence was found to be negligible. The results highlight the need for additional research to gain a better understanding of the underlying mechanisms and develop appropriate interventions aimed at minimizing the risk of TMD in patients undergoing orthodontic treatment. Clinicians should be aware of TMD as a potential complication of orthodontic treatment and implement appropriate monitoring strategies.
  6. The effect of Dermo and Seal-In X5 prosthetic liners on pressure distributions and reported satisfaction during ramp ambulation in persons with transtibial limb loss
    Ali S, Osman NA, Razak A, Hussain S, Wan Abas WA
    Eur J Phys Rehabil Med, 2015 Feb;51(1):31-7.
    PMID: 24963603
    Lower limb amputee's are greatly affected in dealing with the environmental barriers such as ramps and stairs and reported high interface pressure between the residual limb and socket/liner. Interface pressure between the residual limb and socket/liner can affect the satisfaction and use of the prosthesis. Until now, little attention has been paid to interface pressure between socket and stump during ramp negotiation and its effect on amputee's satisfaction.
  7. Synthesis of indole-based-thiadiazole derivatives as a potent inhibitor of α-glucosidase enzyme along with in silico study
    Alomari M, Taha M, Rahim F, Selvaraj M, Iqbal N, Chigurupati S, et al.
    Bioorg Chem, 2021 03;108:104638.
    PMID: 33508679 DOI: 10.1016/j.bioorg.2021.104638
    A series of nineteen (1-19) indole-based-thiadiazole derivatives were synthesized, characterized by 1HNMR, 13C NMR, MS, and screened for α-glucosidase inhibition. All analogs showed varied α-glucosidase inhibitory potential with IC50 value ranged between 0.95 ± 0.05 to 13.60 ± 0.30 µM, when compared with the standard acarbose (IC50 = 1.70 ± 0.10). Analogs 17, 2, 1, 9, 7, 3, 15, 10, 16, and 14 with IC50 values 0.95 ± 0.05, 1.10 ± 0.10, 1.30 ± 0.10, 1.60 ± 0.10, 2.30 ± 0.10, 2.30 ± 0.10, 2.80 ± 0.10, 4.10 ± 0.20 and 4.80 ± 0.20 µM respectively showed highest α-glucosidase inhibition. All other analogs also exhibit excellent inhibitory potential. Structure activity relationships have been established for all compounds primarily based on substitution pattern on the phenyl ring. Through molecular docking study, binding interactions of the most active compounds were confirmed. We further studied the kinetics study of analogs 1, 2, 9 and 17 and found that they are Non-competitive inhibitors.
  8. 5-Bromo-2-aryl benzimidazole derivatives as non-cytotoxic potential dual inhibitors of α-glucosidase and urease enzymes
    Arshad T, Khan KM, Rasool N, Salar U, Hussain S, Asghar H, et al.
    Bioorg Chem, 2017 06;72:21-31.
    PMID: 28346872 DOI: 10.1016/j.bioorg.2017.03.007
    On the basis of previous report on promising α-glucosidase inhibitory activity of 5-bromo-2-aryl benzimidazole derivatives, these derivatives were further screened for urease inhibitory and cytotoxicity activity in order to get more potent and non-cytotoxic potential dual inhibitor for the patients suffering from diabetes as well as peptic ulcer. In this study, all compounds showed varying degree of potency in the range of (IC50=8.15±0.03-354.67±0.19μM) as compared to standard thiourea (IC50=21.25±0.15μM). It is worth mentioning that derivatives 7 (IC50=12.07±0.05μM), 8 (IC50=10.57±0.12μM), 11 (IC50=13.76±0.02μM), 14 (IC50=15.70±0.12μM) and 22 (IC50=8.15±0.03μM) were found to be more potent inhibitors than standard. All compounds were also evaluated for cytotoxicity towards 3T3 mouse fibroblast cell line and found to be completely non-toxic. Previously benzimidazole 1-25 were also showed α-glucosidase inhibitory potential. In silico studies were performed on the lead molecules i.e.2, 7, 8, 11, 14, and 22, in order to rationalize the binding interaction of compounds with the active site of urease enzyme.
  9. Fulltext Evaluation and comparison the performance of titanium and zirconium(IV) tetrachloride in textile wastewater treatment
    Aziz HA, Razak MHA, Rahim MZA, Kamar WISW, Abu Amr SS, Hussain S, et al.
    Data Brief, 2018 Jun;18:920-927.
    PMID: 29900259 DOI: 10.1016/j.dib.2018.03.113
    Wastewater treatment is a key challenge in the textile industry. The current treatment methods for textile wastewater are insufficient or ineffective for complex dyes generated from the textile industry. This study evaluated the performances of two novel inorganic coagulants with high cationic charges, namely, titanium tetrachloride (TiCl4) and zirconium tetrachloride (ZrCl4). They were utilised to treat textile industry wastewater. Both coagulation processes were performed under the same experimental operational conditions. Turbidity, suspended solids (SS), colour, chemical oxygen demand (COD) and ammonia were measured to assess the efficiencies of the coagulants. Results indicated that ZrCl4 and TiCl4 exhibited high potentials for textile wastewater treatment. ZrCl4 presented high removal efficiency in COD and SS, whereas TiCl4 showed excellent removal in ammonia.
  10. Fulltext Do Right, Be Bright: A Protocol on the Development of an Inter-Professional Health Intervention Model for Pre-School Children Through a Community-Based Service-Learning Initiative
    Bilal S, Misra S, Hussain S, Tan SS, Priya E
    J Multidiscip Healthc, 2023;16:1301-1310.
    PMID: 37197578 DOI: 10.2147/JMDH.S405031
    An inter-professional project with a collaborative endeavor between the programs of Dentistry, Nutrition and Medicine was carried out with the aim to emphasise oral health maintenance, making the right nutritional choices and effective hand washing among pre-school children. The purpose of this paper is to share a detailed description of the design, development process, implementation, and planned evaluation of an interprofessional school-based health promotion intervention model "Do Right, Be Bright". This model is part of a quasi-experimental study, targeting pre-school children as the "Targets of Change" through the empowerment of school teachers as the "Agents of Change". The program design was based on Bartholomew's Intervention Mapping Approach, which proposes a direction for developing a theory-based health promotion intervention and on the most extensively applied theories of health behavior, the Health Belief Model. Therefore, based on a thorough literature review and needs assessment, three key areas of needs were identified for the targeted preschool children: oral hygiene, hand hygiene and nutrition. The efficacy of this model will be pilot tested in a preschool in Kuala Lumpur Malaysia.
  11. Awareness and perception of seasonal influenza (Flu) among health science and Non-Health science university students in Pakistan: A nationwide survey
    Bukhsh A, Hussain S, Rehman IU, Mallhi TH, Khan YH, Khaliel AM, et al.
    Pak J Pharm Sci, 2019 Jul;32(4(Supplementary)):1789-1796.
    PMID: 31680074
    Seasonal influenza is a highly contagious viral respiratory disorder. Prior knowledge of flu among general community is of paramount importance in order to mitigate its growing burden. In a pandemic, young adults are more likely to be infected increasing the potential for universities to be explosive disease outbreak centers. In this context, current study aims to assess the knowledge and perception of flu among university students from health sciences (HS) and non-HS background. Questionnaire-based cross sectional (August-December 2015) study was conducted among students of 65 universities across Pakistan. The students willing to participate were requested to fill out the self-administered questionnaire and responses were recorded and descriptively analyzed by SPSS. A total of 1694 students (age: 21.12 ± 2.13 years), 95% which belonged to age group 18-25 years, participated in the current study. Most of the participants (91.7%) had suffered from influenza during their life but only 55.7% correctly answered virus as causative agent of flu, while majority of participants, primarily from non-HS disciplines were not aware of flu cause. Very few participants (8.1%) believed that flu can cause death. About 20% students, mainly from non-HS disciplines reported that antibiotic can kill viruses. Similarly, 47.1% respondents agreed on the effectiveness of antibiotic in flu. A large proportion of study population preferred self-medication for influenza. Only 20.1% students were aware of influenza vaccine while majority of students (79.9%) from both disciplines reported that there is no such vaccine. Awareness and health literacy regarding seasonal influenza is poor among university students, especially from non-HS disciplines. These findings necessitate dire need to appropriately structured awareness programs in educational institutes to curb the growing burden of influenza.
  12. Goniothalamin induces apoptosis in vascular smooth muscle cells
    Chan KM, Rajab NF, Ishak MH, Ali AM, Yusoff K, Din LB, et al.
    Chem Biol Interact, 2006 Feb 1;159(2):129-40.
    PMID: 16297902
    Restenosis represents a major impediment to the success of coronary angioplasty. Abnormal proliferation of vascular smooth muscle cells (VSMCs) has been shown to be an important process in the pathogenesis of restenosis. A number of agents, particularly rapamycin and paclitaxel, have been shown to impact on this process. This study was carried out to determine the mechanisms of cytotoxicity of goniothalamin (GN) on VSMCs. Results from MTT cytotoxicity assay showed that the IC(50) for GN was 4.4 microg/ml (22 microM), which was lower compared to the clinically used rapamycin (IC(50) of 25 microg/ml [27.346 microM]). This was achieved primarily via apoptosis where up to 25.83 +/- 0.44% of apoptotic cells were detected after 72 h treatment with GN. In addition, GN demonstrated similar effects as rapamycin in inhibiting VSMCs proliferation using bromodeoxyuridine (BrdU) cell proliferation assay after 72 h treatment at IC(50) concentration (p > 0.05). In order to understand the mechanisms of GN, DNA damage detection using comet assay was determined at 2h post-treatment with GN. Our results showed that there was a concentration-dependent increase in DNA damage in VSMCs prior to cytotoxicity. Moreover, GN effects were comparable to rapamycin. In conclusion, our data show that GN initially induces DNA damage which subsequently leads to cytotoxicity primarily via apoptosis in VSMCs.
  13. The direct cost of treating bronchial asthma in a teaching hospital in Malaysia
    Chan PW, Hussain S, Ghani NH, Debruyne JA, Liam CK
    Southeast Asian J. Trop. Med. Public Health, 2002 Sep;33(3):600-3.
    PMID: 12693597
    A pilot study to evaluate the direct cost of treating 51 adults and 50 children with bronchial asthma was conducted. All aspects of the medical care provided over a 6-month period were considered. The mean treatment costs per month were US dollars 22.97 (adults) and US dollars 15.56 (children). The cost of maintenance therapy accounted for 55.5% and 73.4% of the total direct cost treatment for adults and children respectively. Only 27 (52.9%) adults and 17 (34.0%) children paid for their inhaled prophylactic drugs, amounting to 12.3% of the total maintenance therapy costs. Thirteen (25.4%) adults and 9 (18.0%) children were using alternative therapy at a monthly cost of US dollars 41.50 and US dollars 16.77 respectively. A substantial proportion of the direct cost of asthma treatment is heavily subsidized in Malaysia. Adequate attention to the allocation of the health budget, to ensure the optimal provision of health care, is warranted.
  14. Fulltext Minimizing thermal stress for data center servers through thermal-aware relocation
    Chaudhry MT, Ling TC, Hussain SA, Manzoor A
    ScientificWorldJournal, 2014;2014:684501.
    PMID: 24987743 DOI: 10.1155/2014/684501
    A rise in inlet air temperature may lower the rate of heat dissipation from air cooled computing servers. This introduces a thermal stress to these servers. As a result, the poorly cooled active servers will start conducting heat to the neighboring servers and giving rise to hotspot regions of thermal stress, inside the data center. As a result, the physical hardware of these servers may fail, thus causing performance loss, monetary loss, and higher energy consumption for cooling mechanism. In order to minimize these situations, this paper performs the profiling of inlet temperature sensitivity (ITS) and defines the optimum location for each server to minimize the chances of creating a thermal hotspot and thermal stress. Based upon novel ITS analysis, a thermal state monitoring and server relocation algorithm for data centers is being proposed. The contribution of this paper is bringing the peak outlet temperatures of the relocated servers closer to average outlet temperature by over 5 times, lowering the average peak outlet temperature by 3.5% and minimizing the thermal stress.
  15. Fulltext The effects of music and auditory stimulation on autonomic arousal, cognition and attention: A systematic review
    Chee ZJ, Chang CYM, Cheong JY, Malek FHBA, Hussain S, de Vries M, et al.
    Int J Psychophysiol, 2024 May;199:112328.
    PMID: 38458383 DOI: 10.1016/j.ijpsycho.2024.112328
    According to the arousal-mood hypothesis, changes in arousal and mood when exposed to auditory stimulation underlie the detrimental effects or improvements in cognitive performance. Findings supporting or against this hypothesis are, however, often based on subjective ratings of arousal rather than autonomic/physiological indices of arousal. To assess the arousal-mood hypothesis, we carried out a systematic review of the literature on 31 studies investigating cardiac, electrodermal, and pupillometry measures when exposed to different types of auditory stimulation (music, ambient noise, white noise, and binaural beats) in relation to cognitive performance. Our review suggests that the effects of music, noise, or binaural beats on cardiac, electrodermal, and pupillometry measures in relation to cognitive performance are either mixed or insufficient to draw conclusions. Importantly, the evidence for or against the arousal-mood hypothesis is at best indirect because autonomic arousal and cognitive performance are often considered separately. Future research is needed to directly evaluate the effects of auditory stimulation on autonomic arousal and cognitive performance holistically.
  16. High-Sensitivity Troponin I after Cardiac Surgery and 30-Day Mortality
    Devereaux PJ, Lamy A, Chan MTV, Allard RV, Lomivorotov VV, Landoni G, et al.
    N Engl J Med, 2022 Mar 03;386(9):827-836.
    PMID: 35235725 DOI: 10.1056/NEJMoa2000803
    BACKGROUND: Consensus recommendations regarding the threshold levels of cardiac troponin elevations for the definition of perioperative myocardial infarction and clinically important periprocedural myocardial injury in patients undergoing cardiac surgery range widely (from >10 times to ≥70 times the upper reference limit for the assay). Limited evidence is available to support these recommendations.

    METHODS: We undertook an international prospective cohort study involving patients 18 years of age or older who underwent cardiac surgery. High-sensitivity cardiac troponin I measurements (upper reference limit, 26 ng per liter) were obtained 3 to 12 hours after surgery and on days 1, 2, and 3 after surgery. We performed Cox analyses using a regression spline that explored the relationship between peak troponin measurements and 30-day mortality, adjusting for scores on the European System for Cardiac Operative Risk Evaluation II (which estimates the risk of death after cardiac surgery on the basis of 18 variables, including age and sex).

    RESULTS: Of 13,862 patients included in the study, 296 (2.1%) died within 30 days after surgery. Among patients who underwent isolated coronary-artery bypass grafting or aortic-valve replacement or repair, the threshold troponin level, measured within 1 day after surgery, that was associated with an adjusted hazard ratio of more than 1.00 for death within 30 days was 5670 ng per liter (95% confidence interval [CI], 1045 to 8260), a level 218 times the upper reference limit. Among patients who underwent other cardiac surgery, the corresponding threshold troponin level was 12,981 ng per liter (95% CI, 2673 to 16,591), a level 499 times the upper reference limit.

    CONCLUSIONS: The levels of high-sensitivity troponin I after cardiac surgery that were associated with an increased risk of death within 30 days were substantially higher than levels currently recommended to define clinically important periprocedural myocardial injury. (Funded by the Canadian Institutes of Health Research and others; VISION Cardiac Surgery ClinicalTrials.gov number, NCT01842568.).

  17. Does foreign direct investment asymmetrically affect the mitigation of environmental degradation in Malaysia?
    Faheem M, Hussain S, ArsalanTanveer, Safdar N, Anwer MA
    Environ Sci Pollut Res Int, 2022 Jan;29(5):7393-7405.
    PMID: 34476703 DOI: 10.1007/s11356-021-16231-0
    In this modern era, the global warming issue has been on the front burner of almost all countries including Malaysia. This study utilizing time series data spanning from 1970 to 2018. To this end, a linear and nonlinear autoregressive distributed lag model was conducted to reveal the foreign direct investment-growth-environment nexus. The conclusion validates the existence of the pollution haven hypothesis in Malaysia. Specifically, the empirical results of the linear autoregressive distributed lag model indicate that foreign direct investment and real gross domestic product have a significant positive impact on CO2 emission while carbon damage cost and the interaction term of foreign direct investment and carbon damage cost have a negative impact in the long run and short run. To find the asymmetric behavior of the foreign direct investment our study employed a nonlinear autoregressive distributed lag model. The findings confirmed the asymmetry association of foreign direct investment with CO2 emission. Interestingly, our results of the interaction term in both models are significant with a negative sign that shows the mediating effect of carbon damage cost that converts the positive effect of foreign direct investment on CO2 emission to negative. Thus, it is vital to reinforce the use of significant regulation as the Malaysian economy opens up to attract more foreign direct investment.
  18. Fulltext The Lancet Commission on diagnostics: transforming access to diagnostics
    Fleming KA, Horton S, Wilson ML, Atun R, DeStigter K, Flanigan J, et al.
    Lancet, 2021 Nov 27;398(10315):1997-2050.
    PMID: 34626542 DOI: 10.1016/S0140-6736(21)00673-5
  19. Fulltext The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019
    GBD 2019 Lip, Oral, and Pharyngeal Cancer Collaborators, Cunha ARD, Compton K, Xu R, Mishra R, Drangsholt MT, et al.
    JAMA Oncol, 2023 Oct 01;9(10):1401-1416.
    PMID: 37676656 DOI: 10.1001/jamaoncol.2023.2960
    IMPORTANCE: Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.

    OBJECTIVE: To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.

    EVIDENCE REVIEW: The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.

    FINDINGS: In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.

    CONCLUSIONS AND RELEVANCE: In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.

  20. Fixed dose drug combinations - are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries
    Godman B, McCabe H, D Leong T, Mueller D, Martin AP, Hoxha I, et al.
    Expert Rev Pharmacoecon Outcomes Res, 2020 Apr 01.
    PMID: 32237953 DOI: 10.1080/14737167.2020.1734456
    Introduction: There are positive aspects regarding the prescribing of fixed dose combinations (FDCs) versus prescribing the medicines separately. However, these have to be balanced against concerns including increased costs and their irrationality in some cases. Consequently, there is a need to review their value among lower- and middle-income countries (LMICs) which have the greatest prevalence of both infectious and noninfectious diseases and issues of affordability.Areas covered: Review of potential advantages, disadvantages, cost-effectiveness, and availability of FDCs in high priority disease areas in LMICs and possible initiatives to enhance the prescribing of valued FDCs and limit their use where there are concerns with their value.Expert commentary: FDCs are valued across LMICs. Advantages include potentially improved response rates, reduced adverse reactions, increased adherence rates, and reduced costs. Concerns include increased chances of drug:drug interactions, reduced effectiveness, potential for imprecise diagnoses and higher unjustified prices. Overall certain FDCs including those for malaria, tuberculosis, and hypertension are valued and listed in the country's essential medicine lists, with initiatives needed to enhance their prescribing where currently low prescribing rates. Proposed initiatives include robust clinical and economic data to address the current paucity of pharmacoeconomic data. Irrational FDCs persists in some countries which are being addressed.
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