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  1. Fulltext Remote Heparin-Induced Haemorrhagic Bullae Occurring in a Patient Treated for Acute Coronary Syndrome: A Rare Entity
    Mohd Parid R, Wan Ahmad Kammal WSL, Jamil A, Wan Ahmad Kammal WSE, Md Isa N, Md Nor N
    Acta Cardiol Sin, 2021 Jan;37(1):111-113.
    PMID: 33488036 DOI: 10.6515/ACS.202101_37(1).20201014A
  2. Sarcoid Myopathy Mimicking Polymyositis: A Case Report and Pool Analysis of the Literature Reviews
    Sazliyana Shaharir S, Jamil A, Kosasih S, Soo Fin L, Sridharan R, Hayati Md Pauzi S
    Acta Med Iran, 2017 Dec;55(12):800-806.
    PMID: 29373888
    A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more extensive systemic involvement, i.e., hypercalcemia, lymphadenopathy and subcutaneous nodules. Finally, a biopsy of the thigh and subcutaneous nodule revealed non-caseating granulomatous inflammation, consistent with sarcoidosis. He responded well to the corticosteroids, and finally, azathioprine was added as a steroid-sparing agent. Including our series, there are 103 cases of symptomatic muscle involvement in sarcoidosis patients published in the English literature to date. Further pool analysis of the cases will be reported in this review.
  3. Fulltext Ethnic disparities and its association between epicardial adipose tissue thickness and cardiometabolic parameters
    Mohamed W, Ishak KN, Baharum N, Zainudin N, Lim HY, Noh M, et al.
    Adipocyte, 2024 Dec;13(1):2314032.
    PMID: 38373876 DOI: 10.1080/21623945.2024.2314032
    Excessive deposit of epicardial adipose tissue (EAT) were recently shown to be positively correlated with cardiovascular disease (CVD). This study aims to investigate the thickness of EAT and its association with the components of metabolic syndrome among multi-ethnic Malaysians with and without acute coronary syndrome (ACS). A total of 213 patients were recruited, with the thickness of EAT were quantified non-invasively using standard two-dimensional echocardiography. EAT thickness among the Malaysian population was prompted by several demographic factors and medical comorbidities, particularly T2DM and dyslipidaemia. ACS patients have significantly thicker EAT compared to those without ACS (4.1 mm vs 3.7 mm, p = 0.035). Interestingly, among all the races, Chinese had the thickest EAT distribution (4.6 mm vs 3.8 mm), with age (p = 0.04 vs p 
  4. Severe cutaneous adverse reaction to drug excipient following brand-to-generic switch of levetiracetam
    Lim JA, Jamil A, Ramli NA, Johar FM, Nor M
    Am J Health Syst Pharm, 2024 Jan 24;81(3):e69-e72.
    PMID: 37864830 DOI: 10.1093/ajhp/zxad264
    PURPOSE: Levetiracetam is an antiepileptic drug known for its high tolerability, and severe adverse drug reactions are rare. We report the case of a severe cutaneous adverse drug reaction in a patient who was switched from brand-name to generic levetiracetam.

    SUMMARY: A 29-year-old woman undergoing contrast-enhanced computed tomography developed lesions over her trunk starting 6 hours after imaging. Although initially diagnosed as an allergy to the radiocontrast agent, the condition progressively worsened into toxic epidermal necrolysis-drug reaction with eosinophilia and systemic symptoms overlap syndrome, despite adequate hydration and treatment. Investigation of the patient's medications revealed that she had been switched from brand-name to generic levetiracetam a week before the onset of symptoms. Levetiracetam was immediately discontinued, with the patient recovering after 2 weeks of intensive care. Adverse drug reaction analysis identified excipients in generic levetiracetam as the likely cause of the severe reaction.

    CONCLUSION: This is the first reported case of severe cutaneous drug allergy after a brand-to-generic switch for levetiracetam. Brand-to-generic switches of medications can potentially cause severe allergic reactions due to differences in excipients.

  5. Fulltext A randomized half-body, double blind, controlled trial on the effects of a pH-modified moisturizer vs. standard moisturizer in mild to moderate atopic dermatitis
    Goh SW, Jamil A, Safian N, Md Nor N, Muhammad N, Saharudin NL
    An Bras Dermatol, 2020 03 21;95(3):320-325.
    PMID: 32291095 DOI: 10.1016/j.abd.2019.11.007
    BACKGROUND: Higher skin pH in atopic dermatitis contributes to impaired epidermal barrier. A moisturizer compatible with physiological pH could improve atopic dermatitis.

    OBJECTIVE: To determine the effect of a physiologically compatible pH moisturizer in atopic dermatitis.

    METHODS: A randomized half body, double blind, controlled trial involving patients with stable atopic dermatitis was performed. pH-modified moisturizer and standard moisturizer were applied to half body for 6 weeks.

    RESULTS: A total of 6 (16.7%) males and 30 (83.3%) females participated. Skin pH reductions from week 0, week 2 and 6 were significant at the forearms (5.315 [0.98] to 4.85 [0.54] to 5.04 [0.78], p=0.02) and abdomen (5.25 [1.01], 4.82 [0.64], 5.01 [0.59], p=0.00) but not at the shins (5.01 [0.80], 4.76 [0.49], 4.85 [0.79], p=0.09) with pH-modified moisturizer. Transepidermal water loss (TEWL) at the forearms decreased (4.60 [2.55] to 3.70 [3.10] to 3.00 [3.55], p=0.00), abdomen (3.90 [2.90] to 2.40 [3.45] to 2.70 [2.25], p=0.046). SCORAD improved from 14.1±12.75 to 10.5±13.25 to 7±12.25, p=0.00. In standard moisturizer group, pH reductions were significant at the forearms (5.29 [0.94] to 4.84 [0.55] to 5.02 [0.70], p=0.00) and abdomen (5.25 [1.09], 4.91 [0.63], 5.12 [0.66], p=0.00). TEWL at the forearm were (4.80 [2.95], 4.10 [2.15], 4.60 [3.40], p=0.67), shins (3.80 [1.40], 3.50 [2.35], 4.00 [2.50], p=0.91) and abdomen (3.70 [2.45], 4.10 [3.60], 3.40 [2.95], p=0.80). SCORAD improved from 14.2±9.1 to 10.9±10.65 to 10.5±11, p=0.00. Reduction in pH was observed with both moisturizers while TEWL significantly improved with pH-modified moisturizer. pH-modified moisturizer resulted in greater pH, TEWL and SCORAD improvements however the differences were not significant from standard moisturizer.

    STUDY LIMITATION: Skin hydration was not evaluated.

    CONCLUSION: Moisturization is beneficial for atopic dermatitis; use of physiologically compatible pH moisturizer is promising.

  6. Fulltext Maxillofacial trauma of paediatric patients: University of Malaya experience
    Mohd Jamil A., Md Kamal F., Kathreena Kadir
    Ann Dent, 2017;24(1):1-9.
    MyJurnal
    This study aimed to determine the incidence, aetiology, types of injury, management and the outcomes of
    the treatment of maxillofacial trauma among paediatric patients treated in Faculty of Dentistry, University of
    Malaya. A retrospective study (2005-2015) was carried out which involved retrieving past records (manual/
    electronic form) of paediatric patients (under 16 years old) who presented with maxillofacial trauma. Data
    collected was organized using descriptive statistics with SPSS version 12.0.1. The total number of patients
    was 120 but only 93 had complete records. The ratio of boys to girls was 2:1. The main cause of injury
    was falling (54%) followed by motor-vehicle accident (MVA) (42%), assault (3%), and sport (1%). The total
    count of soft tissue injury only was about 41% while 59% presented with maxillofacial fracture. Midface
    were the most common fracture occurred followed by mandibular fractures. Both fractures were mostly
    managed by open reduction and internal fixation (ORIF) using non-resorbable plates except for condylar
    fractures which were mostly managed conservatively. In conclusion, the incidence of maxillofacial trauma
    in children increased within the time frame of this study. The most common aetiology was fall. Hard tissue
    injury accounting for most of the cases whereby midface was the most common site involved. ORIF was the
    treatment of choice for most of the fracture cases except for condylar fractures (conservative management).
    All patients had achieved reasonable outcomes postoperatively in terms of form and functions.
  7. Vesicles and erosions in a patient with chronic eczema: is it just eczema?
    Jamil A, Muthupalaniappen L
    Ann Acad Med Singap, 2014 Feb;43(2):130-1.
    PMID: 24652437
  8. Antidiabetic effects of Brucea javanica seeds in type 2 diabetic rats
    Ablat A, Halabi MF, Mohamad J, Hasnan MH, Hazni H, Teh SH, et al.
    BMC Complement Altern Med, 2017 Feb 06;17(1):94.
    PMID: 28166749 DOI: 10.1186/s12906-017-1610-x
    Brucea javanica (B. javanica) seeds, also known as "Melada pahit" in Indo-Malay region are traditionally used to treat diabetes. The objective of this study was to determine antidiabetic, antioxidant and anti-inflammatory effects of B. javanica seeds on nicotinamide (NA)-streptozotocin (STZ) induced type 2 diabetic (T2D) rats and to analyze its chemical composition that correlate with their pharmacological activities.
  9. Fulltext Differential expression of the angiogenesis growth factors in psoriasis vulgaris
    Liew SC, Das-Gupta E, Chakravarthi S, Wong SF, Lee N, Safdar N, et al.
    BMC Res Notes, 2012;5:201.
    PMID: 22537619 DOI: 10.1186/1756-0500-5-201
    Angiogenesis has been reported to be one of the contributory factors to the pathogenesis of psoriasis vulgaris. This study aims to compare the expression of different angiogenesis growth factors namely (1) the vascular endothelial growth factor (VEGF) subfamily: A, B, C, D and placenta growth factor (PlGF); (2) nerve growth factor (NGF) and (3) von Willebrand factor (vWFr) in the skins of patients with psoriasis vulgaris and non-psoriatic volunteers.

    Study site: Dermatology Department of Hospital Kuala Lumpur, Kuala Lumpur and Tuanku Ja’afar Hospital, Seremban, Malaysia
  10. Fulltext Visualising functional 5-HT3 receptors containing A and C subunits at or near the cell surface
    Abad IPL, Fam RL, Nguyen DT, Nowell CJ, Trinh PNH, Manallack DT, et al.
    Biomed Pharmacother, 2020 Dec;132:110860.
    PMID: 33059258 DOI: 10.1016/j.biopha.2020.110860
    Five different subunits of the human serotonin 3 (5-hydroxytrptamine 3; 5-HT3) receptor exist and these are present in both central and peripheral systems. Different subunits alter the efficacy of 5-HT3 receptor antagonists used to treat diarrhoea predominant-irritable bowel syndrome, chemotherapy induced nausea and vomiting and depression. Cell surface arrangement of 5-HT3 receptor complexes and the contribution of C, D and E subunits to receptor function is poorly understood. Here, we examine interactions of A and C subunits using 5-HT3 receptor subunits containing fluorescent protein inserts between the 3rd and 4th transmembrane spanning region. HEK293T cells that do not normally express 5-HT3 receptor subunits, were transiently transfected with A or C or both subunits. Patch clamp experiments show that cells transfected with either fluorescent protein tagged A or A and C subunits generate whole cell currents in response to 5-HT. These findings correlate with the apparent distribution of fluorescent protein tagged A and C subunits at or near cell surfaces detected using TIRF microscopy. In co-transfected cells, the A and C subunits are associated forming AC heteromer complexes at or near the cell surface and a proportion can also form A or C homomers. In conclusion, it is likely that both A homomers and AC heteromers contribute to whole cell currents in response to 5-HT with minimal contribution from C homomers.
  11. Horseradish peroxidase-labeled silver/reduced graphene oxide thin film-modified screen-printed electrode for detection of carcinoembryonic antigen
    Lee SX, Lim HN, Ibrahim I, Jamil A, Pandikumar A, Huang NM
    Biosens Bioelectron, 2017 Mar 15;89(Pt 1):673-680.
    PMID: 26718548 DOI: 10.1016/j.bios.2015.12.030
    In this study, a disposable and simple electrochemical immunosensor was fabricated for the detection of carcinoembryonic antigen. In this method, silver nanoparticles (AgNPs) were mixed with reduced graphene oxide (rGO) to modify the surface of screen-printed carbon electrode (SPE). Initially, AgNPs-rGO modified-SPEs were fabricated by using simple electrochemical deposition method. Then the carcinoembryonic antigen (CEA) was immobilized between the primary antibody and horseradish peroxidase (HRP)-conjugated secondary antibody onto AgNPs-rGO modified-SPEs to fabricate a sandwich-type electrochemical immunosensor. The proposed method could detect the CEA with a linear range of 0.05-0.50µgmL-1 and a detection limit down to 0.035µgmL-1 as compared to its non-sandwich counterpart, which yielded a linear range of 0.05-0.40µgmL-1, with a detection limit of 0.042µgmL-1. The immunosensor showed good performance in the detection of carcinoembryonic antigen, exhibiting a simple, rapid and low-cost. The immunosensor showed a higher sensitivity than an enzymeless sensor.
  12. Advances in Chemistry and Bioactivity of the Genus Chisocheton Blume
    Shilpi JA, Saha S, Chong SL, Nahar L, Sarker SD, Awang K
    Chem Biodivers, 2016 May;13(5):483-503.
    PMID: 26970405 DOI: 10.1002/cbdv.201400373
    Chisocheton is one of the genera of the family Meliaceae and consists of ca. 53 species; the distribution of most of those are confined to the Indo-Malay region. Species of broader geographic distribution have undergone extensive phytochemical investigations. Previous phytochemical investigations of this genus resulted in the isolation of mainly limonoids, apotirucallane, tirucallane, and dammarane triterpenes. Reported bioactivities of the isolated compounds include cytotoxic, anti-inflammatory, antifungal, antimalarial, antimycobacterial, antifeedant, and lipid droplet inhibitory activities. Aside from chemistry and biological activities, this review also deals briefly with botany, distribution, and uses of various species of this genus.
  13. Plant extract-based green fabrication of nickel ferrite (NiFe2O4) nanoparticles: An operative platform for non-enzymatic determination of pentachlorophenol
    Taqvi SIH, Solangi AR, Buledi JA, Khand NH, Junejo B, Memon AF, et al.
    Chemosphere, 2022 Jan 28;294:133760.
    PMID: 35092751 DOI: 10.1016/j.chemosphere.2022.133760
    Environmental pollution has become a major human concern with the extensive exploitation of pesticides. Pentachlorophenol (PCP) is the most hazardous of all chlorophenols which are being used as pesticide, fungicide, and wood preservative. Thus, the fabrication of ultrasensitive electrochemical methods for the determination of pesticides is of great significance. In the present experiment, a simple, green, and sensitive electrochemical sensor was constructed for the determination of PCP by using a chemically modified nickel ferrite glassy carbon electrode (NiFe2O4/GCE). The fabricated nanoparticles were primarily characterized by several analytical tools to confirm the functionalities, surface texture, crystallinity, and elemental composition. For the investigation of conductive nature, the proposed NiFe2O4/GCE was exploited to the primary electrochemical characterization tools e.g. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The ultra-sensitive determination of PCP was carried out under the linear dynamic range from 0.01 to 90 μM at the pulse amplitude of 80 mV/s in BRB buffer pH of 4. The limit of detection of the developed methods for PCP was calculated to be 0.0016 μM. The analytical applicability of the fabricated sensor was tested in different water samples depicting the acceptable recovery values.
  14. Comparison of transepidermal water loss and skin hydration in diabetics and nondiabetics
    Lai CCK, Md Nor N, Kamaruddin NA, Jamil A, Safian N
    Clin Exp Dermatol, 2021 Jan;46(1):58-64.
    PMID: 32619023 DOI: 10.1111/ced.14363
    BACKGROUND: Pruritus is common in patients with diabetes mellitus (DM), and may lead to complex dermatological conditions if left untreated. Pruritus can be caused by increased transepidermal water loss (TEWL) and reduced skin hydration.

    AIMS: To compare TEWL and skin hydration in patients with DM and controls, and to investigate associations between TEWL and skin hydration with glycated haemoglobin (HbA1c), fasting blood sugar (FBS), treatment, peripheral neuropathy (PN) and age in patients with diabetes.

    METHODS: This was a prospective, case-control study carried out at a tertiary medical centre in Kuala Lumpur, Malaysia. TEWL and skin hydration measurements were taken at six different body sites in both groups.

    RESULTS: In total, 146 patients (73 cases, 73 controls) were included (24 men and 49 women in each group). No significant difference in TEWL or skin hydration was seen between patients with DM and controls, but there were significant reductions in skin hydration in patients with DM who had FBS > 7 mmol/L (P  6.5% (P  1 U/kg/day (P  45 years old, there was a significant reduction in TEWL (P = 0.04) and hydration (P  8 mmol/L and increased in patients with higher insulin requirement.

  15. A Randomized, Single-Blind Trial of Clobetasol Propionate 0.05% Cream Under Silicone Dressing Occlusion Versus Intra-Lesional Triamcinolone for Treatment of Keloid
    Nor NM, Ismail R, Jamil A, Shah SA, Imran FH
    Clin Drug Investig, 2017 Mar;37(3):295-301.
    PMID: 27888448 DOI: 10.1007/s40261-016-0484-x
    BACKGROUND AND OBJECTIVE: Keloid is conventionally treated with intra-lesional (IL) triamcinolone, which is highly operator dependent and has its own adverse effects. Topical steroid and silicone dressings are a patient friendly and non-invasive treatment alternative. We therefore sought to determine the efficacy and safety of topical clobetasol propionate (Dermovate(®)) 0.05% cream under occlusion with Mepiform(®) silicone dressing compared to IL triamcinolone in the treatment of keloid.

    METHODS: This was a prospective, randomised, observer-blinded study. Two keloids on the same site were randomly assigned to receive either daily topical clobetasol propionate 0.05% cream under occlusion with silicone dressing (Scar 1) or monthly IL triamcinolone injection (Scar 2). Efficacy was assessed using patient and observer scar assessment scale (POSAS) at 4-weekly intervals up to 12 weeks. Dimension of keloid and adverse effects were also assessed.

    RESULTS: A total of 34 scars from 17 patients completed the study. There was significant improvement of POSAS at 12 weeks compared to baseline within each treatment group. However, there was no statistically significant difference in POSAS at 12 weeks between the two treatments. Keloid dimensions showed a similar trend of improvement by week 12 with either treatment (p = 0.002 in Scar 1, p = 0.005 for Scar 2). However, there was no significant difference between the treatment. In the IL triamcinolone group, all patients reported pain and 70.6% observed necrotic skin reaction. There was a significantly higher rate of adverse effects such as erythema (41.2 vs. 17.6%), hypopigmentation (35.3 vs. 23.5%), telangiectasia (41.2 vs. 17.6%) and skin atrophy (23.5 vs. 5.9%) documented in the IL triamcinolone group when compared to clobetasol propionate 0.05% cream under occlusion with silicone dressing.

    CONCLUSION: Clobetasol propionate 0.05% cream under occlusion with silicone dressing is equally effective and has fewer adverse effects compared to IL triamcinolone. Hence, it may be used as an alternative treatment for keloid particularly in patients with low pain threshold, needle phobia and those who prefers home-based treatment.

  16. Fulltext Knowledge of Medical Students Towards the Re-emergence of Human Monkeypox Virus
    Raman H, Jamil A, Rasheed A, Abdulrahman Jairoun A, Lua PL, Ibrahim UI, et al.
    Cureus, 2023 Oct;15(10):e46761.
    PMID: 37954738 DOI: 10.7759/cureus.46761
    INTRODUCTION: Declaration of human monkeypox(HMPX) virus as Public Health Emergency of International Concern (PHEIC) by World Health Organisation (WHO) has raised concerns among the public andlack of knowledge is a prominent challenge in curbing this outbreak. Therefore, assessment ofknowledge level on this outbreak among the medical students is also necessary due to the fact that they are the future healthcare practitioners who will be directly involved in the disease management as well as a major source of knowledge dissemination to the public.

    AIM: The main objective of this study is to assess the knowledge level of medical students at Universiti Sultan Zainal Abidin (UniSZA) regarding the emergence of HMPX. Additionally, the study aims to investigate potential associations between socio-demographic characteristics and knowledge levels, while also identifying factors that predict a high level of knowledge in this context..

    METHODS: A descriptive cross-sectional study was conducted among UniSZA undergraduatemedical students from Year 1 to Year 5. A validated questionnaire comprising six socio-demographic variables and 27 knowledge items was shared online. Descriptive statistics, non-parametric tests and multivariate logistic regression were performed using SPSS software.

    RESULTS: A total of 138 medical students out of 300 participated in this study. Overall, the average knowledge score was 73.95% ±4.43, which indicates that the medical students have moderate knowledge level. Nearly half of them had good knowledge level (n= 68; 49.3%), 43 of them had moderate knowledge level (31.2%), and 27 of them had poor knowledge level (19.6%). There was a significant association between knowledge level and two factors: receiving information on HMPX during their education and seniority (P-value < 0.01 and P-value < 0.05, respectively). Besides, received information on HMPX during their education was a significant predicting factor of good knowledge level (P-value = 0.002).

    CONCLUSION: The knowledge level among the medical students was relatively inadequate.

  17. A case paradoxical hidradenitis suppurativa with janus kinase inhibitor, literature review and pooled analysis of biological agent-induced HS
    Shaharir SS, Jamil A, Chua SH, Arumugam M, Rosli N
    Dermatol Ther, 2020 11;33(6):e14021.
    PMID: 32677247 DOI: 10.1111/dth.14021
    Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin disease. Biological therapy has revolutionized it's the treatment. Paradoxical HS occur with various biological and targeted agents. We report a patient with juvenile rheumatoid arthritis who developed HS after 6 months of tofacitinib therapy. A comprehensive literature review identified 43 cases of paradoxical HS among patients on biological and targeted agents. Pooled analysis of the cases showed Crohn's disease 18(41.8%) and RA 9(20.9%) as commonest indications for biological therapy. Adalimumab 20(46.5%) followed by infliximab 9(20.9%) were the commonest offending agents. Duration of biological treatment prior to HS manifestation was 12(1-120) months. Smoking 21(48.8%) and overweight or obese 20(46.5%) were most frequent HS risk factors. Fourteen (32.6%) patients had a second paradoxical event, 11(25.6%) developed psoriasis and 4(9.3%) Crohn's disease. Presence of ≥1 risk factor for HS, continuation of the implicated biological agent and occurrence of more than one paradoxical event were factors associated with poor paradoxical HS outcome.
  18. Efficacy and safety of intralesional tuberculin purified protein derivative versus cryotherapy in the treatment of warts: An assessor-blinded, randomized controlled trial
    Wan Ahmad Kammal WSL, Jamil A, Md Nor N
    Dermatol Ther, 2021 09;34(5):e15080.
    PMID: 34351693 DOI: 10.1111/dth.15080
    Cryotherapy is a standard treatment for warts. Tuberculin immunotherapy is a novel therapeutic option. We compared the efficacy and safety of cryotherapy versus tuberculin immunotherapy in a randomized, assessor-blinded study. 15 patients were treated with intralesional tuberculin and 15 patients received cryotherapy every 2 weeks until complete wart resolution or a maximum of six sessions. Wart diameter, total number of warts and adverse effects were documented. Complete clearance of treated warts was achieved in 13(86.7%) and 11(73.3%) of patients with immunotherapy and cryotherapy respectively. Immunotherapy showed greater wart size reduction (51.88 ± 89.36 mm) than cryotherapy (32.99 ± 36.19 mm), (p = 0.46). Immunotherapy resulted in 64% reduction in total number of warts compared to 23.2% with cryotherapy, p 
  19. Comparison of noninvasive screening tools for hepatic fibrosis, association with methotrexate cumulative dose, and risk factors in psoriasis patients
    Lee JHM, Loo CH, Tan WC, Lee CK, Jamil A, Khor YH
    Dermatol Ther, 2022 Jan;35(1):e15203.
    PMID: 34779102 DOI: 10.1111/dth.15203
    Methotrexate (MTX) is a first-line systemic psoriasis therapy with risk of liver fibrosis. Noninvasive tools for liver fibrosis screening are Fibroscan®, Fibrosis-4 (FIB-4) index, and aspartate aminotransferase-to-platelet ratio (APRI) index. To compare Fibroscan®, FIB-4, and APRI in detecting fibrosis, determine association of fibrosis with MTX cumulative dose, and explore risk factors for fibrosis. A case-control study involving psoriasis patients aged ≥18 years with MTX cumulative dose ≥1 g, with age and sex-matched MTX naïve psoriasis patients was performed. Noninvasive tools were used to assess liver fibrosis. Sixty-one patients on MTX and 54 controls participated. Fibroscan® detected fibrosis in 22 (36.1%) patients on MTX compared to 11 (19.6%) controls (p = 0.05). FIB-4 predicted fibrosis in 13 (21.3%) patients on MTX and in 10 (17.9%) controls (p = 0.64) while APRI diagnosed 7 (11.5%) versus 7 (12.5%), p = 0.65. No significant correlation between Fibroscan® assessed liver stiffness and MTX cumulative dose (p = 0.47). Independent risk factors for liver fibrosis were MTX use with raised alanine aminotransferase (OR = 68.56, 95% CI 8.26; 568.86, p 
  20. Potential treatment of atopic dermatitis: tolerability and safety of cream containing nanoparticles loaded with hydrocortisone and hydroxytyrosol in human subjects
    Siddique MI, Katas H, Jamil A, Mohd Amin MCI, Ng SF, Zulfakar MH, et al.
    Drug Deliv Transl Res, 2019 04;9(2):469-481.
    PMID: 29159691 DOI: 10.1007/s13346-017-0439-7
    Hydrocortisone (HC), topical glucocorticoid along with hydroxytyrosol (HT), and anti-microbial- and anti-oxidant-loaded chitosan nanoparticles (CSNPs) were prepared in large scale and analyzed for their adverse effects on healthy human skin followed by repeated applications. Ten subjects were randomized to receive test (HC-HT CSNPs) and vehicle samples (aqueous (AQ) cream). They were applied on the arms for 28 days, and transepidermal water loss (TEWL), erythema intensity, and irritation score were measured. Blood samples were analyzed for blood hematology, blood biochemistry, and adrenal cortico-thyroid hormone (ACTH) levels. Skin biopsy was obtained to assess histopathological changes in the skin. HC-HT CSNP AQ cream was stored at 4, 25, and 45 °C for a period of 1 year, and its stability was assessed by monitoring their physical appearances, particle size, and pH. Spherical-shaped NPs were successfully upscaled using spinning-disc technology, with insignificant changes in particle size, zeta potential, and incorporation of drugs as compared to the well-established laboratory method. Particle size of HC-HT CSNPs was
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