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  1. Incidence of tumours suitable for radiosurgery in a developing country like Malaysia: retrospective study done before the decision to start a radiosurgery programme
    Abdullah J, Ridzuan MY
    Stereotact Funct Neurosurg, 1997;69(1-4 Pt 2):152-5.
    PMID: 9711749
    This is a descriptive epidemiologic study that was done retrospectively for the years 1990-1996. The objective was to determine whether tumours less than 4 cm in diameter are common and thereafter suitable for radiosurgical treatment. The results showed that the incidence of brain tumours less than 4 cm in diameter was 73.3% and about 20% were situated in the eloquent area.
  2. Fulltext Effect of Eurycoma longifolia extract on the Glutathione level in Plasmodium falciparum infected erythrocytes in vitro
    Mohd Ridzuan MA, Noor Rain A, Zhari I, Zakiah I
    Trop Biomed, 2005 Dec;22(2):155-63.
    PMID: 16883282 MyJurnal
    In the present study we examined the effect of E. longifolia methanol extract (TA164) on the GSH levels of P. falciparum infected erythrocytes and uninfected erythrocytes. Our study on parasite growth shows the IC50 and IC75 values of TA164 to be 0.17 g/ml and 6 g/ml respectively while for BSO was 25.5 g/ml and 46.5 g/ml respectively. About 95% to 100% growth inhibition of P. falciparum infected erythrocyte was observed when treated with TA164 and BSO at 16 g/ml and 64 g/ml respectively. The study on GSH contents indicated that non-infected erythrocytes treated with 6 g/ml (IC75 values) of TA164 at 24 hours incubation showed less GSH content as compared to non-treated erythrocytes. A similar observation was seen on treated trophozoite infected erythrocyte (10% parasitemia) when treated with 6 g/ml at 3 hours incubation. Analysis of the GSH contents of parasite compartments treated with TA164 at the same concentration (6 g/ml) for 3 hours incubation indicated a reduction of GSH contents. At the same concentration, TA164 did not affect the GSH contents of enriched trophozoite infected erythrocytes (60-70% parasitemia). TA164 did affect the GSH content of non-infected erythrocyte at 24 hours (accept IC50 value) as well as the parasite compartments (trophozoite infected erythrocyte and parasite itself) but fails to affect the GSH content of enriched trophozoite infected erythrocyte.
  3. Fulltext Geographical distribution and spatio-temporal patterns of hospitalization due to dengue infection at a leading specialist hospital in Malaysia
    Low GKK, Papapreponis P, Isa RM, Gan SC, Chee HY, Te KK, et al.
    Geospat Health, 2018 05 07;13(1):642.
    PMID: 29772885 DOI: 10.4081/gh.2018.642
    Increasing numbers of dengue infection worldwide have led to a rise in deaths due to complications caused by this disease. We present here a cross-sectional study of dengue patients who attended the Emergency and Trauma Department of Ampang Hospital, one of Malaysia's leading specialist hospitals. The objective was to search for potential clustering of severe dengue, in space and/or time, among the annual admissions with the secondary objective to describe the spatio-temporal pattern of all dengue cases admitted to this hospital. The dengue status of the patients was confirmed serologically with the geographic location of the patients determined by residency, but not more specific than the street level. A total of 1165 dengue patients were included in the analysis using SaTScan software. The mean age of these patients was 27.8 years, with a standard deviation of 14.2 years and an age range from 1 to 77 years, among whom 54 (4.6%) were cases of severe dengue. A cluster of general dengue cases was identified occurring from October to December in the study year of 2015 but the inclusion of severe dengue in that cluster was not statistically significant (P=0.862). The standardized incidence ratio was 1.51. General presence of dengue cases was, however, detected to be concentrated at the end of the year, which should be useful for hospital planning and management if this pattern holds.
  4. Fulltext Antimalarial properties of Goniothalamin in combination with chloroquine against Plasmodium yoelii and Plasmodium berghei growth in mice
    Mohd Ridzuan MA, Ruenruetai U, Noor Rain A, Khozirah S, Zakiah I
    Trop Biomed, 2006 Dec;23(2):140-6.
    PMID: 17322815 MyJurnal
    Malaria is a disease which is still endemic and has become a disastrous scourge because of the emergence of antimalarial drug resistant Plasmodium falciparum. A new approach in addressing this is in developing a combination drug. This study is to show the enhancement of antimalarial properties, when single compound, goniothalamin combine with standard drug, chloroquine. Based on 4 Day Test, percentage of parasite growth on treated infected mice were determined. Oral treatment with 1 mg/kg BW of chloroquine on experimental mice suppressed 70% and 76.7% of both Plasmodium yoelii and Plasmodium berghei, respectively. The infection of P. berghei in mice was inhibited less than 50% by goniothalamin individual treatment at all doses in this study. About 27.8% and 18.5% inhibition of infection were observed in P. yoelii infected mice treated with 30 mg/kg and 60 mg/kg of goniothalamin respectively and the suppression exceed more than 50% at higher doses (90 and 120 mg/kg). Combination of 1 mg/kg chloroquine with either 30 mg/kg or 60 mg/kg of goniothalamin decreased the parasitemia of P. yoelii infected mice more than 90% and prolong the survival up to 100% after treatment. Similar treatment to P. berghei infected mice only shows about 60% reduction of parasitemia. The study findings showed that antimalarial property of goniothalamin was enhanced by combination with chloroquine at lower dose of each drug.
  5. Novel usage of fresh frozen plasma in hereditary angioedema
    Hanizah N, Affirul CA, Farah NA, Shamila MA, Ridzuan MI
    Clin Ter, 2016 Nov-Dec;167(6):182-184.
    PMID: 28051822 DOI: 10.7417/CT.2016.1969
    Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Early recognition and timely intervention with the correct treatment are crucial particularly preventing airway obstruction. New disease specific treatment including plasma derived or recombinant C1-INH, ecallantide and icatibant have recently emerged and its appropriate use can reduce HAE-associated mortality and morbidity. However due to its costs, these disease specific treatments have yet to reach Malaysia. Despite that no randomized clinical trial on FFP has been performed, its efficacy in treating acute attacks of HAE is only demonstrated in case studies. This case report illustrates the successful treatment of acute HAE episode with FFP in a Malaysian government hospital setting.
  6. Fulltext Eurycoma longifolia extract-artemisinin combination: parasitemia suppression of Plasmodium yoelii-infected mice
    Mohd Ridzuan MA, Sow A, Noor Rain A, Mohd Ilham A, Zakiah I
    Trop Biomed, 2007 Jun;24(1):111-8.
    PMID: 17568384 MyJurnal
    Eurycoma longifolia, locally known as 'Tongkat Ali' is a popular local medicinal plant that possess a lot of medicinal properties as claimed traditionally, especially in the treatment of malaria. The claims have been proven scientifically on isolated compounds from the plant. The present study is to investigate the anti malaria properties of Eurycoma longifolia standardized extract (root) (TA164) alone and in combination with artemisinin in vivo. Combination treatment of the standardized extract (TA164) with artemisinin suppressed P. yoelii infection in the experimental mice. The 4 day suppressive test showed that TA164 suppressed the parasitemia of P. yoelii-infected mice as dose dependent manner (10, 30 and 60 mg/kg BW) by oral and subcutaneous treatment. By oral administration, combination of TA164 at 10, 30 and 60 mg/kg BW each with artemisinin respectively showed a significant increase in the parasitemia suppression to 63, 67 and 80 percent as compared to artemisinin single treatment (31%). Using subcutaneous administration, at 10 mg/kg BW of TA164 in combination with 1.7 mg/kg BW of artemisinin gave a suppression of 80% of infection. This study showed that combination treatment of TA164 with artemisinin gives a promising potential anti malaria candidate using both oral and subcutaneous route, the later being the most potent.
  7. Biotransformation of sesquiterpenoids: a recent insight
    Aminudin NI, Ridzuan M, Susanti D, Zainal Abidin ZA
    J Asian Nat Prod Res, 2022 Feb;24(2):103-145.
    PMID: 33783284 DOI: 10.1080/10286020.2021.1906657
    Sesquiterpenoids have been identified as natural compounds showing remarkable biological activities found in medicinal plants. There is great interest in developing methods to obtain sesquiterpenoids derivatives and biotransformation is one of the alternative methods for structural modification of complex sesquiterpenes structures. Biotransformation is a great drug design tool offering high selectivity and green method. The present review describes a comprehensive summary of biotransformation products of sesquiterpenoids and its structural modification utilizing a variety of biocatalysts including microorganisms, plant tissue culture and enzymes. This review covers recent literatures from 2007 until 2020 and highlights the experimental conditions for each biotransformation process.
  8. Fulltext "Fishing for lines": removal of endovascular catheters from the cardiovascular system
    Wong AR, Suhaimi H, Ridzuan MA, Rizal MM, Saedah A
    Singapore Med J, 2009 Oct;50(10):e358-61.
    PMID: 19907875
    We present two infants whose endovascular lines were accidentally cut or fractured, and had to be retrieved via transcatheter means in the cardiac catheterisation laboratory. The first case was a two-month-old infant with transposition of the great arteries, requiring an emergency balloon atrial septostomy. An indwelling vascular catheter that was placed in the right femoral vein was accidentally cut and had migrated into the inferior vena cava, before being retrieved. The second case was a one-week-old neonate who presented with pneumonia at birth, and had a long intravenous catheter placed in the left saphenous vein, which became fractured, and subsequently migrated into the heart. This case presented as a pulmonary embolus with haemodynamic instability, as the catheter had partially obstructed the right ventricular outflow tract. This was later retrieved via transcatheter means.
  9. Fulltext A case of chronic myeloid leukaemia in blast transformation with leukemic ascites
    Mohd Ridzuan MS, Yap E, Wan Fariza WJ, Fadilah SA, Salwati S
    Med J Malaysia, 2016 04;71(2):85-7.
    PMID: 27326952 MyJurnal
    Chronic Myeloid Leukaemia (CML) is a disease characterised by a distinctive marker that is the Philadelphia Chromosome and an ability to transform into blast phase, which confers a poor prognosis. The median survival was reported to be between three to six months in correlation to blast phase. Extramedullary involvement with CML to sites such as pleural, meningeal and bones have been reported. We report a case of 41-year-old man who was diagnosed with CML in blast phase and presented with ascites. Ultrasound of abdomen showed coarse echotexture of liver suggestive leukaemic infiltration to the liver. The liver profile was severely deranged and associated with coagulopathy. Flow cytometry analysis of the peritoneal fluid revealed presence of myeloblasts consistent with CML in blast crisis with leukaemic ascites. Bone marrow biopsy also confirmed disease transformation. He received standard induction chemotherapy for acute myeloid leukaemia with dose modifications based on liver enzymes performance. Our case highlights an unusual presentation of CML in blast crisis with leukaemic ascites and the challenges in managing cytotoxic treatments due to the liver infiltration.
  10. Ultrasound findings of plasma leakage as imaging adjunct in clinical management of dengue fever without warning signs
    Xin Tian C, Baharuddin KA, Shaik Farid AW, Andey R, Ridzuan MI, Siti-Azrin AH
    Med J Malaysia, 2020 11;75(6):635-641.
    PMID: 33219170
    INTRODUCTION: Plasma leakage is a major cause of morbidity and mortality in dengue fever. Few studies have shown the sensitivity of thoracoabdominal ultrasound in detecting plasma leakage in severe dengue, however its sensitivity in the early presentation of dengue fever without warning signs remains unknown. This study is aimed to determine the role of serial ultrasound in order to detect plasma leakage in dengue fever without warning signs.

    METHODS: This prospective cohort study was conducted at Hospital Universiti Sains Malaysia (USM) from 1st October 2016 to 30th November 2017. Serial bedside ultrasound procedures were performed for 83 patients who were diagnosed as having dengue fever without warning signs and were initially treated as outpatients. Ultrasonography evidence of plasma leakage either pleural effusion, thickened gallbladder wall, ascites or pericardial effusion were compared with clinical findings and laboratory parameters for plasma leakage.

    RESULTS: Of the 83 dengue patients, eventually 72.3% had dengue fever with warning signs and 6.0% had severe dengue fever. There were 38 patients who had subclinical plasma leakage at initial presentation, 84.2% and 7.9% of them then progressed to dengue fever with warning signs and severe dengue respectively. There was a minimal agreement between serial bedside ultrasound and haematocrit level in the detection of plasma leakage (observed kappa 0.135).

    CONCLUSIONS: Serial bedside ultrasound is an adjunct procedure to physical examination and may detect plasma leakage earlier compared to haemoconcentration. The early usage of serial ultrasound is of paramount importance in detecting dengue patients who are at risk of progressing to severe dengue.

  11. Analysis and physicochemical properties of cellulose nanowhiskers from Pennisetum purpureum via different acid hydrolysis reaction time
    Sucinda EF, Abdul Majid MS, Ridzuan MJM, Sultan MTH, Gibson AG
    Int J Biol Macromol, 2020 Jul 15;155:241-248.
    PMID: 32240733 DOI: 10.1016/j.ijbiomac.2020.03.199
    Cellulose nanowhisker (NWC) was extracted by hydrolysing Pennisetum purpureum (PP) fibres with acid and alkali. They were subjected to different periods of acid hydrolysis; 30, 45, and 60 min. NWC morphology and physicochemical properties were characterised by transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), particle size analyser, Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and thermogravimetric analysis. NWC3, which underwent the longest hydrolysis time, showed the smallest width and length, under TEM. All samples presented a needle-like shape under TEM and AFM; uneven lengths and irregular shapes under FESEM; and a broad range of distribution, with the particle size analyser. All samples exhibited a good crystallinity index (CrI)-72.0 to 74.6%. The highest CrI% corresponded to 60 min of acid hydrolysis. Thermogravimetric analysis showed thermal stability between 310.72 °C and 336.28 °C. Thus, cellulose nanowhisker from PP fibres, have high potential as bio-nanocomposites.
  12. Fulltext Antiplasmodial properties of some Malaysian medicinal plants
    Noor Rain A, Khozirah S, Mohd Ridzuan MA, Ong BK, Rohaya C, Rosilawati M, et al.
    Trop Biomed, 2007 Jun;24(1):29-35.
    PMID: 17568375 MyJurnal
    Seven Malaysian medicinal plants were screened for their antiplasmodial activities in vitro. These plants were selected based on their traditional claims for treatment or to relieve fever. The plant extracts were obtained from Forest Research Institute Malaysia (FRIM). The antiplasmodial activities were carried out using the pLDH assay to Plasmodium falciparum D10 strain (sensitive strain) while the cytotoxic activities were carried out towards Madin- Darby bovine kidney (MDBK) cells using MTT assay. The concentration of extracts used for both screening assays were from the highest concentration 64 microg/ml, two fold dilution to the lowest concentration 0.03 microg/ml. Goniothalamus macrophyllus (stem extract) showed more than 60% growth inhibition while Goniothalamus scortechinii root and stem extract showed a 90% and more than 80% growth inhibition at the last concentration tested, 0.03 microg/ml. The G. scortechini (leaves extract) showed an IC50 (50% growth inhibition) at 8.53 microg/ml, Ardisia crispa (leaves extract) demonstrated an IC50 at 5.90 +/- 0.14 microg/ml while Croton argyratus (leaves extract) showed a percentage inhibition of more than 60% at the tested concentration. Blumea balsamifera root and stem showed an IC50 at 26.25 +/- 2.47 microg/ml and 7.75 +/- 0.35 microg/ ml respectively. Agathis borneensis (leaves extract) demonstrated a 50% growth inhibition at 11.00 +/- 1.41 microg/ml. The study gives preliminary scientific evidence of these plant extracts in line with their traditional claims.
  13. Mechanical, thermal and morphological characterisation of 3D porous Pennisetum purpureum/PLA biocomposites scaffold
    Revati R, Abdul Majid MS, Ridzuan MJM, Normahira M, Mohd Nasir NF, Rahman Y MN, et al.
    Mater Sci Eng C Mater Biol Appl, 2017 Jun 01;75:752-759.
    PMID: 28415525 DOI: 10.1016/j.msec.2017.02.127
    The mechanical, thermal, and morphological properties of a 3D porous Pennisetum purpureum (PP)/polylactic acid (PLA) based scaffold were investigated. In this study, a scaffold containing P. purpureum and PLA was produced using the solvent casting and particulate leaching method. P. purpureum fibre, also locally known as Napier grass, is composed of 46% cellulose, 34% hemicellulose, and 20% lignin. PLA composites with various P. purpureum contents (10%, 20%, and 30%) were prepared and subsequently characterised. The morphologies, structures and thermal behaviours of the prepared composite scaffolds were characterised using field-emission scanning electron microscopy (FESEM), Fourier transform infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA). The morphology was studied using FESEM; the scaffold possessed 70-200μm-sized pores with a high level of interconnectivity. The moisture content and mechanical properties of the developed porous scaffolds were further characterised. The P. purpureum/PLA scaffold had a greater porosity factor (99%) and compression modulus (5.25MPa) than those of the pure PLA scaffold (1.73MPa). From the results, it can be concluded that the properties of the highly porous P. purpureum/PLA scaffold developed in this study can be controlled and optimised. This can be used to facilitate the construction of implantable tissue-engineered cartilage.
  14. Development and characterisation of packaging film from Napier cellulose nanowhisker reinforced polylactic acid (PLA) bionanocomposites
    Sucinda EF, Abdul Majid MS, Ridzuan MJM, Cheng EM, Alshahrani HA, Mamat N
    Int J Biol Macromol, 2021 Sep 30;187:43-53.
    PMID: 34271052 DOI: 10.1016/j.ijbiomac.2021.07.069
    A packaging material that is environment-friendly with excellent mechanical and physicochemical properties, biodegradable and ultraviolet (UV) protection and thermal stability was prepared to reduce plastic waste. Six different concentrations of Pennisetum purpureum/Napier cellulose nanowhiskers (NWCs) (i.e. 0, 0.5, 1.0, 1.5, 2.0, and 3.0 wt%) were used to reinforce polylactic acid (PLA) by a solvent casting method. The resulting bionanocomposite film samples were characterised in terms of their morphology, chemical structure, crystallinity, thermal degradation and stability, light transmittance, water absorption, biodegradability, and physical and mechanical properties. Field-emission scanning electron microscopy showed the excellent dispersion of NWC in the PLA matrix occurred with NWC concentrations of 0.5-1.5 wt%. All the bionanocomposite film samples exhibited good thermal stability at approximately 343-359 °C. The highest water absorption was 1.94%. The lowest transparency at λ800 was 16.16% for the PLA/3.0% NWC bionanocomposite film, which also has the lowest UVA and UVB transmittance of 7.49% and 4.02%, respectively, making it suitable for packaging materials. The PLA/1.0% NWC film exhibited the highest crystallinity of 50.09% and high tensile strength and tensile modulus of 21.22 MPa and 11.35 MPa, respectively.
  15. In vitro biodegradation, cytotoxicity, and biocompatibility of polylactic acid/napier cellulose nanofiber scaffold composites
    Revati R, Majid MSA, Ridzuan MJM, Mamat N, Cheng EM, Alshahrani HA
    Int J Biol Macromol, 2022 Dec 31;223(Pt A):479-489.
    PMID: 36368357 DOI: 10.1016/j.ijbiomac.2022.11.041
    This study aimed to evaluate the bioactivities and biocompatibilities of porous polylactic acid (PLA) reinforced with cellulose nanofiber (CNF) scaffolds. The in vitro degradation behaviors of the porous PLA/CNF scaffolds were systematically measured for up to 8 weeks in a phosphate-buffered saline medium at 37 °C. The reinforcement of CNF resisted the biodegradation of the scaffolds. The in vitro cytotoxicity and biocompatibility of the scaffolds were determined using the Beas2B American Type Culture Collection cells. The 3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide cytotoxicity and proliferation tests showed that the scaffolds were non-toxic, and epithelial cells grew well on the scaffold after 7 days of culture, whereas the percentage of cell proliferation on the PLA/CNF15 scaffold was the largest, 130 %. A scratch wound-healing assay was performed to evaluate the suitability of the scaffolds for cell migration. The results demonstrated that the scaffolds exhibited good cell migration towards nearly complete wound closure.
  16. Dielectric and material analysis on physicochemical activity of porous hydroxyapatite/cornstarch composites
    Beh CY, Cheng EM, Mohd Nasir NF, Eng SK, Abdul Majid MS, Ridzuan MJM, et al.
    Int J Biol Macromol, 2021 Jan 01;166:1543-1553.
    PMID: 33181217 DOI: 10.1016/j.ijbiomac.2020.11.034
    This paper provides a comprehensive analysis of the dielectric and physicochemical properties of the porous hydroxyapatite/cornstarch (HAp/Cs) composites in a new perspective. The porous composites have been characterized via SEM, FTIR, XRD and dielectric spectroscopy. The dielectric permittivity spectra were obtained in Ku-band (12.4-18.0 GHz) and it was correlated with the physicochemical properties of the porous HAp/Cs. Porous HAp/Cs composites exhibits low ε' and negative ε″, which influenced by the microstructural morphology, interaction between Hap and Cs, as well as crystalline features due to the various proportion of the HAp/Cs. The physicochemical effect of the composites results in the dielectric polarization and energy loss. This phenomenon indicates the presence of the three obvious relaxation responses in the ε' spectrum (13.2-14.0, 15.2-16.0, and 16.6-17.4 GHz) and the negative behaviours in the ε″ spectrum. The relationships between physicochemical and dielectric properties of the porous composite facilitate the development of the non-destructive microwave evaluation test for the porous composite.
  17. Low Frequency Dielectric and Optical Behavior on Physicochemical Properties of Hydroxyapatite/Cornstarch Composite
    Beh CY, Cheng EM, Mohd Nasir NF, Khor SF, Eng SK, Abdul Majid MS, et al.
    J Colloid Interface Sci, 2021 Oct 15;600:187-198.
    PMID: 34015511 DOI: 10.1016/j.jcis.2021.03.158
    An investigation on relationship among the physicochemical, optical and dielectric properties of the hydroxyapatite/cornstarch (HA/Cs) composites with the starch proportion of 30, 40, 50, 60, 70, 80 and 90 wt% is presented in this work. The HA/Cs composites have been characterized via FTIR, XRD, DRS and impedance analyzer. This work depicts that the strong interaction is exhibited between the hydroxyapatite nanoparticles and starch as the starch proportion increases. This increment trend results in the higher crystallinity of the HA/Cs composites. The highly crystallized HA/Cs with hydroxyapatite nucleation center presents low optical properties (diffuse reflectance and optical band gap energy). The HA/Cs composite with 80 wt% starch proportion (H2C8) show higher dielectric properties (dielectric constant, loss factor and conductivity) due to the stronger interfacial interaction and close-packed HA/Cs crystalline structure. The relationship among the physicochemical, optical and dielectric properties of the HA/Cs composite is studied in this work for potential of instrumentation design.
  18. In vitro degradation of a 3D porous Pennisetum purpureum/PLA biocomposite scaffold
    Revati R, Majid MSA, Ridzuan MJM, Basaruddin KS, Rahman Y MN, Cheng EM, et al.
    J Mech Behav Biomed Mater, 2017 10;74:383-391.
    PMID: 28688321 DOI: 10.1016/j.jmbbm.2017.06.035
    The in vitro degradation and mechanical properties of a 3D porous Pennisetum purpureum (PP)/polylactic acid (PLA)-based scaffold were investigated. In this study, composite scaffolds with PP to PLA ratios of 0%, 10%, 20%, and 30% were immersed in a PBS solution at 37°C for 40 days. Compression tests were conducted to evaluate the compressive strength and modulus of the scaffolds, according to ASTM F451-95. The compression strength of the scaffolds was found to increase from 1.94 to 9.32MPa, while the compressive modulus increased from 1.73 to 5.25MPa as the fillers' content increased from 0wt% to 30wt%. Moreover, field emission scanning electron microscopy (FESEM) and X-ray diffraction were employed to observe and analyse the microstructure and fibre-matrix interface. Interestingly, the degradation rate was reduced for the PLA/PP20scaffold, though insignificantly, this could be attributed to the improved mechanical properties and stronger fibre-matrix interface. Microstructure changes after degradation were observed using FESEM. The FESEM results indicated that a strong fibre-matrix interface was formed in the PLA/PP20scaffold, which reflected the addition of P. purpureum into PLA decreasing the degradation rate compared to in pure PLA scaffolds. The results suggest that the P. purpureum/PLA scaffold degradation rate can be altered and controlled to meet requirements imposed by a given tissue engineering application.
  19. Administration of tranexamic acid for victims of severe trauma within pre-hospital care ambulance services (PHCAS) in Malaysia
    Shah Jahan MY, Shamila MA, Nurul Azlean N, Mohd Amin M, Anandakumar K, Ahmad Ibrahim KB, et al.
    Med J Malaysia, 2019 08;74(4):300-306.
    PMID: 31424037
    INTRODUCTION: Trauma is a Global threat and the 5th highest cause of all-cause mortality in Malaysia caused predominantly due to road traffic accidents. Majority of trauma victims are young adults aged between 21-40 years old. In Malaysia, 24 out of 100,000 population die annually due to trauma, rating us amongst the highest in South East Asia. These alarming figures justify aggressive preventive and mitigation strategies. The aim of this paper is to promote the implementation of evidence-based interventions that will reduce the rate of preventable death because of trauma. Tranexamic acid is one of the few interventions in the early management of severe trauma with level-one evidence. Tranexamic acid has been proven to reduce all causes of mortality and mortality due to bleeding. Evidence proves that it is most effective when administered early, particularly within the 1st hour of trauma. This proposed guideline is formulated based upon quality evidence from multicentre studies, clinical practices in other countries and consideration of the local demographic factors with the intent of enabling an easy and simple pathway to administer tranexamic acid early in the care of the severely injured.

    CONCLUSION: The guideline highlights select pre-hospital criteria's and the methods for drug administration. The authors recognise that some variants may be present amongst certain institutions necessitating minor adaptations, nevertheless the core principles of advocating tranexamic acid early in the course of pre-hospital trauma should be adhered to.

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