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Fulltext Selecting antihypertensive medication in patients with essential hypertension in Malaysia

Ong HT, Rozina G

Med J Malaysia, 2009 Mar;64(1):3-11.
PMID: 19852313 MyJurnal

Since hypertension is generally asymptomatic, in treating hypertension we are actually seeking to prevent target organ damage and reduce adverse clinical outcome. There have been numerous large clinical trials addressing the question of whether any antihypertensive drug has special protective effects on the cardiovascular and renal systems in addition to the benefit from blood pressure (BP) reduction1-15. In seeking to correctly interpret the message from these trials, it is important to avoid the confusion that can occur when pharmaceutical companies seek to make the results suit their marketing needs 16-18. The aim of this article is thus to provide an unbiased review of the value of the different antihypertensive drugs for the clinician treating essential hypertension in Malaysia.
Student-Based Analysis of Perception Regarding the Educational Environment Using the Dundee Ready Education Environment Measure Questionnaire at Chattagram Maa-O-Shishu Hospital Medical College, Bangladesh

Mostafa A, Hoque R, Haque M

Florence Nightingale Hemsire Derg, 2019 Oct;27(3):211-221.
PMID: 34267975 DOI: 10.5152/FNJN.2019.19025

Aim: The educational environment is the most significant manifestation of the curriculum. The Dundee Ready Education Environment Measure questionnaire is the precise quantitative assessment tool for the EE for medical- and health-related professional schools.
Method: This was a cross-sectional study conducted in Chattagram Maa-O-Shishu Hospital Medical College, Chittagong, Bangladesh during the study period of 2017-2018. The DREEM questionnaire was distributed to the paraclinical and clinical students in their regular classes. Data were analyzed using SPSS version 19.
Results: A total of 170 students responded to the questionnaire, of which 27.6% were male, and 72.4% were female. The mean total Dundee Ready Education Environment Measure score of the present study was 130.46. Paraclinical students scored statistically significantly higher than clinical students (p=0.040). Students' social self-perceptions were significantly higher for male than for female students (p<0.05). Most of the students opined that a positive learning experience (80.6%), appropriate teaching method (81.2%), and academic self-perceptions were positive (77.1%), and positive learning atmosphere (65.9%) as well as social surroundings were in acceptable range (70.6%) in Chattagram Maa-O-Shishu Hospital Medical College.
Conclusion: The findings and evidences of the present study will hopefully provide the basis to take effective measures to improve teaching and learning environment of this medical school.
Fulltext Effectiveness of a Peer-Led Behavioral Intervention Program on Tobacco Use-Related Knowledge, Attitude, Normative Beliefs, and Intention to Smoke among Adolescents at Iranian Public High Schools

Mohammadi M, Ghaleiha A, Rahnama R

Int J Prev Med, 2019;10:111.
PMID: 31360358 DOI: 10.4103/ijpvm.IJPVM_493_17

Background: Theory-based tobacco use prevention programs in schools were implemented to evaluate the effectiveness of this peer-led intervention on tobacco use-related knowledge, attitude, normative beliefs, and intention to tobacco use of school children aged 14-17 years old.
Methods: A school-based cluster randomized controlled intervention study was conducted among 1st, 2nd, and 3rd grade high school children in Sanandaj City, Iran. 4-h integrated tobacco use prevention program comprising of four structured modules was developed and delivered to the intervention group by trained peer educator. Outcome measures comprised changes in students' smoking-related knowledge, attitude, normative beliefs, and intention to tobacco use from baseline to 6-month follow-up through validated anonymous questionnaire.
Results: The present study showed an intervention effect on tobacco use-related knowledge, normative beliefs, and intention to tobacco use but not attitude. The results indicated that there was significant decrease in intention to tobacco use (P ≤ 0.013) observed after 6-month postintervention. The intervention module was also effective in improving smoking knowledge (P ≤ 0.001), normative beliefs with regard to perceived prevalence of cigarette smoking and water-pipe use among adults and adolescents (P ≤ 0.001) in intervention group 6-month postintervention.
Conclusions: Participation in the peer-led education program to tobacco use prevention may have improvement in knowledge, normative beliefs, and intention to tobacco use. An implementation of the peer-led behavioral intervention components in the school setting may have a beneficial effect on public health by decreasing intention to tobacco use among nonsmoker adolescents.
Fulltext Intern doctors' views on the current and future antibiotic resistance situation of Chattagram Maa O Shishu Hospital Medical College, Bangladesh

Hoque R, Mostafa A, Haque M

Ther Clin Risk Manag, 2015;11:1177-85.
PMID: 26316762 DOI: 10.2147/TCRM.S90110

BACKGROUND: Bacterial resistance due to antibiotic misuse is reported every day. Such threat calls for a consensus to develop new strategies to prevent the development of antibiotic resistance of bacteria. Medical doctors must play a pivotal role to control and prevent the misuse of antibiotics. There were complaints that prescribers are lacking behind in updates and advancement in the field. To address such knowledge gap, a study was conducted to know the views of interns on the current antibiotic resistance situation in a teaching hospital in Bangladesh.
METHODS: This study was a cross-sectional, randomized, and questionnaire-based survey. Interns of the medicine, gynecology, and surgery departments of Chattagram Maa O Shishu Hospital Medical College were the study population.
RESULTS: Out of 50 respondents, 98% would like more education on antibiotic selection. All respondents believed that prescribing inappropriate or unnecessary antibiotics was professionally unethical. Ninety percent of the participants were confident in making an accurate diagnosis of infection. Eighty-four percent of them were confident about dosage schedule. In all, 98% participants thought that antibiotic resistance is a national problem and 64% of the respondents thought that same problem also existed in their hospital. Study participants were of the view that 41%-60% of antibiotic usages are irrational in Bangladesh. Fifty-eight percent of the study population thought that antimicrobial resistance (AR) would be a greater problem in the future.
CONCLUSION: The interns believe that there is a knowledge gap on AR. More emphasis should be given to AR and its implications in the undergraduate curriculum. Latest national and international guidelines for antimicrobial therapy and resistance should be made available to the interns.
Drug use and dosing in chronic kidney disease

Hassan Y, Al-Ramahi R, Abd Aziz N, Ghazali R

Ann Acad Med Singap, 2009 Dec;38(12):1095-103.
PMID: 20052447

One of the most important drug-related problems in patients with chronic kidney disease (CKD) is medication dosing errors. Many medications and their metabolites are eliminated through the kidney. Thus, adequate renal function is important to avoid toxicity. Patients with renal impairment often have alterations in their pharmacokinetic and pharmacodynamic parameters. The clearance of drugs eliminated primarily by renal filtration is decreased by renal disease. Therefore, special consideration should be taken when these drugs are prescribed to patients with impaired renal function. Despite the importance of dosage adjustment in patients with CKD, such adjustments are sometimes ignored. Physicians and pharmacists can work together to accomplish safe drug prescribing. This task can be complex and require a stepwise approach to ensure effectiveness, minimise further damage and prevent drug nephrotoxicity.
Impact of a renal drug dosing service on dose adjustment in hospitalized patients with chronic kidney disease

Hassan Y, Al-Ramahi RJ, Aziz NA, Ghazali R

Ann Pharmacother, 2009 Oct;43(10):1598-605.
PMID: 19776297 DOI: 10.1345/aph.1M187

Appropriate drug selection and dosing for patients with chronic kidney disease (CKD) is important to avoid unwanted drug effects and ensure optimal patient outcomes.
Fulltext Dialysis for end stage renal disease: a descriptive study in Penang Hospital

Shaza AM, Rozina G, Izham MIM, Azhar SSS

Med J Malaysia, 2005 Aug;60(3):320-7.
PMID: 16379187 MyJurnal

This research was carried out to study the characteristics of ESRD patients and the resources consumed with dialysis treatment as well as to assess the clinical outcomes of ESRD treatment in Penang Hospital. A total of 117 ESRD patients were studied over 30 months. 56.4% of the patients were male and the median age was 40. Diabetic nephropathy was the commonest cause of ESRD (29.9%). Hypertension was the predominant comorbidity (60.6%). A larger proportion started treatment with Continuous Ambulatory Peritoneal Dialysis (59.0%). At the end of the study period, 49.6% of the patients continued their treatment in the same modality and 27.4% died. Average Dialysis Adequacy (Kt/V) achieved was satisfactory, 2.29 in CAPD and 1.50 in Haemodialysis.
Anti-gay "Honor" Abuse: A Multinational Attitudinal Study of Collectivist- Versus Individualist-Orientated Populations in Asia and England

Lowe M, Khan R, Thanzami V, Barzy M, Karmaliani R

J Interpers Violence, 2021 08;36(15-16):7866-7885.
PMID: 30924715 DOI: 10.1177/0886260519838493

Cultural collectivism, a core feature of honor cultures, is associated with the acceptance of aggression if it is used in the name of so-called "honor." Currently overlooked in the research literature, this study explored perceptions of antigay "honor" abuse in collectivist-orientated honor cultures, where homosexuality, in particular, is considered to be dishonorable. To conduct exploratory and comparative analysis, this study recruited 922 students in four Asian countries (India, Iran, Malaysia, and Pakistan), as well as Asian British and White British students in England. All participants read a brief vignette depicting a man whose relatives verbally abuse him and threaten him with life-threatening violence, after suspecting that he is gay and has joined an online dating website to meet men. Participants then completed a short questionnaire that assessed the extent to which they thought the man's actions had damaged his family's honor and their approval of the antigay "honor" abuse depicted in the scenario. Broadly in line with predictions, data analyses revealed attitudes more supportive of antigay "honor" abuse in all five collectivist-orientated populations than the sample of individualistic-orientated counterparts in England. Notably, however, a series of one-way analyses of variance (ANOVAs) demonstrated that these results varied depending on country of residence, gender, religious denomination, educational status, and age. The findings show that individual and demographic differences influence perceptions toward homophobic "honor" abuse in collectivist cultures. These differences are useful indices of the psychosocial factors that underpin hostile attitudes toward gay males in cultures where homosexuality is denounced.
A comparison of knowledge of diabetes mellitus between patients with diabetes and healthy adults: a survey from north Malaysia

Yun LS, Hassan Y, Aziz NA, Awaisu A, Ghazali R

Patient Educ Couns, 2007 Dec;69(1-3):47-54.
PMID: 17720351 DOI: 10.1016/j.pec.2007.06.017

Objective: The primary objective of this study was to assess and compare the knowledge of diabetes mellitus possessed by patients with diabetes and healthy adult volunteers in Penang, Malaysia.
Method: A cross-sectional study was conducted from 20 February 2006 to 31 March 2006. We randomly selected 120 patients with diabetes mellitus from a diabetic clinic at the General Hospital Penang, Malaysia and 120 healthy adults at a shopping complex in Penang. Each participant was interviewed face-to-face by a pharmacist using a validated questionnaire, and they were required to answer a total of 30 questions concerning knowledge about diabetes mellitus using Yes, No or Unsure as the only response.
Results: The results showed that patients with diabetes mellitus were significantly more knowledgeable than the healthy volunteers about risk factors, symptoms, chronic complications, treatment and self-management, and monitoring parameters. Educational level was the best predictive factor for diabetes mellitus and public awareness.
Conclusion: Knowledge about diabetes mellitus should be improved among the general population.
Practice implications: This study has major implications for the design of an educational programme for diabetics and a health promotion programme as a primary prevention measure for the healthy population in general, and especially for those at high risk. The results could be useful in the design of future studies for evaluating patients' and the general public's knowledge about diabetes mellitus.
Multicenter analysis on the impact of nephrologist-initiated catheter insertion program on peritoneal dialysis penetration

Ng EK, Goh BL, Chew SE, Tan CC, Ching CH, Sha'ariah MY, et al.

Semin Dial, 2012 Sep-Oct;25(5):569-73.
PMID: 22353629 DOI: 10.1111/j.1525-139X.2012.01051.x

The demands for timely catheter insertion have spurred the growth of peritoneoscopic catheter insertion program by nephrologists in Malaysia. We performed a multicenter analysis to study its impact on the growth of peritoneal dialysis (PD) population. Data were collected retrospectively from five centers at the point of program initiation until December 2009. In Center 1, with this program, PD population continued to grow from 25 patients in 2006 to 120 in 2009. In center 2, the program began in 2005, but comprised only 28.6% of total insertions. From 2007 onwards, nephrologists had overtaken the surgeon, inserting from 85% to 97% of the total insertions. In center 3, with the program at its infancy, a modest growth in its PD population was shown. In center 4, nephrologists maintained an annual average of 41.8% of total catheter insertions, and thus maintaining a stable PD population. In center 5, surgeon-assisted PD catheter insertions helped to maintain the growth of its PD, seeing lesser impact from this program. Subanalysis showed that 1-year catheter survival in Center 1 was 85.4%. This study on PD catheter insertion program by nephrologists showed the greatest impact on new center and center experiencing suboptimal catheter insertions by traditional providers.
Fulltext A report of the Malaysian dialysis registry of the National Renal Registry, Malaysia

Lim YN, Lim TO, Lee DG, Wong HS, Ong LM, Shaariah W, et al.

Med J Malaysia, 2008 Sep;63 Suppl C:5-8.
PMID: 19230240

The Malaysian National Renal Registry was set up in 1992 to collect data for patients on renal replacement therapy (RRT). We present here the report of the Malaysian dialysis registry. The objectives of this papar are: (1) To examine the overall provision of dialysis treatment in Malaysia and its trend from 1980 to 2006. (2) To assess the treatment rate according to the states in the country. (3) To describe the method, location and funding of dialysis. (4) To characterise the patients accepted for dialysis treatment. (5) To analyze the outcomes of the dialysis treatment. Data on patients receiving dialysis treatment were collected at initiation of dialysis, at the time of any significant outcome, as well as yearly. The number of dialysis patients increased from 59 in 1980 to almost 15,000 in 2006. The dialysis acceptance rate increased from 3 per million population in 1980 to 116 per million population in 2006, and the prevalence rate from 4 to 550 per million population over the same period. The economically advantaged states of Malaysia had much higher dialysis treatment rates compared to the less economically advanced states. Eighty to 90% of new dialysis patients were accepted into centre haemodialysis (HD), and the rest into the chronic ambulatory peritoneal dialysis (CAPD) programme. The government provided about half of the funding for dialysis treatment. Patients older than 55 years accounted for the largest proportion of new patients on dialysis since the 1990s. Diabetes mellitus has been the main cause of ESRD and accounted for more than 50% of new ESRD since 2002. Annual death rate averaged about 10% on HD and 15% on CAPD. The unadjusted 5-year patient survival on both HD and CAPD was about 80%. Fifty percent of dialysis patients reported very good median QoL index score. About 70% of dialysis patients were about to work full or part time. There has been a very rapid growth of dialysis provision in Malaysia particularly in the older age groups. ESRD caused by diabetes mellitus, despite being a preventable and treatable cause of ESRD--has increased and accounted for more than 50% of incident dialysis patients. Death and survival rates on dialysis are comparable to those from other countries.
Fulltext Pregnancy in patients with renal transplants in Malaysia

Hooi LS, Rozina G, Wan Shaariah MY, Teo SM, Tan CHH, Bavanandan S, et al.

Med J Malaysia, 2003 Mar;58(1):27-36.
PMID: 14556324

There were 72 pregnancies in 46 renal transplants (RTs) between 1984 and 2001, 89% from living donors, 11% cadaveric. Mean age at RT was 26.9 +/- 4.3 years and at pregnancy 30.7 +/- 4.7 years. Mean time to pregnancy after RT was 4.5 +/- 3.1 years. 54% were unplanned. 45 (63%) resulted in surviving infants, 37% delivered by Caesarean section. 35% were premature. Mean birth weight was 2.38 +/- 0.57 kg. 64% were on cyclosporine. No patient had an acute rejection during pregnancy; 38% had pre-existing hypertension. Complications include urinary infection (13%), proteinuria (15%) and preeclampsia (15%). Mean serum creatinine before pregnancy was 112.7 +/- 32.6 umol/l, 1 year post-pregnancy it was 119.4 +/- 38.7. The mean time of follow up of mothers is 4.9 +/- 3.5 years. 10 year graft survival was 83% and patient survival 94%.
Artificial neural network and convolutional neural network for prediction of dental caries

Basri KN, Yazid F, Mohd Zain MN, Md Yusof Z, Abdul Rani R, Zoolfakar AS

Spectrochim Acta A Mol Biomol Spectrosc, 2024 May 05;312:124063.
PMID: 38394882 DOI: 10.1016/j.saa.2024.124063

Dental caries has high prevalence among kids and adults thus it has become one of the global health concerns. The current modern dentistry focused on the preventives measures to reduce the number of dental caries cases. The employment of machine learning coupled with UV spectroscopy plays a crucial role to detect the early stage of caries. Artificial neural network with hyperparameter tuning was employed to train spectral data for the classification based on the International Caries Detection and Assesment System (ICDAS). Spectra preprocessing namely mean center (MC), autoscale (AS) and Savitzky Golay smoothing (SG) were applied on the data for spectra correction. The best performance of ANN model obtained has accuracy of 0.85 with precision of 1.00. Convolutional neural network (CNN) combined with Savitzky Golay smoothing performed on the spectral data has accuracy, precision, sensitivity and specificity for validation data of 1.00 respectively. The result obtained shows that the application of ANN and CNN capable to produce robust model to be used as an early screening of dental caries.
Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative lupus nephritis

Ong LM, Hooi LS, Lim TO, Goh BL, Ahmad G, Ghazalli R, et al.

Nephrology (Carlton), 2005 Oct;10(5):504-10.
PMID: 16221103 DOI: 10.1111/j.1440-1797.2005.00444.x

BACKGROUND: The aim of the present study was to evaluate the efficacy of mycophenolate mofetil in the induction therapy of proliferative lupus nephritis.
METHODS: Forty-four patients from eight centres with newly diagnosed lupus nephritis World Health Organization class III or IV were randomly assigned to either mycophenolate mofetil (MMF) 2 g/day for 6 months or intravenous cyclophosphamide (IVC) 0.75-1 g/m(2) monthly for 6 months in addition to corticosteroids.
RESULTS: Remission occurred in 13 out of 25 patients (52%) in the IVC group and 11 out of 19 patients (58%) in the MMF group (P = 0.70). There were 12% in the IVC group and 26% in the MMF group that achieved complete remission (P = 0.22). Improvements in haemoglobin, the erythrocyte sedimentation rate, serum albumin, serum complement, proteinuria, urinary activity, renal function and the Systemic Lupus Erythematosus Disease Activity Index score were similar in both groups. Twenty-four follow-up renal biopsies at the end of therapy showed a significant reduction in the activity score in both groups. The chronicity index increased in both groups but was only significant in the IVC group. Adverse events were similar. Major infections occurred in three patients in each group. There was no difference in gastrointestinal side-effects.
CONCLUSIONS: MMF in combination with corticosteroids is an effective induction therapy for moderately severe proliferative lupus nephritis.
Fulltext Cost effectiveness evaluation of the Ministry of Health Malaysia dialysis programme

Lim TO, Lim YN, Wong HS, Ahmad G, Singam TS, Morad Z, et al.

Med J Malaysia, 1999 Dec;54(4):442-52.
PMID: 11072461

We determine the cost effectiveness of centre and home haemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and intermittent peritoneal dialysis (IPD) treatment in the Ministry of Health (MOH) programme. The viewpoint taken for this evaluation is that of MOH. Cost categories identified were capital cost, dialysis operational cost, medical cost and general hospital cost. Cost estimates were mostly based on actual resource utilisation. Life years saved were estimated based on Dialysis Registry data on 2480 HD and 732 CAPD patients. Overall, the cost-effectiveness ratio (CER) of centre HD was RM21620/life year saved. Those of home HD, CAPD and IPD were RM23375, RM30469 and RM36016 respectively. Sensitivity analyses did not change the ranking of the CER. We conclude the MOH dialysis programme was cost-effective, and among the various dialysis modalities centre HD was the most cost-effective.
Fulltext Outcome assessment of the Ministry of Health Malaysia dialysis programme

Lim TO, Lim YN, Wong HS, Ahmad G, Singam TS, Morad Z, et al.

Med J Malaysia, 1999 Dec;54(4):459-70.
PMID: 11072463

We describe the outcomes on haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) provided by the Ministry of Health (MOH). The assessment was based on data from the Malaysian Dialysis Registry on 2480 HD and 732 CAPD patients who commenced dialysis between 1980 and 1996. Young patients (age < 40) have remarkable long term survival (life expectancies of 16 years on HD, 18 years on CAPD). Adjusting for background mortality, relative survival of older patients was as good as younger ones. Diabetics did poorly. 52% of HD and 26% of CAPD patients were employed in 1996. 71% of HD patients scored 10(normal) on QL index (a measure of quality of life) while 60% of CAPD patients have similar score. Differences in rehabilitation and QL index scores by age, gender and diabetes were also observed. Outcomes of dialysis in the MOH programme are reassuring.
Exploring the factors and barriers of healthcare professionals in tertiary care hospitals towards pharmacovigilance: a multicenter study from Khyber Pakhtunkhwa, Pakistan

Sharif MJH, Farrukh MJ, Khan FU, Khan Q, Ahmed SS, Kousar R, et al.

Curr Med Res Opin, 2022 Feb 15.
PMID: 35166143 DOI: 10.1080/03007995.2022.2042992

BACKGROUND: Spontaneous Adverse drug reactions (ADRs) reporting is a cornerstone for a successful pharmacovigilance program as under-reporting of ADRs remains a major issue around the globe. The current study aimed to assess the knowledge attitude and practices of health care professionals regarding pharmacovigilance along with barriers and factors to encourage ADR reporting at tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan.
METHODS: A questionnaire-based cross-sectional survey was conducted, using the convenience sampling method to collect the data from doctors, nurses, and pharmacists working in seven tertiary care hospitals from seven districts of Khyber-Pakhtunkhwa province, Pakistan, between July 2019 and March 2020.
RESULTS: During the study, a total of 830 questionnaires were distributed, out of which 669 were returned (response rate 80.6%). Overall, Healthcare professionals exhibited poor knowledge (79.5%) about ADR reporting and pharmacovigilance however, 73.5% of pharmacists were more knowledgeable as compared to 18.7% doctors and 13.8% nurses (p < 0.001). Moreover, poor reporting practices were displayed by 95.6% doctors, 94.4% nurses 94.4% and 75.5% pharmacists (p < 0.001). However, the majority of healthcare professionals showed an overall positive attitude (94%) towards ADR reporting. The most frequently cited barriers were unavailability of reporting forms (92.5%), absence of a professional environment to discuss ADRs (82.5%), and lack of training (81.8%) whereas, most common factors to encourage ADR reporting were obligatory reporting (85.9%) and provision of ADR management guidelines and training (84.3%). A significant relation was found between the healthcare professionals and their professional status with the overall knowledge, attitude, and practice (KAP) scores (p
A randomized, multicenter, open-label trial to establish therapeutic equivalence between the Carex and ultra disconnect systems in patients on continuous ambulatory peritoneal dialysis

Ong LM, Lim TO, Hooi LS, Morad Z, Tan PC, Wong HS, et al.

Perit Dial Int, 2003 Dec;23 Suppl 2:S139-43.
PMID: 17986534

OBJECTIVE: In the present study, we undertook to establish therapeutic equivalence with respect to peritonitis and technique failure between the Carex disconnect system (B. Braun Carex, Mirandola, Italy) and the standard Ultra system (Baxter Healthcare, Tokyo, Japan) in patients on continuous ambulatory peritoneal dialysis (CAPD).
DESIGN: This multicenter, parallel group, randomized controlled trial involved 363 prevalent CAPD patients from 8 centers. The primary endpoint was peritonitis rate; secondary endpoints were technique failure and technical problems encountered. The duration of the evaluation was 1 year.
RESULTS: The risk of peritonitis on Carex varied between the centers. We found a significant treatment-center interaction effect (likelihood ratio test: p = 0.03). The incidence rate ratio (IRR) of peritonitis on Carex as compared with Ultra ranged from 0.4 to 7.2. In two centers, Carex was inferior to Ultra with regard to peritonitis; but, in five centers, the results were inconclusive. Equivalence was not demonstrated in any center. The overall rate of peritonitis in the Carex group was twice that in the Ultra group [IRR: 2.18; 95% confidence interval (CI): 1.51 to 3.14]. Technique failure and technical problems were more common with the Carex system. Technique failure rate at 1 year was 44% in the Carex group and 22% in the Ultra group.
CONCLUSIONS: Equivalence between the Carex disconnect system and the Ultra disconnect system could not be demonstrated. The risk of peritonitis on Carex varied significantly between centers.
Randomized controlled trial to compare the efficacy and safety of oral paricalcitol with oral calcitriol in dialysis patients with secondary hyperparathyroidism

Ong LM, Narayanan P, Goh HK, Manocha AB, Ghazali A, Omar M, et al.

Nephrology (Carlton), 2013 Mar;18(3):194-200.
PMID: 23311404 DOI: 10.1111/nep.12029

The objective of the study was to compare the efficacy and safety of oral paricalcitol with oral calcitriol for treating secondary hyperparathyroidism.
Hazardous waste management (Buxus papillosa) investment for the prosperity of environment and circular economy: Response surface methodology-based simulation

Faiz I, Ahmad M, Ramadan MF, Zia U, Rozina, Bokhari A, et al.

J Environ Manage, 2024 Jan 15;350:119567.
PMID: 38007927 DOI: 10.1016/j.jenvman.2023.119567

Dealing with the current defaults of environmental toxicity, heating, waste management, and economic crises, exploration of novel non-edible, toxic, and waste feedstock for renewable biodiesel synthesis is the need of the hour. The present study is concerned with Buxus papillosa with seeds oil concentration (45% w/w), a promising biodiesel feedstock encountering environmental defaults and waste management; in addition, this research performed simulation based-response surface methodology (RSM) for Buxus papillosa bio-diesel. Synthesis and application of novel Phyto-nanocatalyst bimetallic oxide with Buxus papillosa fruit capsule aqueous extract was advantageous during transesterification. Characterization of sodium/potassium oxide Phyto-nanocatalyst confirmed 23.5 nm nano-size and enhanced catalytic activity. Other characterizing tools are FTIR, DRS, XRD, Zeta potential, SEM, and EDX. Methyl ester formation was authenticated by FTIR, GC-MS, and NMR. A maximum 97% yield was obtained at optimized conditions i.e., methanol ratio to oil (8:1), catalyst amount (0.37 wt%), reaction duration (180 min), and temperature of 80 °C. The reusability of novel sodium/potassium oxide was checked for six reactions. Buxus papillosa fuel properties were within the international restrictions of fuel. The sulphur content of 0.00090% signified the environmental remedial nature of Buxus papillosa methyl esters and it is a highly recommendable species for biodiesel production at large scale due to a t huge number of seeds production and vast distribution.

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