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  1. Fulltext Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia
    Nordin RB, Soni T, Kaur A, Loh KP, Miranda S
    Singapore Med J, 2019 Jan;60(1):40-47.
    PMID: 29774359 DOI: 10.11622/smedj.2018049
    INTRODUCTION: Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia.

    METHODS: We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale.

    RESULTS: The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114).

    CONCLUSION: ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.

  2. Fulltext A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur
    Farouk Musa A, Quan CZ, Xin LZ, Soni T, Dillon J, Hay YK, et al.
    F1000Res, 2018;7:164.
    PMID: 30254739 DOI: 10.12688/f1000research.13244.2
    Background: Atrial fibrillation (AF) is common after cardiac surgery and has been associated with poor outcome and increased resource utilization. The main objective of this study is to determine the incidence of POAF in Malaysia and identify the predictors of developing POAF. The secondary outcome of this study would be to investigate the difference in mortality and morbidity rates and the duration of intensive care unit (ICU), high dependency unit (HDU) and hospital stay between the two. Methods: This is a retrospective single-center, cross sectional study conducted at the National Heart Institute, Malaysia. Medical records of 637 who underwent coronary artery bypass grafting (CABG) surgery in 2015 were accrued. Pre-operative, operative and post-operative information were subsequently collected on a pre-formulated data collection sheet. Data were then analyzed using IBM SPSS v23. Results: The incidence of POAF in our study stands at 28.7% with a mean onset of 45±33 hours post operatively. Variables with independent association with POAF include advancing age, Indian population, history of chronic kidney disease, left ventricular ejection fraction and beta-blocker treatment. The mortality rate is significantly higher statistically ( p < 0.05), and similarly the incidence of stroke. The incidence of other post-operative complications was also significantly higher statistically. The duration of ICU, HDU and hospital stays were statistically longer ( p < 0.001) with higher rates of ICU readmissions and reintubations seen. Conclusion: We conclude that the incidence of POAF in Malaysia is comparable to the figures in Western countries, making POAF one of the most commonly encountered condition after CABG with similar higher rates of mortality, poor outcomes and longer duration of stay, and therefore increased cost of care. Strategies to reduce the incidence of AF after cardiac surgery should favorably affect surgical outcomes and reduce utilization of resources and thus lower cost of care.
  3. Formulation development and characterization of lumefantrine nanosuspension for enhanced antimalarial activity
    Shah R, Soni T, Shah U, Suhagia BN, Patel MN, Patel T, et al.
    J Biomater Sci Polym Ed, 2021 05;32(7):833-857.
    PMID: 33380264 DOI: 10.1080/09205063.2020.1870378
    Variable and low oral bioavailability (4-11%) of lumefantrine (LUF), an anti-malarial agent, is characterized by very low solubility in aqueous vehicle. Thus, the present study was intended to formulate lyophilized nanosuspensions of LUF to resolve its solubility issues for the improvement of oral bioavailability. A three level 32 factorial design was applied to analyze the influence of independent variables, concentration of polysorbate 80 (X1) and sonication time (X2) on the responses for dependent variables, particle size (Y1) and time to 90% release of LUF (t90) (Y2). Optimized formulation (F3) has shown to possess lowest particle size (95.34 nm) with minimum t90 value (⁓3 mins), which was lyophilized to obtain the dry powder form of the nanosuspension. The characterization parameters confirmed the amorphous form of LUF with good stability and no chemical interactions of the drug with the incorporated components. Further, saturation solubility study revealed increased solubility of the LUF nanosuspension (1670 µg/mL) when compared to the pure drug (212.33 µg/mL). Further, rate of dissolution of LUF from the nanosuspension formulations were found to be significantly (p 
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