Displaying publications 1 - 20 of 59 in total

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  1. Zawiah M, Khan AH, Farha RA, Usman A, Al-Ashwal FY, Akkaif MA
    Front Neurol, 2024;15:1322971.
    PMID: 38361641 DOI: 10.3389/fneur.2024.1322971
    BACKGROUND: Acute ischemic stroke (AIS) remains a substantial global health challenge, contributing to increased morbidity, disability, and mortality. This study aimed at investigating the predictive value of the neutrophil percentage to albumin ratio (NPAR) in determining intensive care unit (ICU) admission among AIS patients.

    METHODS: A retrospective observational study was conducted, involving AIS cases admitted to a tertiary hospital in Jordan between 2015 and 2020. Lab data were collected upon admission, and the primary outcome was ICU admission during hospitalization. Descriptive and inferential analyses were performed using SPSS version 29.

    RESULTS: In this study involving 364 AIS patients, a subset of 77 (21.2%) required admission to the ICU during their hospital stay, most frequently within the first week of admission. Univariable analysis revealed significantly higher NPAR levels in ICU-admitted ischemic stroke patients compared to those who were not admitted (23.3 vs. 15.7, p 

  2. Rawindran H, Lim JW, Lam MK, Supramaniam U, Tong WY, Ng HS, et al.
    Mol Biotechnol, 2023 Nov 14.
    PMID: 37964101 DOI: 10.1007/s12033-023-00955-0
    Conventionally, increasing the yield of microalgal biomass has been the primary focus of research, while the significant protein reserve within this biomass has remained largely unexplored. This protein reserve possesses substantial value and versatility, offering a wide range of prospective applications and presenting an enticing chance for innovation and value enhancement for various sectors. Current study employed an innovative research approach that focused solely on the LCA of protein production potential from microalgal biomass, a lesser-explored aspects within this domain. Most environmental impact categories were shown to be significantly affected by cultivation phase because of the electrical obligation, followed by the harvesting and protein extraction phase. Still, the environmental aspect was seen to yield a minimal impact on global warming potential, i.e., 4 × 10-3 kg CO2, underscoring the ecologically favorable nature of the process. Conversely, the overall energy impact was seen to intensify with NEB of - 39.33 MJ and NER of 0.49, drawing attention to the importance of addressing the energy aspect to harness the full potential of microalgal protein production.
  3. Leong WH, Lim JW, Rawindran H, Liew CS, Lam MK, Ho YC, et al.
    Chemosphere, 2023 Nov;341:139953.
    PMID: 37634592 DOI: 10.1016/j.chemosphere.2023.139953
    Life cycle assessments of microalgal cultivation systems are often conducted to evaluate the sustainability and feasibility factors of the entire production chain. Unlike widely reported conventional microalgal cultivation systems, the present work adopted a microalgal-bacterial cultivation approach which was upscaled into a pilot-scale continuous photobioreactor for microalgal biomass production into biodiesel from wastewater resources. A multiple cradle-to-cradle system ranging from microalgal biomass-to-lipid-to-biodiesel was evaluated to provide insights into the energy demand of each processes making up the microalgae-to-biodiesel value chain system. Energy feasibility studies revealed positive NER values (4.95-8.38) for producing microalgal biomass but deficit values for microalgal-to-biodiesel (0.14-0.23), stemming from the high energy input requirements in the downstream processes for converting biomass into lipid and biodiesel accounting to 88-90% of the cumulative energy demand. Although the energy balance for microalgae-to-biodiesel is in the deficits, it is comparable with other reported biodiesel production case studies (0.12-0.40). Nevertheless, the approach to using microalgal-bacterial cultivation system has improved the overall energy efficiency especially in the upstream processes compared to conventional microalgal cultivation systems. Energy life cycle assessments with other microalgal based biofuel systems also proposed effective measures in increasing the energy feasibility either by utilizing the residual biomass and less energy demanding downstream extraction processes from microalgal biomass. The microalgal-bacterial cultivation system is anticipated to offer both environmental and economic prospects for upscaling by effectively exploiting the low-cost nutrients from wastewaters via bioconversion into valuable microalgal biomass and biodiesel.
  4. Zawiah M, Khan AH, Abu Farha R, Usman A, AbuHammour K, Abdeen M, et al.
    Postgrad Med, 2023 Sep;135(7):681-689.
    PMID: 37756038 DOI: 10.1080/00325481.2023.2261354
    BACKGROUND: Early recognition of stroke-associated pneumonia (SAP) is critical to reducing morbidity and mortality associated with SAP. This study investigated the predictors of SAP, and the predictive value of the neutrophil percentage-to-albumin ratio (NPAR) for SAP.

    METHODS: This retrospective cohort study was conducted among stroke patients admitted to Jordan University Hospital from January 2015 to May 2021. Multivariable logistic regression was used to identify independent predictors for SAP. The predictive performance was assessed using C-statistics, described as the area under the receiver-operating characteristic curve (AUC, ROC) with a 95% confidence interval.

    RESULTS: Four hundred and six patients were included in the analysis, and the prevalence of SAP was 19.7%. Multivariable logistic analysis showed that males (Adjusted Odds Ratio (AOR): 5.74; 95% Confidence Interval (95%CI): 2.04-1 6.1)], dysphagia (AOR: 5.29; 95% CI: 1.80-15.5), hemiparesis (AOR: 3.27; 95% CI: 1.13-9.47), lower GCS score (AOR: 0.73; 95% CI: 0.58-0.91), higher levels of neutrophil-lymphocyte ratio (NLR) (AOR: 1.15; 95% CI: 1.07-1.24), monocyte-lymphocyte ratio (MLR) (AOR: 1.49; 95% CI: 1.13-1.96), and neutrophil percentage to albumin ratio (NPAR) (AOR: 1.53; 95% CI: 1.33-1.76) were independent predictors of SAP. The NPAR demonstrated a significantly higher AUC than both the NLR (0.939 versus 0.865, Z = 3.169, p = 0.002) and MLR (0.939 versus 0.842, Z = 3.940, p 

  5. Usman J, Salami BA, Gbadamosi A, Adamu H, Usman AG, Benaafi M, et al.
    Chemosphere, 2023 Aug;331:138726.
    PMID: 37116721 DOI: 10.1016/j.chemosphere.2023.138726
    Due to the significant energy and economic losses brought on by the global oil spill, there has been an increased interest in oil-water separation. This study presents strong non-linear machine learning models (support vector regression (SVR) and Gaussian process regression (GPR)) with the Response surface method (RSM) to predict the oil flux and oil-water separation efficiency of wastewater using ceramic membrane technology. For the model development and prediction of oil flux (OF) and oil-water separation efficiency (OSE), oil concentration (mg/L), feed flow rate (mL/min), and pH were considered as input variables. The input variables are combined in three combinations to study the most contributing input features to the models' performance. Mean square error (MSE) and Nash-Sutcliffe coefficient efficiency (NSE) were used to assess the prediction performances of the developed models with the different number of input combinations considered in the study. For the two target variables (OF and OSE), GPR and SVR models were used to separately predict them. For OF, the SVR-2 [Combo-2] model (MSE = 0.9255 and NSE = 2.7976) performed better with higher prediction accuracy compared to GPR-2 [Combo-2] model (MSE = 0.763 and NSE = 6.437). In addition, for OSE, the GPR-3 [Combo-3] model (MSE = 0.995 and NSE = 0.5544) performed slightly better than SVR-3 [Combo-3] model (MSE = 0.992 and NSE = 0.8066). The results showed that the SVR model with the combo-2 and GPR-3 models for OF and OSE variables are the proposed models with the best performance and accuracy. This machine learning study will aid in better evaluating the function of materials such as ceramic in membrane performance features such as oil flux and rejection prediction, separation efficiency, water recovery, membrane fouling, and so on. As for academics and manufacturers, this machine learning (ML) strategy will boost performance and allow a better understanding of system governance.
  6. Zawiah M, Hayat Khan A, Abu Farha R, Usman A, Bitar AN
    Curr Med Res Opin, 2023 Mar;39(3):475-482.
    PMID: 36710633 DOI: 10.1080/03007995.2023.2174327
    BACKGROUND: Predicting stroke-associated pneumonia (SAP) is crucial for intensifying preventive measures and decreasing morbidity and mortality. This meta-analysis aims to evaluate the association between baseline neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) with SAP and to determine the strength of the association.

    METHODS: The Web of Science, SCOPUS, and PUBMED databases were searched to find eligible studies. The standardized mean difference (SMD) and 95% confidence interval (CI) were used to evaluate the differences in NLR, MLR, and PLR levels between SAP and non-SAP patients. The meta-analysis was conducted using the software "Review Manager" (RevMan, version 5.4.1, September 2020). The random-effect model was used for the pooling analysis if there was substantial heterogeneity. Otherwise, the fixed-effect model was adopted.

    RESULTS: Twelve studies comprising 6302 stroke patients were included. The pooled analyses revealed that patients with SAP had significantly higher levels of NLR, MLR, and PLR than the non-SAP group. The SMD, 95% CI, p-value, and I2 for them were respectively reported as (0.88, 0.70-1.07, .00001, 77%); (0.94, 0.43-1.46, .0003, 93%); and (0.61, 0.47-0.75, .001, 0%). Subgroup analysis of NLR studies showed no significant differences in the effect size index between the severity of the stroke, the sample size, and the period between the stroke onset and the blood sampling.

    CONCLUSION: This systematic review and meta-analysis suggest that an elevated NLR, MLR, and PLR were associated with SAP, indicating that they could be promising blood-based biomarkers for predicting SAP. Large-scale prospective studies from various ethnicities are recommended to validate this association before they can be applied in clinical practice.

  7. Elnaem MH, Mosaad M, Abdelaziz DH, Mansour NO, Usman A, Elrggal ME, et al.
    Int J Environ Res Public Health, 2022 Nov 06;19(21).
    PMID: 36361453 DOI: 10.3390/ijerph192114571
    Controlling hypertension (HTN) remains a challenge, as it is affected by various factors in different settings. This study aimed to describe the disparities in the prevalence and barriers to hypertension control across countries of various income categories. Three scholarly databases-ScienceDirect, PubMed, and Google Scholar-were systematically examined using predefined search terms to identify potentially relevant studies. Original research articles published in English between 2011 and 2022 that reported the prevalence and barriers to HTN control were included. A total of 33 studies were included in this systematic review. Twenty-three studies were conducted in low and middle-income countries (LMIC), and ten studies were from high-income countries (HIC). The prevalence of hypertension control in the LMIC and HIC studies ranged from (3.8% to 50.4%) to (36.3% to 69.6%), respectively. Concerning barriers to hypertension control, patient-related barriers were the most frequently reported (n = 20), followed by medication adherence barriers (n = 10), lifestyle-related barriers (n = 8), barriers related to the affordability and accessibility of care (n = 8), awareness-related barriers (n = 7), and, finally, barriers related to prescribed pharmacotherapy (n = 6). A combination of more than one category of barriers was frequently encountered, with 59 barriers reported overall across the 33 studies. This work reported disparities in hypertension control and barriers across studies conducted in LMIC and HIC. Recognizing the multifactorial nature of the barriers to hypertension control, particularly in LMIC, is crucial in designing and implementing customized interventions.
  8. Usman A, Sutanto MH, Napiah M, Zoorob SE, Yaro NSA, Khan MI
    Polymers (Basel), 2021 Aug 06;13(16).
    PMID: 34451150 DOI: 10.3390/polym13162610
    The utilization of waste polyethylene terephthalate (WPET) as aggregate substitutes in pavement has been extensively promoted because of its environmental advantages. However, previous studies have shown that a high percentage of WPET reduces the performance of the pavement. To increase the durability of pavement and mitigate the environmental issues caused by WPET, WPET is treated with gamma-irradiation as a component in asphalt mixtures. The study objectives were to investigate the feasibility of using WPET granules as a sustainable aggregate on asphalt mixture stiffness and rutting and predict the asphalt mixture performance containing irradiated WPET via an RSM-ANN-framework. To achieve the objectives, stiffness and rutting tests were conducted to evaluate the WPET modified mixtures' performance. The result indicated that samples containing 40% irradiated WPET provided a better performance compared to mixtures containing 20% non-irradiated WPET, increasing the stiffness by 27% and 21% at 25 °C and 40 °C, respectively, and rutting resistance by 11% at 45 °C. Furthermore, both predictive models developed demonstrated excellent reliability. The ANN exhibited superior performance than the RSM. The utilization of WPET as aggregate in asphalt mixtures represents a way to addressing related recycling issues while also improving performance. With gamma-irradiation treatment, the utilization of WPET can be increased with improved asphalt mixture performance.
  9. Liew CS, Kiatkittipong W, Lim JW, Lam MK, Ho YC, Ho CD, et al.
    Chemosphere, 2021 Aug;277:130310.
    PMID: 33774241 DOI: 10.1016/j.chemosphere.2021.130310
    Sewage sludge has long been regarded as a hazardous waste by virtue of the loaded heavy metals and pathogens. Recently, more advanced technologies are introduced to make use of the nutrients from this hazardous sludge. Successful recovery of sludge's carbon content could significantly convert waste to energy and promote energy sustainability. Meanwhile, the recovery of nitrogen and trace minerals allows the production of fertilizers. This review is elucidating the performances of modern thermal treatment technologies in recovering resources from sewage sludge while reducing its environmental impacts. Exhaustive investigations show that most modern technologies are capable of recovering sludge's carbon content for energy generation. Concurrently, the technologies could as well stabilize heavy metals, destroy harmful pathogens, and reduce the volume of sludge to minimize the environmental impacts. Nevertheless, the high initial investment cost still poses a huge hurdle for many developing countries. Since the initial investment cost is inevitable, the future works should focus on improving the profit margin of thermal technologies; so that it would be more financially attractive. This can be done through process optimization, improved process design as well as the use of suitable co-substrates, additives, and catalyst as propounded in the review.
  10. Usman A, Mustafa N, Iqbal SP, Hasan MZ, Shaikh MF, Dujaili JA, et al.
    Int J Clin Pract, 2021 Aug;75(8):e14315.
    PMID: 33934480 DOI: 10.1111/ijcp.14315
    BACKGROUND: Incidence of hypokalemia during the management of diabetic ketoacidosis (DKA) is high despite detailed potassium replacement guidelines in its treatment.

    AIM: We aimed to find the role of pH-adjusted potassium (pHK ) in the development of hypokalemia, and their mutual impact on patient outcomes during DKA management.

    METHODOLOGY: Adult DKA patient's admission data of preceding 3 years (2015-2017) were retrospectively clerked. Outcomes of interest were time to develop hypokalemia and to terminate emergency department (ED) care (hours), severity of hypokalemia and hospitalisation length (days). Linear regression was used to determine significant associations/predictors.

    RESULTS: The study was concluded on 85 patients. Hypokalemia was observed in nearly 3/4th of all admissions and occurred by the time of ED care termination. Each 1 mmol/L increase in pHK significantly (a) reduced the degree of hypokalemia by 0.07 mmol/L, (b) delayed time to develop hypokalemia by 4.58 hours, (c) and reduced the ED care time by 1.28 hours. Arterial pH was the other factor significantly delaying time to develop hypokalemia (36.25 hours) and facilitating early discharge from ED (13.86 hours). Moreover, each 1 mmol/L reduction in the degree of hypokalemia increased hospitalisation length by 1.86 days. Though significant, acute kidney injury negligibly increased hospitalisation length by 0.01 days.

    CONCLUSION: pH-adjusted potassium shall be used as a marker for hypokalemia and to initiate potassium replacement instead of measured serum potassium in DKA. Utilising pHK will help to avoid hypokalemia, reduce its severity and shorten ED care which will subsequently reduce hospitalisation length. We expect pHK to improve pharmacoeconomics in the future.

  11. Lim MJ, Shahri NNM, Taha H, Mahadi AH, Kusrini E, Lim JW, et al.
    Carbohydr Polym, 2021 May 15;260:117806.
    PMID: 33712152 DOI: 10.1016/j.carbpol.2021.117806
    Chitin-encapsulated cadmium sulfide quantum dots (CdS@CTN QDs) were successfully synthesized from chitin and Cd(NO3)2 precursor using the colloidal chemistry method, toward the development of biocompatible and biodegradable QDs for biomedical applications. CdS@CTN QDs exhibited the nanocrystalline cubic CdS encapsulated by α-chitin. The average particle size of CdS@CTN QDs was estimated using empirical Henglein model to be 3.9 nm, while their crystallite size was predicted using Scherrer equation to be 4.3 nm, slightly larger compared to 3-mercaptopropionic acid-capped CdS QDs (3.2 and 3.6 nm, respectively). The mechanism of formation was interpreted based on the spectroscopic data and X-ray crystal structures of CdS@CTN QDs fabricated at different pH values and mass ratios of chitin to Cd(NO3)2 precursor. As an important step to explore potential biomolecular and biological applications of CdS@CTN QDs, their antibacterial activities were tested against four different bacterial strains; i.e. Escherichia coli, Bacillus subtillus, Staphylococcus aureus and Pseudomonas aeruginosa.
  12. Usman A, Shaikh MF, Dujaili JA, Mustafa N, Gan SH
    Diabetes Metab Syndr, 2021 Mar 05;15(2):573-580.
    PMID: 33706189 DOI: 10.1016/j.dsx.2021.03.001
    BACKGROUND AND AIMS: Diabetic ketoacidosis (DKA) treatment guidelines recommend to initiate potassium-replacement when serum potassium (SK) drops within normal range, and to withhold insulin if SK is below normal. Despite strict recommendations, hypokalemia is frequently observed in DKA.

    METHODS: Scientific literature was thoroughly searched to find 1) DKA treatment guidelines, 2) studies reporting hypokalemia in DKA, 3) and literature elaborating mechanisms involved in hypokalemia.

    RESULTS: Acidosis affects SK and its regulators including insulin, catecholamines and aldosterone. Current conceptual framework is an argument to gauge the degree of hypokalemia before it strikes DKA patients utilizing SK level after adjusting it with pH. Suggested approach will reduce hypokalemia risk and its associated complications. The nomogram calculates pH-adjusted potassium and expected potassium loss. It also ranks hypokalemia associated risk, and proposes the potassium-replacement rate over given time period. The differences between current DKA treatment guidelines and proposed strategy are also discussed. Moreover, reasons and risk of hyperkalemia due to early initiation of potassium replacement and remedial actions are debated.

    CONCLUSION: In light of proposed strategy, utilizing the nomogram ensures reduced incidence of hypokalemia in DKA resulting in improved clinical and patient outcomes. Pharmacoeconomic benefits can also be expected when avoiding hypokalemia ensures early discharge.

  13. Kusrini E, Sabira K, Hashim F, Abdullah NA, Usman A, Putra N, et al.
    Acta Ophthalmol, 2021 Mar;99(2):e178-e188.
    PMID: 32701190 DOI: 10.1111/aos.14541
    PURPOSE: Contact lenses have direct contact with the corneal surface and can induce sight-threatening infection of the cornea known as Acanthamoeba keratitis. The objective of this study was to evaluate the dysprosium-based nanoparticles (Dy-based NPs), namely Fe3 O4 -PEG-Dy2 O3 nanocomposites and Dy(OH)3 nanorods, as an active component against Acanthamoeba sp., as well as the possibility of their loading onto contact lenses as the drug administering vehicle to treat Acanthamoeba keratitis (AK).

    METHODS: The Dy-based NPs were synthesized, and they were loaded onto commercial contact lenses. The loading content of the NPs and their release kinetics was determined based on the absorbance of their colloidal solution before and after soaking the contact lenses. The cytotoxicity of the NPs was evaluated, and the IC50 values of their antiamoebic activity against Acanthamoeba sp. were determined by MTT colorimetric assay, followed by observation on the morphological changes by using light microscopy. The mechanism of action of the Dy-based NPs against Acanthamoeba sp. was evaluated by DNA laddering assays.

    RESULTS: The loading efficiencies of the Dy-based NPs onto the contact lens were in the range of 30.6-36.1% with respect to their initial concentration (0.5 mg ml-1 ). The Dy NPs were released with the flux approximately 5.5-11 μg cm-2  hr-1 , and the release was completed within 10 hr. The emission of the NPs consistently showed a peak at 575 nm due to Dy3+ ion, offering the possible monitoring and tracking of the NPs. The SEM images indicated the NPs are aggregated on the surface of the contact lenses. The DNA ladder assay suggested that the cells underwent DNA fragmentation, and the cell death was due most probably to necrosis, rather than apoptosis. The cytotoxicity assay of Acanthamoeba sp. suggested that Fe3 O4 -PEG, Fe3 O4 -PEG-Dy2 O3 , Dy(NO3 )3 .6H2 O and Dy(OH)3 NPs have an antiamoebic activity with the IC50 value being 4.5, 5.0, 9.5 and 22.5 μg ml-1 , respectively.

    CONCLUSIONS: Overall findings in this study suggested that the Dy-based NPs can be considered as active antiamoebic agents and possess the potential as drugs against Acanthamoeba sp. The NPs could be loaded onto the contact lenses; thus, they can be potentially utilized to treat Acanthamoeba keratitis (AK).

  14. Saleem H, Usman A, Mahomoodally MF, Ahemad N
    J Ethnopharmacol, 2021 Feb 10;266:113356.
    PMID: 32956758 DOI: 10.1016/j.jep.2020.113356
    ETHNOPHARMACOLOGICAL RELEVANCE: Bougainvillea glabra (Choisy). (Family: Nyctinaginacea) is a valuable ornamental plant with culinary uses and also utilized in traditional medicine for treating common ailments. It is traditionally employed against several diseases such as diarrhoea, hypotension, intestinal disorders, stomachache, nausea, inflammation-related ailments, and in pain management. Though widely validated via in vitro and in vivo models, to date no endeavour has been made to compile in a single review the traditional, phytochemistry and pharmacological properties of B. glabra.

    AIMS: To provide an up-to-date, authoritative review with respect to the traditional uses, chemical composition, in vitro and in vivo pharmacological properties, and toxicological estimations accomplished either utilizing the crude extracts or, wherever applicable, the bioactive compounds isolated from B. glabra. Besides, a critical evaluation of the published literature has been undertaken with regards to the current biochemical and toxicological data.

    MATERIALS AND METHODS: Key databases per se, Ovid, Pubmed, Science Direct, Scopus, and Google scholar amongst others were probed for a systematic search using keywords to retrieve relevant publications on this plant. A total of 52 articles were included for the review depending on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

    RESULTS: The studies conducted on either crude extracts, solvent fractions or isolated pure compounds from B. glabra had reported a varied range of biological effects comprising antibacterial, antifungal, antidiabetic, cytotoxic, analgesic, antipyretic, anti-inflammatory, and antioxidant activities. Phytochemical analysis of different parts of B. glabra unveiled 105 phytochemicals, belonging to phenolic, flavonoid, betacyanin, terpenoid, glycoside and essential oils classes of secondary metabolites.

    CONCLUSION: Most of the pharmacological activities of crude extracts from this plant have been reported. A very few studies have reported the isolation of compounds responsible for observed biological potential of this plant. Moreover, the toxicity studies of this plant still need to be explored comprehensively to ensure its safety parameters. Additional investigations are recommended to transmute the ethnopharmacological claims of this plant species in folklore medicines into scientific rationale-based information.

  15. Ur-Rehman A, Khan SG, Naqvi SAR, Ahmad M, Akhtar N, Bokhari TH, et al.
    Pak J Pharm Sci, 2021 Jan;34(1(Special)):441-446.
    PMID: 34275792
    A series of new derivatives of 4-(2-chloroethyl)morpholine hydrochloride (5) were efficiently synthesized. Briefly, different aromatic organic acids (1a-f) were refluxed to acquire respective esters (2a-f) using conc. H2SO4 as catalyst. The esters were subjected to nucleophillic substitution by monohydrated hydrazine to acquire hydrazides (3a-f). The hydrazides were cyclized with CS2 in the presence of KOH to yield corresponding oxadiazoles (4a-f). Finally, the derivatives, 6a-f, were prepared by reacting oxadiazoles (4a-f) with 5 using NaH as activator. Structures of all the derivatives were elucidated through 1D-NMR EI-MS and IR spectral data. All these molecules were subjected to antibacterial and hemolytic activities and showed good antibacterial and hemolytic potential relative to the reference standards.
  16. Khan FU, Khan A, Shah S, Hayat K, Usman A, Khan FU, et al.
    Front Pharmacol, 2021;12:754000.
    PMID: 34819859 DOI: 10.3389/fphar.2021.754000
    Background: Antibiotic resistance (ABR) is one of the major issues around the globe. Timely education and awareness of pharmacy students regarding the appropriate use of antibiotics, ABR, and antimicrobial stewardships are required. Methods: The present study was first conducted in 12 (public and private sector) universities among undergraduate pharmacy students (UGPS) (n = 414) irrespective of their study year through a validated questionnaire, and the insights of pharmacy teachers were taken through in-depth semi-structured interviews in the second phase. For the quantitative data, different statistical methods were used, and data were presented in tabulated form, whereas inductive thematic interpretation was used to categorize themes and derive conclusions from qualitative evidence. Results: The majority of the students were males (n = 223, 54%) with the mean age group 19-23 years, and 20 faculty members were interviewed with a mean duration of 15 min. Students have good knowledge about antibiotics use and the majority purchased antibiotics through prescription (n = 277, 66.9%) during the last month and strongly agreed to stop unnecessary household storage (n = 183 44.2%). Most of the students have heard the terminologies related to antimicrobial resistance through social media while unaware (n = 104, 25.1%) of a Pakistan national action plan against AMR (antimicrobial resistance). Overall, respondents have a somewhat good understanding of the ABR. Regular use of antibiotics without consultation of a physician can lead to ABR and some wrong answers were observed (162, 39.1%; p > 0.05). The majority of the students (n = 198, 47.8%) and teachers believe that the current pharmacy syllabus must be swiftly updated with the new subjects related to ABR and AMS (antimicrobial stewardship) in Pakistan. The UGPS have emphasized (n = 220, 53.1%; Median = 1, IQR = 2) establishing a link between academia and hospitals. The ABR issue has been highlighted by pharmacy faculty members, who have urged students to take practical efforts toward ABR and AMS knowledge. Conclusion: The UGPS knowledge related to ABR and AMS must be updated. Students at the undergraduate level must get training in order to encourage the sensible use of antibiotics. Courses on ABR and AMS should be included in present pharmacy curricula.
  17. Abdullah NA, Zullkiflee N, Zaini SNZ, Taha H, Hashim F, Usman A
    Saudi J Biol Sci, 2020 Nov;27(11):2902-2911.
    PMID: 33100845 DOI: 10.1016/j.sjbs.2020.09.014
    The present study focused on the evaluation of phytochemical properties, essential mineral elements, and heavy metals contained in raw propolis produced by stingless bees Geniotrigona thoracica, Heterotrigona itama, and Tetrigona binghami found in the same ecological conditions and environment in Brunei Darussalam. The results indicated that propolis of the three stingless bee species mainly consisted of lipids (45.60-47.86%) and very low carbohydrate (0.17-0.48%) and protein contents (0.18-1.18%). The propolis was rich in mineral elements, thus good sources of minerals, while they contained low concentrations of all heavy metals. Propolis of the different bee species could be distinguished based on their mineral compositions. The vibrational and absorption spectra suggested that propolis contains π-conjugated aliphatic and aromatic compounds as well as aromatic acids having amine, ester, carbonyl, alkyl, and hydroxyl functional groups which might be attributed to the presence of phenolic and flavonoid compounds. The antioxidant capacity of the propolis, based on radical scavenging activity of their ethanol extract, was in line with their total phenolic content. The ethanol extract of the propolis also showed antimicrobial activities against four bacterial strains (Bacillus subtilis, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa). The propolis showed slightly higher antibacterial activity against Gram-positive (B. subtilis and S. aureus) bacteria, indicating that the antimicrobial active compounds could be associated with flavonoids, which were quantified to be approximately comparable in all the propolis.
  18. Kusrini E, Usman A, Sani FA, Wilson LD, Abdullah MAA
    Environ Monit Assess, 2019 Jul 10;191(8):488.
    PMID: 31292792 DOI: 10.1007/s10661-019-7634-6
    This paper presents the adsorption capacity of a biosorbent derived from the inner part of durian (Durio zibethinus) rinds, which are a low-cost and abundant agro-waste material. The durian rind sorbent has been successfully utilized to remove lanthanum (La) and yttrium (Y) ions from their binary aqueous solution. The effects of several adsorption parameters including contact time, pH, concentrations of La and Y, and temperature on the removal of La and Y ions were investigated. The adsorption isotherm and kinetics of the metal ions were also evaluated in detail. Both La and Y ions were efficiently adsorbed by the biosorbent with optimum adsorption capacity as high as 71 mg La and 35 mg Y per gram biosorbent, respectively. The simultaneous adsorption of La and Y ions follows Langmuir isotherm model, due to the favorable chelation and strong chemical interactions between the functional groups on the surface of the biosorbent and the metal ions. The addition of oxygen content after adsorption offers an interpretation that the rare-earth metal ions are chelated and incorporated most probably in the form of metal oxides. With such high adsorption capacity of La and Y ions, the durian rind sorbent could potentially be used to treat contaminated wastewater containing La and Y metal ions, as well as for separating and extracting rare-earth metal ions from crude minerals.
  19. Usman A, Makmor Bakry M, Mustafa N, Rehman IU, Bukhsh A, Lee SWH, et al.
    Diabetes Metab Syndr Obes, 2019;12:1323-1338.
    PMID: 31496770 DOI: 10.2147/DMSO.S208492
    Background: During the progress and resolution of a diabetic ketoacidosis (DKA) episode, potassium levels are significantly affected by the extent of acidosis. However, none of the current guidelines take into account acidosis during resuscitation of potassium level in DKA management, which may increase the risk of cardiovascular adverse events.

    Objective: To assess literature regarding the adjustment of potassium level using pH to calculate pH-adjusted corrected potassium level, and to observe the relationship of cardiovascular outcomes with reported potassium level and pH-adjusted corrected potassium in DKA.

    Methodology: Seven databases were searched from inception to January 2018 for studies which had reported people with diabetes developing diabetic ketoacidosis, in relation to prevalence or incidence, fluid resuscitation or potassium supplementation treatment, treatment or cardiovascular outcomes, and experimentation with DKA management or insulin. Quality of studies was evaluated using Cochrane Risk of Bias and Newcastle Ottawa Scale.

    Results: Forty-seven studies were included in qualitative synthesis out of a total of 10,292 retrieved studies. Forty-one studies discussed the potassium level and blood pH at the time of admission, ten studies discussed cardiovascular outcomes, and only four studies concurrently discussed potassium level, pH, and cardiovascular outcomes. Only two studies were graded as good on the Newcastle Ottawa Scale. The reported potassium level was well within normal range (5.8 mmol/L), whereas pH rendered patients to be moderately acidotic (7.13). Surprisingly, none of the included studies mentioned pH-adjusted corrected potassium level and, hence, this was calculated later. Although mean corrected potassium was within the normal range (3.56 mmol/L), 13 studies had corrected potassium below 3.5 mmol/L and five had it below 3.0 mmol/L. Nevertheless, with the exception of one study, none discussed cardiovascular outcomes in the context of potassium or pH-adjusted potassium level.

    Conclusion: The evidence surrounding cardiovascular outcomes during DKA episodes in light of a pH-adjusted corrected potassium level is scarce. A prospective observational, or preferably, an experimental study in this regard will ensure we can modify and enhance safety of existing DKA treatment protocols.
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