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Malaysian speech-language pathology students' reflections about their participation in an AAC training program

Joginder Singh S, Suhumaran LV, Skulski K, Ahmad Rusli Y

Augment Altern Commun, 2022 Dec;38(4):236-244.
PMID: 36573041 DOI: 10.1080/07434618.2022.2141135

Most speech-language pathologists (SLPs) in Malaysia practice with an undergraduate degree, which provides them with limited knowledge about and training in augmentative and alternative communication (AAC). This limited knowledge and training may affect their confidence and competence when introducing and using AAC with individuals for whom it is required. This study aimed to obtain feedback, via semi-structured interviews, from a group of 11 Malaysian university students who participated in an AAC training program about their experiences participating in and the effectiveness of the training program. Three themes were derived from qualitative content analysis of the interviews: (a)Time Demands, (b) Generalizing the use of AAC, and (c) Learning Required When Introducing AAC. The participants reported that they obtained better insights into the role of SLPs and communication partners with regards to AAC, as well as the struggles they faced. Students also reported increased confidence when working with individuals who use AAC after participating in the training program, thus supporting the need for similar training programs in the future.
Fulltext Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now

Chowdhury K, Ahmad R, Sinha S, Dutta S, Haque M

Cureus, 2023 Feb;15(2):e35154.
PMID: 36819973 DOI: 10.7759/cureus.35154

Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.
Fulltext Impact of COVID-19 Pandemic on Healthcare Utilization among Patients with Type 2 Diabetes Mellitus: A Systematic Review

Amsah N, Md Isa Z, Ahmad N, Abdul Manaf MR

Int J Environ Res Public Health, 2023 Mar 04;20(5).
PMID: 36901588 DOI: 10.3390/ijerph20054577

As the COVID-19 pandemic continues, healthcare services have been grossly overwhelmed by the pandemic. Due to this circumstance, routine care for individuals with type 2 diabetes mellitus (T2DM) has been temporarily disrupted. The purpose of this systematic review was to summarize the evidence regarding the impact of the COVID-19 pandemic on healthcare utilization among patients with T2DM. A systematic search was conducted in the Web of Science, Scopus, and PubMed databases. The process of identifying the final articles followed the PRISMA guidelines. The inclusion criteria were articles published between 2020 and 2022, written in English, and studies focusing on the research question. Any proceedings and books were excluded. A total of fourteen articles relevant to the research question were extracted. Following that, the included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT) and the Joanna Briggs Institute Critical Appraisal Tool to assess the quality of the studies. The findings were further classified into three themes: reduced healthcare utilization among T2DM patients in routine healthcare services, a surge of telemedicine usage, and delay in the delivery of healthcare services. The key messages include demands for monitoring the long-term effects of the missed care and that better preparedness is crucial for any pandemic in the future. A tight diagnostic workup at the community level and regular follow-ups are crucial in managing the impact of the pandemic among T2DM patients. Telemedicine should be on the agenda of the health system to maintain and complement healthcare services. Future research is warranted to determine effective strategies to deal with the impact of the pandemic on healthcare utilization and delivery among T2DM patients. A clear policy is essential and should be established.
Fulltext A fuzzy controller for lower limb exoskeletons during sit-to-stand and stand-to-sit movement using wearable sensors

Reza SM, Ahmad N, Choudhury IA, Ghazilla RA

Sensors (Basel), 2014 Mar 04;14(3):4342-63.
PMID: 24599193 DOI: 10.3390/s140304342

Human motion is a daily and rhythmic activity. The exoskeleton concept is a very positive scientific approach for human rehabilitation in case of lower limb impairment. Although the exoskeleton shows potential, it is not yet applied extensively in clinical rehabilitation. In this research, a fuzzy based control algorithm is proposed for lower limb exoskeletons during sit-to-stand and stand-to-sit movements. Surface electromyograms (EMGs) are acquired from the vastus lateralis muscle using a wearable EMG sensor. The resultant acceleration angle along the z-axis is determined from a kinematics sensor. Twenty volunteers were chosen to perform the experiments. The whole experiment was accomplished in two phases. In the first phase, acceleration angles and EMG data were acquired from the volunteers during both sit-to-stand and stand-to-sit motions. During sit-to-stand movements, the average acceleration angle at activation was 11°-48° and the EMG varied from -0.19 mV to +0.19 mV. On the other hand, during stand-to-sit movements, the average acceleration angle was found to be 57.5°-108° at the activation point and the EMG varied from -0.32 mV to +0.32 mV. In the second phase, a fuzzy controller was designed from the experimental data. The controller was tested and validated with both offline and real time data using LabVIEW.
Fulltext Bioactivity-Guided Fractionation and Identification of Antidiabetic Compound of Syzygium polyanthum (Wight.)'s Leaf Extract in Streptozotocin-Induced Diabetic Rat Model

Widyawati T, Yusoff NA, Bello I, Asmawi MZ, Ahmad M

Molecules, 2022 Oct 12;27(20).
PMID: 36296407 DOI: 10.3390/molecules27206814

(1) Background: An earlier study on the hypoglycemic activity of S. polyanthum (Wight.) leaf methanol extract identified squalene as the major chemical compound. The present study was conducted to assess the hypoglycemic effect of fractions and subfractions of the methanol extract of S. polyanthum compared to the squalene using a bioassay-guided in vivo study. (2) Methods: The methanol extract was fractionated using the liquid−liquid fractionation method. Streptozotocin-induced type 1 diabetic rat was used to study the hypoglycemic effect. (3) Results: The findings showed that chloroform fraction significantly (p < 0.05) lowered blood glucose levels of diabetic rats as compared to the control. Further fractionation of chloroform fraction yielded subfraction-1 and -2, whereby subfraction-1 exhibited a higher blood-glucose-lowering effect. The lipid profile test showed that the total cholesterol level of subfraction-1 and squalene-treated groups decreased significantly (p < 0.05). An immunohistochemistry study revealed that none of the treatments regenerated pancreatic β-cells. Gas chromatography−mass spectrophotometer analysis identified the presence of squalene in the active methanol extract, chloroform fraction, and subfraction-1. In silico analysis revealed a higher affinity of squalene against protein receptors that control lipid metabolism than metformin. (4) Conclusions: Data obtained from the present work suggested the crude methanol extract exerted the highest hypoglycemic effect compared to fraction, subfraction, and squalene, confirming synergistic effect may be responsible for the hypoglycemic activity of S. polyanthum.
Fulltext Comparable Benefits of Stingless Bee Honey and Caffeic Acid in Mitigating the Negative Effects of Metabolic Syndrome on the Brain

Muhammad Abdul Kadar NN, Ahmad F, Teoh SL, Yahaya MF

Antioxidants (Basel), 2022 Oct 31;11(11).
PMID: 36358526 DOI: 10.3390/antiox11112154

There is mounting evidence that metabolic syndrome (MetS) contributes to the development of neurodegenerative disorders such as Alzheimer’s disease. Honey, which has been used for generations, is high in antioxidants and has been demonstrated to benefit the brain and mental health by reducing oxidative stress and boosting cognitive outcomes. Honey from the stingless bees of Heterotrigona itama has been found to have higher phenolic content compared to other types of honeys. The aim of this study is to investigate the effects of stingless bee honey (SBH) supplementation and to compare it with a pure form of antioxidant, caffeic acid (CA), on MetS parameters and inflammatory markers in the brains of MetS-induced rats. A total of 32 male Wistar rats were divided equally into groups of control, high-carbohydrate high-fructose (HCHF) diet (MetS), HCHF + SBH supplemented (1 g/kg) (SBH), and HCHF + CA supplemented (10 mg/kg) (CA) groups. The total duration for SBH and CA supplementation was eight weeks. The HCHF diet was found to promote hypertension, hyperglycemia, and hypertriglyceridemia, and to increase brain TNF-α levels. Supplementation with SBH and CA significantly reversed (p < 0.05) the hyperglycemic and hypertensive effects of the HCHF diet. Although both supplemented groups showed no significant changes to serum HDL or TG, SBH significantly reduced (p < 0.05) brain TNF-α levels and increased (p < 0.05) brain BDNF levels. Immunohistochemistry investigations of neurogenesis (EdU) and apoptosis (TUNEL) on the cornu Ammonis 1 (CA1) and dentate gyrus (DG) areas of the hippocampus showed no changes with SBH and CA supplementation compared to the control. These findings suggest that SBH and CA have the potential to mitigate HCHF-induced MetS effects and possess neuroprotective abilities.
Evolutionary loss of complexity in animal signals: cause and consequence

Ord TJ, Diesmos A, Ahmad N, Das I

Evolution, 2023 Mar 01;77(3):660-669.
PMID: 36626820 DOI: 10.1093/evolut/qpac057

We identified hypotheses for the cause and consequences of the loss of complexity in animal signals and tested these using a genus of visually communicating lizards, the Southeast Asian Draco lizards. Males of some species have lost the headbob component from their display, which is otherwise central to the communication of this genus. These males instead display a large, colorful dewlap to defend territories and attract mates. This dewlap initially evolved to augment the headbob component of the display, but has become the exclusive system of communication. We tested whether the loss of headbobs was caused by relaxed selection, habitat-dependent constraints, or size-specific energetic constraints on display movement. We then examined whether the consequences of this loss have been mitigated by increased signaling effort or complexity in the color of the dewlap. It appears the increased cost of display movement resulting from the evolution of large body size might have contributed to the loss of headbobs and has been somewhat compensated for by the evolution of greater complexity in dewlap color. However, this evolutionary shift is unlikely to have maintained the complexity previously present in the communication system, resulting in an apparent detrimental loss of information potential.
Psychometric Properties of the CAGE Questionnaire Amongst Middle-Aged and Older Adults in Khuzistan Province of Iran

Asadollahi A, Kaveh MH, Saberi LF, Karimi M, Ahmad N

J Cross Cult Gerontol, 2023 Mar;38(1):97-109.
PMID: 36792867 DOI: 10.1007/s10823-023-09470-w

The CAGE questionnaire is an instrument, proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The questionnaire has been more pervasive simple tool than AUDIT and LAST scales to screen in busy medical settings where limited time is considered for adult patient interviews. The present study aimed to determine the reliability and validity of the CAGE questionnaire in Khuzistan province, Iran and evaluate its role in detecting alcohol-related problems. For this purpose, 382 men with mean age of 65 ± 5 were sampled by cluster-random sampling method in convenience model from the medical centers in eight counties of Khuzistan province during 2019 and they responded to the CAGE questionnaire. The coefficients of Cronbach's alpha (α = 0.82), convergent validity (0.73), divergent validity (-0.06), and criterion validity (0.87) were estimated (ρ
Safety assessment: predicting fatality rates in methanol plant incidents

Ahmad MA, Rashid ZA, Alzahrani AA, El-Harbawi M

Heliyon, 2022 Nov;8(11):e11610.
PMID: 36444264 DOI: 10.1016/j.heliyon.2022.e11610

In this article, the prediction of fatality accident rate at methanol (MeOH) plant was studied using different assessment methods. The prediction method was performed and simulated using HYSYS, ALOHA, MARPLOT, and MATLAB software. Recent studies for pressure variation up to 442 bar in MeOH synthesis by carbon dioxide (CO2) hydrogenation showed that three times more MeOH was produced than in conventional plants, with 90% CO2 conversion and 95% MeOH selectivity. However, safety concerns were noted when MeOH production was operated at pressures above 76-500 bar. Therefore, a safety assessment of the pressures between 76 and 500 bar was performed to predict the fatality rate at the MeOH plant. Adaptive Neuro-Fuzzy Inference System (ANFIS) was compared with a conventional analysis by using the consequence method to predict the fatality rate. First, 26 input parameters were simulated in HYSYS, ALOHA, and MARPLOT software by using the consequence method. Then, the input parameters were reduced to six, namely, pressure, mass, volume, leakage size, wind speed, and wind direction, for prediction using ANFIS tool in MATLAB. This study aimed to highlight the accuracy of the fatality rate prediction by using the ANFIS method. In this manner, accurate prediction of fatality rate for MeOH plant incidents was achieved. The prediction values for the ANFIS method was validated using the standard error of the regression. The percent error measurement obtained the lowest regression of 0.0088 and the lowest percent error of 0.02% for Hydrogen (H2) Vapor Cloud Explosion (VCE) ident. Therefore, the ANFIS method was found to be a simpler and alternative prediction method for the fatality rate than the conventional consequence method.
Fulltext Quality of Life and Its Associated Factors among Patients with Psoriasis in a Semi-Urban Northeast Malaysia

Ahmad Fuat MS, Mat Yudin Z, Muhammad J, Mohd Zin F

Int J Environ Res Public Health, 2022 Sep 14;19(18).
PMID: 36141851 DOI: 10.3390/ijerph191811578

Psoriasis is a chronic relapsing dermatological disorder that significantly affects the patients' psychosocial well-being and quality of life (QOL). This study aimed to determine the proportion of severely impaired QOL, the factors associated with severely impaired QOL, and its correlation with depression among semi-urban populations on the Northeast Coast of the Peninsular Malaysia. A cross-sectional study was conducted among 257 patients with psoriasis at the Dermatology Clinic of Hospital Sultanah Bahiyah via a self-administered questionnaire that included sociodemographic profiles, the validated Malay version of the Dermatology Life Quality Index (DLQI), and the Malay version of the Beck depression scale. The data were analysed using logistic and linear regression models. About 20.5% of the patients had severely impaired QOL quality of life, while 79.5% of the patients had non-impaired QOL. Multiple logistic regression analysis showed that the psoriatic severity [Adjusted OR = 1.91, 95% CI: 1.76, 9.93; p < 0.001] and exposed area [Adjusted OR 2.93, 95% CI: 0.38, 2.29; p = 0.050] had a significant association with severely impaired QOL. Among the patients, 18.7% had a positive result in the screening for depression, which revealed a significant association between QOL and depression scores [r = 0.47, 95% CI: 0.35, 0.56, p < 0.001]. Psoriasis can impair QOL and have a relation with mental health. Regular screening for depression among patients with psoriasis is a beneficial strategy for the early detection of depression, especially in semi-urban areas.
Fulltext Prevalence of depression among women attending a primary urban care clinic in Malaysia

Mohd Sidik S, Arroll B, Goodyear-Smith F, Ahmad R

Singapore Med J, 2012 Jul;53(7):468-73.
PMID: 22815016

Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.
Antibacterial mode of action of violacein from Chromobacterium violaceum UTM5 against Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA)

Aruldass CA, Masalamany SRL, Venil CK, Ahmad WA

Environ Sci Pollut Res Int, 2018 Feb;25(6):5164-5180.
PMID: 28361404 DOI: 10.1007/s11356-017-8855-2

Violacein, violet pigment produced by Chromobacterium violaceum, has attracted much attention recently due to its pharmacological properties including antibacterial activity. The present study investigated possible antibacterial mode of action of violacein from C. violaceum UTM5 against Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) strains. Violet fraction was obtained by cultivating C. violaceum UTM5 in liquid pineapple waste medium, extracted, and fractionated using ethyl acetate and vacuum liquid chromatography technique. Violacein was quantified as major compound in violet fraction using HPLC analysis. Violet fraction displayed bacteriostatic activity against S. aureus ATCC 29213 and methicillin-resistant S. aureus ATCC 43300 with minimum inhibitory concentration (MIC) of 3.9 μg/mL. Fluorescence dyes for membrane damage and scanning electron microscopic analysis confirmed the inhibitory effect by disruption on membrane integrity, morphological alternations, and rupture of the cell membranes of both strains. Transmission electron microscopic analysis showed membrane damage, mesosome formation, and leakage of intracellular constituents of both bacterial strains. Mode of action of violet fraction on the cell membrane integrity of both strains was shown by release of protein, K+, and extracellular adenosine 5'-triphosphate (ATP) with 110.5 μg/mL, 2.34 μg/mL, and 87.24 ng/μL, respectively, at 48 h of incubation. Violet fraction was toxic to human embryonic kidney (HEK293) and human fetal lung fibroblast (IMR90) cell lines with LC50 value of 0.998 ± 0.058 and 0.387 ± 0.002 μg/mL, respectively. Thus, violet fraction showed a strong antibacterial property by disrupting the membrane integrity of S. aureus and MRSA strains. This is the first report on the possible mode of antibacterial action of violet fraction from C. violaceum UTM5 on S. aureus and MRSA strains.
Developing and validating the Malay version instrument to assess knowledge, attitudes and practices regarding second-hand smoke in the workplace: a cross-sectional study in teaching hospital in Malaysia

Rashiden I, Ahmad Tajuddin NAN, Yee A, Amer Nordin AS

Environ Sci Pollut Res Int, 2021 Aug;28(32):44557-44564.
PMID: 33855660 DOI: 10.1007/s11356-021-13883-w

This research sought to develop and validate the "Workplace Second-hand Smoke: Perception on the SHS Knowledge, Attitude, and Practice" (WSHS: PAP) instrument, which targets non-smoking employees. A cross-sectional study was conducted between April and June 2018 to validate WSHS: PAP among non-smoking employees at Universiti Malaya Medical Centre (UMMC). Experts were invited to validate the instrument. Then, for exploratory factor analysis, a cross-sectional study was conducted among 336 UMMC non-smoking employees who were recruited by convenience sampling. A total of 28 items on KAP, rated on five-point Likert scales, underwent exploratory factor analysis and were tested for internal consistency (Cronbach's alpha). Participants were approached after 2 weeks for the assessment of test-retest reliability. Cronbach's alpha was 0.828, 0.743 and 0.837, respectively, for the domains of perception of the knowledge, attitude and practice, indicating acceptable internal consistency (above 0.7). Exploratory factor analysis identified a one-factor solution for each of the KAP domains. Therefore, the Malay version of the WSHS: PAP instrument demonstrated satisfactory psychometric properties for the assessment of non-smoking employees in workplaces with a smoking ban.
Application of rotten rice as a substrate for bacterial species to generate energy and the removal of toxic metals from wastewater through microbial fuel cells

Daud NNM, Ahmad A, Yaqoob AA, Ibrahim MNM

Environ Sci Pollut Res Int, 2021 Nov;28(44):62816-62827.
PMID: 34215989 DOI: 10.1007/s11356-021-15104-w

Microbial fuel cells (MFCs) are the efficient and sustainable approach for the removal of toxic metals and generate energy concurrently. This article highlighted the effective use of rotten rice as an organic source for bacterial species to generate electricity and decrease the metal concentrations from wastewater. The obtained results were corresponding to the unique MFCs operation where the 510 mV voltage was produced within 14-day operation with 1000 Ω external resistance. The maximum power density and current density were found to be 2.9 mW/m2 and 168.42 mA/m2 with 363.6 Ω internal resistance. Similarly, the maximum metal removal efficiency was found to be 82.2% (Cd), 95.71% (Pb), 96.13% (Cr), 89.50% (Ni), 89.82 (Co), 99.50% (Ag), and 99.88% (Cu). In the biological test, it was found that Lysinibacillus strains, Chryseobacterium strains, Escherichia strains, Bacillus strains are responsible for energy generation and metal removal. Furthermore, a multiparameter optimization revealed that MFCs are the best approach for a natural environment with no special requirements. Lastly, the working mechanism of MFCs and future recommendations are enclosed.
Efficiencies and mechanisms of steel slag with ferric oxides for removing phosphate from wastewater using a column filter system

Ahmad SZN, Al-Gheethi A, Hamdan R, Othman N

Environ Sci Pollut Res Int, 2020 Oct;27(28):35184-35194.
PMID: 32583114 DOI: 10.1007/s11356-020-09582-7

The current study aimed to investigate the efficiencies and mechanisms of slag filter media for removing phosphorus from synthetic wastewater. The steel slag with high ferric oxides (Fe2O3) was subjected for the electric arc furnace (EAF) and selected as the filter media (HFe). The chemical characteristics of HFe were determined using pH, point of zero charge (PZC) and XRF. The phosphorus removal efficiency was studied in a designed vertical steel slag column rock filters in unaerated HFe (UEF) and aerated HFe (AEF) system. The microstructure of HFe was analyzed by FTIR, XRD and SEM-EDX analysis. The results of XRF revealed that ferric oxide (Fe2O3) ranged from 26.1 to 38.2%. PZC for Filter HFe was recorded at pH 10.55 ± 0.27. The highest efficiencies were recorded by UEF and AEF systems at pH 3 and pH 5 (89.97 ± 4.02% and 79.95 ± 6.25% at pH 3 and 72.97 ± 8.38% and 66.00 ± 12.85% at pH 5 for UEF and AEF, respectively). These findings indicated that AEF exhibiting higher removal than UEF systems might be due to presence high Fe concentration in AEF which play important role in the phosphorus removal. The main elements available on the surface of HFe included carbon, oxygen, iron, calcium, magnesium, silicon, platinum, sulphur, manganese, titanium and aluminium. The XRD analysis indicated that the precipitation of orthophosphate as calcium and iron-phosphates was the removal mechanism as confirmed using FT-IR analysis. These findings demonstrated the efficiency of HFe in removing of phosphorus from wastewater.
Evaluating the toxicity of polyurethane during marine clay stabilisation

Saleh S, Ahmad K, Mohd Yunus NZ, Hezmi MA

Environ Sci Pollut Res Int, 2020 Jun;27(17):21252-21259.
PMID: 32266626 DOI: 10.1007/s11356-020-08549-y

In civil engineering, many geotechnical and forensic projects employ polyurethane (PU) for ground improvement, and the results have shown to be effective in terms of time and cost savings. However, similar to many other chemical stabilisers, the use of PU for soil stabilisation may have environmental repercussions. Therefore, this paper utilised a toxicity characteristic leaching procedure (TCLP) to investigate the potential for ground contamination resulting from the application of PU for the stabilisation of marine clay. Furthermore, the hazardousness of PU during the stabilisation of marine clay was investigated by testing its reactivity, ignitability, corrosivity and physical properties. The results reveal that the quantity of heavy metals present in PU is far below the regulatory limits. The results further confirm that PU is odourless and non-corrosive and that it is non-cyanide and non-sulphide-bearing. However, PU is capable of igniting. Overall, the potential application of PU for ground improvement is promising due to its environmental friendliness.
Fulltext Assessing the impact of green consumption behavior and green purchase intention among millennials toward sustainable environment

Ali M, Ullah S, Ahmad MS, Cheok MY, Alenezi H

Environ Sci Pollut Res Int, 2023 Feb;30(9):23335-23347.
PMID: 36322356 DOI: 10.1007/s11356-022-23811-1

Social media is playing a vital role in the promotion of green products by reshaping the millennial green purchasing intention and green consumption behaviors, resulting in progressive growth toward sustainable environment and lower carbon emission. Non-organic consumption among humans has increased the carbon emission in contrary risked environment; therefore, consumption behavior and purchasing intention are required to change for better sustainable environment. This study's goal is to determine the effects of social media in molding the consumption behaviors while considering eco-labeling, eco-branding, social norms, and purchase intensions among millennials to promote green consumption and lower carbon emission. It was decided to use a cross-sectional questionnaire survey to get information from the students of different faculties including social sciences, engineering, and bio-sciences. SPSS.V.22 and Smart-PLS were used to analyzed the data. Results indicated that social media has a profoundly good impact on molding and impacting youth behaviors regarding the green consumption, resulting in increasing intention toward sustainable environment which results in lower carbon emission. The results are in line with the predictions and contextual analysis, as the whole world is coming back toward natural life and is working for environmental protection and sustainability specially to lower the carbon emission. Therefore, students are molding themselves toward green consumption. The study recommends that future research may be conducted to study more contextual variables, who has influence on the green consumption among the general public regarding green consumptions and lowering carbon emission and stepping toward the sustainable environment.
PFAS, bisphenol, and paraben in Malaysian food and estimated dietary intake

Mohamad Haron DE, Yoneda M, Ahmad ED, Aziz MY

Food Addit Contam Part B Surveill, 2023 Mar 23.
PMID: 36959529 DOI: 10.1080/19393210.2023.2188611

Endocrine disrupting chemicals (EDCs) such as per- and polyfluoroalkyl substances (PFAS), bisphenols, and parabens are used in food packaging or as preservatives and their unintended consumption has been associated with cancer and other diseases. Food EDCs data are scarce in Malaysia. Thus, liquid chromatography mass tandem spectrometry (LC-MS/MS) was utilised to analyse 18 EDCs from different food categories. Bisphenol was the most abundant EDC found, followed by PFAS and paraben. Bisphenol levels in canned foods, dairy products, canned drinks, fruits, and vegetables ranged from 1.16 to 183 ng/g. PFAS was found in almost every food category, with canned foods having the highest concentrations (0.18-34.5 ng/g). Only canned foods, fruits, and vegetables contained parabens, with mean concentrations ranging from 0.27 to 26.7 ng/g. PFOS, PFBA, PFHQA and bisphenol A all had hazard quotients (HQ) above 1, indicating that they can pose a risk to human health.
Causes, factors, and complications associated with hospital admissions among patients with Parkinson's disease

Shaibdat NS, Ahmad N, Azmin S, Ibrahim NM

Front Neurol, 2023;14:1136858.
PMID: 36959822 DOI: 10.3389/fneur.2023.1136858

INTRODUCTION: Patients with Parkinson's disease (PD) are at a higher risk of hospital admissions compared to the general population. We studied the causes and factors associated with admissions among patients with PD over 6 years.
METHODS: We included all PD admissions between 1 January 2016 and 31 December 2021. Other causes of parkinsonism were excluded. Causes of admissions were divided into PD-related (direct or indirect) or non-PD-related. The type of admission was categorized into emergency or elective.
RESULTS: We identified 605 hospital admissions (259 patients with PD); 345 (57.0%) were PD-related and 260 (43%) were non-PD-related. Emergency PD admissions contributed to 50.4% of all admissions, most commonly from respiratory infection (23%). PD admissions in comparison to non-PD admissions were associated with worse disease severity (HY ≥ 3; p < 0.001), longer disease duration [8.71 (SD 6.23) vs. 6.60 (SD 5.39) years; p < 0.001], and longer hospital stay [7.70 (SD 5.89) vs. 6.42 (SD 7.63) days; p = 0.020]. Non-PD admissions were associated with more comorbidities (97.3%; p = 0.013). There were 124 (20.5%) complications and 31 deaths (5.1%). A total of 29 deaths were due to respiratory infection and 3 deaths were due to COVID-19 pneumonia. Emergency admission (PD- and non-PD-related; p = 0.001) and respiratory-related causes (p < 0.001) were predictors of unfavorable hospital admission outcomes (death and complications).
CONCLUSION: Respiratory infection was the leading cause of hospital admission and a significant independent predictor of unfavorable hospital admission outcomes (death and complications). PD-related admissions were associated with disease severity and led to more complications and longer hospital stays. Non-PD-related admissions were associated with comorbidities.
Fulltext Presumptive Rhino-Orbital Mucormycosis Secondary to Corticosteroid Therapy in a Diabetic Patient With COVID-19 Infection

Sidhu JK, Wan Hitam WH, Ahmad Tajudin LS

Cureus, 2023 Feb;15(2):e35199.
PMID: 36968851 DOI: 10.7759/cureus.35199

The coronavirus disease 2019 (COVID-19) pandemic has led to the widespread use of steroids as a life-saving measure. In patients with preexisting diabetes, the therapeutic use of steroids coupled with poorly controlled sugar has led to a surge of mucormycosis. We report a rare case of orbital apex syndrome secondary to mucormycosis post-COVID-19. A 43-year-old female with poorly controlled diabetes mellitus presented with right eye complete ptosis one week post-recovery from COVID-19 infection. During COVID-19 hospitalization, she received a course of dexamethasone. The visual acuity of the right eye was 6/60. She had complete ophthalmoplegia and diplopia in all gazes. There was a positive relative afferent pupillary defect (RAPD) and reduced optic nerve function test in the right eye. MRI showed right ethmoid sinusitis with possible extension to the right orbit and the presence of right perineural optic nerve enhancement. The nasal scope revealed fungal-like thick mucopurulent discharge at the middle meatus. She was clinically diagnosed with rhino-orbital mucormycosis and was started on antifungal for six weeks. Her overall condition improved with 6/6 visual acuity and minimum residual ophthalmoplegia. In conclusion, corticosteroid treatment for COVID-19 infection in diabetic patients causes poor glycemic control and immunosuppression that can lead to secondary infections such as rhino-orbital mucormycosis.

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