Displaying publications 201 - 220 of 556 in total

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  1. Nurhanis Syazni Roslan, Jamilah Al-Muhammady Mohammad, Mohd Al-Aarifin Ismail, Anisa Ahmad, Muhamad Saiful Bahri Yusof
    MyJurnal
    Educational environment is an important determinant of medical students’ behaviour. It impacts their
    academic performance, motivation, and psychological well-being. Quantitative evidence have shown
    that there is a decrease in the positive perception of clinical medical students towards the educational
    environment. The primary focus on this study was to explore the clinical education environment
    through the lived experience of clinical medical students during medical training. Using hermeneutic
    phenomenology we aimed to interpret participants’ experience of personal clinical learning journey
    through free text input. Thematic analysis was performed to analyse the written texts. Various
    measures were taken to enhance the trustworthiness of the findings. A total of 154 (74.8%) fourth year
    students and 144 (74.6%) final year students participated in the study. We identified six overarching
    themes of education environment in clinical setting that are personal development, teaching and
    learning, assessment for learning, facility, support and nurturing curriculum. The overlapping
    relationship of the themes is illustrated in the Clinical Education Environment Framework. While
    many themes were consistent with existing framework, our findings also proposed assessment as an
    important component to influence perception on education environment. The themes in this study
    finding conform to the definition of education environment which covers physical, social, and
    psychological aspects of students learning. Medical schools should take active measures to incorporate
    a nurturing education environment especially in clinical year where students struggle with the hidden
    curriculum.
  2. Wan Azfarozza Wan Athmar, Nur Azmina Ghazali, Muhammad Saiful Adli Mohd Nasir, Anis Athirah Zuhaizar, Farahani Mohd Asli
    MyJurnal
    Social media are now acknowledged as one of the platforms for engaging e-health that contributing to serious discussion and information regarding on medical and health issues. However, there are challenges and risks associated with social media in medical and health care which is misinformation. Misinformation can spread quickly on Twitter and each retweet is exposing to wider audiences. The aim of this paper is to identify the use of @MedTweetMYHQ among its’ users sepcifically among UiTM Melaka students. The researchers used in-depth interviews to five informants based on purposive sampling. The data was analysed using thematic analysis. Four themes emerged from the analysis which are the use of @MedTweetMYHQ to receive updated useful information on health, to share information on healthy lifestyle, to debunk health myths and as a platform for health discussions.
  3. Goon JA, Haryati Ahmad Hairi, Suzana Makpol, Mariati Abdul Rahman, Saiful Anuar Karsani, Wan Zurinah Wan Ngah
    Sains Malaysiana, 2011;40:1247-1253.
    Replicative senescence of human diploid fibroblasts (HDFs) occurs when cells lose their capacity to proliferate and enter a phase of irreversible growth arrest. Stress-induced premature senescence (SIPS) on the other hand is caused by subcytotoxic concentrations of various oxidants which trigger accelerated cellular senescence. In this study, a SIPS model was established by exposing human diploid fibroblasts (HDFs) to 20 μM H2O2 for 2 weeks. A proteomic comparison between young, senescent and SIPS cells was done using two dimensional gel electrophoresis (2DGE) to elucidate the changes in protein expression associated with cellular aging. Our analysis showed that 28 protein spots were differentially expressed in senescent cells whereas 10 protein spots were differentially expressed in SIPS as compared to young cells. Three similar protein spots were differentially expressed in both senescent and SIPS cells when compared to the young cells. These results indicate that a difference in protein expression exists between senescent cells and SIPS cells compared to young cells.
  4. Muhamad Saiful Bahri Yusoff, Ahmad Fuad Abdul Rahim, Abdul Aziz Baba, Shaiful Bahari Ismail, Hatta Sidi, Ab Rahman Esa
    Sains Malaysiana, 2013;42:423-428.
    The study of medicine is often regarded by students as a stressful environment particularly during examination period. Studies found a high percentage of medical students experience significant psychological distress during the examination period. This study compared percentage and level of psychological distress between two batches of first year medical students who underwent different selection admission processes during a stressful examination period. A comparative
    cross-sectional study was done on two batches of first year medical students; one group selected based on academic merit (2008/2009 batch) and the other selected based on academic merit, psychometric tests and interview (2009/2010 batch). The psychological distress was measured by the 12-item general health questionnaire (GHQ-12). The data were collected right after the final examinations. A total of 99 (46.05%) medical students of the 2008/2009 batch and 196 (100%) medical students of the 2009/2010 batch participated. The percentage of medical students who had psychological distress of the 2008/2009 and the 2009/2010 batches were 58.59% and 42.3%, respectively. The mean GHQ-12 score and percentage of psychological distress were significantly different between the two batches (p< 0.01). The older batch had 2.01 times higher risk for developing psychological distress compared with the newer batch (p< 0.01). The newer batch
    of medical students had better psychological health status and was less likely to develop psychological distress during the stressful period compared with older batch.
  5. Rufaidah Othman, Saiful Anuar Karsani, Rozana Othman, Aida Baharuddin, Ramakrishnan NR, Noorsaadah Abd. Rahman, et al.
    Sains Malaysiana, 2017;46:1865-1875.
    Dengue is a potentially deadly disease with no effective drug. An in silico molecular docking was performed using Autodock
    4.2.6 to investigate the molecular interactions between protease inhibitors, comprising antibiotic derivatives namely
    doxycycline (3), rolitetracycline (5) and a non-steroidal anti-inflammatory drug (NSAID), meclofenamic acid (4), against
    the NS2B-NS3 protease from dengue virus-2 (DENV-2). The non-competitive inhibitor (3) showed lower binding energy
    (-5.15 kcal/mol) than the predicted competitive inhibitors 4 and 5 (-3.64 and -3.21 kcal/mol, respectively). Structural
    analyses showed compound 3 that bound to a specific allosteric site, interacted with Lys74, a significant amino acid
    residue bonded to one of the catalytic triad, Asp75. Compounds 4 and 5 showed direct binding with two of the catalytic
    triad, His51 and Ser135, hence, predicted to be competitive inhibitors.
  6. Rou CN, Yunie Soon Yu Yeap, Gwendoline Cheng Lian Ee, Nur Kartinee Kassim, Saiful Latifah Yazan, Khalid Hamid Musa
    Sains Malaysiana, 2018;47:1749-1756.
    In this paper, antioxidant properties of Aegle marmelos (stem bark, leaves) and Murraya koenigii (stem bark, root) were
    evaluated by 2,2-diphenyl-1-picrylhydrazy (DPPH) free radical scavenging, 2,2’-Azino-bis(3-ethylbenzthiozoline-6-sulfonic
    acid) (ABTS) decolourisation, cupric reducing antioxidant capacity (CUPRAC), ferric reducing antioxidant power (FRAP)
    and linoleic acid/β-carotene assays. The chloroform extract of Murraya koenigii stem bark was found to possess the
    highest antioxidant activity in CUPRAC (1490.89 mgTE/g extract). In contrary, the hexane extract from Aegle marmelos
    leaves exhibited the weakest antioxidant activity in the DPPH assay (81.06 mgTE/g extract). The bioactive compound
    mahanimbine (7) isolated from the stem bark of Murraya koenigii was found to be the most active antioxidant agent
    with TEAC of 927.73 and 1649.31 mgTE/g corresponding to the ABTS and CUPRAC assays, respectively, as well as a good
    lipid peroxidation inhibitor with an inhibitory percentage of 70.95%. These CUPRAC and ABTS assays are the first report
    for Malaysian Murraya koenigii species.
  7. Yeong LT, Abdul Hamid R, Saiful Yazan L, Khaza'ai H, Mohtarrudin N
    BMC Complement Altern Med, 2015;15(1):431.
    PMID: 26638207 DOI: 10.1186/s12906-015-0954-3
    Drastic increment of skin cancer incidence has driven natural product-based chemoprevention as a promising approach in anticancer drug development. Apart from its traditional usages against various ailments, Ardisia crispa (Family: Myrsinaceae) specifically its triterpene-quinone fraction (TQF) which was isolated from the root hexane extract (ACRH) was recently reported to exert antitumor promoting activity in vitro. This study aimed at determining chemopreventive effect of TQF against chemically-induced mouse skin tumorigenesis as well as elucidating its possible pathway(s).
  8. Ng WK, Saiful Yazan L, Yap LH, Wan Nor Hafiza WA, How CW, Abdullah R
    Biomed Res Int, 2015;2015:263131.
    PMID: 25632388 DOI: 10.1155/2015/263131
    Thymoquinone (TQ) has been shown to exhibit antitumor properties. Thymoquinone-loaded nanostructured lipid carrier (TQ-NLC) was developed to improve the bioavailability and cytotoxicity of TQ. This study was conducted to determine the cytotoxic effects of TQ-NLC on breast cancer (MDA-MB-231 and MCF-7) and cervical cancer cell lines (HeLa and SiHa). TQ-NLC was prepared by applying the hot high pressure homogenization technique. The mean particle size of TQ-NLC was 35.66 ± 0.1235 nm with a narrow polydispersity index (PDI) lower than 0.25. The zeta potential of TQ-NLC was greater than -30 mV. Polysorbate 80 helps to increase the stability of TQ-NLC. Differential scanning calorimetry showed that TQ-NLC has a melting point of 56.73°C, which is lower than that of the bulk material. The encapsulation efficiency of TQ in TQ-NLC was 97.63 ± 0.1798% as determined by HPLC analysis. TQ-NLC exhibited antiproliferative activity towards all the cell lines in a dose-dependent manner which was most cytotoxic towards MDA-MB-231 cells. Cell shrinkage was noted following treatment of MDA-MB-231 cells with TQ-NLC with an increase of apoptotic cell population (P < 0.05). TQ-NLC also induced cell cycle arrest. TQ-NLC was most cytotoxic towards MDA-MB-231 cells. It induced apoptosis and cell cycle arrest in the cells.
  9. Yeong LT, Abdul Hamid R, Saiful Yazan L, Khaza'ai H, Awang Hamsin DE
    Nat Prod Res, 2014;28(22):2026-30.
    PMID: 24836304 DOI: 10.1080/14786419.2014.917415
    An isomeric mixture of α,β-amyrin (triterpene) and 2-methoxy-6-undecyl-1,4-benzoquinone (quinone) isolated from the Ardisia crispa root hexane (ACRH) extract was reported to possess anti-inflammatory properties in vivo. Considering the close association between inflammation and cancer, on top of the lack of antitumour study on those compounds, this study aimed to determine the potential of both compounds against tumour promotion in vitro, either as single agent or in combination. Triterpene and quinone compounds, as well as triterpene-quinone fraction (TQF) and ACRH were subjected to inhibition of Epstein-Barr virus-early antigen (EBV-EA) activation assay for that purpose. Compared with curcumin (positive control), inhibition against EBV-EA activation occurred in the order: ACRH>TQF ≥ curcumin>α,β-amyrin ≥ 2-methoxy-6-undecyl-1,4-benzoquinone. These findings reported, for the first time, the antitumor-promoting effect of α,β-amyrin and 2-methoxy-6-undecyl-1,4-benzoquinone from the roots of A. crispa, which was enhanced when both compounds act in synergy.
  10. Foo JB, Saiful Yazan L, Tor YS, Wibowo A, Ismail N, Armania N, et al.
    J Ethnopharmacol, 2016 Jul 1;187:195-204.
    PMID: 27131434 DOI: 10.1016/j.jep.2016.04.048
    Dillenia suffruticosa is traditionally used for treatment of cancerous growth including breast cancer in Malaysia.
  11. Saiful AJ, Mastura M, Zarizal S, Mazurah MI, Shuhaimi M, Ali AM
    J Basic Microbiol, 2008 Aug;48(4):245-51.
    PMID: 18720500 DOI: 10.1002/jobm.200700387
    Efflux-mediated resistance has been recognized as an important contributor of antibiotic resistance in bacteria, especially in methicillin-resistant Staphylococcus aureus (MRSA) isolates. This study was carried out to detect and analyze efflux genes (norA and mdeA) and active efflux activity in a collection of Malaysian MRSA and methicillin-sensitive S. aureus (MSSA) clinical isolates. Nineteen isolates including three ATCC S. aureus reference strains were subjected to PCR detection and DNA sequence analysis for norA and mdeA and active efflux detection using modified minimum inhibitory concentration (MIC) assay. From the 19 isolates, 18 isolates harboured the mdeA gene while 16 isolates contained norA gene. DNA sequence analysis reveals 98-100% correlation between the PCR product and the published DNA sequences in GenBank. In addition, 16 isolates exhibited active efflux activity using the ethidium bromide (EtBr)-reserpine combination MIC assay. To our knowledge, this is the first report on the detection of efflux genes and active efflux activity amongst Malaysian clinical isolates of MRSA/MSSA. Detection of active efflux activity may explain the previous report on efflux-mediated drug resistance profile amongst the local clinical isolates.
  12. Saiful Bahri A, Tuan Mahmood TM, Abdul-Aziz SA, Makmor-Bakry M, Mohamed Shah N
    Patient Prefer Adherence, 2021;15:227-235.
    PMID: 33568899 DOI: 10.2147/PPA.S293029
    Context: Globally, breast cancer is the most common cancer affecting women, and adjuvant endocrine therapy (AET) is part of its treatment modality, which improves patients' outcome. However, there are concerns on side effects related to its use, which may affect treatment adherence.

    Purpose: This study was conducted to explore attitude and practice on using AET among breast cancer patients in Malaysia.

    Patients and Methods: Postmenopausal breast cancer patients on at least 3 months of AET attending the outpatient oncology clinic at a tertiary care hospital were interviewed. Patients underwent in-depth interviews exploring their attitude and practices while on AET using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using thematic analysis.

    Results: There were four main themes for attitude toward the use of AET: 1) benefits of using AET, 2) concerns on taking AET, 3) beliefs on alternative treatment, and 4) beliefs toward the doctor. For practice, six themes were obtained: 1) correct use of AET, 2) appointment adherence, 3) information-seeking behavior, 4) counseling services obtained, 5) experienced side effects of AET, and 6) usage of complementary and alternative medicines.

    Conclusion: Several themes concerning attitude and practice of breast cancer patients receiving AET were identified, which may be addressed during treatment consultations in clinical practice.

  13. Zawawi N, Chong PJ, Mohd Tom NN, Saiful Anuar NS, Mohammad SM, Ismail N, et al.
    Molecules, 2021 Jul 21;26(15).
    PMID: 34361551 DOI: 10.3390/molecules26154399
    Honey is a well-known natural sweetener and is rich in natural antioxidants that prevent the occurrence of oxidative stress, which is responsible for many human diseases. Some of the biochemical compounds in honey that contribute to this property are vitamins and phenolic compounds such as phenolic acids and flavonoids. However, the extent to which these molecules contribute towards the antioxidant capacity in vitro is inconsistently reported, especially with the different analytical methods used, as well as other extrinsic factors that influence these molecules' availability. Therefore, by reviewing recently published works correlating the vitamin, total phenolic, and flavonoid content in honey with its antioxidant activities in vitro, this paper will establish a relationship between these parameters. Based on the literature, vitamins do not contribute to honey's antioxidant capacity; however, the content of phenolic acids and flavonoids has an impact on honey's antioxidant activity.
  14. Ong YS, Saiful Yazan L, Ng WK, Noordin MM, Sapuan S, Foo JB, et al.
    Int J Nanomedicine, 2016 11 09;11:5905-5915.
    PMID: 27877037
    BACKGROUND: Thymoquinone (TQ), the predominant active lipophilic component in Nigella sativa seed oil, has a variety of pharmacological properties such as anticancer activities. However, translation of TQ to clinical phase is still not possible due to its hydrophobic properties. This problem can be solved by encapsulating it in nanoformulations to enhance its pharmacological properties. In our previous study, TQ has been successfully encapsulated in a nanostructured lipid carrier (hereinafter referred to as TQNLC) with excellent physiochemical properties such as high encapsulation efficiency, high drug-loading capacity, particle diameter less than 100 nm, and stability up to 2 years. In vitro studies also proved that TQNLC exhibited antiproliferative activity toward breast and cervical cancer cell lines. However, no toxicity profile related to this formulation has been reported. In this study, we determine and compare the in vivo toxicity of both TQNLC and TQ.

    MATERIALS AND METHODS: The in vivo toxicity (acute and subacute toxicity) study was carried out by oral administration of TQNLC and TQ to BALB/c mice. Animal survival, body weight, organ weight-to-body weight ratio, hematological profile, biochemistry profile, and histopathological changes were analyzed.

    RESULTS: In acute toxicity, TQ that is loaded in nanostructured lipid carrier (NLC) was found to be less toxic than pure TQ. It can be concluded that encapsulation of TQ in lipid carrier minimizes the toxicity of the compound. In the subacute toxicity study, oral administration of 100 mg/kg of TQNLC and TQ did not cause mortality to either male or female but resulted in toxicity to the liver. It is postulated that long-term consumption of TQNLC and TQ may cause toxicity to the liver but not to the extent of altering the functions of the organ. For both treatments, the no observed adverse effect level (NOAEL) was found to be 10 mg/kg/d for mice in both sexes.

    CONCLUSION: For long-term oral consumption, TQ and TQNLC at a dose of 10 mg/kg is safe in mice and does not exert any toxic effect. The results provide safety information of TQNLC, which would further help researchers in clinical use.

  15. Ramli M, Abdullah AAW, Saiful MIB, Fafiz MN, Fahmi AAZ
    MyJurnal
    Introduction: Maternal psychological well-being determines early mother-infant relationship and babys health. Paying attention on this aspect is essential particularly in early postpartum period. This study aimed to determine early psychological reactions toward socioeconomic profi les, delivery methods and delivery outcomes among postpartum mothers in Kuala Lumpur Hospital. Materials and Methods: A total of 150 two week-postpartum mothers participated in this cross sectional study and their psychological perspective was measured by using the Depressive, Anxiety and Stress Scale (DASS). Results: 4%, 16% and 4.7% of respondents had significant depressive, anxiety and stress levels respectively. Conclusion: Socioeconomic variables such household income, level of education and presence of medical illness were statistically signifi cant to determine early postpartum psychological reactions but not the modes or outcomes of delivery.
  16. Chee KH, Tan KL, Luqman I, Saiful SS, Chew YY, Chinna K, et al.
    Front Cardiovasc Med, 2021;8:676862.
    PMID: 34646868 DOI: 10.3389/fcvm.2021.676862
    Objective: Existing data showed that left ventricular diastolic dysfunction is common in individuals with type 2 diabetes mellitus (T2DM). However, most of the studies included diabetic patients who have prior cardiovascular disease, which might be the compounding factor for ventricular dysfunction. This study aimed to determine the prevalence and predictors of left ventricular diastolic dysfunction in an Asian population with T2DM without prior cardiovascular disease using the latest recommended echocardiographic assessment for left ventricular diastolic dysfunction. Design and Participants: This is a cross-sectional study in which eligible patients with T2DM without history of coronary artery disease, heart failure, or valvular heart disease were recruited. Demographic data, diabetic control, comorbidities, microvascular/macrovascular complications, and medications prescribed were recorded. Venous blood was sent to test for B-type natriuretic peptide, and transthoracic echocardiography was performed to assess left ventricular dysfunction. Setting: This study was performed in a tertiary healthcare center located in Kuala Lumpur, Malaysia. Results: Of the 301 patients, 83.1% have had T2DM for >10 years, with 45.8% being poorly controlled. Comorbidities include hypertension (77.1%), hyperlipidemia (91.0%), and pre-obesity/obesity (72.9%). Majority had absence of microvascular (albuminuria, retinopathy, and neuropathy) and macrovascular (peripheral vascular disease and stroke) complications. None had raised B-type natriuretic peptide levels, and 93.7% had no symptoms of heart failure. On echocardiographic assessment, 70.1% had left ventricular diastolic dysfunction, and 90.5% had Grade 1/mild severity. Age, ethnicity, insulin therapy, presence of hypertension, and hyperlipidemia were significantly associated with left ventricular diastolic dysfunction. Older T2DM patients of Chinese ethnicity and on insulin are about two times more likely to develop left ventricular diastolic dysfunction. Conclusion: There was a high prevalence of asymptomatic left ventricular diastolic dysfunction among patients with T2DM without prior known cardiovascular disease. Older age, insulin therapy, and Chinese ethnicity were risk factors for left ventricular diastolic dysfunction in T2DM.
  17. Yakop F, Abd Ghafar SA, Yong YK, Saiful Yazan L, Mohamad Hanafiah R, Lim V, et al.
    Artif Cells Nanomed Biotechnol, 2018;46(sup2):131-139.
    PMID: 29561182 DOI: 10.1080/21691401.2018.1452750
    PURPOSE: The purpose of this study was to investigate apoptotic activity of silver nanoparticle Clinacanthus nutans (AgNps-CN) towards HSC-4 cell lines (oral squamous cell carcinoma cell lines).

    METHODS: Methods involved were MTT assay (cytotoxic activity), morphological cells analysis, flow cytometry and cell cycle analysis and western blot.

    RESULTS: MTT assay revealed IC50 concentration was 1.61 µg/mL, 3T3-L1 cell lines were used to determine whether AgNps-CN is cytotoxic to normal cells. At the highest concentration (3 µg/mL), no cytotoxic activity has been observed. Flow cytometry assay revealed AgNps-CN caused apoptosis effects towards HSC-4 cell lines with significant changes were observed at G1 phase when compared with untreated cells. Morphological cells analysis revealed that most of the cells exhibit apoptosis characteristics rather than necrosis. Protein study revealed that ratio of Bax/Bcl-2 increased mainly due to down-regulation of Bcl-2 expression.

    CONCLUSION: AgNps-CN have shown potential in inhibiting HSC-4 cell lines. IC50 was low compared to few studies involving biosynthesized of silver nanoparticles. Apoptosis effects were shown towards HSC-4 cell lines by the increased in Bax/Bcl-2 protein ratio. Further study such as PCR or in vivo studies are required.

  18. Abd Ghafar SA, Ismail M, Saiful Yazan L, Fakurazi S, Ismail N, Chan KW, et al.
    PMID: 23606884 DOI: 10.1155/2013/549705
    Kenaf (Hibiscus cannabinus) from the family Malvaceae, is a valuable fiber plant native to India and Africa and is currently planted as the fourth commercial crop in Malaysia. Kenaf seed oil contains alpha-linolenic acid, phytosterol such as β -sitosterol, vitamin E, and other antioxidants with chemopreventive properties. Kenaf seeds oil (KSO) was from supercritical carbon dioxide extraction fluid (SFE) at 9 different permutations of parameters based on range of pressures from 200 to 600 bars and temperature from 40 to 80°C. They were 200/40, 200/60, 200/80, 400/40, 400/60, 400/80, 600/40, 600/60, and 600/80. Extraction from 9 parameters of KSO-SFE was screened for cytotoxicity towards human colorectal cancer cell lines (HT29) and mouse embryonic fibroblast (NIH/3T3) cell lines using MTS assay. KSO-SFE at 600/40 showed the strongest cytotoxicity towards HT29 with IC50 of 200 µg/mL. The IC50 for NIH/3T3 was not detected even at highest concentration employed. Cell cycle analysis showed a significant increase in the accumulation of KSO-SFE-treated cells at sub-G1 phase, indicating the induction of apoptosis by KSO-SFE. Further apoptosis induction was confirmed by Annexin V/PI and AO/PI staining.
  19. Raja Bongsu RH, Khalid K, Razali WAD, Zainal Abidin N, Saiful Nizam NAI, Rahidin NA, et al.
    Malays J Pathol, 2024 Aug;46(2):247-257.
    PMID: 39207002
    Congenital Adrenal Hyperplasia (CAH) is primarily caused by mutations in genes responsible to produce enzymes involved in the synthesis of cortisol, aldosterone, or both. This study aims to determine the prevalence, sociodemographic distributions, and clinical factors associated with CAH in the Malaysian population. This retrospective study reviewed laboratory records of 17-hydroxyprogesterone (17OHP) test requests received at the Institute for Medical Research, Kuala Lumpur from January 2021 to December 2021. Descriptive statistics were employed for most variables, and logistic regression analysis was conducted to determine factors associated with CAH. The dataset included a total of 775 patients (64.2%) from 1,207 test requests screened. The prevalence of newly diagnosed CAH in the year 2021 was 13.5% (n=105). The majority were Malays (15.1%), neonates (13.8%), and females (45.7%). Higher baseline 17-OHP (cOR:1.31, 95% CI:1.19, 1.45), unknown gender at birth (cOR:7.82, 95% CI:2.86, 21.37), and neonatal age group at presentation (cOR:29.3, 95% CI:12.07, 71.03) independently predict CAH. The high prevalence of CAH in our region has been speculated to be due to the cultural consanguinity norms, resulting in genetic aberrations. CAH may manifest as ambiguous genitalia, particularly in females, due to the overproduction of androgens in-utero, resulting in atypical genitalia, necessitating thorough investigation. To the best of our knowledge, the data presented are the latest report on CAH prevalence, distribution, and description of positive CAH cases in the Malaysian population. These findings are essential for further public health planning to improve the diagnostic capacity and clinical management of CAH.
  20. Said AH, Abd Rahim IS, Mohamad Zaini NNB, Saiful Nizam NIB
    Oman Med J, 2023 Jul;38(4):e523.
    PMID: 37736054 DOI: 10.5001/omj.2023.67
    OBJECTIVES: Dyslipidemia is an important risk factor for cardiovascular disease. In developed countries, only 50% of patients with chronic illness adhere to their long-term therapy. This article aimed to review the factors affecting adherence to lipid-lowering drugs (LLDs).

    METHODS: The searched articles were selected based on the available keywords in the title and abstract with the publication restricted between January 2010 and September 2020. Articles generated from the databases must fulfill both inclusion and exclusion criteria in the present systematic review. Our initial search retrieved 221 literature reviews. After excluding articles with irrelevant topics, a total of 23 articles were chosen for this current review.

    RESULTS: The factors were classified based on three main factors: patient-related, medication-related, and healthcare workers-related factors. For patient-related factors, gender, age, number of family members, education level, post-hospitalization, comorbidities and cardiovascular disease risk, follow-up status, occupation, socio-economy, insurance, perception, ethnicity, and health plan were among the factors affecting adherence to LLDs. As for medication-related factors, timing, polypharmacy, duration of treatment, generic medication, intensity of medication, side effects, initiating dose, packaging, drug dosing, and type of drugs were revealed as contributing factors. In the light of healthcare workers, related factors shown were counseling, medication optimization, type of provider, and location of the hospital.

    CONCLUSIONS: Recommendations to improve adherence include educating patients on the disease itself and the importance of the treatment, modification of the dosing, timing and type of LLDs, and effective consultations by healthcare workers. Further studies need to be done in Malaysia as there is inadequate research on this topic.

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