Spinal cord injury (SCI) is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions. Its pathophysiology comprises acute and chronic phases and incorporates a cascade of destructive events such as ischemia, oxidative stress, inflammatory events, apoptotic pathways and locomotor dysfunctions. Many therapeutic strategies have been proposed to overcome neurodegenerative events and reduce secondary neuronal damage. Efforts have also been devoted in developing neuroprotective and neuro-regenerative therapies that promote neuronal recovery and outcome. Although varying degrees of success have been achieved, curative accomplishment is still elusive probably due to the complex healing and protective mechanisms involved. Thus, current understanding in this area must be assessed to formulate appropriate treatment modalities to improve SCI recovery. This review aims to promote the understanding of SCI pathophysiology, interrelated or interlinked multimolecular interactions and various methods of neuronal recovery i.e., neuroprotective, immunomodulatory and neuro-regenerative pathways and relevant approaches.
Owing to their tremendous potential, the inference of nano-scaled materials has revolutionized many fields including the medicine and health, particularly for development of various types of targeted drug delivery devices for early prognosis and successful treatment of various diseases, including the brain disorders. Owing to their unique characteristic features, a variety of nanomaterials (particularly, ultra-fine particles (UFPs) have shown tremendous success in achieving the prognostic and therapeutic goals for early prognosis and treatment of various brain maladies such as Alzheimer's disease, Parkinson's disease, brain lymphomas, and other ailments. However, serious attention is needful due to innumerable after-effects of the nanomaterials. Despite their immense contribution in optimizing the prognostic and therapeutic modalities, biological interaction of nanomaterials with various body tissues may produce severe nanotoxicity of different organs including the heart, liver, kidney, lungs, immune system, gastro-intestinal system, skin as well as nervous system. However, in this review, we have primarily focused on nanomaterials-induced neurotoxicity of the brain. Following their translocation into different regions of the brain, nanomaterials may induce neurotoxicity through multiple mechanisms including the oxidative stress, DNA damage, lysosomal dysfunction, inflammatory cascade, apoptosis, genotoxicity, and ultimately necrosis of neuronal cells. Our findings indicated that rigorous toxicological evaluations must be carried out prior to clinical translation of nanomaterials-based formulations to avoid serious neurotoxic complications, which may further lead to develop various neuro-degenerative disorders.
This study compares the distribution of dissolved nutrients (NO3 − and PO4 3−) between two seasons (pre-monsoon and post-monsoon) in Pulau Perhentian, Terengganu. The concentration of dissolved PO4 3− was found to be 16 to 83 times higher during the postmonsoon period (April 2015) compared to the pre-monsoon period (October 2014). On the other hand, the concentration of dissolved NO3 − was two (2) to three (3) times higher during the post-monsoon period (April 2015) compared to the pre-monsoon period (October 2014). These nutrients’ inputs were converted from P limitation condition during the premonsoon period to N limitation condition during the post-monsoon period at our study area. The results of this study suggest that the Northeast monsoon plays an important role in influencing the distribution of dissolved nutrients between seasons in Pulau Perhentian. It is thought that during the post-monsoon period, a considerable input of nutrients from bottom water is responsible for increasing dissolved nutrients in surface water, in particular PO4 3−.
Sabah has extensive mangrove forests surrounded by oceanic waters which provide suitable habitat for many species of animals including mud crabs (Scylla spp.). This study was conducted to obtain information on the species composition, distribution and catch per unit effort in Marudu Bay, Sabah. Samplings were done monthly in five mangrove areas along the river channels in Marudu Bay (06°33’N; 114°44’E) from October 2012 to September 2013 using collapsible baited crab traps. From a total of 1859 mud crab specimens caught in Marudu Bay, three species were identified. Scylla tranquebarica was the dominant species forming 78% of the total followed by S. paramamosain 13% and S. olivacea 8%. The number of males (n=1224) was higher compared to females (n=635) with an average sex ratio male : female of 1.0:0.5. The catch per unit effort (CPUE) showed an average value of 0.55 trap-1 day-1 and revealed a declining trend throughout the sampling. S. tranquebarica was widely distributed in all the rivers surveyed, however, it mostly occurred in near the lower reaches of the river near the areas open to the sea where average water salinity ranged from 12.98 to 14.28 ppt and the environment favoured the growth of Rhizophora sp. Other species, S. paramamosain and S. olivacea, were mostly found in upstream areas covered generally by Nypa sp. and where average water salinity varied from 6.93 to 7.50 ppt. The information on the species composition, distribution and CPUE of the mud crabs in Marudu Bay can be useful for mud crab fisheries resources management in Sabah.
Leptospirosis is one of the most widespread zoonotic diseases and can infect both humans and animals worldwide. Healthy cat, as a potential source of exposure to humans, are likely underestimated owing to the lack of overt clinical signs associated with Leptospira spp. infection in this species. The aim of the study was to determine the exposure, shedding, and carrier status of leptospires in shelter cats in Malaysia by using serological, molecular, and bacteriological methods. For this study, 82 healthy cats from two shelters were sampled. The blood, urine, and kidneys were tested using the microscopic agglutination test (MAT), polymerase chain reaction (PCR), and bacterial culture. On the basis of serological, molecular, and/or culture techniques, the total detection of leptospiral infection was 29.3% (n = 24/82). Through culture techniques, 16.7% (n = 4/24) of the cats that tested positive were carriers with positive kidney cultures, and one cat was culture positive for both urine and kidney. The Leptospira spp. isolates were identified as pathogenic L. interrogans serovar Bataviae through serological and molecular methods. Through serological techniques, 87.5% (n = 21/24) had positive antibody titers (100-1600) and most of the Bataviae serogroup (n = 19/21). Using PCR, 16.7% (n = 4/24) of cats were shown to have pathogenic Leptospira spp. DNA in their urine. Furthermore, three out of four culture positive cats were serology negative. The present study reports the first retrieval of pathogenic leptospires from urine and kidneys obtained from naturally infected cats. The results provide evidence of the potential role of naturally infected cats in the transmission of leptospires. Additionally, leptospiral infection occurs sub-clinically in cats. The culture isolation provides evidence that healthy cats could be reservoirs of leptospiral infection, and this information may promote the development of disease prevention strategies for the cat population.
The biological, chemical, and in silico properties of methanol and dichloromethane (DCM) extracts of Alhagi maurorum roots with respect to the antioxidant, enzyme inhibition, and phytochemical composition were evaluated. Total bioactive contents were determined spectrophotometrically, and the individual secondary metabolites composition was assessed via ultra-high-performance liquid chromatography mass spectrometry (UHPLC-MS) analysis. Antioxidant capacities were evaluated using a panoply of assays (2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) free radical scavenging, ferric reducing antioxidant power (FRAP), cupric reducing antioxidant power (CUPRAC), phosphomolybdenum total antioxidant capacity (TAC), and metal chelating activity (MCA)). The enzyme inhibition potential was studied against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), α-amylase, α-glucosidase, tyrosinase, urease and lipoxygenase (LOX) enzymes. The methanol extract was found to contain higher total phenolic (105.91 mg GAE/g extract) and flavonoid (2.27 mg RE/g extract) contents which can be correlated to its more substantial antioxidant potential as well as AChE, BChE, tyrosinase and α-glucosidase inhibition. However, the DCM extract was the most effective against α-amylase (1.86 mmol ACAE/g extract) enzyme inhibition. The UHPLC-MS analysis of methanol extract identified the tentative presence of a total of 18 secondary metabolites, including flavonoids, saponins, phenolic and terpenoid derivatives. Three compounds named emmotin A, luteolin 5,3'-dimethyl ether, and preferrugone were further investigated for their in silico molecular docking studies against the tested enzymes. The selected compounds were found to have higher binding interaction with AChE followed by BChE, α-glucosidase, α-amylase, and tyrosinase. The results of the present study have demonstrated A. mauroram to be considered as a lead source of natural antioxidant and enzyme inhibitor compounds.
Mesenchymal stem cells (MSCs) are multipotent stem cells with strong immunosuppressive property that renders them an attractive source of cells for cell therapy. MSCs have been studied in multiple clinical trials to treat liver diseases, peripheral nerve damage, graft-versus-host disease, autoimmune diseases, diabetes mellitus, and cardiovascular damage. Millions to hundred millions of MSCs are required per patient depending on the disease, route of administration, frequency of administration, and patient body weight. Multiple large-scale cell expansion strategies have been described in the literature to fetch the cell quantity required for the therapy. In this review, bioprocessing strategies for large-scale expansion of MSCs were systematically reviewed and discussed. The literature search in Medline and Scopus databases identified 26 articles that met the inclusion criteria and were included in this review. These articles described the large-scale expansion of 7 different sources of MSCs using 4 different bioprocessing strategies, i.e., bioreactor, spinner flask, roller bottle, and multilayered flask. The bioreactor, spinner flask, and multilayered flask were more commonly used to upscale the MSCs compared to the roller bottle. Generally, a higher expansion ratio was achieved with the bioreactor and multilayered flask. Importantly, regardless of the bioprocessing strategies, the expanded MSCs were able to maintain its phenotype and potency. In summary, the bioreactor, spinner flask, roller bottle, and multilayered flask can be used for large-scale expansion of MSCs without compromising the cell quality.
Pharmacology teaching during preclinical years is important for medical students to make rational choices in choosing suitable treatment for patients in future. Therefore, the present study determined the adequacy and effectiveness of pharmacology teaching in the undergraduate medical program at the Universiti Kebangsaan Malaysia Medical Center (UKMMC). Suggestions for improvement of the curriculum were also identified. An online questionnaire on the perceptions of pharmacology teaching methodology was distributed to a total of 459 medical students in 4th and 5th year at UKMMC. The questionnaire covered demographics, perceptions about pharmacology teaching, the ideal teaching learning methodology for learning pharmacology, pharmacology topics which are useful for future clinical practice, the pharmacology topic which was most interesting and recommendations for improvement. The response rate was 46.4% and majority of the participants were females (65.7%). Most of the students agreed that interactive learning was more helpful than didactic lectures (88.0%). Seventy percent of the students reported that pharmacology lectures in the preclinical years were helpful during the clinical years. Percentage of students who agreed that pharmacology teaching in their preclinical was adequate for their clinical practice was 47.0%. There was no association between demographic variables (gender, race, year of study and medical family background) and interest in pharmacology (p>0.05). In conclusion, the pharmacology teaching during preclinical years was perceived to be effective and useful for students’ clinical practice. More pharmacology teaching sessions in clinical years was suggested which may improve adequacy of pharmacology teaching.
Each human being exhibits their own personality traits and each aspect of stress and coping is essential and related. The relationship between the big five personality traits, coping mechanisms and stress level among final year medical students of Universiti Kebangsaan Malaysia (UKM) was investigated in this study. In this cross-sectional study, 152 final year medical students batch 2017/2018, were randomly selected, excluding those who had chronic diseases, married and repeated final year. The questionnaires used were Big Five Personality Inventory and 12-Item General Health Questionnaire. An open-ended question was used to determine how the respondents cope with their stress. Data was analyzed using SPSS 20.0. Agreeableness was the most common personality trait portrayed among the students, whereas Openness to Experience appeared to be the least. The relationship between the Big Five Personality Traits and coping mechanisms (p=0.016; p
Integrated fixed-film activated sludge (IFAS) process is considered as one of the leading-edge processes that provides a sustainable solution for wastewater treatment. IFAS was introduced as an advancement of the moving bed biofilm reactor by integrating the attached and the suspended growth systems. IFAS offers advantages over the conventional activated sludge process such as reduced footprint, enhanced nutrient removal, complete nitrification, longer solids retention time and better removal of anthropogenic composites. IFAS has been recognized as an attractive option as stated from the results of many pilot and full scales studies. Generally, IFAS achieves >90% removals for combined chemical oxygen demand and ammonia, improves sludge settling properties and enhances operational stability. Recently developed IFAS reactors incorporate frameworks for either methane production, energy generation through algae, or microbial fuel cells. This review details the recent development in IFAS with the focus on the pilot and full-scale applications. The microbial community analyses of IFAS biofilm and floc are underlined along with the special emphasis on organics and nitrogen removals, as well as the future research perspectives.
Mixed matrix membranes (MMMs) were fabricated by the hydrothermal synthesis of ordered mesoporous KIT-6 type silica and incorporating in polyimide (P84). KIT-6 and MMMs were characterized to evaluate morphology, thermal stability, surface area, pore volume, and other characteristics. SEM images of synthesized MMMs and permeation data of CO2 suggested homogenous dispersion of mesoporous fillers and their adherence to the polymer matrix. The addition of KIT-6 to polymer matrix improved the permeability of CO2 due to the increase in diffusivity through porous particles. The permeability was 3.2 times higher at 30% loading of filler. However, selectivity showed a slight decrease with the increase in filler loadings. The comparison of gas permeation results of KIT-6 with the well-known MCM-41 revealed that KIT-6 based MMMs showed 14% higher permeability than that of MMMs composed of mesoporous MCM-41. The practical commercial viability of synthesized membranes was examined under different operating temperatures and mixed gas feeds. Mesoporous KIT-6 silica is an attractive additive for gas permeability enhancement without compromising the selectivity of MMMs. Graphical abstract.
Lignin depolymerization for the purpose of synthesizing aromatic molecules is a growing focus of research to find alternative energy sources. In current studies, the photocatalytic depolymerization of lignin has been investigated by two new iso-propylamine-based lead chloride perovskite nanomaterials (SK9 and SK10), synthesized by the facile hydrothermal method. Characterization was done by Powder X-Ray Diffraction (PXRD), Scanning Electron Microscopy (SEM), UV-Visible (UV-Vis), Photoluminescence (PL), and Fourier-Transform Infrared (FTIR) Spectroscopy and was used for the photocatalytic depolymerization of lignin under UV light. Lignin depolymerization was monitored by taking absorption spectra and catalytic paths studied by applying kinetic models. The %depolymerization was calculated for factors such as catalyst dose variation, initial concentration of lignin, and varying temperatures. Pseudo-second order was the best suited kinetic model, exhibiting a mechanism for lignin depolymerization that was chemically rate controlled. The activation energy (Ea) for the depolymerization reaction was found to be 15 kJ/mol, which is remarkably less than conventional depolymerization of the lignin, i.e., 59.75 kJ/mol, exhibiting significant catalytic efficiencies of synthesized perovskites. Products of lignin depolymerization obtained after photocatalytic activity at room temperature (20 °C) and at 90 °C were characterized by GC-MS analysis, indicating an increase in catalytic lignin depolymerization structural subunits into small monomeric functionalities at higher temperatures. Specifically, 2-methoxy-4-methylphenol (39%), benzene (17%), phenol (10%) and catechol (7%) were detected by GC-MS analysis of lignin depolymerization products.
Withania coagulans (W. coagulans) is well-known in herbal medicinal systems for its high biological potential. Different parts of the plant are used against insomnia, liver complications, asthma, and biliousness, as well as it is reported to be sedative, emetic, diuretic, antidiabetic antimicrobial, anti-inflammatory, antitumor, hepatoprotective, antihyperglycemic, cardiovascular, immuno-suppressive and central nervous system depressant. Withanolides present in W. coagulans have attracted an immense interest in the scientific field due to their diverse therapeutic applications. The current study deals with chemical and biological evaluation of chloroform, and n-butanol fractions of W. coagulans. The activity-guided fractionation of both extracts via multiple chromatographic steps and structure elucidation of pure isolates using spectroscopies (NMR, mass spectrometry, FTIR and UV-Vis) led to the identification of a new withanolide glycoside, withacogulanoside-B (1) from n-butanol extract and five known withanolides from chloroform extract [withanolid J (2), coagulin E (3), withaperuvin C (4), 27-hydroxywithanolide I (5), and ajugin E (6)]. Among the tested compounds, compound 5 was the most potent α-glucosidase inhibitor with IC50 = 66.7 ± 3.6 µM, followed by compound 4 (IC50: 407 ± 4.5 µM) and compound 2 (IC50: 683 ± 0.94 µM), while no antiglycation activity was observed with the six isolated compounds. Molecular docking was used to predict the binding potential and binding site interactions of these compounds as α-glucosidase inhibitors. Consequently, this study provides basis to discover specific antidiabetic compounds from W. coagulans.
Neonatal mastitis and abscess are rare and most often unilateral. Neonatal breast massage for physiological breast hypertrophy is suspected to be a predisposing factor in the case reported here: a 14-day-old neonate with bilateral neonatal breast abscess, treated effectively with intravenous cloxacillin and surgical aspiration.
Background:Recent retrospective studies suggest irrelevance of urine screening for neonate with prolonged jaundice. We re-evaluated the incidence of urinary tract infection (UTI) among these infants, their renal outcome and evaluated the cost incurred. Methods: This is a prospective cohort study. Asymptomatic, prolonged jaundiced infants with unconjugated hyperbilirubinemia were screened for evidence of UTI as per local guidelines. Infants with pyuria would have urine sent for culture and sensitivity. Unit cost was referenced from hospital purchase. Statistical analysis was performed using SPSS 24.0. Results:A total of 291 cases were analyzed. Majority were term infants (93.8%). The commonest cause of prolonged jaundice was breast milk jaundice, hence an incidence rate of 0.34%. Only one infant persistently showed single uropathogen on urinary culture with concurrent pyuria. Urinary structures were normal on ultrasonography and there was no evidence of renal cortical scarring. No recurrence of UTI documented in the first year of life. Each “clean-catch” urinalysis costed RM7. This unit cost escalated to RM37 for catheterized sample. A negative urine culture costed RM28 while a positive culture twice this price. The average cost effectiveness ratio (ACER) in this study was RM5856.56 per detection of case. Conclusion: Incidence of UTI is low. In our study, an undesirable outcome is negligible. Unnecessary parental anxiety from the potentially laborious procedure could be avoided. This study refutes previous literature to include such screening in prolonged jaundice as this may well be irrelevant.
Traditional postpartum practices generally involve food proscriptions and prescriptions. Certain foods are prohibited due to their properties such as “windy”, “cold” and “hot”. As lactating mother needs higher energy and protein intake, this practice may impact their ability to meet their nutritional requirements. Consequently, their health may not be fully restored, wound healing would be slowed, and lactation success may be interfered. This study was conducted in Kuantan, Pahang, to investigate Malay mothers’ perception on confinement dietary practices during postpartum period. A total of 80 respondents aged between 23-43 years old were interviewed using a questionnaire which consisted of an extensive list of food items. It was found that 100% of respondents mentioned that they do observe the traditional postpartum practices after childbirth with most of them (63.0%) chose to confine for up to 44 days. Flavored rice, roti canai and various types of noodle were generally avoided during postpartum period due to their ‘oily/fatty’ property. Tubers, and most fruits and vegetables were also avoided due to their ‘cold’ property. Moreover, the famous ‘reason’ for exclusion of fish was ‘bisa’ and ‘causing itchiness’ for seafood. Milk and dairy products were included in majority of respondents’ diet. Out of 80, 43 (53.8%) respondents avoided soy sauce because it was believed to give negative effect on wound healing. Other than
that, iced drink, tea and sugarcane drink were avoided due to their ‘cold’ and ‘sharp/sour’ properties. In addition, statistical tests of all food items show that there is no difference in terms of level of acceptance for each food between women delivered via normal delivery or caesarean section. It is concluded that postpartum food taboo beliefs are still prevalent among Malay women. Extensive food prohibition and restriction causes limited food choices which may affect mothers’ nutritional intake. Thus, a more balanced diet should be recommended for Malay mothers during postpartum period to ensure adequate nutrient intake, as much as culturally acceptable.
Acute lymphoblastic leukemia (ALL) is the most common leukemia subtypes among paediatrics in Malaysia. Although treatment options are available but some patients remain incurable, some undergo relapse and many experiences adverse effects by the conventional therapies. Thus, we aim to investigate possible treatment alternative by studying the antileukemogenesis properties of concentrated Nypa fruticans sap called nisaan by focusing on adiponectin expression.
Our study model was CCRF-CEM, an acute lymphoblastic leukemia cell lines. The cells were treated with nisaan at a range of concentration and treated for 24, 48 and 72 hours followed by determination of the leukemic cells viability using tryphan blue method. Effective nisaan concentrations that significantly reduced the cells viability were again treated to the cells followed by determination of the cell proliferation using BrdU colorimetric kit and adiponectin level using adiponectin ELISA kit.
The results showed that, increase concentration of nisaan treatment reduced the cells viability and cells proliferation and enhance the adiponectin level in the leukemic cells.
This preliminary data suggest that Nypa fruticans might has the antileukemogenesis effect on acute lymphoblastic cells by regulating the adiponectin expression.
ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS
New Frontiers in Health: Expecting the Unexpected
Held at the Faculty of Medicine and Health Sciences,
Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
Introduction: Obesity is a global epidemic with major healthcare implications and costs. The availability of Smart-phone app as a new technological innovation developed is increasing rapidly. This new technological innovation can have a huge potential for interventions to help weight loss and combat obesity. To perform a systematic review and meta-analysis of studies to compare the effectiveness of Smartphone apps compared with other methods to promote weight loss and obesity. Methods: We conducted a systematic review and meta-analysis of relevant studies identified by a search of independently screened studies for inclusion criteria and extracted data. We included arti-cles that assessed any (Smartphone/Mobile phone app intervention with anthropometric measurement like weight/BMI, waist circumference), adult or children population then exclude articles in which the primary outcome is not weight/BMI/Waist circumference, non-original articles (Reviews, Editorials, Non-research letters), case reports or case series, non RCT study design, participant with co-morbidities or condition like pregnancy and Intervention using SMS or any text messaging. Results: We included 7 articles in this systematic review and meta-analysis. This me-ta-analysis shows that smartphone app interventions compared with conventional or other interventions is non-sig-nificant decreases in body weight, with the pooled estimates of the net change in body weight being -1.62 kg (95% CI –3.61 to 0.36; I2 = 93%). Pooled results indicated a non-significant net difference in BMI between smart phone app and control intervention groups (WMD 0.26 kg/m2, 95% CI -0.83 to 1.34; I2 = 68%). For waist circumference, there is non-significant net difference in BMI between smart phone app and control intervention groups (WMD -5.2 cm 95% CI --0.15 to 4.60; I2 = 93%). Conclusion: Smartphone apps intervention alone is not producing substantial evidence of weight loss despite there might be effective for certain groups. However, there are still explorable pros-pect on the use of smartphone app in combination of other approach to assist and promote weight loss as the use of smartphone are proven to influence health related behavioural modification.
Introduction:Despite significant advancements in testing technologies and treatment, 80% of 80 million chronically hepatitis C virus (HCV) infected people remain undiagnosed. FIND in collaboration with Ministries of Health and local partners, initiated seven Unitaid funded Hepatitis C Elimination through Access to Diagnostics (HEAD-Start) projects in four countries (Georgia, India, Malaysia and Myanmar) to demonstrate innovative models of HCV care to inform programme scale-up nationally and globally. Here, we describe preliminary findings for patient retention in the HCV cascade for each project. Methods: Target populations and settings include people who inject drugs (PWID) in harm reduction sites (Manipur, Georgia, Myanmar), high risk patients in primary health care facilities (Malaysia), general population in polyclinics and district hospitals (Delhi) and people living with HIV (PLHIV) in antiretroviral therapy (ART) clinics (Punjab). All projects employ rapid diagnostic tests for HCV screening. HCV seropositive patients received confirmatory testing either on site (Georgia, Myanmar) or via centralized laboratory (Malaysia, Georgia, Delhi) or testing hubs (Punjab, Manipur). Results: In Malaysia, 4,613 patients were screened - 23% (1,042) are HCV seropositive, 57% (594) received RNA confirmatory testing and 11% (54) confirmed RNA-positive initiated treatment. In Delhi, 17,101 patients were screened – 2% (355) are seropositive, 92% (326) received confirmatory testing and 70% (180) initiated treatment. In Punjab, 17,507 patients were screened – 19% (3,368) are seroposi-tive, 94% (3,165) received confirmatory testing and 31% (828) initiated treatment. In Manipur, 3,845 patients were screened - 56% (2,180) are seropositive, 73% (1,591) received confirmatory testing and 67% (823) initiated treat-ment. In Myanmar, 199 patients were screened – 96% (191) are seropositive, 100% received confirmatory testing and 86% (151) initiated treatment. In Georgia (Arm 1) - 100% (619) received confirmatory testing and 76% (389) initiated treatment. Conclusion: The fully decentralised HCV testing model demonstrated higher numbers of patients progressing to each step in the care cascade.
A study was carried out to determine the effectiveness of lignin, extracted from oil palm (Elaeis guineensis) biomass as water-in-oil (W/O) emulsifying agent. To achieve this goal, soda lignin (SL) was extracted via soda pulping process and a series of nanosized soda lignin (NSL) were prepared using homogenizer at three different speed i.e. 10,400 rpm (NSL 10), 11,400 rpm (NSL 11) and 12,400 rpm (NSL 12) for one hour. All prepared samples were characterized by FT-IR, UV-Vis spectroscopy, thermogravimetric analysis (TGA), zeta potential analyser, Transmission Electron Microscope (TEM) and Extreme High Resolution Field Emission Scanning Electron Microscope (XHR-FESEM). The result of FTIR showed that there is no prominent change occurred in spectra of all samples while a good stability was reflected by TGA curves. The percentage of creaming index and visual observations of all samples demonstrated that NSL 12 and dosage 2 g (out of 1 g, 1.5 g and 2 g) were found to be the best among all samples. Furthermore, the results of IFT indicate that NSL 12 was proven to be more stable than the commercial product. Therefore, NSL 12 is selected for toxicological studies and was found safe in both, in vitro and in vivo studies.