Displaying publications 261 - 280 of 594 in total

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  1. Ibrahim MD, Amran SNA, Yunos YS, Rahman MRA, Mohtar MZ, Wong LK, et al.
    Appl Bionics Biomech, 2018;2018:7854321.
    PMID: 29853998 DOI: 10.1155/2018/7854321
    The skin of a fast swimming shark reveals riblet structures that help reduce the shark's skin friction drag, enhancing its efficiency and speed while moving in the water. Inspired by the structure of the shark skin denticles, our team has carried out a study as an effort in improving the hydrodynamic design of marine vessels through hull design modification which was inspired by this riblet structure of shark skin denticle. Our study covers on macroscaled design modification. This is an attempt to propose an alternative for a better economical and practical modification to obtain a more optimum cruising characteristics for marine vessels. The models used for this study are constructed using computer-aided design (CAD) software, and computational fluid dynamic (CFD) simulations are then carried out to predict the effectiveness of the hydrodynamic effects of the biomimetic shark skins on those models. Interestingly, the numerical calculated results obtained show that the presence of biomimetic shark skin implemented on the vessels give about 3.75% reduction of drag coefficient as well as reducing up to 3.89% in drag force experienced by the vessels. Theoretically, as force drag can be reduced, it can lead to a more efficient vessel with a better cruising speed. This will give better impact to shipping or marine industries around the world. However, it can be suggested that an experimental procedure is best to be conducted to verify the numerical result that has been obtained for further improvement on this research.
  2. Rejab M, Wong JHD, Jamalludin Z, Jong WL, Malik RA, Wan Ishak WZ, et al.
    Australas Phys Eng Sci Med, 2018 Jun;41(2):475-485.
    PMID: 29756166 DOI: 10.1007/s13246-018-0647-6
    This study investigates the characteristics and application of the optically-stimulated luminescence dosimeter (OSLD) in cobalt-60 high dose rate (HDR) brachytherapy, and compares the results with the dosage produced by the treatment planning system (TPS). The OSLD characteristics comprised linearity, reproducibility, angular dependence, depth dependence, signal depletion, bleaching rate and cumulative dose measurement. A phantom verification exercise was also conducted using the Farmer ionisation chamber and in vivo diodes. The OSLD signal indicated a supralinear response (R2 = 0.9998). It exhibited a depth-independent trend after a steep dose gradient region. The signal depletion per readout was negligible (0.02%), with expected deviation for angular dependence due to off-axis sensitive volume, ranging from 1 to 16%. The residual signal of the OSLDs after 1 day bleached was within 1.5%. The accumulated and bleached OSLD signals had a standard deviation of ± 0.78 and ± 0.18 Gy, respectively. The TPS was found to underestimate the measured doses with deviations of 5% in OSLD, 17% in the Farmer ionisation chamber, and 7 and 8% for bladder and rectal diode probes. Discrepancies can be due to the positional uncertainty in the high-dose gradient. This demonstrates a slight displacement of the organ at risk near the steep dose gradient region will result in a large dose uncertainty. This justifies the importance of in vivo measurements in cobalt-60 HDR brachytherapy.
  3. Razali N, Agarwal R, Agarwal P, Froemming GRA, Tripathy M, Ismail NM
    Eur J Pharmacol, 2018 Nov 05;838:1-10.
    PMID: 30171854 DOI: 10.1016/j.ejphar.2018.08.035
    Trans-resveratrol was earlier shown to lower intraocular pressure (IOP) in rats; however, its mechanisms of action remain unclear. It has been shown to modulate adenosine receptor (AR) and TGF-β2 signaling, both of which play a role in regulating IOP. Hence, we investigated effects of trans-resveratrol on AR and TGF-β2 signaling. Steroid-induced ocular hypertensive (SIOH) rats were pretreated with A1AR, phospholipase C (PLC) and ERK1/2 inhibitors and were subsequently treated with single drop of trans-resveratrol. Metalloproteinases (MMP)-2 and -9 were measured in aqueous humor (AH). In another set of experiments, effect of trans-resveratrol on AH level of tissue plasminogen activator (tPA) and urokinase plasminogen activator (uPA) was determined after single and multiple drop administration in SIOH rats. Effect of trans-resveratrol on ARs expression, PLC and pERK1/2 activation and MMPs, tPA and uPA secretion was determined using human trabecular meshwork cells (HTMC). Further, effect of trans-resveratrol on TGF-β2 receptors, SMAD signaling molecules and uPA and tPA expression by HTMC was determined in the presence and absence of TGF-β2. Pretreatment with A1AR, PLC and ERK1/2 inhibitors antagonized the IOP lowering effect of trans-resveratrol and caused significant reduction in the AH level of MMP-2 in SIOH rats. Trans-resveratrol increased A1AR and A2AAR expression, cellular PLC, pERK1/2 levels and MMP-2, tPA and uPA secretion by HTMC. Additionally, it produced TGFβRI downregulation and SMAD 7 upregulation. In conclusion, IOP lowering effect of trans-resveratrol involves upregulation of A1AR expression, PLC and ERK1/2 activation and increased MMP-2 secretion. It downregulates TGFβRI and upregulates SMAD7 hence, inhibits TGF-β2 signaling.
  4. Hoe CH, Suan MAM, Hoe CH, Tang TH, Kiew KK, Hassan MRA, et al.
    Med J Malaysia, 2018 08;73(4):260.
    PMID: 30121693
    No abstract provided.
  5. Makama AB, Salmiaton A, Choong TSY, Hamid MRA, Abdullah N, Saion E
    Chemosphere, 2020 Aug;253:126689.
    PMID: 32304862 DOI: 10.1016/j.chemosphere.2020.126689
    Removal of ciprofloxacin (CIP) pollutant from wastewater using conventional process is particularly challenging due to poor removal efficiency. In this work, CIP was photocatalytically degraded using a porous ZnO/SnS2 photocatalyst prepared via microwaves. The influence of process parameters (e.g., pH, catalyst mass and initial CIP concentration) and radical scavengers on visible-light induced degradation of CIP on the catalyst was investigated. From the study, it was found that visible-light induced degradation of CIP on ZnO/SnS2 is a surface-mediated process and the reaction kinetics followed the Langmuir-Hinshelwood first-order kinetics. It was found that the optimum condition for CIP degradation was at pH of 6.1 and catalyst dosage of 500 mg L-1. Higher catalyst dosage however led to a decline in reaction rate due to light scattering effect and reduction in light penetration.
  6. Nazrin A, Sapuan SM, Zuhri MYM, Ilyas RA, Syafiq R, Sherwani SFK
    Front Chem, 2020;8:213.
    PMID: 32351928 DOI: 10.3389/fchem.2020.00213
    Synthetic plastics are severely detrimental to the environment because non-biodegradable plastics do not degrade for hundreds of years. Nowadays, these plastics are very commonly used for food packaging. To overcome this problem, food packaging materials should be substituted with "green" or environmentally friendly materials, normally in the form of natural fiber reinforced biopolymer composites. Thermoplastic starch (TPS), polylactic acid (PLA) and polybutylene succinate (PBS) were chosen for the substitution, because of their availability, biodegradability, and good food contact properties. Plasticizer (glycerol) was used to modify the starch, such as TPS under a heating condition, which improved its processability. TPS films are sensitive to moisture and their mechanical properties are generally not suitable for food packaging if used alone, while PLA and PBS have a low oxygen barrier but good mechanical properties and processability. In general, TPS, PLA, and PBS need to be modified for food packaging requirements. Natural fibers are often incorporated as reinforcements into TPS, PLA, and PBS to overcome their weaknesses. Natural fibers are normally used in the form of fibers, fillers, celluloses, and nanocelluloses, but the focus of this paper is on nanocellulose. Nanocellulose reinforced polymer composites demonstrate an improvement in mechanical, barrier, and thermal properties. The addition of compatibilizer as a coupling agent promotes a fine dispersion of nanocelluloses in polymer. Additionally, nanocellulose and TPS are also mixed with PLA and PBS because they are costly, despite having commendable properties. Starch and natural fibers are utilized as fillers because they are abundant, cheap and biodegradable.
  7. Amelia JJN, Zuhri MYM, Leman Z, Zahari NI, As'arry A, Ilyas RA
    Polymers (Basel), 2021 Oct 19;13(20).
    PMID: 34685362 DOI: 10.3390/polym13203603
    In recent years, there has been a growing interest for composite materials due to the superior capability to absorb energy and lightweight factor. These properties are compatible to be utilized in the development for transportation system as it can reduce the fuel consumption and also minimize the effect of crash to the passenger. Therefore, the aim for this project is to study the compression strength and energy absorbing capability for Polyvinyl chloride (PVC) and bamboo tubes reinforced with foam. Several parameters are being considered, these being the effect of single and multiple tube reinforced foam structure, foam density, diameter of the tube as well as effect of different crosshead speed. The results showed that increasing the relative foam density will led to an increase in the compression strength and specific energy absorption (SEA) values. Furthermore, a significant increase of compression strength can be seen when several tubes are introduced into the foam while SEA remained almost the same. Finally, the influence of crosshead below 20 mm/min did not vary significantly for both compression strength and SEA.
  8. Abotbina W, Sapuan SM, Sultan MTH, Alkbir MFM, Ilyas RA
    Polymers (Basel), 2021 Oct 11;13(20).
    PMID: 34685246 DOI: 10.3390/polym13203487
    This work aims to develop cornstarch (CS) based films using fructose (F), glycerol (G), and their combination (FG) as plasticizers with different ratios for food packaging applications. The findings showed that F-plasticized film had the lowest moisture content, highest crystallinity among all films, and exhibited the highest tensile strength and thermostability. In contrast, G-plasticized films showed the lowest density and water absorption with less crystallinity compared to the control and the other plasticized film. In addition, SEM results indicated that FG-plasticized films had a relatively smoother and more coherent surface among the tested films. The findings have also shown that varying the concentration of the plasticizers significantly affected the different properties of the plasticized films. Therefore, the selection of a suitable plasticizer at an appropriate concentration may significantly optimize film properties to promote the utilization of CS films for food packaging applications.
  9. Hafila KZ, Jumaidin R, Ilyas RA, Selamat MZ, Yusof FAM
    Int J Biol Macromol, 2022 Jan 01;194:851-860.
    PMID: 34838853 DOI: 10.1016/j.ijbiomac.2021.11.139
    Thermoplastic starch is a potentially sustainable and biodegradable material. However, it possesses some limitations in terms of mechanical performance and high moisture sensitivity. In this current work, the characteristics of thermoplastic cassava starch (TPCS) containing palm wax at various loading were evaluated. TPCS was prepared via hot pressing by varying the ratios of palm wax (2.5, 5, 10, and 15 wt%). Next, characterization via scanning electron microscopy (SEM), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), Fourier-transform infrared spectroscopy (FT-IR), mechanical, water solubility, thickness swelling and moisture absorption tests, were conducted on the samples. The findings showed that incorporating starch-based thermoplastics with palm wax has remarkably improved mechanical characteristics of the thermoplastic blends. Besides, the morphology of the samples demonstrated irregular and rougher cleavage fracture after palm wax addition. FT-IR indicated the existence of intermolecular interaction between TPCS and palm wax with the intermolecular hydrogen bonds that existed between them. The thermal stability of TPCS has improved with rising palm wax content. The incorporation of 15 wt% palm wax resulted in the lowest moisture absorption value among the samples. Overall, the developed TPCS/palm wax with improved mechanical and moisture resistance characteristics has the potential to be used as biodegradable materials.
  10. Mokhtar NM, Jaafar NM, Alfian E, Mohd Rathi ND, Abdul Rani R, Raja Ali RA
    Acta Gastroenterol Belg, 2021 12 30;84(4):585-591.
    PMID: 34965040 DOI: 10.51821/84.4.009
    Background: Gut dysbiosis is linked with the pathophysiology of irritable bowel syndrome (IBS). Manipulation of intestinal microbiota using cultured milk drinks may stimulate the immune system, hence providing beneficial support in IBS treatment. This study aimed to investigate the effects of cultured milk drink on clinical symptoms, intestinal transit time (ITT), fecal pH and cytokines in constipation-predominant IBS (IBS-C) as compared to non-IBS participants.

    Methods: Each recruited participant was given three bottles of 125 ml cultured milk drink containing 109 cfu Lactobacillus acidophilus LA-5 and Lactobacillus paracasei L. CASEI-01 consumed daily for 30 days. At pre- and post-30-day consumption, fecal pH, ITT, clinical symptoms, IL-6, IL-8 and TNF-α levels were assessed. Seventy-seven IBS-C and 88 non-IBS were enrolled.

    Results: Post-consumption, 97.4% of IBS-C experienced improvements in constipation-related symptoms supported by the significant reduction of ITT and decreased fecal pH (p<0.05). All pro-inflammatory cytokines were significantly lower in post as compared to pre-consumption of cultured milk drinks in IBS-C (p<0.05). There was significant reduction in the IL-8 and TNF-α levels in post- as compared to pre-consumption for the non-IBS (p<0.05).

    Conclusion: Cultured milk drink taken daily improved clinical symptoms and reduced cytokines, hence should be considered as an adjunctive treatment in IBS-C individuals.

  11. Mohammed AABA, Omran AAB, Hasan Z, Ilyas RA, Sapuan SM
    Polymers (Basel), 2021 Oct 21;13(21).
    PMID: 34771181 DOI: 10.3390/polym13213624
    Biocomposite materials create a huge opportunity for a healthy and safe environment by replacing artificial plastic and materials with natural ingredients in a variety of applications. Furniture, construction materials, insulation, and packaging, as well as medical devices, can all benefit from biocomposite materials. Wheat is one of the world's most widely cultivated crops. Due to its mechanical and physical properties, wheat starch, gluten, and fiber are vital in the biopolymer industry. Glycerol as a plasticizer considerably increased the elongation and water vapor permeability of wheat films. Wheat fiber developed mechanical and thermal properties as a result of various matrices; wheat gluten is water insoluble, elastic, non-toxic, and biodegradable, making it useful in biocomposite materials. This study looked at the feasibility of using wheat plant components such as wheat, gluten, and fiber in the biocomposite material industry.
  12. Hon SA, Lee LT, Tan KK, Lee RA, Low QJ
    Med J Malaysia, 2021 Nov;76(6):914-917.
    PMID: 34806684
    Sarcoidosis is a multi-systemic, non-caseating granulomatous disorder with an idiopathic aetiology. We report a 58-year-old Malay woman, with underlying type II diabetes mellitus, hypertension and history of stage II pulmonary sarcoidosis presenting with incidental finding of multiple hypodense liver lesions. Her recent contrasted enhanced computed tomography of the abdomen and pelvis demonstrated multiple intra-abdominal lymphadenopathies with evidence of liver and splenic infiltrations. Her ageappropriate malignancy screening was negative while liver biopsy showed non-caseating granulomatous hepatitis consistent with hepatic sarcoidosis. In view of her normal liver enzymes and normalised serum calcium levels, no immunosuppressive therapy was commenced. She remains asymptomatic and is currently under our close monitoring.
  13. Alih RA, Solomon SG, Olufeagba SO, Cheikyula JO, Abol-Munafi AB, Okomoda VT
    Zygote, 2022 Feb;30(1):125-131.
    PMID: 34176523 DOI: 10.1017/S0967199421000411
    The study sought to investigate the chronology of events and timing of embryogenesis, as well as breeding performances of three strains of Heterobranchus longifilis from Nigeria. Fish samples were collected from Benue River in Makurdi, Niger River in Onitsha, and Rima River in Sokoto for this study. Induced spawning of the strains was carried out so that egg development could be tracked from fertilization to hatching using a simple microscope. The microphotographs obtained showed that the embryogenesis of the strains followed a similar pattern to those of other members of the family Clariidae, however with changes occurring in the specific timing of the sequences of events (i.e. interstrain and interspecies differences). When the different strains were compared, the study noted similarities (P > 0.05) in the overall breeding performance (except for fertilization rate), survival at different stages of development, timing of embryogenesis, and larvae characteristics. The outcomes of this study, therefore, provide baseline information on what genetic improvement of the species through strain crossing can be attempted in future studies.
  14. Ghasemzadeh-Moghaddam H, van Wamel W, van Belkum A, Hamat RA, Tavakol M, Neela VK
    Eur J Clin Microbiol Infect Dis, 2018 Feb;37(2):255-263.
    PMID: 29103153 DOI: 10.1007/s10096-017-3124-3
    The humoral immune responses against 46 different staphylococcal antigens in 27 bacteremia patients infected by clonally related methicillin-resistant Staphylococcus aureus (MRSA) strains of a single sequence type (ST) 239 were investigated. A group of non-infected patients (n = 31) hospitalized for different reasons served as controls. All strains were confirmed as ST 239 by S. aureus and mecA-specific PCR, spa, and multi-locus sequence typing (MLST). In each bacteremia patient, a unique pattern of S. aureus antigen-specific immune responses after infection was observed. Antibody levels among bacteremia patients were significantly higher than controls for HlgB (P = 0.001), LukD (P = 0.009), LukF (P = 0.0001), SEA (P = 0.0001), SEB (P = 0.011), SEC (P = 0.010), SEQ (P = 0.049), IsaA (P = 0.043), IsdA (P = 0.038), IsdH (P = 0.01), SdrD (P = 0.001), SdrE (P = 0.046), EsxA (P = 0.0001), and SA0104 (P = 0.0001). On the other hand, the antibody levels were significantly higher among controls for SSL3 (P = 0.009), SSL9 (P = 0.002), and SSL10 (P = 0.007) when the IgG level on the day of infection was compared with that measured on the day of admission. Diversity was observed in the immune response against the antigens. However, a set of antigens (IsaA, IsdA, IsdH, SdrD, and HlgB) triggered a similar type of immune response in different individuals. We suggest that these antigens could be considered when developing a multi-component (passive) vaccine. SEA and/or its specific antibodies seem to play a critical role during ST239 MRSA bacteremia and SEA-targeted therapy may be a strategy to be considered.
  15. Koh KC, Islam M, Chan WK, Lee WY, Ho YW, Alsagoff SAH, et al.
    Med J Malaysia, 2017 08;72(4):209-214.
    PMID: 28889131
    INTRODUCTION: In Malaysia, the prevalence of missed opportunities for HIV-testing is unknown. Missed opportunities have been linked to late diagnosis of HIV and poorer outcome for patients. We describe missed opportunities for earlier HIV-testing in newly-HIV-diagnosed patients.

    METHODS: Cross sectional study. Adult patients diagnosed with HIV infection and had at least one medical encounter in a primary healthcare setting during three years prior to diagnosis were included. We collected data on sociodemographic characteristics, patient characteristics at diagnosis, HIV-related conditions and whether they were subjected to risk assessment and offered HIV testing during the three years prior to HIV diagnosis.

    RESULTS: 65 newly HIV-diagnosed patients (male: 92.3%; Malays: 52.4%; single: 66.7%; heterosexual: 41%; homosexual 24.6%; CD4 <350 at diagnosis: 63%). 93.8% were unaware of their HIV status at diagnosis. Up to 56.9% had presented with HIV-related conditions at a primary healthcare facility during the three years prior to diagnosis. Slightly more than half were had risk assessment done and only 33.8% were offered HIV-testing.

    CONCLUSIONS: Missed opportunities for HIV-testing was unacceptably high with insufficient risk assessment and offering of HIV-testing. Risk assessment must be promoted and primary care physicians must be trained to recognize HIV-related conditions that will prompt them to offer HIVtesting.

  16. Nafis ZAS, Nuzaimah M, Kudus SIA, Yusuf Y, Ilyas RA, Knight VF, et al.
    Materials (Basel), 2023 Jan 04;16(2).
    PMID: 36676215 DOI: 10.3390/ma16020479
    The efficacy of wood dust fibre treatment on the property of wood dust reinforced recycled polypropylene composite (r-WoPPC) filament was investigated. The wood dust fibre was treated using alkali, silane, and NaOH-silane. The treated wood fibre was incorporated with r-PP using a twin-screw extruder to produce filament. The silane treatment on wood dust fibre enhances interfacial bonding between wood fibre and recycled PP; hence, a filament has the highest wire pull strength, which is 35.2% higher compared to untreated and alkaline-treated wood dust filament. It is because silanol in silane forms a siloxane bond that acts as a coupling agent that improves interfacial bonding between wood dust fibre and recycled PP. The SEM micrograph of the fracture structure reveals that treated silane has strong interfacial bonding between wood dust fibre and recycled PP, having minimal void, gap, and good fibre adhesion. The water absorption test results indicate that filament with treated wood dust absorbs less water than filament with untreated wood because the treatment minimizes the gap between wood fibres and recycled PP. The FTIR analysis identified the presence of silane on the wood dust surface for silane-treated wood dust. The DSC studies suggest that the temperature range 167-170 °C be used in the extrusion machine to produce r-WoPPC filament. As a result, r-WoPPc filaments containing silane-treated wood dust have better mechanical properties and have a greater potential for usage in FDM applications.
  17. Mohamed NA, Alanzi ARA, Azizan NA, Azizan SA, Samsudin N, Jenatabadi HS
    Front Psychol, 2023;14:1060963.
    PMID: 36910750 DOI: 10.3389/fpsyg.2023.1060963
    INTRODUCTION: Depression and obesity are the main threat among women which have been considered by many research scholars in psychology studies. In their analysis for measuring and estimating obesity and depression they were involving statistical functions.

    METHODS: Regression, Analysis of Variance (ANOVA), and in the last two decades Structural Equation Modeling are the most familiar statistical methods among research scholars. Taguchi algorism process is one the statistical methods which mostly have been applying in engineering studies. In this study we are looking at two main objectives. The first one is to introduce Taguchi algorism process and apply it in a case study in psychology area. The second objective is challenging among four statistical techniques include ANOVA, regression, SEM, and Taguchi technique in a same data. To achieve those aims we involved depression and obesity indices with other familiar indicators contain socioeconomic, screen time, sleep time, and usage fitness and nutrition mobile applications.

    RESULTS AND DISCUSSION: Outputs proved that Taguchi technique is able to analyze some correlations which are not achieved by applying ANOVA, regression, and SEM. Moreover, SEM has a special capability to estimate some hidden correlations which are not possible to evaluate them by using ANOVA, regression, and even Taguchi method. In the last, we found that some correlations are significant by SEM, however, in the same data with regression those correlation were not significant. This paper could be a warning for psychology research scholars to be more careful with involving statistical methods for measuring and estimating of their research variables.

  18. Chopra L, Thakur KK, Chohan JS, Sharma S, Ilyas RA, Asyraf MRM, et al.
    Materials (Basel), 2022 Mar 24;15(7).
    PMID: 35407737 DOI: 10.3390/ma15072404
    The hydrogels responding to pH synthesized by graft copolymerization only and then concurrent grafting and crosslinking of monomer N-isopropyl acrylamide (NIPAAM) and binary comonomers acrylamide, acrylic acid and acrylonitrile (AAm, AA and AN) onto chitosan support were explored for the percent upload and release study for anti-inflammatory diclofenac sodium drug (DS), w.r.t. time and pH. Diclofenac sodium DS was seized in polymeric matrices by the equilibration process. The crosslinked-graft copolymers showed the highest percent uptake than graft copolymers (without crosslinker) and chitosan itself. The sustainable release of the loaded drug was studied with respect to time at pH 2.2, 7.0, 7.4 and 9.4. Among graft copolymers (without crosslinking), Chit-g-polymer (NIPAAM-co-AA) and Chit-g-polymer (NIPAAM-co-AN) exhibited worthy results for sustainable drug deliverance, whereas Crosslink-Chit-g-polymer (NIPAAM-co-AA) and Crosslink-Chit-g-polymer (NIPAAM-co-AAm) presented the best results for controlled/sustained release of diclofenac sodium DS with 93.86 % and 96.30 % percent release, respectively, in 6 h contact time. Therefore, the grafted and the crosslinked graft copolymers of the chitosan showed excellent delivery devices for the DS with sustainable/prolonged release in response to pH. Drug release kinetics was studied using Fick’s law. The kinetic study revealed that polymeric matrices showed the value of n as n > 1.0, hence drug release took place by non-Fickian diffusion. Hence, the present novel findings showed the multidirectional drug release rate. The morphological changes due to interwoven network structure of the crosslinked are evident by the Scanning electron microscopy (SEM) analysis.
  19. Azarisman SM, Hadzri HM, Fauzi RA, Fauzi AM, Faizal MP, Roslina MA, et al.
    Singapore Med J, 2008 Nov;49(11):886-91; quiz 892-6.
    PMID: 19037555
    INTRODUCTION: Malaysia has a high rate of smoking prevalence and the figure is increasing. Although there has been many local and regional studies on the prevalence and symptomatology of chronic obstructive pulmonary disease patients, data is lacking on the degree of compliance to national management guidelines in the treatment of chronic obstructive pulmonary disease.
    METHODS: 86 patients who attended the respiratory outpatient clinic of the Hospital Universiti Kebangsaan Malaysia were enrolled into a prospective, observational study.
    RESULTS: 88 percent of the patients were male and the majority was ethnically Chinese (65 percent). The majority of patients were in the moderate to very severe categories, with a mean FEV1 of 0.97 +/- 0.56 L/sec and predicted mean FEV1 percentage of 43.1 +/- 21.3 percent. 58 percent of the patients were on long-acting beta-agonist, 65 percent were on inhaled steroids, and only 16 percent were on scheduled pulmonary rehabilitation.
    CONCLUSION: The low uptake rate for long-acting beta-agonist and pulmonary rehabilitation could be attributed to several factors. Financial cost, the need for strict compliance to a structured rehabilitation regime, lack of significant social support and clear up-to-date guidelines are possible reasons.
    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  20. Lim TO, Ngah BA, Rahman RA, Suppiah A, Ismail F, Chako P, et al.
    Singapore Med J, 1992 Feb;33(1):63-6.
    PMID: 1598610
    Poor compliance with drug treatment is a barrier to effective management of hypertension. Drug compliance behaviour of 168 patients were studied, their drug compliance was measured by the pill-counting method. The prevalence of non-compliance with medication was 26%. Thirteen variables were examined for their association with compliance; these were age, sex, duration of hypertension since diagnosis, adequacy of blood pressure control, complexity of drug regimen and side-effect of drug, history of previous admission for hypertension related reason, patient's knowledge of hypertensive complications, patient's belief that drug was 'panas' or 'san', previous use of traditional treatment for hypertension, patient's fatalistic attitude, their social support and satisfaction with the health services. None of these variables were significantly related to compliance (p greater than 0.05) except adequacy of blood pressure control. The performance of patient self-report was compared with pill-count as a measure of drug compliance; it was poorly predictive of non-compliance (sensitivity = 71%, specificity = 50%). An inverse relationship was found between non-compliance with medication and patient subsequent drop-out rate. Patients who were compliant were more likely to remain on treatment and vice versa. As a measure of drug compliance, detection of drop-out compared well with pill-count (sensitivity 97%, specificity 66%, positive predictive value 89%, negative predictive value 88%).
    Study site: outpatient clinic, Hospital Mentakab, Pahang, Malaysia
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