Displaying publications 261 - 280 of 364 in total

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  1. Ganasegeran K, Menke JM, Challakere Ramaswamy VM, Abdul Manaf R, Alabsi AM, Al-Dubai SA
    Biomed Res Int, 2014;2014:370273.
    PMID: 24701573 DOI: 10.1155/2014/370273
    BACKGROUND: Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention.

    PURPOSE: This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers.

    METHODS: A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA.

    RESULTS: Mean (± SD) age of the respondents was 41.4 (± 10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥ 50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores.

    CONCLUSION: The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.

  2. Manokaran P, Krishnasamy S, Aman RRABR, Teoh VWY, Loch A
    Indian J Thorac Cardiovasc Surg, 2024 Jan;40(1):68-77.
    PMID: 38125320 DOI: 10.1007/s12055-023-01580-x
    Pseudoaneurysms of the aortic root are rare. A case of prosthetic aortic valve infection progressing from a confined intramural abscess to a ruptured abscess communicating with the aorta and forming a large pseudoaneurysm is described. Additionally, data from all cases and case series, published between 2000 and 2021, was analyzed. A PUBMED search for the keywords "aortic root mycotic aneurysm," "aortic root abscess AND infective endocarditis," and "aortic root mycotic aneurysm AND infective endocarditis" yielded 152 publications (with 157 cases described): Aortic pseudoaneurysm is more common in males (80.9%, n = 127). Mean age is 51 years (4 months-84 years). The most common symptom is fever (68.5%, n = 102). Mean time until diagnosis is 27.2 days. Embolic complications are present in 17.8% (n = 28) at diagnosis. Most cases are due to valvular infections (n = 72 cases, 45.9%). Prior cardiac surgery is documented in 49.0% (n = 77). The mean time interval for developing aortic root abscess following heart surgery is 32.2 months. 22.3% (n = 35) are immunocompromised. Aetiological agents were Staphylococcus sp. (34.1%, n = 47) and Streptococcus sp. (23.2%, n = 32). Mean antimicrobial therapy lasts 58.5 days. Outcome with surgery is superior to medical treatment: overall inpatient mortality 18.5% (n = 27); with surgery 12.2% (n = 15 out of 123 patients), with only medical management 47.8% (n = 11 out of 23 patients). In conclusion, aortic root pseudoaneurysm occurs most commonly in middle-aged male patients. History of prior aortic procedures is commonly present. Correct diagnosis hinges on detailed history, transoesophageal echocardiography, and computed tomography (CT) aorta. Surgery is the preferred therapeutic option.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-023-01580-x.

  3. Ganasegeran K, Abdul Manaf MR, Safian N, Waller LA, Abdul Maulud KN, Mustapha FI
    PMID: 38061019 DOI: 10.1146/annurev-publhealth-101322-031206
    The industrial revolution and urbanization fundamentally restructured populations' living circumstances, often with poor impacts on health. As an example, unhealthy food establishments may concentrate in some neighborhoods and, mediated by social and commercial drivers, increase local health risks. To understand the connections between neighborhood food environments and public health, researchers often use geographic information systems (GIS) and spatial statistics to analyze place-based evidence, but such tools require careful application and interpretation. In this article, we summarize the factors shaping neighborhood health in relation to local food environments and outline the use of GIS methodologies to assess associations between the two. We provide an overview of available data sources, analytical approaches, and their strengths and weaknesses. We postulate next steps in GIS integration with forecasting, prediction, and simulation measures to frame implications for local health policies. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
  4. Asngari NJM, Bakar KA, Feroz SR, Razak FA, Halim AAA
    Biophys Chem, 2024 Feb;305:107140.
    PMID: 38118338 DOI: 10.1016/j.bpc.2023.107140
    Odanacatib (ODN) is a selective cathepsin K inhibitor that acts as an anti-resorptive agent to treat osteoporosis. ODN is also found effective in reducing the effect of severe periodontitis. The interaction between ODN and human serum albumin (HSA) was investigated using spectroscopic, microscopic, and in silico approaches to characterize their binding. The fluorescence intensity of HSA increased upon the addition of increasing concentrations of ODN accompanied by blueshift in the fluorescence spectrum, which suggested hydrophobic formation around the microenvironment of the fluorophores upon ODN binding. A moderate binding affinity was obtained for ODN-HSA binding, with binding constant (Ka) values of ∼104 M-1. Circular dichroism results suggested that the overall secondary and tertiary structures of HSA were both only slightly altered upon ODN binding. The surface morphology of HSA was also affected upon ODN binding, showing aggregate formation. Drug displacement and molecular docking results revealed that ODN preferably binds to site III in subdomain IB of HSA, while molecular dynamics simulations indicated formation of a stable protein complex when site III was occupied by ODN. The ODN-HSA complex was mainly stabilized by a combination of hydrogen bonding, hydrophobic interactions, and van der Waals forces. These findings provide additional information to understand the interaction mechanism of ODN in blood circulation and may help in future improvements on the adverse effects of ODN.
  5. Ballouze R, Marahat MH, Mohamad S, Saidin NA, Kasim SR, Ooi JP
    J Biomed Mater Res B Appl Biomater, 2021 Oct;109(10):1426-1435.
    PMID: 33484103 DOI: 10.1002/jbm.b.34802
    Autologous bone grafting remains the gold standard for almost all bone void-filling orthopedic surgery. However, autologous bone grafting has several limitations, thus scientists are trying to identify an ideal synthetic material as an alternative bone graft substitute. Magnesium-doped biphasic calcium phosphate (Mg-BCP) has recently been in the spotlight and is considered to be a potential bone substitute. The Mg-BCP is a mixture of two bioceramics, that is, hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), doped with Mg2+ , and can be synthesized through chemical wet-precipitation, sol-gel, single diffusion gel, and solid state reactions. Regardless of the synthesis routes, it is found that the Mg2+ preferentially accommodates in β-TCP lattice instead of the HA lattice. The addition of Mg2+ to BCP leads to desirable physicochemical properties and is found to enhance the apatite-forming ability as compared to pristine BCP. In vitro results suggest that the Mg-BCP is bioactive and not toxic to cells. Implantation of Mg-BCP in in vivo models further affirmed its biocompatibility and efficacy as a bone substitute. However, like the other bioceramics, the optimum physicochemical properties of the Mg-BCP scaffold have yet to be determined. Further investigations are required regarding Mg-BCP applications in bone tissue engineering.
  6. Hamdan PNF, Hamzaid NA, Hasnan N, Abd Razak NA, Razman R, Usman J
    Sci Rep, 2024 Mar 18;14(1):6451.
    PMID: 38499594 DOI: 10.1038/s41598-024-56955-w
    Literature has shown that simulated power production during conventional functional electrical stimulation (FES) cycling was improved by 14% by releasing the ankle joint from a fixed ankle setup and with the stimulation of the tibialis anterior and triceps surae. This study aims to investigate the effect of releasing the ankle joint on the pedal power production during FES cycling in persons with spinal cord injury (SCI). Seven persons with motor complete SCI participated in this study. All participants performed 1 min of fixed-ankle and 1 min of free-ankle FES cycling with two stimulation modes. In mode 1 participants performed FES-evoked cycling with the stimulation of quadriceps and hamstring muscles only (QH stimulation), while Mode 2 had stimulation of quadriceps, hamstring, tibialis anterior, and triceps surae muscles (QHT stimulation). The order of each trial was randomized in each participant. Free-ankle FES cycling offered greater ankle plantar- and dorsiflexion movement at specific slices of 20° crank angle intervals compared to fixed-ankle. There were significant differences in the mean and peak normalized pedal power outputs (POs) [F(1,500) = 14.03, p 
  7. Hashim H, Azmin S, Razlan H, Yahya NW, Tan HJ, Manaf MR, et al.
    PLoS One, 2014;9(11):e112330.
    PMID: 25411976 DOI: 10.1371/journal.pone.0112330
    BACKGROUND: Previous studies have demonstrated a higher prevalence of Helicobacter pylori (H. pylori) infection in patients with Parkinson's disease (PD) compared to controls. H. pylori infection affects levodopa absorption and its eradication significantly improves clinical response to levodopa. Here, we studied the prevalence of H. pylori infection and its eradication effects among our PD patients.

    METHODS: A prospective study involving idiopathic PD patients on levodopa therapy. 13C-urea breath test (UBT) was used to detect H. pylori. UBT-positive patients were given standard eradication therapy and followed up at 6 and 12 weeks in an open label single arm design. Repeat UBT was performed at 12 weeks. The UPDRS, PD NMQ, PD NMSS and PDQ-39 were administered at baseline and post-eradication (6 and 12 weeks). Levodopa 'onset' time and ON-duration were recorded.

    RESULTS: Of 82 patients recruited, 27 (32.9%) had positive UBT. H. pylori-positive patients had significantly poorer total UPDRS (p = 0.005) and PDQ39 (p<0.0001) scores compared to H. pylori-negative patients. At 12 weeks post-eradication, the mean levodopa onset time shortened by 14 minutes (p = 0.011). The mean ON duration time increased by 56 minutes at week 6 (p = 0.041) and 38 minutes at week 12 (p = 0.035). The total UPDRS scores (p<0.0001), scores for parts II (p = 0.001), III (p<0.0001) and IV (p = 0.009) were significantly better. The total PDQ-39 scores (p = 0.001) and subdomains mobility (p = 0.002), ADL (p = 0.001), emotional well being (p = 0.026) and stigma (p = 0.034) significantly improved. The PD NMSQ did not show significant improvement.

    CONCLUSIONS: H. pylori eradication improved levodopa onset time, ON duration, motor severity and quality of life parameters. Screening and eradication of H. pylori is inexpensive and should be recommended in PD patients, particularly those with erratic response to levodopa.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT02112812.

  8. Mohd Baharudin JA, Mohd Zain MR, Taib F, Abd Hamid IJ
    PMID: 38371722 DOI: 10.51866/oa.202
    INTRODUCTION: Parents are key decision-makers in the immunisation practice and compliance of children. This study aimed to determine the knowledge and practice of immunisation among parents in Kelantan, Malaysia, and their associated factors.

    METHODS: A cross-sectional study was conducted using a validated online questionnaire from May to June 2021. An invitation was distributed to parents attending a university hospital and extended families of staff through online platforms. A total of 311 parents participated in the study. The questionnaire consisted of 10 questions each on knowledge and practice and three questions on vaccination status. Descriptive analysis was performed. The associations between the sociodemographic characteristics and knowledge and practice scores were determined using the chi-square test, and predictive factors were identified using logistic regression analysis.

    RESULTS: Most respondents were Malay (94.2%), Muslim (94.5%), women (79.7%) and married (96.1%). The median score for immunisation knowledge and practice was 8 (interquartile range [IQR]=2) and 7 (IQR=3), respectively. Multiple logistic regression revealed that parents who were unmarried or single, less educated, and had lower incomes were predicted to have poor knowledge of childhood vaccination (P<0.05). Conversely, those living outside Kota Bharu, less educated, and younger parents were predicted to have poor vaccination practice of childhood vaccination (P<0.05). Most respondents (97.8%) indicated completing their children's vaccination schedule.

    CONCLUSION: Parental education and household income are associated with immunisation knowledge and practice. Improving access to information about childhood vaccination among targeted groups may further boost immunization coverage.

  9. Naing NN, Ahmad Z, Musa R, Hamid FR, Ghazali H, Bakar MH
    Tob Induc Dis, 2004 Sep 15;2(3):133-40.
    PMID: 19570279 DOI: 10.1186/1617-9625-2-3-133
    A cross-sectional study was conducted to identify the factors related to smoking habits of adolescents among secondary school boys in Kelantan state, Malaysia. A total of 451 upper secondary male students from day, boarding and vocational schools were investigated using a structured questionnaire. Cluster sampling was applied to achieve the required sample size. The significant findings included: 1) the highest prevalence of smoking was found among schoolboys from the vocational school; 2) mean duration of smoking was 2.5 years; 3) there were significant associations between smoking status and parents' smoking history, academic performance, perception of the health hazards of smoking, and type of school attended. Peer influence was the major reason students gave for taking up the habit. Religion was most often indicated by non-smokers as their reason for not smoking. Approximately 3/5 of the smokers had considered quitting and 45% of them had tried at least once to stop smoking. Mass media was indicated as the best information source for the students to acquire knowledge about negative aspects of the smoking habit. The authors believe an epidemic of tobacco use is imminent if drastic action is not taken, and recommend that anti-smoking campaigns with an emphasis on the religious aspect should start as early as in primary school. Intervention programs to encourage behavior modification of adolescents are also recommended.
  10. Liew YM, Ooi JH, Azman RR, Ganesan D, Zakaria MI, Mohd Khairuddin AS, et al.
    Phys Med, 2024 Jul 11;124:103400.
    PMID: 38996627 DOI: 10.1016/j.ejmp.2024.103400
    BACKGROUND/INTRODUCTION: Traumatic brain injury (TBI) remains a leading cause of disability and mortality, with skull fractures being a frequent and serious consequence. Accurate and rapid diagnosis of these fractures is crucial, yet current manual methods via cranial CT scans are time-consuming and prone to error.

    METHODS: This review paper focuses on the evolution of computer-aided diagnosis (CAD) systems for detecting skull fractures in TBI patients. It critically assesses advancements from feature-based algorithms to modern machine learning and deep learning techniques. We examine current approaches to data acquisition, the use of public datasets, algorithmic strategies, and performance metrics RESULTS: The review highlights the potential of CAD systems to provide quick and reliable diagnostics, particularly outside regular clinical hours and in under-resourced settings. Our discussion encapsulates the challenges inherent in automated skull fracture assessment and suggests directions for future research to enhance diagnostic accuracy and patient care.

    CONCLUSION: With CAD systems, we stand on the cusp of significantly improving TBI management, underscoring the need for continued innovation in this field.

  11. Samiei V, Wan Puteh SE, Abdul Manaf MR, Abdul Latip K, Ismail A
    Malays J Med Sci, 2016 Mar;23(2):44-52.
    PMID: 27547114 MyJurnal
    BACKGROUND: The idea of launching an internet-based self-management program for patients with diabetes led us to do a cross-sectional study to find out about the willingness, interest, equipment, and level of usage of computer and internet in a medium- to low-social class area and to find the feasibility of using e-telemonitoring systems for these patients.

    METHODS: A total of 180 patients with type 2 diabetes participated in this study and fulfilled the self-administered questionnaire in Diabetes Clinic of Primary Medical Center of University Kebangsaan Malaysia Medical Centre; the response rate was 84%. We used the universal sampling method and assessed three groups of factors including sociodemographic, information and communication technology (ICT), willingness and interest, and disease factors.

    RESULTS: Our results showed that 56% of the patients with diabetes were interested to use such programs; majority of the patients were Malay, and patients in the age group of 51-60 years formed the largest group. Majority of these patients studied up to secondary level of education. Age, education, income, and money spent for checkup were significantly associated with the interest of patients with diabetes to the internet-based programs. ICT-related factors such as computer ownership, computer knowledge, access to the internet, frequency of using the internet and reasons of internet usage had a positive effect on patients' interest.

    CONCLUSION: Our results show that among low to intermediate social class of Malaysian patients with type 2 diabetes, more than 50% of them can and wanted to use the internet-based self-management programs. Furthermore, we also show that patients equipped with more ICT-related factors had more interest toward these programs. Therefore, we propose making ICT more affordable and integrating it into the health care system at primary care level and then extending it nationwide.

  12. Yanasegaran K, Ng JYE, Chua EW, Nawi AM, Ng PY, Abdul Manaf MR
    Sci Rep, 2024 Aug 29;14(1):20062.
    PMID: 39209904 DOI: 10.1038/s41598-024-70674-2
    Single nucleotide polymorphisms (SNPs) could increase the susceptibility of individuals to develop obesity and type 2 diabetes (T2DM). Obesity and T2DM are closely related pathophysiologically, thus similar SNPs could mediate both these diseases, but this is rarely reported. Furthermore, limited studies have been performed to summarize SNP data in the Asian population compared to the Western population. In this study, we aimed to summarize SNPs that are associated with the development of obesity and T2DM among Asian populations. We searched six literature databases and Review Manager (RevMan) was used for meta-analysis. The pooled odds ratios (ORs) and 95% CIs were calculated with a random effects model for the heterogeneity among studies. The pooled analysis showed that rs9939609 (FTO gene) and rs17782313 and rs571312 (MC4R gene) are associated with obesity with an odd ratio (OR) of 1.37, 1.36 and 1.29 respectively. For T2DM, five SNPs, rs7903146 and rs12255372 (TCF7L2 gene), rs13266634 and rs11558471 (SLC30A8 gene) and rs2283228 (KCNQ1 gene) have also shown strong associations with T2DM at OR of 1.64, 1.61, 1.22, 1.29 and 1.60 respectively. This data could be used to develop a gene screening panel for assessing obesity and T2DM susceptibility.
  13. Amir SM, Idris IB, Said ZM, Yusoff HM, Manaf MRA
    Iran J Public Health, 2023 Jun;52(6):1108-1120.
    PMID: 37484154 DOI: 10.18502/ijph.v52i6.12952
    BACKGROUND: This study reviewed cervical cancer policies implemented in developing countries that adhered to WHO standards. Despite long being known as a preventable disease, cervical cancer is still one of the leading causes of mortality among women. Nine out of ten cervical cancer deaths occurred in less-developed countries, suggesting that the preventive and control approaches in these countries might differ from those in developed nations.

    METHODS: Cervical cancer policies in six developing countries from each WHO region were selected while related data from the Cervical Cancer Country Profiles 2021 by WHO were retrieved for comparison.

    RESULTS: The cervical cancer policies that were included in this review were from Malaysia, Thailand, Iran, Kenya, Argentina, and Ukraine. According to the latest guidelines on the management of cervical cancers, WHO recommendations have been elaborated on primary, secondary, and tertiary prevention. A comparison of policies among these selected countries showed variation in each level of prevention. The cancer burden in each country was also found to determine the progression of cervical cancer prevention and policy controls in these countries.

    CONCLUSION: This review emphasizes the dissimilarities of cervical cancer policies in six developing countries compared to recommendations by the WHO. Identifying these discrepancies could help policymakers in developing nations to recognize the pressing issues surrounding cervical cancer prevention and establish more effective prevention and control approaches.

  14. Matheen FIA, Leong JF, Abdul Rani R, Hayyun MF, Mohamad Yahaya NH
    Cureus, 2024 Sep;16(9):e68482.
    PMID: 39364451 DOI: 10.7759/cureus.68482
    Extra-articular deformities (EAD) can pose a challenge to surgeons during a total knee arthroplasty (TKA) surgery. Obtaining an acceptable post-operative hip-knee-ankle (HKA) angle may be difficult, especially in a limb with multiplanar deformities of both the femur and the tibia.  Our case is about a 66-year-old gentleman with a long-term deformity of his right lower limb secondary to malunion of the right femoral shaft and tibial shaft fractures. He initially presented with a right floating knee injury, 45 years ago, which was managed with conservative measures. He subsequently presented to us with ipsilateral knee osteoarthritis and underwent a robotic-assisted total knee arthroplasty surgery. Robotic- or computer-assisted total knee arthroplasty is an actively developing area and is gaining popularity among arthroplasty surgeons. In cases with severe extra-articular deformities such as in this case, robotic-assisted surgery can be superior to conventional surgery.
  15. Rizal S, Olaiya FG, Saharudin NI, Abdullah CK, N G O, Mohamad Haafiz MK, et al.
    Polymers (Basel), 2021 Jan 20;13(3).
    PMID: 33498323 DOI: 10.3390/polym13030325
    Textile waste cellulose nanofibrillated fibre has been reported with excellent strength reinforcement ability in other biopolymers. In this research cellulose nanofibrilated fibre (CNF) was isolated from the textile waste cotton fabrics with combined supercritical carbon dioxide and high-pressure homogenisation. The isolated CNF was used to enhance the polylactic acid/chitin (PLA/chitin) properties. The properties enhancement effect of the CNF was studied by characterising the PLA/chitin/CNF biocomposite for improved mechanical, thermal, and morphological properties. The tensile properties, impact strength, dynamic mechanical analysis, thermogravimetry analysis, scanning electron microscopy, and the PLA/chitin/CNF biocomposite wettability were studied. The result showed that the tensile strength, elongation, tensile modulus, and impact strength improved significantly with chitin and CNF compared with the neat PLA. Furthermore, the scanning electron microscopy SEM (Scanning Electron Microscopy) morphological images showed uniform distribution and dispersion of the three polymers in each other, which corroborate the improvement in mechanical properties. The biocomposite's water absorption increased more than the neat PLA, and the contact angle was reduced. The results of the ternary blend compared with PLA/chitin binary blend showed significant enhancement with CNF. This showed that the three polymers' combination resulted in a better material property than the binary blend.
  16. Rizal S, Saharudin NI, Olaiya NG, Khalil HPSA, Haafiz MKM, Ikramullah I, et al.
    Molecules, 2021 Apr 01;26(7).
    PMID: 33916094 DOI: 10.3390/molecules26072008
    The degradation and mechanical properties of potential polymeric materials used for green manufacturing are significant determinants. In this study, cellulose nanofibre was prepared from Schizostachyum brachycladum bamboo and used as reinforcement in the PLA/chitosan matrix using melt extrusion and compression moulding method. The cellulose nanofibre(CNF) was isolated using supercritical carbon dioxide and high-pressure homogenisation. The isolated CNF was characterised with transmission electron microscopy (TEM), FT-IR, zeta potential and particle size analysis. The mechanical, physical, and degradation properties of the resulting biocomposite were studied with moisture content, density, thickness swelling, tensile, flexural, scanning electron microscopy, thermogravimetry, and biodegradability analysis. The TEM, FT-IR, and particle size results showed successful isolation of cellulose nanofibre using this method. The result showed that the physical, mechanical, and degradation properties of PLA/chitosan/CNF biocomposite were significantly enhanced with cellulose nanofibre. The density, thickness swelling, and moisture content increased with the addition of CNF. Also, tensile strength and modulus; flexural strength and modulus increased; while the elongation reduced. The carbon residue from the thermal degradation and the glass transition temperature of the PLA/chitosan/CNF biocomposite was observed to increase with the addition of CNF. The result showed that the biocomposite has potential for green and sustainable industrial application.
  17. Atiqah MSN, Gopakumar DA, F A T O, Pottathara YB, Rizal S, Aprilia NAS, et al.
    Polymers (Basel), 2019 Nov 05;11(11).
    PMID: 31694184 DOI: 10.3390/polym11111813
    The conventional isolation of cellulose nanofibers (CNFs) process involves high energy input which leads to compromising the pulp fiber's physical and chemical properties, in addition to the issue of elemental chlorine-based bleaching, which is associated with serious environmental issues. This study investigates the characteristic functional properties of CNFs extracted via total chlorine-free (TCF) bleached kenaf fiber followed by an eco-friendly supercritical carbon dioxide (SC-CO2) treatment process. The Fourier transmission infra-red FTIR spectra result gave remarkable effective delignification of the kenaf fiber as the treatment progressed. TEM images showed that the extracted CNFs have a diameter in the range of 10-15 nm and length of up to several micrometers, and thereby proved that the supercritical carbon dioxide pretreatment followed by mild acid hydrolysis is an efficient technique to extract CNFs from the plant biomass. XRD analysis revealed that crystallinity of the fiber was enhanced after each treatment and the obtained crystallinity index of the raw fiber, alkali treated fiber, bleached fiber, and cellulose nanofiber were 33.2%, 54.6%, 88.4%, and 92.8% respectively. SEM images showed that amorphous portions like hemicellulose and lignin were removed completely after the alkali and bleaching treatment, respectively. Moreover, we fabricated a series of cellulose nanopapers using the extracted CNFs suspension via a simple vacuum filtration technique. The fabricated cellulose nanopaper exhibited a good tensile strength of 75.7 MPa at 2.45% strain.
  18. Olaiya NG, Nuryawan A, Oke PK, Khalil HPSA, Rizal S, Mogaji PB, et al.
    Polymers (Basel), 2020 Mar 05;12(3).
    PMID: 32151004 DOI: 10.3390/polym12030592
    The current research trend for excellent miscibility in polymer mixing is the use of plasticizers. The use of most plasticizers usually has some negative effects on the mechanical properties of the resulting composite and can sometimes make it toxic, which makes such polymers unsuitable for biomedical applications. This research focuses on the improvement of the miscibility of polymer composites using two-step mixing with a rheomixer and a mix extruder. Polylactic acid (PLA), chitin, and starch were produced after two-step mixing, using a compression molding method with decreasing composition variation (between 8% to 2%) of chitin and increasing starch content. A dynamic mechanical analysis (DMA) was used to study the mechanical behavior of the composite at various temperatures. The tensile strength, yield, elastic modulus, impact, morphology, and compatibility properties were also studied. The DMA results showed a glass transition temperature range of 50 °C to 100 °C for all samples, with a distinct peak value for the loss modulus and factor. The single distinct peak value meant the polymer blend was compatible. The storage and loss modulus increased with an increase in blending, while the loss factor decreased, indicating excellent compatibility and miscibility of the composite components. The mechanical properties of the samples improved compared to neat PLA. Small voids and immiscibility were noticed in the scanning electron microscopy images, and this was corroborated by X-ray diffraction graphs that showed an improvement in the crystalline nature of PLA with starch. Bioabsorption and toxicity tests showed compatibility with the rat system, which is similar to the human system.
  19. Ude CC, Shamsul BS, Ng MH, Chen HC, Ohnmar H, Amaramalar SN, et al.
    Exp Gerontol, 2018 04;104:43-51.
    PMID: 29421350 DOI: 10.1016/j.exger.2018.01.020
    BACKGROUND: Hyaline articular cartilage, which protects the bones of diarthrodial joints from forces associated with load bearing, frictions, and impacts has very limited capacities for self-repair. Over the years, the trend of treatments has shifted to regenerations and researchers have been on the quest for a lasting regeneration. We evaluated the treatment of osteoarthritis by chondrogenically induced ADSCs and BMSCs for a long time functional recovery.

    METHODS: Osteoarthritis was induced at the right knee of sheep by complete resection of ACL and medial meniscus. Stem cells from sheep were induced to chondrogenic lineage. Test sheep received 5 mls single doses of 2 × 107 autologous PKH26-labelled ADSCs or BMSCs, while controls received basal medium. Functional recovery of the knees was evaluated via electromyography.

    RESULTS: Induced ADSCs had 625, 255, 393, 908, 409, 157 and 1062 folds increases of collagen I, collagen II, aggrecan, SOX9, cartilage oligomeric protein, chondroadherin and fibromodullin compare to uninduced cells, while BMSCs had 702, 657, 321, 276, 337, 233 and 1163 respectively; p = .001. Immunocytochemistry was positive for these chondrogenic markers. 12 months post-treatment, controls scored 4 in most regions using ICRS, while the treated had 8; P = .001. Regenerated cartilages were positive to PKH26 and demonstrated the presence of condensing cartilages on haematoxylin and eosin; and Safranin O. OA degenerations caused significant amplitude shift from right to left hind limb. After treatments, controls persisted with significant decreases; while treated samples regained balance.

    CONCLUSIONS: Both ADSCs and BMSCs had increased chondrogenic gene expressions using TGF-β3 and BMP-6. The treated knees had improved cartilage scores; PKH26 can provide elongated tracking, while EMG results revealed improved joint recoveries. These could be suitable therapies for osteoarthritis.

  20. Loh DA, Naqiah Hairi N, Mohd Hairi F, Peramalah D, Kandiben S, Abd Hamid MAI, et al.
    J Aging Phys Act, 2023 Aug 01;31(4):531-540.
    PMID: 36509091 DOI: 10.1123/japa.2022-0047
    This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were divided into the intervention (n = 163) and control (n = 86) groups. The mean (SD) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6 weeks (T1), 3 months postintervention (T2), and 6 months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p = .001), whereas no significant association were found for group (p = .650) and interaction (p = .348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity.
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