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  1. Lee CBTL, Wu TY, Ting CH, Tan JK, Siow LF, Cheng CK, et al.
    Bioresour Technol, 2019 Apr;278:486-489.
    PMID: 30711220 DOI: 10.1016/j.biortech.2018.12.034
    The performances of various anhydrous and aqueous choline chloride-dicarboxylic acid based deep eutectic solvents (DESs) were evaluated for furfural production from oil palm fronds without any additional catalyst. The effects of different carbon chain length dicarboxylic acids and water content in each DES on furfural production were investigated. Oil palm fronds, DES and water (0-5 ml) were mixed and reacted in an oil bath (60-300 min). Reacted oil palm fronds had the potential to be reused as cellulose-rich-valuable by-products. At 100 °C, aqueous choline chloride-oxalic acid (16.4 wt% H2O) produced the highest furfural yield of 26.34% and cellulose composition up to 72.79% in the reacted oil palm fronds. Despite operating at suitable reaction duration for dicarboxylic acid with longer carbon chain length, aqueous choline chloride-malonic acid and aqueous choline chloride-succinic acid performed poorly with furfural yield of less than 1%.
  2. Shahiduzzaman M, Fukaya S, Muslih EY, Wang L, Nakano M, Akhtaruzzaman M, et al.
    Materials (Basel), 2020 May 11;13(9).
    PMID: 32403454 DOI: 10.3390/ma13092207
    Perovskite solar cells (PSCs) have appeared as a promising design for next-generation thin-film photovoltaics because of their cost-efficient fabrication processes and excellent optoelectronic properties. However, PSCs containing a metal oxide compact layer (CL) suffer from poor long-term stability and performance. The quality of the underlying substrate strongly influences the growth of the perovskite layer. In turn, the perovskite film quality directly affects the efficiency and stability of the resultant PSCs. Thus, substrate modification with metal oxide CLs to produce highly efficient and stable PSCs has drawn attention. In this review, metal oxide-based electron transport layers (ETLs) used in PSCs and their systemic modification are reviewed. The roles of ETLs in the design and fabrication of efficient and stable PSCs are also discussed. This review will guide the further development of perovskite films with larger grains, higher crystallinity, and more homogeneous morphology, which correlate to higher stable PSC performance. The challenges and future research directions for PSCs containing compact ETLs are also described with the goal of improving their sustainability to reach new heights of clean energy production.
  3. Hassan MZ, Roslan SA, Sapuan SM, Rasid ZA, Mohd Nor AF, Md Daud MY, et al.
    Polymers (Basel), 2020 Jun 17;12(6).
    PMID: 32560539 DOI: 10.3390/polym12061367
    The objective of this research is to optimize the alkaline treatment variables, including sodium hydroxide (NaOH) concentration, soaking, and drying time, that influence the mechanical behavior of bamboo fiber-reinforced epoxy composites. In this study, a Box-Behnken design (BBD) of the response surface methodology (RSM) was employed to design an experiment to investigate the mercerization effect of bamboo fiber-reinforced epoxy composites. The evaluation of predicted tensile strength as a variable parameter of bamboo fiber (Bambusa vulgaris) reinforced epoxy composite structures was determined using analysis of variance (ANOVA) of the quadratic model. In this study, a total of 17 experiment runs were measured and a significant regression for the coefficient between the variables was obtained. Further, the triangular and square core structures made of treated and untreated bamboo fiber-reinforced epoxy composites were tested under compressive loading. It was found that the optimum mercerization condition lies at 5.81 wt.% of the NaOH, after a soaking time of 3.99 h and a drying time of 72 h. This optimum alkaline treatment once again had a great effect on the structures whereby all the treated composite cores with square and triangular structures impressively outperformed the untreated bamboo structures. The treated triangular core of bamboo reinforced composites gave an outstanding performance compared to the treated and untreated square core composite structures for compressive loading and specific energy absorbing capability.
  4. Yong YK, Wen NCM, Yeo GEC, Chew ZX, Chan LL, Md Zain NZ, et al.
    PMID: 34574752 DOI: 10.3390/ijerph18189828
    Several bacterial species cause post-operative infections, which has been a critical health concern among hospital patients. Our study in this direction is a much-needed exploratory study that was carried out at the National Heart Institute (IJN) of Malaysia to examine the virulence properties of causative bacteria obtained from postoperative patients. The bacterial isolates and data were provided by the IJN. Antibiotic resistance gene patterns, and the ability to form biofilm were investigated for 127 isolates. Klebsiella pneumoniae (36.2%) was the most common isolate collected, which was followed by Pseudomonas aeruginosa (26%), Staphylococcus aureus (23.6%), Streptococcus spp. (8.7%) and Acinetobacter baumannii (5.5%). There were 49 isolates that showed the presence of multidrug resistance genes. The mecA gene was surprisingly found in methicillin-susceptible S. aureus (MSSA), which also carried the ermA gene from those erythromycin-susceptible strains. The phenotypic antibiotic resistance profiles varied greatly between isolates. Findings from the biofilm assay revealed that 44 of the 127 isolates demonstrated the ability to produce biofilms. Our findings provide insights into the possibility of some of these bacteria surviving under antibiotic stress, and some antibiotic resistance genes being silenced.
  5. Abdul Karim AK, Shafiee MN, Abd Aziz NH, Omar MH, Abdul Ghani NA, Lim PS, et al.
    Gynecol Endocrinol, 2019 Jan;35(1):10-16.
    PMID: 30044157 DOI: 10.1080/09513590.2018.1490404
    Endometriosis is a benign, chronic inflammatory condition characterized by the presence and growth of endometrial implants outside the uterine cavity. The cause of endometriosis is multifactorial. It is due to the diversity of hypothesis and plausibility of hormonal alterations which could play a major role. Evidence has shown that progesterone resistance is a key factor for endometriosis sufferers. Medical therapy can avoid surgical intervention, which may lead to a reduced in ovarian reserve, and its effects of earlier menopause and reduced fecundity. Progesterone receptor isoform has provided new insight as the potential treatment. Progestin, anti-progestin and selective progesterone receptor modulators usage, which target these receptors, could avoid hypo-estrogenic side effects, which can be debilitating. Numerous types of these medications have been used on and off labeled to treat endometriosis with varying success. This review aims to consolidate series of clinical trials using progestins in endometriosis.
  6. Abdul Manaf SA, Mohamad Fuzi SFZ, Low KO, Hegde G, Abdul Manas NH, Md Illias R, et al.
    Appl Microbiol Biotechnol, 2021 Nov;105(21-22):8531-8544.
    PMID: 34611725 DOI: 10.1007/s00253-021-11616-0
    Carbon nanomaterials, due to their catalytic activity and high surface area, have potential as cell immobilization supports to increase the production of xylanase. Recombinant Kluyveromyces lactis used for xylanase production was integrated into a polymeric gel network with carbon nanomaterials. Carbon nanomaterials were pretreated before cell immobilization with hydrochloric acid (HCl) treatment and glutaraldehyde (GA) crosslinking, which contributes to cell immobilization performance. Carbon nanotubes (CNTs) and graphene oxide (GO) were further screened using a Plackett-Burman experimental design. Cell loading and agar concentration were the most important factors in xylanase production with low cell leakage. Under optimized conditions, xylanase production was increased by more than 400% compared to free cells. Immobilized cell material containing such high cell densities may exhibit new and unexplored beneficial properties because the cells comprise a large fraction of the component. The use of carbon nanomaterials as a cell immobilization support along with the entrapment method successfully enhances the production of xylanase, providing a new route to improved bioprocessing, particularly for the production of enzymes. KEY POINTS: • Carbon nanomaterials (CNTs, GO) have potential as cell immobilization supports. • Entrapment in a polymeric gel network provides space for xylanase production. • Plackett-Burman design screen for the most important factor for cell immobilization.
  7. Lee SY, Ma J, Khoo TS, Abdullah N, Nik Md Noordin Kahar NNF, Abdul Hamid ZA, et al.
    Front Bioeng Biotechnol, 2021;9:735090.
    PMID: 34733829 DOI: 10.3389/fbioe.2021.735090
    Stem cell-based therapy appears as a promising strategy to induce regeneration of damaged and diseased tissues. However, low survival, poor engraftment and a lack of site-specificity are major drawbacks. Polysaccharide hydrogels can address these issues and offer several advantages as cell delivery vehicles. They have become very popular due to their unique properties such as high-water content, biocompatibility, biodegradability and flexibility. Polysaccharide polymers can be physically or chemically crosslinked to construct biomimetic hydrogels. Their resemblance to living tissues mimics the native three-dimensional extracellular matrix and supports stem cell survival, proliferation and differentiation. Given the intricate nature of communication between hydrogels and stem cells, understanding their interaction is crucial. Cells are incorporated with polysaccharide hydrogels using various microencapsulation techniques, allowing generation of more relevant models and further enhancement of stem cell therapies. This paper provides a comprehensive review of human stem cells and polysaccharide hydrogels most used in regenerative medicine. The recent and advanced stem cell microencapsulation techniques, which include extrusion, emulsion, lithography, microfluidics, superhydrophobic surfaces and bioprinting, are described. This review also discusses current progress in clinical translation of stem-cell encapsulated polysaccharide hydrogels for cell delivery and disease modeling (drug testing and discovery) with focuses on musculoskeletal, nervous, cardiac and cancerous tissues.
  8. Yeap SS, Thambiah SC, Suppiah S, Md-Said S, Appannah G, Samsudin IN, et al.
    PLoS One, 2021;16(7):e0255069.
    PMID: 34293028 DOI: 10.1371/journal.pone.0255069
    OBJECTIVE: This study aimed to determine the prevalence of vertebral fractures (VF) in a selected urban population in Malaysia and to explore possible variables associated with VF in the study population.

    METHODS: A cross-sectional study involving community-living, healthy subjects aged between 45-90 years from the state of Selangor, Malaysia, were invited to attend a bone health check-up. Subjects with diseases known to affect bone metabolism or were on treatment for osteoporosis (OP) were excluded. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA). Lateral and antero-posterior view lumbar spine x-rays were performed and VF was determined by the semi-quantitative Genant method.

    RESULTS: A total of 386 subjects were studied. Asymptomatic morphometric VF were found in 44 (11.4%) subjects. T12 was the most common vertebrae to be fractured. The prevalence of VF was significantly higher in menopausal women (12.4%) compared to non-menopausal women, in those above the age of 60 (18.5%), in those of Chinese ethnicity (16.5%), in those with a low body fat percentage (17.1%) and among those with OP (27.0%). The mean (standard deviation) 25-hydroxyvitamin D [25(OH)D] levels were significantly higher in those with VF compared to those without VF, 67.64 (23.50) and 57.47 (21.71) nmol/L, respectively. However, after multiple regression analysis, age over 60 years and OP on DXA BMD measurement were the only significant associated factors for VF.

    CONCLUSION: Overall, 11.4% of a selected Malaysian urban population had asymptomatic morphometric VF. Age over 60 years and OP on DXA BMD measurement, but not 25(OH)D levels, were associated with VF.

  9. Nadhirah Md Rahim SA, Lee CS, Abnisa F, Ashri Wan Daud WM, Aroua MK, Cognet P, et al.
    Chemosphere, 2022 Feb 11.
    PMID: 35157890 DOI: 10.1016/j.chemosphere.2022.133949
    Redox mediators supply an effective way to promote electrons (and protons) transport between the electrode and substrate without being in direct physical contact with the electrode. Here, the carbon-based electrodes with Amberlyst-15 as the redox mediator were used in the electrocatalytic reduction to investigate their ability to indirectly convert glycerol into 1,2-propanediol. The process aims to study the influence of different activated carbon compositions (60%, 70%, 80%, and 90% of total weight) in the activated carbon composite (ACC) electrodes on the electrochemical properties, reaction mechanisms, and selectivity of the yielded products. Their electrochemical behavior and physicochemical properties were determined by cyclic voltammetry (CV) and chronoamperometry (CA), followed by FESEM-EDX for the selected ACC electrode. Electroactive surface area (EASA) plays a role in glycerol mass transport and electrons transfer. EASA of 60ACC, 70ACC, 80ACC, and 90ACC (geometrical surface area of 0.50 cm2) were 19.62, 24.50, 36.74 and 30.83 cm2, respectively. With the highest EASA, 80ACC enhanced the mass transport and electrons transfer process that eventually improved its electrocatalytic activity. It outperformed other ACC electrodes by generating Amberlyst-15 radicals (A-15•-) with high current density at low potential (-0.5 V vs. Ag/AgCl). A-15•- served as the electron-donor for the homogeneous redox reaction with glycerol in delivering highly reactive glycerol radical for further intermediates development and generated 1,2-propanediol at -2.5 V vs. Ag/AgCl (current density of -0.2018 A cm-2). High activated carbon content portrayed a dominant role in controlling EASA and favored consecutive acetol-1,2-propanediol production through the C-O bond breakage. From the galvanostatic electrolysis, 1,2-propanediol selectivity was higher on 80ACC (88.6%) compared to 60ACC (61.4%), 70ACC (70.4%) and 90ACC (72.5%). Diethylene glycol formation was found to be the side reaction but preferred low activated carbon percentage in 60ACC and 70ACC.
  10. Imran Firdaus Kamardan M, Atikah Binti Marsid E, Nadia Md Akhir F, Ali Muhammad Yuzir M, Othman N, Hara H
    J Gen Appl Microbiol, 2022 Nov 10;68(3):117-124.
    PMID: 35400678 DOI: 10.2323/jgam.2021.09.004
    Tropical peatlands account for one of the largest carbon stores in the form of organic matter due to the accumulation of plant litter and waterlogged conditions. Recent anthropogenic disturbances, such as forest fires, agricultural conversion and drainage, in tropical peatlands have caused a vast amount of carbon to be released into the atmosphere, and microbial activities are impacted by these changes. A recent study showed that many phenol- and lignin-degrading bacteria prefer alkaline and neutral pH conditions, while tropical peatland conditions are acidic, possibly changing the mechanisms of the utilization of organic matter from peat soil. The purpose of this study was to isolate and characterize phenolic compound-degrading bacteria from tropical peatlands under acidic conditions due to the lack of information on how the biological processes of microorganisms occur in this unique habitat. Two isolates show the capability to utilize phenolic aldehydes based on building blocks of lignin that are abundant in tropical peatlands, including hydroxyphenyl, guaiacyl and syringyl units. The identification of these isolates by 16S rRNA gene sequence shows that strain S38 is similar to Stenotrophomonas sp., while strain S46 is similar to Burkholderia sp. Further characterization of these isolates shows their ability to degrade 4-hydroxybenzaldehyde and vanillin into phenolic acids within 24 hours of incubation and syringaldehyde within 7 days of incubation. In conclusion, these isolated bacteria show the ability to withstand the acidic environment of tropical peatlands and utilize lignin monomers through unknown metabolic pathways.
  11. Gan Z, Roslan MAM, Abd Shukor MY, Halim M, Yasid NA, Abdullah J, et al.
    Biosensors (Basel), 2022 Oct 25;12(11).
    PMID: 36354431 DOI: 10.3390/bios12110922
    Aptamers are a group of synthetic single-stranded nucleic acids. They are generated from a random library of single-stranded DNA or RNA by a technology named systematic evolution of ligands by exponential enrichment (SELEX). SELEX is a repetitive process to select and identify suitable aptamers that show high affinity and specificity towards target cells. Great strides have been achieved in the design, construction, and use of aptamers up to this point. However, only a small number of aptamer-based applications have achieved widespread commercial and clinical acceptance. Additionally, finding more effective ways to acquire aptamers with high affinity remains a challenge. Therefore, it is crucial to thoroughly examine the existing dearth and advancement in aptamer-related technologies. This review focuses on aptamers that are generated by SELEX to detect pathogenic microorganisms and mammalian cells, as well as in cell-internalizing SELEX for diagnostic and therapeutic purposes. The development of novel aptamer-based biosensors using optical and electrical methods for microbial detection is reported. The applications and limitations of aptamers are also discussed.
  12. Saminathan M, Wan Mohamed WN, Md Noh ', Ibrahim NA, Fuat MA, Kumari Ramiah S, et al.
    PMID: 34907603 DOI: 10.1111/jpn.13670
    Ammoniation of oil palm frond (OPF) with non-protein nitrogen (N) sources has been shown to improve the nutritional value and digestibility of OPF in ruminants. This study evaluated the effect of treating OPF without (control) or with different urea levels (1%-5%) on chemical composition and in vitro gas production, digestibility and fermentation properties using goat rumen fluids. The results showed that the treated OPF with urea (1%-5%) had significantly lower (p 
  13. Ahmad AM, Al-Marzouqi A, Dias JM, Saifan AR, Md Kassim N, Mohamad MN, et al.
    Nurs Forum, 2022 Jan;57(1):211-214.
    PMID: 34478171 DOI: 10.1111/nuf.12647
    Aligned with international standards, the UAE Government and many other developing countries in the region (GCC and MENA) have started to implement strict quality improvement initiatives to develop their healthcare systems. Most of these initiatives are geared toward meeting patient satisfaction and avoiding circumstances or events that would dissatisfy patients. It is also used to measure healthcare institution performance, assess efficiency and determine their funding and reimbursement. With this emphasis on quality, it is also important for healthcare organizations to fulfill their other functions. Among the most important is performing their teaching role to prepare future healthcare professionals, and attracting and retaining healthcare professionals. These roles are also a paramount for a quality, sustained healthcare system. However, clinical educators and managers reflect on how these roles seem to be frequently missed or at least compromised while applying the quality assurance measures in the region developing countries. This reflective paper discusses this concern and suggests possible strategies that may help overcome this challenge and thus contributing to the achievement of the quality goal of the service in a more comprehensive and sustainable manner. The similarities between the UAE healthcare system and neighboring Gulf Cooperation Council and the Middle East/North African countries mean these challenges and solutions may resonate with these countries and support the implementation of effective health services in these countries as well.
  14. Yahya MN, Goh BS, Mohammad Nasseri FZ, Kamal Nor NA, Wan Md Zin WN, Abdul Latif H
    Acta Otolaryngol, 2022 Feb 02.
    PMID: 35107400 DOI: 10.1080/00016489.2022.2028007
    BACKGROUND: Down syndrome (DS) is the most common human chromosomal genetic disorder; caused by extra copy of chromosome 21-one out of 792 babies globally and one in 950 in Malaysia.

    OBJECTIVES: To obtain spectrum of upper airway pathology in DS children-prevalence, causes and management practices.

    MATERIALS AND METHODS: A cross-sectional study of children with DS aged less than 18 years old with signs of UAO was conducted. Diagnosis of UAO, management and final outcome was observed and documented.

    RESULTS: Ninety-one patients were recruited. 20 cases (22%) had significant noisy breathing which indicates the prevalence of upper airway pathology (p=.025). Laryngomalacia (34.5%) was the most common pathology, followed by paediatric SDB (24.1%), tracheal bronchus (17.2%), tracheal stenosis (6.9%), and tracheomalacia (6.9%). Seven cases (7.7%) presented with respiratory distress. 12 cases were managed conservatively, while eight cases required further investigations under general anaesthesia (GA) with/without surgical intervention. Six cases showed symptoms resolution within a week post-surgical intervention, and another case resolved after 30 days and one case resolved after 8 months of post-surgical intervention.

    CONCLUSION AND SIGNIFICANCE: Early detection and high index of suspicion is required to diagnose and treat these anomalies timely.

  15. Amiruddin A, Massi MN, Islam AA, Patellongi I, Pratama MY, Sutandyo N, et al.
    Ann Med Surg (Lond), 2022 Jan;73:103092.
    PMID: 35079352 DOI: 10.1016/j.amsu.2021.103092
    Background: Around 70% of breast cancers (BCs) are estrogen receptor-α (ERα)-positive. Adjuvant endocrine therapy is used to reduce estrogen levels and inhibit signal transduction through the ER. The anti-estrogen drugs that are most commonly used in endocrine therapy belong to the selective ER modulator (SERM) class and include tamoxifen. Although it has been used for three decades in cases of early-stage and ERα-positive BC, resistance to tamoxifen is a common problem. microRNAs (miRNAs) have a potential role in demonstrating BC resistance to tamoxifen therapy. Hence, there is a need to investigate the expression of miRNA-221 (miR-221) in luminal-subtype BC patients receiving tamoxifen therapy.

    Methods: This case-control study investigated luminal-subtype BC patients who had undergone endocrine therapy for at least 1 year. The case group comprised patients with local or metastatic recurrence, and the control group comprised patients without local or metastatic recurrence.

    Results: There was a significant difference in miR-221 expression (p = 0.005) between the case and control groups. There were no significant differences between the groups that were positive and negative for the progesterone receptor (PR) (p = 0.25), had high and low marker of proliferation Ki-67 levels (p = 0.60), were positive and negative for lymphovascular invasion (p = 0.14), and had stage 2 and stage 3 cancer (p = 0.25).

    Conclusion: miR-221 expression was higher in tamoxifen-resistant BC cases. miR-221 is a potential biomarker of tamoxifen resistance.

  16. Shahiduzzaman M, Chen B, Akhtaruzzaman M, Wang L, Fukuhara H, Tomita K, et al.
    ACS Appl Mater Interfaces, 2021 Nov 17;13(45):53758-53766.
    PMID: 34735118 DOI: 10.1021/acsami.1c13793
    In this study, the spontaneous microstructure tuning of TiO2 was observed by aging the ethanol/water TiO2 paste for up to 20 days at ambient conditions. A dynamic light scattering study reveals that it formed the outstanding reproducible TiO2 microstructure with a ∼200 nm average particle size and stabilizes in 6 to 20 days under an ambient atmosphere. Interestingly, the as-deposited day 15 sample spontaneously changed its crystallinity upon keeping the paste at ambient conditions; meanwhile the day 0 sample showed an amorphous structure. A dense, uniform, and stable TiO2 electrode was cast on a fluorine doped-tin oxide substrate using the electrospray technique. We exploit the spontaneous evolution of the TiO2 nanopowder to revisit the fabrication procedure of the TiO2 photoelectrode for dye-sensitized solar cells (DSSCs). The controlled microstructure TiO2 film was used in DSSCs, which, to the best of our knowledge, achieved the highest power conversion efficiency of 9.65% using N719 dye in sensitizing the TiO2 photoanode.
  17. Selvanathan V, Aminuzzaman M, Tey LH, Razali SA, Althubeiti K, Alkhammash HI, et al.
    Materials (Basel), 2021 Oct 25;14(21).
    PMID: 34771914 DOI: 10.3390/ma14216379
    In this study, phytochemical assisted nanoparticle synthesis was performed using Muntingia calabura leaf extracts to produce copper oxide nanoparticles (CuO NPs) with interesting morphology. Scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis of the biosynthesized CuO NPs reveal formation of distinct, homogeneous, and uniform sized CuO nanorods structure with thickness and length of around 23 nm and 79 nm, respectively. Based on Fourier-transform infrared (FTIR) analysis, the unique combinations of secondary metabolites such as flavonoid and polyphenols in the plant extract are deduced to be effective capping agents to produce nanoparticles with unique morphologies similar to conventional chemical synthesis. X-ray diffraction (XRD) analysis verified the monoclinical, crystalline structure of the CuO NPs. The phase purity and chemical identity of the product was consolidated via X-Ray photoelectron spectroscopy (XPS) and Raman spectroscopic data which indicate the formation of a single phase CuO without the presence of other impurities. The direct and indirect optical band gap energies of the CuO nanorods were recorded to be 3.65 eV and 1.42 eV.
  18. Seow WL, Md Ariffin UK, Lim SY, Mohamed NA, Lee KW, Devaraj NK, et al.
    Foods, 2022 Jan 03;11(1).
    PMID: 35010241 DOI: 10.3390/foods11010115
    Food safety is an important indicator of public health, as foodborne illnesses continue to cause productivity and economic loss. In recent years, web-based applications have been extensively used by the online users' population. Almost one third (28.3%) of online users found web-based application to be a notable source of food safety information. The objective of the current review is to determine the effectiveness of a web-based application systems as a health promotion tool for consumers to increase their knowledge and awareness of food safety. A systematic literature review was conducted by analyzing 11 selected web-based food safety education-related articles. The studies were categorized into several themes: (1) web-based applications used in accessing food safety information; (2) food safety evaluation and perception among consumers; (3) beliefs and level of knowledge, attitude and practices (KAP) of consumers; and (4) impact and contribution of social media use. A diverse number of online applications have been utilized to promote food safety education among consumers, yet these web-based applications need to be improved with regards to social connection and integration among consumers. KAP surveys were conducted on the majority of the respondents with a particular focus on their knowledge level. Findings show that web-based applications may act as an alternative to the traditional media in enhancing food safety education among consumers, especially youths who are tech-savvy.
  19. Goh ET, Jalalonmuhali M, Ng KP, Wan Md Adnan AH, Hing Wong A, Cheng SF, et al.
    Transplant Proc, 2022 Feb 04.
    PMID: 35131101 DOI: 10.1016/j.transproceed.2021.12.039
    Living-kidney transplantation increases with years, however, the rate is comparatively low to support local needs. Marginal living donors like the elderly were used to increase the donor pool. We retrospectively evaluate the outcome of 25 elderly living kidney donors (eLKDs) who were ≥60 years old at the time of donation in our center. Their medical history and laboratory results were analyzed retrospectively from e-medical records. There are 16 females (64.0%) with a median age of 63 (60.5-66.0). The mean follow-up duration was 4.36 ± 2.46 years. Their mean body mass index increased from 23.70 ± 3.07 kg/m2 to 24.21 ± 2.93 kg/m2 (t[14] = -2.176, P = .047) post donation. Systolic blood pressure (SBP) increased from 133.33 ± 11.65 mm Hg to 140.56 ± 17.78 mm Hg (t[17] = -2.124, P = .049). However, the prevalence of overweight and hypertension were not significant. Only 5.56% of the eLKDs developed proteinuria post nephrectomy (P =1.000). Serum creatinine increased from 62.33 ± 14.39 mmol/L to 104.63 ± 28.53 mmol/L post 1-month donation (t[23] = -9.720, P = .000) and decreased to 99.67 ± 22.39 mmol/L post 1-year donation (t[17] = -8.415, P = .006), and latest results were 94.28 ± 20.74mmol/L (t[17] = -6.630, P = .033). Fasting blood glucose and HbA1c level recorded no significant changes post donation. We noted that 47.62% of the eLKDs had dyslipidemia pre donation, which increased to 76.20% post donation (P = .031). eLKDs with hyperuricemia increased significantly from 5.88% to 52.94%; with uric acid level from 306.12 ± 68.67 umol/L to 412.24 ± 74.14 umol/L (t[16] = -7.726, P = .000). None of the eLKDs were diagnosed with metabolic syndrome pre and post kidney donation. Postdonation kidney function of the eLKDs compensated well and were stable in the short term. We noted statistically significant increments of weight, body mass index, SBP, uric acid, and lipid levels, which did not translate to clinical significance post donation. Elderly living-kidney donation can be done safely with close monitoring post donation.
  20. Teoh SL, Chong HY, Abdul Aziz S, Chemi N, Othman AR, Md Zaki N, et al.
    Neuropsychiatr Dis Treat, 2017;13:1979-1987.
    PMID: 28814869 DOI: 10.2147/NDT.S137140
    INTRODUCTION: Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.

    METHODS: A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.

    RESULTS: The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M.

    CONCLUSION: This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

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