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  1. Adnan MSB, Hart A, Hertelendy AJ, Tin D, Abelanes SM, Issa F, et al.
    Prehosp Disaster Med, 2022 Dec;37(6):836-842.
    PMID: 36373499 DOI: 10.1017/S1049023X22002187
    INTRODUCTION: Despite the increasing risks and complexity of disasters, education for Malaysian health care providers in this domain is limited. This study aims to assess scholarly publications by Malaysian scholars on Disaster Medicine (DM)-related topics.

    METHODOLOGY: An electronic search of five selected journals from 1991 through 2021 utilizing multiple keywords relevant to DM was conducted for review and analysis.

    RESULTS: A total of 154 articles were included for analysis. The mean number of publications per year from 1991 through 2021 was 5.1 publications. Short reports were the most common research type (53.2%), followed by original research (32.4%) and case reports (12.3%). Mean citations among the included articles were 12.4 citations. Most author collaborations were within the same agency or institution, and there was no correlation between the type of collaboration and the number of citations (P = .942). While a few clusters of scholars could build a strong network across institutions, most research currently conducted in DM was within small, isolated clusters.

    CONCLUSION: Disaster Medicine in Malaysia is a growing medical subspecialty with a significant recent surge in research activity, likely due to the SARS-CoV-2/coronavirus disease 2019 (COVID-19) global pandemic. Since most publications in DM have been on infectious diseases, the need to expand DM-related research on other topics is essential.

  2. W Adnan WF, Nik Mahmood NMZ, Ismail MP, Mohamad Zon E, Othman MS, Kamaludin Z
    Cancer Treat Res Commun, 2022;33:100660.
    PMID: 36455511 DOI: 10.1016/j.ctarc.2022.100660
    BACKGROUND: Endometrial cancer in young women (less than 40-year-old) is associated with anovulatory menses, polycystic ovarian syndrome (PCOS) and subfertility. Endometrial cancer occurring in a miscarriage is rare. We highlight a case of endometrial cancer occurring during miscarriage of a non-viable pregnancy, its management and the outcome.

    CASE: A 32-year-old woman, Gravida 1 Para 0, was referred to our center at 7 weeks gestation in 2018 for uncontrolled diabetes mellitus diagnosed during investigation for subfertility. Her poor compliance with the treatment is consistent with an HbA1c of 8%. During the assessment, she was already complaining of lower abdominal pain. Ultrasound showed irregular IUGS with no fetal echo. She had a miscarriage soon; however, due to ultrasound evidence of thickened and irregular endometrium (17 mm) with mixed echogenicity, dilatation and curettage (D + C) were commenced. The first and second tissues were reported as the product of conception (POC) and well differentiated endometrioid adenocarcinoma, respectively. The first hysteroscopy showed foci area of polypoidal growth at the right posterior endometrium, obscuring the right ostium, with similar histology report. She was commenced on high-dose progestogen with hysteroscopy surveillance 6 months later, which showed disease regression. After two normal hysteroscopies and endometrial biopsies with continuous progestogen therapy for 12 months, cyclical progestogen for 12 months and follow-up for another 6 months, she had spontaneous conception and is currently pregnant at 16 weeks gestation.

    CONCLUSION: Endometrial cancer should be suspected in high-risk patients with first-trimester miscarriage. Individualized treatment with high dose progestogen and follow-up with the proper patient and partner counselling and education has high successful regressionand later on, pregnancy rate.

  3. Ahmad ARD, Imam SS, Adnan R, Oh WD, Abdul Latip AF, Ahmad AAD
    Int J Biol Macromol, 2023 Feb 28;229:838-848.
    PMID: 36586654 DOI: 10.1016/j.ijbiomac.2022.12.287
    The primary aim of this study is to develop an economical, stable, and effective heterogeneous catalyst for wastewater remediation via the Fenton oxidation process. For this purpose, Fe3O4-montmorillonite alginate (FeMA) composite beads were synthesized by entrapping Fe3O4-montmorillonite in calcium alginate beads. The performance of the catalysts was evaluated via the Fenton degradation of ofloxacin (OFL), an antibiotic that is frequently detected in water bodies. The physiochemical properties of the FeMA composite beads were characterized using X-ray photoelectron spectroscopy (XPS), field emission scanning electron microscope/energy dispersive X-ray (FESEM/EDX), Brunauer-Emmett-Teller (BET) analysis, Fourier transform infrared (FTIR) spectroscopy, and thermogravimetric analysis (TGA). FeMA composite beads were found to have a higher surface area, higher porosity, and better thermal stability compared to pristine alginate beads. The composite beads were subsequently used for Fenton degradation of ofloxacin (OFL) in an aqueous solution. The effects of Fe3O4-montmorillonite loading on alginate, FeMA composite beads dosage, initial solution pH, initial OFL concentration, different oxidants, H2O2 dosage, reaction temperature, and inorganic salts on Fenton degradation of OFL in aqueous solution was investigated. The results revealed that the percentage of OFL degradation reached about 80 % under optimized conditions, while the total organic carbon (TOC) removal reached about 53 %. The entrapment of Fe3O4-montmorillonite in alginate beads results in less iron ions leaching compared to previous observation, and the efficiency remains constant over the five cycles investigated. The kinetics of the Fenton degradation process are best fitted to the pseudo-first-order kinetic model. It is therefore believed that FeMA composite beads can be a promising material for wastewater remediation via the Fenton oxidation process.
  4. Ismail R, Ibrahim A, Mohamed HMSH, Mahmood MR, Adnan A
    Data Brief, 2023 Feb;46:108872.
    PMID: 36691557 DOI: 10.1016/j.dib.2022.108872
    Base isolation is a technique installed to absorb any movement or vibration on the structures. The incorporation of nanocomposites into elastomer as the interesting materials especially for the active stiffness and vibration control of structural systems. A base isolator is made up of alternate layers of steel and rubber. The performance of magnetic rubber device is dependent on mechanical and magnetic properties of composite rubber materials. A vibrating sample magnetometer (VSM) is an instrument to detect the magnetic properties. The article provides information on the magnetic properties corresponding to different carbon nanotubes loadings of 0%, 1%, 3% and 5% and different loading of microcarbonyl iron (MCI) i.e. 0% (B0), 10% (B10), 20% (B20) and 30% (B30) in natural rubber compound. The magnetic properties dataset described the data from compression test.
  5. Sharmin Moutushi S, Akter T, Haq MA, Ahmad R, Sinha S, Adnan N, et al.
    Cureus, 2023 Feb;15(2):e35352.
    PMID: 36860825 DOI: 10.7759/cureus.35352
    Introduction Infection with SARS-CoV-2 begins in the lower respiratory tract, but COVID-19 often involves the renal system, resulting in serum electrolyte imbalance. Monitoring serum electrolyte levels and parameters of liver and kidney function is essential to understand disease prognosis. Objectives This study aimed to determine the effect of imbalances in serum electrolytes and other parameters on COVID-19 severity. Material and method This retrospective study comprised 241 patients, ages 14 years and older, including 186 patients who were moderately affected and 55 who were categorized as severely affected by COVID-19. Serum electrolytes (sodium (Na+), potassium (K+), and chloride (Cl-)) and biomarkers of kidney and liver function (creatinine and alanine aminotransferase (ALT)) were measured and correlated with disease severity. This research was conducted among admitted patients of Holy Family Red Crescent Medical College Hospital designated into two groups based on retrospective hospital records. Individuals with moderate illness had evidence of lower respiratory tract infection (cough, cold, breathless, etc.) during clinical assessment or imaging (chest X-ray and computed tomography (CT) scan of the lungs) and have an oxygen saturation by pulse oximetry (SpO2) ≥ 94% on room air at sea level. The severely ill group involved individuals with SpO2 ≤94% on room air at sea level and respiratory rate ≥ 30 breaths/minute, and critically ill patients are those who needed mechanical ventilation or required intensive care unit (ICU) care. This categorization was based on the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines (https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/). Results Average Na+ and creatinine increased by 2.30 parts (95% confidence interval (CI) = 0.20, 4.81, P = 0.041) and 0.35 units (95% CI = 0.03, 0.68, P = 0.043) in severe cases compared with moderate cases. Older participants had relatively Na+ lowered to -0.06 parts (95% CI = -0.12, -0.001, P = 0.045), significant Cl- reduction by 0.09 units (95% CI = -0.14, -0.04, P = 0.001), and ALT by 0.47 units (95% CI = -0.88, -0.06, P = 0.024), whereas serum creatinine was increased by 0.01 parts (95% CI = 0.001, 0.02, P = 0.024). The creatinine and ALT of COVID-19 participants were significantly higher in males by 0.34 units and 23.2 units, respectively, compared with females. In severe COVID-19 cases compared with moderate cases, the risks of hypernatremia, elevated chloride levels, and elevated serum creatinine levels were increased by 2.83-fold (95% CI = 1.26, 6.36, P = 0.012), 5.37-fold (95% CI = 1.90, 15.3, P = 0.002), and 2.00-fold (95% CI = 1.08, 4.31, P = 0.039), respectively. Conclusion Serum electrolyte and biomarker levels can serve as good indicators of the condition and disease prognosis of patients with COVID-19. Our purpose in this study was to determine the association between serum electrolyte imbalance and disease severity. We collected data from ex post facto hospital records and did not intend to assess the mortality rate. Consequently, this study expects that the prompt diagnosis of electrolyte disparity or disturbance possibly minimizes COVID-19-related morbidity and mortality.
  6. Bin Adnan MAA, Bin Kassim MSA, Bt Sahril N, Bin Abd Razak MA
    PMID: 36612905 DOI: 10.3390/ijerph20010586
    The COVID-19 pandemic has created anxiety among hospitalized SARS-CoV-2 patients. Therefore, this study aimed to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. Method: A cross-sectional study was conducted using a web-based online survey involving 401 patients from Malaysia’s leading COVID-19 hospitals from 15th April until 30th June 2020, who were chosen using quota sampling. The General Anxiety Disorders 7 items (GAD-7) scale, the Coping Orientation to Problems Experienced Inventory (Brief-COPE) and a socio-demographic profile questionnaire were used. Descriptive analysis and multiple logistic regression were performed using SPSS v23 to determine the prevalence of anxiety and its associated factors. Result: The results showed that the prevalence of anxiety was 7.0%. Multiple logistic regression analysis revealed that female gender (p < 0.05), a fear of infection (p < 0.05), a lack of information (p < 0.05), a maladaptive coping mechanism of behavioral disengagement (p < 0.001) and self-blame (p < 0.001) were significantly associated with anxiety. Meanwhile, adaptive coping mechanisms via instrumental support (p < 0.001) were a significant protective predictor of anxiety. Conclusions: COVID-19 infection has had a significant influence on the mental health of patients. Findings in our study provide baseline data on the prevalence of anxiety among stabilized COVID-19 inpatients in Malaysia. Despite the relatively low prevalence, the data have the potential to improve the present mental health monitoring system and the deployment of suitable treatments in dealing with similar circumstances.
  7. Abu Bakar SA, Syed Mohamed Shahruddin SNS, Ismail N, Wan Md Adnan WAH
    PeerJ, 2022;10:e13694.
    PMID: 35935256 DOI: 10.7717/peerj.13694
    The estimation of biological age (BA) is an important asymptomatic measure that can be used to understand the physical changes and the aging process of a living being. Factors that contribute towards profiling the human biological age can be diverse. Therefore, this study focuses on developing a BA model for patients with Chronic Kidney Disease (CKD). The procedure commences with the selection of significant biomarkers using a correlation test. Appropriate weighting is then assigned to each selected biomarker using the indexing method to produce a BA index. The BA index is matched to the age variation within the sample to acquire additional terms for the chronological age leading ultimately to the estimated BA. From a sample of 190 patients (133 trained data and 57 testing data) obtained from the University of Malaya Medical Centre (UMMC), Malaysia, the intensity of the BA is found to be between three to nine years from the chronological age. Visual observations further validate the high similarities between the training and testing data sets.
  8. Adnan O, Abidin ZZ, Idris A, Kamarudin S, Al-Qubaisi MS
    Environ Sci Pollut Res Int, 2017 Aug;24(24):20104-20112.
    PMID: 28702910 DOI: 10.1007/s11356-017-9560-x
    A new commercial cationic polyelectrolyte chitosan (CM), obtained from the waste of mushroom production, was examined using models of water and wastewater namely kaolin and palm oil mill effluent (pome). As it is biocompatible, widely available, and economically feasible, chitosan mushroom has high potential to be a suitable replacement for alum. Also, it can be a promising alternative to chitosan obtained traditionally from Crustaceans due to its higher zeta potential and homogeneity based on the raw material required for its production. A wide range of coagulant dose (5-60 mg l(-1)) and wastewater pH (2-12) were taken into account to find the optimal conditions of coagulation. The optimal doses are 10 and 20 mg l(-1) at best pH (11 and 3) when treated with kaolin and palm oil mill effluent, respectively, while 1200 mg l(-1) of alum was not enough to reach the efficiency of chitosan mushroom. On the other hand, the optimum dose of chitosan mushroom (20 mg l(-1)) at pH 3 of pome produced (75, 73, and 98%) removal of chemical oxygen demand (COD), biological oxygen demand (BOD), and total suspended solids (TSS), respectively. The significant potential of chitosan mushroom was proved by zeta potential measurement. Indeed, it possesses the highest zeta potential (+70 mV) as compared to the traditional chitosan produced from crustaceans. In short, chitosan mushroom as a biocoagulant is eco-friendly and it enhances water quality that meets the requirements of environmental conservatives.
  9. Leong KY, Adnan R, Lim PE, Ng SL, Seng CE
    Environ Sci Pollut Res Int, 2017 Sep;24(26):20959-20971.
    PMID: 28726220 DOI: 10.1007/s11356-017-9636-7
    The effects of dry biomass density in cryogel beads, shaking speed and initial concentration ratio of phenol to 4-chlorophenol (4-CP) on the bioregeneration efficiencies of binary phenol and 4-CP-loaded granular activated carbon (GAC) for phenol and 4-CP, respectively, were investigated under the simultaneous adsorption and biodegradation approach. The results revealed higher bioregeneration efficiencies of binary-loaded GAC for phenol and 4-CP at higher dry biomass density but moderate shaking speed. The optimum dry biomass density in cryogel beads and shaking speed for use in bioregeneration were found to be 0.01 g/mL and 250 rpm, respectively. With respect to the initial phenol to 4-CP concentration ratio, the bioregeneration efficiencies were lower under increasing phenol and 4-CP initial concentrations, respectively, with the effect being more conspicuous under increasing 4-CP concentration. Higher bioregeneration efficiencies were achieved with the use of immobilized rather than suspended biomasses.
  10. Ahmad Z, Blin J, Rampal L, Adnan RS, Mohtarrudin N, Abang Yusuf DSY
    Curr Probl Cardiol, 2023 Feb 22;48(6):101659.
    PMID: 36822563 DOI: 10.1016/j.cpcardiol.2023.101659
    Preliminary research has shown that low density lipoprotein receptor (LDLR), tumor protein (TP53) and matrix metalloproteinase 9 (MMP9) genes expression levels were significantly increased in atherosclerosis coronary artery tissue (ACAT) compared to non-atherosclerotic coronary artery tissue (NCAT) samples. Thus, further investigation was carried out to study the association of LDLR, TP53 and MMP9 gene polymorphisms and the risk of developing atherosclerosis (ATH) in a Malaysian population. Single nucleotide polymorphisms of C88S, TP53 codon 72 and MMP9C>T were analyzed in 76 ACAT samples and 149 NCAT samples, representing cases and controls, respectively. In results, heterozygous CT genotype of MMP9C>T polymorphism was significantly higher in ACAT compared to NCAT samples (57.9% vs 27.5%, χ2 = 19.758, df= 1, P < 0.05). The CT genotype was found to be significantly associated with the risk of developing ATH (OR = 3.622, 95% CI = 2.028-6.470). However, the distribution of the CT genotype in a healthy Malaysian study population was incomparable regardless of gender and ethnicity. The DNA sequencing results validated the C88S, TP53 codon 72, and MMP9C>T polymorphisms. In conclusion, the CT genotype of the MMP9-1562C>T polymorphism was found to have a strong association with the risk of developing ATH.
  11. Ubah PC, Dashti AF, Saaid M, Imam SS, Adnan R
    Environ Sci Pollut Res Int, 2023 Jan;30(2):4462-4484.
    PMID: 35969341 DOI: 10.1007/s11356-022-22245-z
    The purpose of this research is to synthesize environmentally friendly nanosorbents for the novel adsorption of diesel range organics (DRO) from contaminated water. Central composite design (CCD) analysis of response surface methodology (RSM) was employed in a model fitting of the variables predicting the adsorption efficiency of Moringa oleifera-functionalized zerovalent iron particles (ZINPs) for the removal of DRO. The effects of the reaction parameters on the response were screened using 24 factorial designs to determine the statistically significant independent variables. A quadratic model predicting the DRO adsorption efficiency of ZINPs with an F value of 276.84 (p value 
  12. Baqer AA, Nor NSM, Alagely HS, Musa M, Adnan NA
    Pol Merkur Lekarski, 2023;51(1):35-41.
    PMID: 36960898 DOI: 10.36740/Merkur202301105
    OBJECTIVE: Aim: Klebsiella pneumonia has emerged as an increasingly important cause of community-acquired nosocomial infections and many of these strains are highly virulent and exhibit a strong propensity to spread. Infections cause by K. pneumonia produces carbapen¬emase (KPC) enzyme and can be difficult to treat since only a few antibiotics are effective against them. Bacteriophage targeting this strain can be an alternative treatment. Characterisation of bacteriophage is utmost important in assisting the application of bacteriophage in phage therapy.

    PATIENTS AND METHODS: Materials and methods: In the present study, the lytic bacteriophage, k3w7, isolated by the host Klebsiella pneumoniae kP2 was characterised using transmission electron microscope (TEM), plaque assay, and restriction digestive enzyme to investigate mor¬phology, host spectrum, bacteriophage life cycle and stability accordingly.

    RESULTS: Results and conclusions: As shown by TEM, k3w7 was observed to have the characteristic of icosahedral heads 100 nm and contractile sheaths 120 nm suggesting it belongs to the family of myoviridae.The Investigation has done on the phage growth cycle showed a short latent period of 20 min and a burst size of approximately 220 plaque forming units per infected cell. Stability test showed the phage was stable over a wide range of pH and temperatures. According to restriction analysis, k3w7 had 50 -kb double-stranded DNA genome as well as the heterogeneous nature of genetic material. These findings suggest that K3W7 has a potential use in therapy against infections caused by K. pneumonia produces carbapenemase.

  13. Khan A, Khan AH, Adnan AS, Sulaiman SAS, Mushtaq S
    BMC Public Health, 2019 May 09;19(1):531.
    PMID: 31072378 DOI: 10.1186/s12889-019-6796-z
    BACKGROUND: Even though depression is one of the most common psychiatric disorders, it is under-recognized in hemodialysis (HD) patients. Existing literature does not provide enough information on evaluation of predictors of depression among HD patients. The objective of the current study was to determine the prevalence and predictors of depression among HD patients.

    METHODS: A multicenter prospective follow-up study. All eligible confirmed hypertensive HD patients who were consecutively enrolled for treatment at the study sites were included in the current study. HADS questionnaire was used to assess the depression level among study participants. Patients with physical and/or cognitive limitations that prevent them from being able to answer questions were excluded.

    RESULTS: Two hundred twenty patients were judged eligible and completed questionnaire at the baseline visit. Subsequently, 216 and 213 patients completed questionnaire on second and final follow up respectively. The prevalence of depression among patients at baseline, 2nd visit and final visit was 71.3, 78.2 and 84.9% respectively. The results of regression analysis showed that treatment given to patients at non-governmental organizations (NGO's) running HD centers (OR = 0.347, p-value = 0.039) had statistically significant association with prevalence of depression at final visit.

    CONCLUSIONS: Depression was prevalent in the current study participants. Negative association observed between depression and hemodialysis therapy at NGO's running centers signifies patients' satisfaction and better depression management practices at these centers.

  14. Shams MS, Mei TS, Adnan Z, Niazi MM, Khan K
    Front Psychol, 2022;13:923874.
    PMID: 36467215 DOI: 10.3389/fpsyg.2022.923874
    Building upon the job demands-resources (JD-R) theory, this research offers an in-depth exploration of the mechanisms by which idiosyncratic deals (I-deals), such as personalized work arrangements, can enhance academics' psychological empowerment (PE) and hence affect their work engagement. This study's purpose was to investigate whether PE mediates the relationships between task and work responsibilities I-deals, flexibility I-deals, and work engagement among academics in higher education and whether the mediating effects are moderated by academics' internal locus of control. Using an online platform, the survey questionnaire was sent to 650 academics working in higher education. The results reveal that task and work responsibilities I-deals and flexibility I-deals, are positively associated with the academics' work engagement and that PE mediates those relationships. Additionally, the internal locus of control strengthens the positive relationship between task and work responsibilities I-deals and PE, and it enhances the indirect effect of task and work responsibilities I-deals on academics' work engagement through PE. Though, this study did not find the moderating effect of internal locus of control on the flexibility I-deals-PE relationship; however, the results indicate that internal locus of control boosts the indirect effect of flexibility I-deals on academics' work engagement through PE.
  15. Ahmed MA, Jouhar R, Adnan S, Ahmed N, Ghazal T, Adanir N
    Eur J Dent, 2020 Dec;14(S 01):S1-S6.
    PMID: 33321543 DOI: 10.1055/s-0040-1721295
    OBJECTIVES:  The aim of this study was to evaluate the patient's knowledge, attitude, and practice of cross-infection control in dentistry during coronavirus diseases 2019 (COVID-19).

    MATERIALS AND METHODS:  This cross-sectional observational study was conducted at Altamash Institute of Dental Medicine, Karachi from June 2020 to August 2020. A total of 775 patients participated to fill questionnaire. After scrutiny, 25 questionnaire forms were excluded due to incomplete information. Questionnaire was divided in to four sections. First section obtained patients sociodemographic information, while knowledge of patients regarding cross-infection control during COVID-19 pandemic was evaluated in second section. Similarly, the purpose of third section was to assess attitude and fourth section was designed to evaluate practice. Likert's 3-point scale was used for registration of participant's response. The reliability of questionnaire was assessed through Crohnbach's α (α = 0.74). Statistical analysis was performed after entering data in to SPSS version 25. Independent t-test was used to evaluate the difference in patients' knowledge, attitude, and practice. A p-value ≤ 0.05 was considered as statistically significant.

    RESULTS:  Majority of the participants agreed that COVID-19 is a highly contagious disease (631, 97%) and daily screening of staff, dental assistants, dentists, and patients is necessary (568, 75.7%) along with proper sterilization of instruments and disinfection of dental operatory (650, 86.66%). A large number of participant also agreed that proper disposal of waste is utmost important for cross-infection control (601, 80.24%) and patient's waiting area should also be marked with social distancing sign (620, 82.66%). However, when asked about the common route of COVID-19 transmission in dentistry, 341 (45.5%) participants disagreed that it is not through aerosol (water droplets) generated during dental procedures.

    CONCLUSIONS:  Dental health professionals should take additional measures to educate dental patients on mechanism of potential spread of COVID-19 through the aerosols and droplets generated during dental procedures. They should also encourage the dental patients to be vigilant and question the cross-infection control measures practiced by the dentist to whom they go for dental treatment, and to decrease their chances of acquiring an infection during their visit to the dental office.

  16. Khan A, Khan AH, Adnan AS, Syed Sulaiman SA, Gan SH, Khan I
    Biomed Res Int, 2016;2016:9710965.
    PMID: 27833921
    Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context. Methods. A comprehensive search of literature employing electronic as well as manual sources and screening 2783 papers published between Jan 1980 and Oct 2015 was conducted to collect, identify, and analyze relevant information through peer-reviewed research articles, systematic reviews, and other published works. The cardiovascular events, including accelerated atherosclerotic cardiovascular disease (ASCVD), stroke, heart failure, myocardial infarction, myocardial ischemia, and stress induced myocardial dysfunction, leading to death were considered relevant. Results. A total of 23 published articles met the inclusion criteria and were included for in-depth review and analysis to finalize a comprehensive systematic review article. All the studies showed a significant association between the blood pressure and cardiovascular disease events in hemodialysis patients. Conclusions. Both intradialytic hypertension/hypotension episodes are major risk factors for cardiovascular mortality with a high percentage of probable causality; however, clinicians are faced with a dilemma on how to evaluate blood pressure and treat this condition.
  17. Supramaniam P, Ismail SH, Ali A, Leong EL, Muninathan P, Adnan TH, et al.
    Health Qual Life Outcomes, 2023 Aug 29;21(1):101.
    PMID: 37644485 DOI: 10.1186/s12955-023-02182-2
    BACKGROUND: Eating behavior primarily depends on eating patterns which are largely influenced by interactions between physiology, environment, psychology, culture and socio-economic status. This study was designed to translate and validate the Eating Behavior Pattern Questionnaire (EBPQ) among Malaysian women.

    METHODS: A cross-sectional study involving translation and validation of the English version of EBPQ. The original questionnaire, contained 51 items extracted into six domains was translated in Malay using forward and backward translation, pre-tested and validated among conveniently sampled female healthcare personnel. Vegetarians, pregnant ladies and women in confinement were excluded due to special daily dietary plans. Construct validity, reliability and feasibility were analyzed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).

    RESULTS: During translation, item modifications were made and subjected to field testing among 394 women. The original questionnaire was used as a reference to identify the positioning of items in constructs. Fifteen items were removed due to poor correlation with items within constructs. Seven factors were extracted using Varimax rotation with Kaiser-Meyer-Olkin (KMO) value range from 0.725-0.872 and significant Bartlett's test of Sphericity (p 

  18. Lone MA, Iqbal UA, Lone MM, Adnan S, Heboyan A, Ahmed N, et al.
    J Med Educ Curric Dev, 2023;10:23821205231193282.
    PMID: 37614332 DOI: 10.1177/23821205231193282
    OBJECTIVES: The objective of this study was to explore current trends in undergraduate fixed prosthodontics teaching at undergraduate dental level education.

    METHODS: This cross-sectional descriptive study included close-ended questions to inquire about the teaching practices of fixed prosthodontics at Bachelor of Dental Surgery level education. Electronic copies of the survey forms were sent to the heads or directors of department of prosthodontics responsible for undergraduate dental students teaching and learning in various institutes of Sindh by the help of Google forms in December 2020. The form included questions on sociodemographic details and questions inquiring the theoretical and clinical teaching practices in undergraduate fixed prosthodontics course. Data was entered and analyzed using SPSS 25. Frequency distribution and percentages of categorical variables were recorded.

    RESULTS: Out of total 18 dental institutes of Sindh, 15 returned the completely filled form, giving a response rate of 83.3%. Seven (46.7%) schools teach various fixed prosthesis in the preclinical years to their students. All 15 colleges carry out didactic teaching and provide exposure by live clinical demonstrations for various fixed prosthesis. Faculty of 12 (80%) dental colleges where fixed prostheses are being constructed in the dental outpatient department mentioned that their students observe or assist the clinical procedures during their clinical rotation; but none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years.

    CONCLUSION: Didactic teaching and live clinical demonstrations of fixed prosthodontics is being carried out in all dental colleges of Sindh. Almost half of the dental schools teach crown preparation on phantom teeth during their preclinical course. Contrary to this, none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. As these procedures are not included in the current undergraduate curriculum, recommendations should be forwarded to governing educational body of the country to include cases of fixed prosthesis in their skill set prior to their graduation.

  19. Nawawi FA, Wan Md Adnan WAH, Ismail M, Jalaludin MY, Majid HA
    Kidney Int Rep, 2023 Oct;8(10):1965-1977.
    PMID: 37850001 DOI: 10.1016/j.ekir.2023.07.028
    INTRODUCTION: The health and wellbeing of adolescents are often neglected, including the knowledge of chronic kidney disease (CKD), especially in its early stages.

    METHODS: A total of 607 adolescents were recruited from the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study, a prospective cohort study conducted from March 2012 to May 2016 that explored the noncommunicable diseases (NCDs) risk factors among 13 to 17 years old students in 3 states of Peninsular Malaysia. Students who participated in all 3 data collection periods in 2012, 2014, and 2016 with kidney function assessment across all 3-time points were included in the current study. The students' estimated glomerular filtration rate (eGFR) was calculated from isotope-dilution mass spectrometry-traceable Schwartz's equation and categorized based on Kidney Disease: Improving Global Outcomes (KDIGO) classification. Changes in kidney function were examined, and the longitudinal relationship between eGFR and multiple NCD risk factors was analyzed using the generalized estimating equation (GEE).

    RESULTS: The prevalence of decreased eGFR (60-89 ml/min per 1.73 m2) among the students increased from 6.1% (2012) to 30.0% (2014) and 40.2% (2016). Based on the GEE, the student's eGFR decreased over time, with a steeper decline during early to midadolescence. Males and rural students had lower eGFR compared to their counterparts. Students who are morbidly obese had lower eGFR than those with normal body mass index (BMI). Protein consumption also has a potential moderating effect on eGFR in adolescents.

    CONCLUSION: Kidney function changes can be detected as early as adolescence and are likely attributable to multiple NCD risk factors. Therefore, more comprehensive prevention efforts from various stakeholders are needed to identify health issues like CKD.

  20. Rehman A, Abbas S, Khan MA, Ghazal TM, Adnan KM, Mosavi A
    Comput Biol Med, 2022 Nov;150:106019.
    PMID: 36162198 DOI: 10.1016/j.compbiomed.2022.106019
    In recent years, the global Internet of Medical Things (IoMT) industry has evolved at a tremendous speed. Security and privacy are key concerns on the IoMT, owing to the huge scale and deployment of IoMT networks. Machine learning (ML) and blockchain (BC) technologies have significantly enhanced the capabilities and facilities of healthcare 5.0, spawning a new area known as "Smart Healthcare." By identifying concerns early, a smart healthcare system can help avoid long-term damage. This will enhance the quality of life for patients while reducing their stress and healthcare costs. The IoMT enables a range of functionalities in the field of information technology, one of which is smart and interactive health care. However, combining medical data into a single storage location to train a powerful machine learning model raises concerns about privacy, ownership, and compliance with greater concentration. Federated learning (FL) overcomes the preceding difficulties by utilizing a centralized aggregate server to disseminate a global learning model. Simultaneously, the local participant keeps control of patient information, assuring data confidentiality and security. This article conducts a comprehensive analysis of the findings on blockchain technology entangled with federated learning in healthcare. 5.0. The purpose of this study is to construct a secure health monitoring system in healthcare 5.0 by utilizing a blockchain technology and Intrusion Detection System (IDS) to detect any malicious activity in a healthcare network and enables physicians to monitor patients through medical sensors and take necessary measures periodically by predicting diseases. The proposed system demonstrates that the approach is optimized effectively for healthcare monitoring. In contrast, the proposed healthcare 5.0 system entangled with FL Approach achieves 93.22% accuracy for disease prediction, and the proposed RTS-DELM-based secure healthcare 5.0 system achieves 96.18% accuracy for the estimation of intrusion detection.
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