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  1. Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia
    Hassali MA, Al-Haddad M, Shafie AA, Tangiisuran B, Saleem F, Atif M, et al.
    J Patient Saf, 2012 Jun;8(2):76-80.
    PMID: 22561848 DOI: 10.1097/PTS.0b013e31824aba86
    OBJECTIVE: This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia.
    METHODS: A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry.
    RESULTS: A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers.
    CONCLUSIONS: General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.
  2. Myxozoan infection of the Malaysian mahseer, Tor tambroides, of Tasik Kenyir Reservoir, Malaysia: description of a new species Myxobolus tambroides sp.n
    Székely C, Shaharom F, Cech G, Mohamed K, Zin NA, Borkhanuddin MH, et al.
    Parasitol Res, 2012 Oct;111(4):1749-56.
    PMID: 22782473
    Tor tambroides, a common and appreciated cyprinid fish of the Tasik Kenyir water reservoir in Malaysia, is one of the species selected for propagation. This fish was first successfully propagated in Malaysia by the Department of Agriculture, Sarawak, Malaysia, and the breeding program continued throughout the country. The gills were frequently infected by a Myxobolus species to be described as Myxobolus tambroides sp. n. The small, 50 to 70 μm, round plasmodia of this species is located intralamellarly. Plasmodia were filled with pyriform myxospores, 9.9 and 7.4 μm wide. In sutural view, the caudal end of the myxospores had a distinctive valvular groove, parallel with the suture. Plasmodia caused deformations on the affected and the neighbouring gill lamellae. The 18S rDNA sequence of M. tambroides sp.n. did not show a close relationship with any other Myxobolus spp., represented in the GenBank. This might be an emerging parasite likely to impact the propagation of this fish.
  3. The phytochemical content and antimicrobial activities of Malaysian Calophyllum canum (stem bark)
    Alkhamaiseh SI, Taher M, Ahmad F, Qaralleh H, Althunibat OY, Susanti D, et al.
    Pak J Pharm Sci, 2012 Jul;25(3):555-63.
    PMID: 22713941
    Recently there was huge increase in using of 'herbal products'. These can be defined as plants, parts of plants or extracts from plants that are used for curing disease. However, Calophyllum species is a tropical plant and it has been used in traditional medicine, the limitation in safety and effectiveness information could lead to serious health problems. Providing information for communities by evaluating the phytochemical contents, antioxidant, antimicrobial and cytotoxic activities will improve the therapeutic values. Three main Calophyllum canum fractions (none - high polar) were tested to find out the phenolic, flavonoid, flavonol content, DPPH radical scavenging, reducing power and chelating iron ions. Also were tested against Bacillus cereus, Staphylococcus aureus, Escherichia coli, Psedomonas aeruginosa, Candida albicans, and Cryptococcus neoformans. In addition, cytotoxic activity was assayed against lung cancer A549 cell line. The methanol fraction showed no bioactivity but achieved the highest amount of phenolic, flavonol and flavonoid contents, also it showed a significant result as antioxidant, reducing power and chelating agent. The n-hexane fraction achieved the minimum inhibitory concentration (MIC) value 12.5 μg. mL(-1) against B. cereus while the MIC value for DCM fraction was 25 μg. mL(-1). The DCM fraction was more active against S. aureus where the result was 50 μg. mL(-1) while the n-hexane fraction was 100 μg. mL(-1). The three main fractions have shown no activity against gram negative bacterial and fungal. The n-hexane and DCM fractions have shown cytotoxicity against lung cancer cell line; the 50% inhibition concentration (IC(50)) was 22 ± 2.64 and 32 ± 3.78 μg. mL(-1) respectively. The results were statistically significant (P < 0.05). Among the results, C. canum fractions proved to be effective against gram positive bacterial and anti-proliferation activity. Also it showed antioxidant activity as well. The results provided beneficial information for communities as well as can help to search for alternative drugs, and will contribute to establish safe and effective use of phytomedicines in the treatment of diseases.
  4. WHO guidelines for treatment of tuberculosis: the missing links
    Atif M, Sulaiman SA, Shafie AA, Ali I, Hassali MA, Saleem F
    Int J Clin Pharm, 2012 Aug;34(4):506-9.
    PMID: 22706597 DOI: 10.1007/s11096-012-9657-8
    Worldwide, the treatment of tuberculosis is based on evidence-based guidelines developed by the World Health Organization (WHO) for national tuberculosis programs. However, the importance of health related quality of life, the adequate management of side effects associated with antituberculosis drugs and the elaboration of tuberculosis treatment outcome categories are a few issues that need to be addressed in forthcoming WHO guidelines for the treatment of tuberculosis.
  5. Guidelines adherence and hypertension control at a tertiary hospital in Malaysia
    Ahmad N, Hassan Y, Tangiisuran B, Meng OL, Abd Aziz N, Ahmad FU, et al.
    J Eval Clin Pract, 2013 Oct;19(5):798-804.
    PMID: 22583820 DOI: 10.1111/j.1365-2753.2012.01852.x
    RATIONALE, AIMS AND OBJECTIVES: Existing literature suggests that doctors' poor adherence with guidelines is one of the major contributing factors to suboptimal control of hypertension. This study aims to evaluate doctors' adherence with Malaysian clinical practice guideline (CPG 2008) in a tertiary care hospital, and factors associated with guideline adherence and hypertension control.
    METHODS: This was a cross-sectional study conducted at Hospital Pulau Pinang, Penang, Malaysia. Prescriptions written by 26 enrolled doctors to 650 established hypertensive outpatients (25 prescriptions per enrolled doctor) were noted on visit 1 along with patients' demographic and clinical data. The noted prescriptions were classified either as compliant or non-compliant to CPG (2008). Five hundred twenty (80%) of the enrolled patients (20 patients per enrolled doctor) were followed for one more visit. Blood pressure (BP) noted on visit 2 was related to the prescription written on visit 1. SPSS 16 (SPSS Inc., Chicago, IL, USA) was used for data analysis.
    RESULTS: Three hundred forty-nine (67.1%) patients received guidelines compliant pharmacotherapy. In multivariate analysis, hypertension clinic had significant negative association with guidelines adherence. Two hundred sixty-five patients (51%) were at goal BP on visit 2. In multivariate analysis, angiotensin-converting enzyme inhibitors and guidelines adherence had significant positive, while renal disease, diabetes mellitus and diabetic clinic had significant negative association with hypertension control.
    CONCLUSIONS: An overall fair level of adherence with guidelines and better control of hypertension was observed. Guidelines compliant practices resulted in better control of hypertension. The gaps between what guidelines recommend and clinical practice were especially seen in the pharmacotherapy of uncomplicated hypertension and hypertension with diabetes mellitus and renal disease.
    KEYWORDS: Malaysia; adherence; guidelines; hypertension
    Study site: Cardiology, nephrology, diabetic and hypertension clinics, Hospital Pulau Pinang, Malaysia
  6. Antifungal activity of Andrographis paniculata extracts and active principles against skin pathogenic fungal strains in vitro
    Sule A, Ahmed QU, Latip J, Samah OA, Omar MN, Umar A, et al.
    Pharm Biol, 2012 Jul;50(7):850-6.
    PMID: 22587518 DOI: 10.3109/13880209.2011.641021
    Andrographis paniculata Nees. (Acanthaceae) is an annual herbaceous plant widely cultivated in southern Asia, China, and Europe. It is used in the treatment of skin infections in India, China, and Malaysia by folk medicine practitioners.
  7. Fulltext Two new acridone alkaloids from Glycosmis macrantha
    Yahayu MA, Rahmani M, Hashim NM, Amin MA, Ee GC, Sukari MA, et al.
    Molecules, 2011 May 27;16(6):4401-7.
    PMID: 21623311 DOI: 10.3390/molecules16064401
    Extraction and chromatographic separation of the extracts of dried stem barks of Glycosmis macrantha lead to isolation of two new acridone alkaloids, macranthanine and 7-hydroxynoracronycine, and a known acridone, atalaphyllidine. The structures of these alkaloids were determined by detailed spectral analysis and also by comparison with reported data.
  8. Application of psyllium husk as coagulant and coagulant aid in semi-aerobic landfill leachate treatment
    Al-Hamadani YA, Yusoff MS, Umar M, Bashir MJ, Adlan MN
    J Hazard Mater, 2011 Jun 15;190(1-3):582-7.
    PMID: 21507572 DOI: 10.1016/j.jhazmat.2011.03.087
    Landfill leachate is a heavily polluted and a likely hazardous liquid that is produced as a result of water infiltration through solid wastes generated industrially and domestically. This study investigates the potential of using psyllium husk as coagulant and coagulant aid for the treatment of landfill leachate. Psyllium husk has been tested as primary coagulant and as coagulant aid with poly-aluminum chloride (PACl) and aluminum sulfate (alum). As primary coagulant, the optimum dosage and pH for PACl were 7.2 and 7.5 g/L, respectively, with removal efficiencies of 55, 80 and 95% for COD, color and TSS, respectively. For alum, the optimum conditions were 11 g/L alum dosage and pH 6.5 with removal efficiencies of 58, 79 and 78% for COD, color and TSS, respectively. The maximum removal efficiencies of COD, color and TSS were 64, 90 and 96%, respectively, when psyllium husk was used as coagulant aid with PACl. Based on the results, psyllium husk was found to be more effective as coagulant aid with PACl in the removal of COD, color and TSS as compared to alum. Zeta potential test was carried out for leachate, PACl, alum and psyllium husk before and after running the jar test to enhance the results of the jar test experiments.
  9. Susceptibility to aplastic anemia is associated with HLA-DRB1*1501 in an aboriginal population in Sabah, Malaysia
    Dhaliwal JS, Wong L, Kamaluddin MA, Yin LY, Murad S
    Hum Immunol, 2011 Oct;72(10):889-92.
    PMID: 21762745 DOI: 10.1016/j.humimm.2011.06.013
    The incidence of aplastic anemia is reported to be higher in Asia than elsewhere. We studied the frequency of human leukocyte antigen (HLA) DRB1 alleles in aplastic anemia patients from 2 genetically similar aboriginal groups, the Kadazan and the Dusun, and compared them with genetically matched community and hospital controls. HLA-DRB1*15 was significantly higher in the patients compared with controls (p = 0.005), confirming similar findings in Japanese and Caucasian studies. Further testing indicated a significantly higher frequency of HLA-DRB1*1501 in patients compared with controls (p = 0.0004) but no significant difference in the frequency of HLA-DRB1*1502. The high frequency of HLA-DRB1*15 in the Kadazan and Dusun population combined with the wide variety of environmental factors associated with aplastic anemia could be the reason for the elevated incidence of aplastic anemia in the Kadazan and Dusun in Sabah.
  10. Short-term estrogen replacement therapy reduces platelet marker levels in Malaysian postmenopausal women
    Sheikh SA, Roshan TM, Khattak MN, Baig AA, Noor SJ, Hassan R, et al.
    Menopause Int, 2011 Mar;17(1):6-10.
    PMID: 21427417 DOI: 10.1258/mi.2011.011001
    In healthy postmenopausal women (PMW) increased platelet activation has been associated with adverse cardiovascular events. There is much debate about the relationship between platelet function and serum estradiol level in PMW. This study assessed the effect of short-term oral estrogen replacement therapy (ERT) on platelet activation markers (CD62P and PAC-1) and its correlation with age and body mass index (BMI) among healthy PMW.
  11. Schwannoma of the tongue in a ten-year old child
    Husain S, Husain S, Yunus MR, Yunus MR, Ramli R, Ramli R, et al.
    J Pak Med Assoc, 2011 May;61(5):500-1.
    PMID: 22204190
    The case of a 10-year-old girl is presented who had a slow-growing, painless swelling on the left side of the tongue since six months. This was associated with disturbances in mastication and phonation. Examination revealed a 5 cm x 4 cm. globular smooth, mobile mass on left side of the tongue. There was no neurological deficit and no neck nodes palpable. She underwent excision of the mass under general anaesthesia. Complete enucleation with primary closure was carried out. The patient had an uneventful postoperative recovery and histological evaluation was consistent with schwannoma. The patient was recurrence free after one year.
  12. Fulltext Embedded nanomicro syringe on chip for molecular therapy
    Jalil MA, Suwanpayak N, Kulsirirat K, Suttirak S, Ali J, Yupapin PP
    Int J Nanomedicine, 2011;6:2925-32.
    PMID: 22131837 DOI: 10.2147/IJN.S26266
    A novel nanomicro syringe system was proposed for drug storage and delivery using a PANDA ring resonator and atomic buffer. A PANDA ring is a modified optical add/drop filter, named after the well known Chinese bear. In principle, the molecule/drug is trapped by the force generated by different combinations of gradient fields and scattering photons within the PANDA ring. A nanomicro needle system can be formed by optical vortices in the liquid core waveguide which can be embedded on a chip, and can be used for long-term treatment. By using intense optical vortices, the required genes/molecules can be trapped and transported dynamically to the intended destinations via the nanomicro syringe, which is available for drug delivery to target tissues, in particular tumors. The advantage of the proposed system is that by confining the treatment area, the effect can be decreased. The use of different optical vortices for therapeutic efficiency is also discussed.
  13. Fulltext Antimicrobial activity of mangrove plant (Lumnitzera littorea)
    Saad S, Taher M, Susanti D, Qaralleh H, Rahim NA
    Asian Pac J Trop Med, 2011 Jul;4(7):523-5.
    PMID: 21803301 DOI: 10.1016/S1995-7645(11)60138-7
    OBJECTIVE: To investigate the antimicrobial activities of n-hexane, ethyl acetate and methanol extracts of the leaves of Lumnitzera littorea (L. littorea) against six human pathogenic microbes.

    METHODS: The antimicrobial activity was evaluated using disc diffusion and microdilution methods.

    RESULTS: The antimicrobial activities of the crude extracts were increased with increasing the concentration. It is clear that n-hexane extract was the most effective extract. Additionally, Gram positive Bacillus cereus (B. cereus) appear to be the most sensitive strain while Pseudomonas aeruginosa (P. aeruginosa) and the yeast strains (Candida albicans (C. albicans) and Cryptococcus neoformans (C. neoformans)) appear to be resistance to the tested concentrations since no inhibition zone was observed. The inhibition of microbial growth at concentration as low as 0.04 mg/mL indicated the potent antimicrobial activity of L. littorea extracts.

    CONCLUSIONS: The obtained results are considered sufficient for further study to isolate the compounds responsible for the activity and suggesting the possibility of finding potent antibacterial agents from L. littorea extracts.

  14. Factors influencing Malaysian public attitudes to agro-biotechnology
    Amin L, Ahmad J, Jahi JM, Nor AR, Osman M, Mahadi NM
    Public Underst Sci, 2011 Sep;20(5):674-89.
    PMID: 22164706
    Despite considerable research in advanced countries on public perceptions of and attitudes to modern biotechnology, limited effort has been geared towards developing a structural model of public attitudes to modern biotechnology. The purpose of this paper is to identify the relevant factors influencing public attitudes towards genetically modified (GM) soybean, and to analyze the relationship between all the attitudinal factors. A survey was carried out on 1,017 respondents from various stakeholder groups in the Klang Valley region. Results of the survey have confirmed that attitudes towards complex issues such as biotechnology should be seen as a multifaceted process. The most important factors predicting support for GM soybean are the specific application-linked perceptions about the benefits, acceptance of risk and moral concern while risk and familiarity are significant predictors of benefit and risk acceptance. Attitudes towards GM soybean are also predicted by several general classes of attitude.
  15. Fulltext Caregivers' satisfaction of healthcare delivery at paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre in 2009
    Aniza I, Rizal AM, Ng YS, Mardhiyyah M, Helmi I, Syamimi BK, et al.
    Med J Malaysia, 2011 Jun;66(2):84-8.
    PMID: 22106682
    Patient's satisfaction has become increasingly important as patients evaluate healthcare services for both medical cost and quality. The purpose of this study was to measure the prevalence and the factors influencing caregivers' satisfaction. A cross sectional study of 262 respondents using universal sampling method was conducted at the paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Overall, 90.5% were satisfied with the services provided. Satisfaction rates based on various healthcare delivery domains were: 95.0% for communication skills, 88.5% for interpersonal aspect, 83.6% for technical quality, 82.1% for financial aspect, 72.9% for time spent with doctors and 64.9% for ease of contact. This study shows that the caregivers (an unpaid person who helps a person cope with disease) were highly satisfied with the communicational aspect delivered by the clinic. However, there is still room for improvement on ease of contact domain and waiting time in order to produce high quality service.

    Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  16. Fulltext Molecular cloning, expression and biochemical characterisation of a cold-adapted novel recombinant chitinase from Glaciozyma antarctica PI12
    Ramli AN, Mahadi NM, Rabu A, Murad AM, Bakar FD, Illias RM
    Microb Cell Fact, 2011;10:94.
    PMID: 22050784 DOI: 10.1186/1475-2859-10-94
    Cold-adapted enzymes are proteins produced by psychrophilic organisms that display a high catalytic efficiency at extremely low temperatures. Chitin consists of the insoluble homopolysaccharide β-(1, 4)-linked N-acetylglucosamine, which is the second most abundant biopolymer found in nature. Chitinases (EC 3.2.1.14) play an important role in chitin recycling in nature. Biodegradation of chitin by the action of cold-adapted chitinases offers significant advantages in industrial applications such as the treatment of chitin-rich waste at low temperatures, the biocontrol of phytopathogens in cold environments and the biocontrol of microbial spoilage of refrigerated food.
  17. Fulltext Preparation of hippurate-zinc layered hydroxide nanohybrid and its synergistic effect with tamoxifen on HepG2 cell lines
    Hussein Al Ali SH, Al-Qubaisi M, Hussein MZ, Zainal Z, Hakim MN
    Int J Nanomedicine, 2011;6:3099-111.
    PMID: 22163163 DOI: 10.2147/IJN.S24510
    A new simple preparation method for a hippurate-intercalated zinc-layered hydroxide (ZLH) nanohybrid has been established, which does not need an anion-exchange procedure to intercalate the hippurate anion into ZLH interlayers.
  18. Fulltext A qualitative exploration of Malaysian cancer patients' perspectives on cancer and its treatment
    Farooqui M, Hassali MA, Shatar AK, Shafie AA, Seang TB, Farooqui MA
    BMC Public Health, 2011;11:525.
    PMID: 21718547 DOI: 10.1186/1471-2458-11-525
    BACKGROUND: Cancer patients' knowledge about cancer and experiences with its treatment play an important role in long-term adherence in their disease management. This study aimed to explore cancer patients' knowledge about cancer, their perceptions of conventional therapies and the factors that contribute to medication adherence in the Malaysian population.
    METHODS: A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by cancer patients. Twenty patients were interviewed using a semi-structured interview guide. A saturation point was reached after the 18th interview, and no new information emerged with the subsequent 2 interviews. All interviews were transcribed verbatim and analysed by means of a standard content analysis framework.
    RESULTS: The majority of patients related the cause of their cancer to be God's will. Participants perceived conventional therapies as effective due to their scientific methods of preparations. A fear of side effects was main reasons given for delay in seeking treatment; however, perceptions were reported to change after receiving treatment when effective management to reduce the risk of side effects had been experienced.
    CONCLUSIONS: This study provides basic information about cancer patients' perceptions towards cancer and its treatment. These findings can help in the design of educational programs to enhance awareness and acceptances of cancer screening. Priorities for future research should focus on patients who refused the conventional therapies at any stage.
  19. Combustion performance evaluation of air staging of palm oil blends
    Mohd Jaafar MN, Eldrainy YA, Mat Ali MF, Wan Omar WZ, Mohd Hizam MF
    Environ Sci Technol, 2012 Feb 21;46(4):2445-50.
    PMID: 22296110 DOI: 10.1021/es2025005
    The problems of global warming and the unstable price of petroleum oils have led to a race to develop environmentally friendly biofuels, such as palm oil or ethanol derived from corn and sugar cane. Biofuels are a potential replacement for fossil fuel, since they are renewable and environmentally friendly. This paper evaluates the combustion performance and emission characteristics of Refined, Bleached, and Deodorized Palm Oil (RBDPO)/diesel blends B5, B10, B15, B20, and B25 by volume, using an industrial oil burner with and without secondary air. Wall temperature profiles along the combustion chamber axis were measured using a series of thermocouples fitted axially on the combustion chamber wall, and emissions released were measured using a gas analyzer. The results show that RBDPO blend B25 produced the maximum emission reduction of 56.9% of CO, 74.7% of NOx, 68.5% of SO(2), and 77.5% of UHC compared to petroleum diesel, while air staging (secondary air) in most cases reduces the emissions further. However, increasing concentrations of RBDPO in the blends also reduced the energy released from the combustion. The maximum wall temperature reduction was 62.7% for B25 at the exit of the combustion chamber.
  20. Fulltext Apoptosis, antimicrobial and antioxidant activities of phytochemicals from Garcinia malaccensis Hk.f
    Taher M, Susanti D, Rezali MF, Zohri FS, Ichwan SJ, Alkhamaiseh SI, et al.
    Asian Pac J Trop Med, 2012 Feb;5(2):136-41.
    PMID: 22221758 DOI: 10.1016/S1995-7645(12)60012-1
    OBJECTIVE: To study the chemical constituents of stembark of Garcinia malaccensis (G. malaccensis) together with apoptotic, antimicrobial and antioxidant activities.

    METHODS: Purification and structure elucidation were carried out by chromatographic and spectroscopic techniques, respectively. MTT and trypan blue exclusion methods were performed to study the cytotoxic activity. Antibacterial activity was conducted by disc diffusion and microdilution methods, whereas antioxidant activities were done by ferric thiocyanate method and DPPH radical scavenging.

    RESULTS: The phytochemical study led to the isolation of α,β-mangostin and cycloart-24-en-3β-ol. α-Mangostin exhibited cytotoxic activity against HSC-3 cells with an IC(50) of 0.33 μM. β- and α-mangostin showed activity against K562 cells with IC(50) of 0.40 μM and 0.48 μM, respectively. α-Mangostin was active against Gram-positive bacteria, Staphylococcus aureus (S. aureus) and Bacillus anthracis (B. anthracis) with inhibition zone and MIC value of (19 mm; 0.025 mg/mL) and (20 mm; 0.013 mg/mL), respectively. In antioxidant assay, α-mangostin exhibited activity as an inhibitor of lipid peroxidation.

    CONCLUSIONS: G. malaccensis presence α- and β-mangostin and cycloart-24-en-3β-ol. β-Mangostin was found very active against HSC-3 cells and K562. The results suggest that mangostins derivatives have the potential to inhibit the growth of cancer cells by inducing apoptosis. In addition, α-and β-mangostin was found inhibit the growth of Gram-positive pathogenic bacteria and also showed the activity as an inhibitor of lipid peroxidation.

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