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  1. A review of biocompatible metal injection moulding process parameters for biomedical applications
    Hamidi MFFA, Harun WSW, Samykano M, Ghani SAC, Ghazalli Z, Ahmad F, et al.
    Mater Sci Eng C Mater Biol Appl, 2017 Sep 01;78:1263-1276.
    PMID: 28575965 DOI: 10.1016/j.msec.2017.05.016
    Biocompatible metals have been revolutionizing the biomedical field, predominantly in human implant applications, where these metals widely used as a substitute to or as function restoration of degenerated tissues or organs. Powder metallurgy techniques, in specific the metal injection moulding (MIM) process, have been employed for the fabrication of controlled porous structures used for dental and orthopaedic surgical implants. The porous metal implant allows bony tissue ingrowth on the implant surface, thereby enhancing fixation and recovery. This paper elaborates a systematic classification of various biocompatible metals from the aspect of MIM process as used in medical industries. In this study, three biocompatible metals are reviewed-stainless steels, cobalt alloys, and titanium alloys. The applications of MIM technology in biomedicine focusing primarily on the MIM process setting parameters discussed thoroughly. This paper should be of value to investigators who are interested in state of the art of metal powder metallurgy, particularly the MIM technology for biocompatible metal implant design and development.
  2. Fulltext Adverse effects on insulin secretion of replacing saturated fat with refined carbohydrate but not with monounsaturated fat: A randomized controlled trial in centrally obese subjects
    Chang LF, Vethakkan SR, Nesaretnam K, Sanders TA, Teng KT
    J Clin Lipidol, 2016 09 17;10(6):1431-1441.e1.
    PMID: 27919361 DOI: 10.1016/j.jacl.2016.09.006
    BACKGROUND: Current dietary guidelines recommend the replacement of saturated fatty acids (SAFAs) with carbohydrates or monounsaturated fatty acids (MUFAs) based on evidence on lipid profile alone, the chronic effects of the mentioned replacements on insulin secretion and insulin sensitivity are however unclear.

    OBJECTIVE: To assess the chronic effects of the substitution of refined carbohydrate or MUFA for SAFA on insulin secretion and insulin sensitivity in centrally obese subjects.

    METHODS: Using a crossover design, randomized controlled trial in abdominally overweight men and women, we compared the effects of substitution of 7% energy as carbohydrate or MUFA for SAFA for a period of 6 weeks each. Fasting and postprandial blood samples in response to corresponding SAFA, carbohydrate, or MUFA-enriched meal-challenges were collected after 6 weeks on each diet treatment for the assessment of outcomes.

    RESULTS: As expected, postprandial nonesterified fatty acid suppression and elevation of C-peptide, insulin and glucose secretion were the greatest with high-carbohydrate (CARB) meal. Interestingly, CARB meal attenuated postprandial insulin secretion corrected for glucose response; however, the insulin sensitivity and disposition index were not affected. SAFA and MUFA had similar effects on all markers except for fasting glucose-dependent insulinotropic peptide concentrations, which increased after MUFA but not SAFA when compared with CARB.

    CONCLUSION: In conclusion, a 6-week lower-fat/higher-carbohydrate (increased by 7% refined carbohydrate) diet may have greater adverse effect on insulin secretion corrected for glucose compared with isocaloric higher-fat diets. In contrast, exchanging MUFA for SAFA at 7% energy had no appreciable adverse impact on insulin secretion.

  3. Effects of chitin and chitosan from cricket and shrimp on growth and carcass performance of broiler chickens
    Lokman IH, Ibitoye EB, Hezmee MNM, Goh YM, Zuki ABZ, Jimoh AA
    Trop Anim Health Prod, 2019 Nov;51(8):2219-2225.
    PMID: 31134556 DOI: 10.1007/s11250-019-01936-9
    Majority of the studies on the effect of chitin and chitosan on growth and carcass characteristics of broiler chickens has concentrated more on shrimp chitin and shrimp chitosan, and often with contradictory results. Therefore, the objective of this present study is to evaluate and compare the effect of dietary chitin and chitosan from cricket and shrimp on growth performance, carcass, and organ characteristics of broiler chickens. One hundred fifty-day-old male Cobb500 broiler chicks of similar average weight were randomly allotted into one of the five dietary treatments with three replicates. Treatment 1 (T1) chicks were fed basal diet only (control), treatment 2 and 3 (T2 and T3) chicks were given basal diet with 0.5 g/kg diet of cricket chitin and cricket chitosan, respectively, while treatment 4 and 5 (T4 and T5) chicks were served basal diet with 0.5 g/kg diet of shrimp chitin and shrimp chitosan respectively. No significant variation occurred between cricket chitin and shrimp chitin, although data on growth performance were higher in cricket chitin, but growth performance varied significantly between cricket chitosan and shrimp chitosan. This study revealed that cricket chitin at 0.5 g/kg significantly improved growth performance, carcass quality, and organ characteristics of broilers more than chitosan. Birds fed basal diet alone, although gained more weight, also accumulated more fat having the poorest feed conversion ratio (FCR) and the highest mortality. However, carcass of birds fed cricket chitin was the leanest and thus economically beneficial as they consumed the least amount of feed with the best FCR.
  4. Fulltext Induction approach via P-Graph to rank clean technologies
    Low CX, Ng WY, Putra ZA, Aviso KB, Promentilla MAB, Tan RR
    Heliyon, 2020 Jan;6(1):e03083.
    PMID: 31909259 DOI: 10.1016/j.heliyon.2019.e03083
    Identification of appropriate clean technologies for industrial implementation requires systematic evaluation based on a set of criteria that normally reflect economic, technical, environmental and other aspects. Such multiple attribute decision-making (MADM) problems involve rating a finite set of alternatives with respect to multiple potentially conflicting criteria. Conventional MADM approaches often involve explicit trade-offs in between criteria based on the expert's or decision maker's priorities. In practice, many experts arrive at decisions based on their tacit knowledge. This paper presents a new induction approach, wherein the implicit preference rules that estimate the expert's thinking pathways can be induced. P-graph framework is applied to the induction approach as it adds the advantage of being able to determine both optimal and near-optimal solutions that best approximate the decision structure of an expert. The method elicits the knowledge of experts from their ranking of a small set of sample alternatives. Then, the information is processed to induce implicit rules which are subsequently used to rank new alternatives. Hence, the expert's preferences are approximated by the new rankings. The proposed induction approach is demonstrated in the case study on the ranking of Negative Emission Technologies (NETs) viability for industry implementation.
  5. Mandibulotomy: an analysis of its morbidities
    Nabil S, Nazimi AJ, Nordin R, Hariri F, Mohamad Yunus MR, Zulkiflee AB
    Int J Oral Maxillofac Surg, 2018 Dec;47(12):1511-1518.
    PMID: 30837061 DOI: 10.1016/j.ijom.2018.05.020
    The mandibulotomy is a procedure that was developed to improve access in tumour resection. This study aimed to investigate the complications associated with mandibulotomy and analyze factors that could affect the risks of developing these complications. The hospital records of all patients who underwent a mandibulotomy as part of their tumour ablative surgery at two major centres in Malaysia were reviewed retrospectively. Demographic, clinical, and complications data were recorded and analyzed. Early postoperative complications occurred in 46.5% of the patients and post-radiation therapy complications in 16.1%. Wound dehiscence (27.9%) and inferior alveolar nerve injury (25.6%) were the common early postoperative complications. Dental injuries (9.7%) and plate exposure/infection (9.7%) were the common post-radiation therapy complications. Furthermore, inferior alveolar nerve injury and early abscess formation were significantly associated with the site of the mandibulotomy. The T-stage of a tumour but not the site of mandibulotomy was significantly associated with tumour margin clearance. Mandibulotomy does pose an added risk of complications for a patient undergoing tumour surgery. The benefits of mandibulotomy in terms of gaining margin clearance could not be proven in this study. The site of mandibulotomy appears to increase the risk of developing an inferior alveolar nerve injury.
  6. Probe-specific loop-mediated isothermal amplification magnetogenosensor assay for rapid and specific detection of pathogenic Leptospira
    Nurul Najian AB, Foo PC, Ismail N, Kim-Fatt L, Yean CY
    Mol Cell Probes, 2019 04;44:63-68.
    PMID: 30876924 DOI: 10.1016/j.mcp.2019.03.001
    This study highlighted the performance of the developed integrated loop-mediated isothermal amplification (LAMP) coupled with a colorimetric DNA-based magnetogenosensor. The biosensor operates through a DNA hybridization system in which a specific designed probe captures the target LAMP amplicons. We demonstrated the magnetogenosensor assay by detecting pathogenic Leptospira, which causes leptospirosis. The color change of the assay from brown to blue indicated a positive result, whereas a negative result was indicated by the assay maintaining its brown color. The DNA biosensor was able to detect DNA at a concentration as low as 200 fg/μl, which is equivalent to 80 genomes/reaction. The specificity of the biosensor assay was 100% when it was evaluated with 172 bacterial strains. An integrated LAMP and probe-specific magnetogenosensor was successfully developed, promising simple and rapid visual detection in clinical diagnostics and service as a point-of-care device.
  7. Influence of parameters and radical scavengers on the visible-light-induced degradation of ciprofloxacin in ZnO/SnS2 nanocomposite suspension: Identification of transformation products
    Makama AB, Salmiaton A, Choong TSY, Hamid MRA, Abdullah N, Saion E
    Chemosphere, 2020 Aug;253:126689.
    PMID: 32304862 DOI: 10.1016/j.chemosphere.2020.126689
    Removal of ciprofloxacin (CIP) pollutant from wastewater using conventional process is particularly challenging due to poor removal efficiency. In this work, CIP was photocatalytically degraded using a porous ZnO/SnS2 photocatalyst prepared via microwaves. The influence of process parameters (e.g., pH, catalyst mass and initial CIP concentration) and radical scavengers on visible-light induced degradation of CIP on the catalyst was investigated. From the study, it was found that visible-light induced degradation of CIP on ZnO/SnS2 is a surface-mediated process and the reaction kinetics followed the Langmuir-Hinshelwood first-order kinetics. It was found that the optimum condition for CIP degradation was at pH of 6.1 and catalyst dosage of 500 mg L-1. Higher catalyst dosage however led to a decline in reaction rate due to light scattering effect and reduction in light penetration.
  8. Clinical and Radiological Evaluation of Sinus Membrane Osteogenicity Subsequent to Internal Sinus Lifting and Implant Placement
    Qabbani AA, Bayatti SWA, Hasan H, Samsudin AB, Kawas SA
    J Craniofac Surg, 2020 1 3;31(3):e233-e236.
    PMID: 31895847 DOI: 10.1097/SCS.0000000000006106
    To evaluate the ability of the maxillary sinus membrane to produce bone after internal sinus lifting and implant placement without adding exogenous bone graft, and to assess the quality of bone that has been produced 6 months postoperatively.In this retrospective study, 10 subjects who underwent maxillary sinus floor lifting and met the inclusion criteria were selected and then subdivided into: Group-A underwent internal sinus elevation and placement of implants without the use of bone graft and Group-B underwent classical internal sinus lifting and placement of bovine bone particles and then placement of the implant as a control group. Radiofrequency analysis (RFA) values for measuring the Implant Stability Quotient (ISQ) of all implants were measured by Osstell device. CBCT was performed involving linear measurements of the site of sinus lifting for both groups.High RFA values demonstrating excellent biomechanical stability were observed in Group-A compared to Group-B at 6 months postoperatively. Group-A showed a median of ISQ value;78 (8), 77(12), 79(3.5) and 77(4.50). Group-A was significantly higher in ISQ values than Group-B, which showed median and interquartile range (IQR) of ISQ value of [51(12.50), 54(14.50), 55(9), and 55(7.50)]. However, the amount of bone available in group B was significantly higher than group A; [3.5 mm (0.75) and 3.8 mm (0.69)].Internal sinus lifting without bone graft has the ability of bone formation by osteogenic potential of the sinus membrane. Nevertheless, the high quality of bone being produced is of high importance for the success of an implant without the need for an exogenous bone graft. The newly formed bone was significantly of a better quality in Group-A. Thus, it is recommended to perform internal sinus lifting, without adding bone graft material and allow the osteogenic potential of the maxillary sinus membrane to produce its own osteogenic cells.
  9. Paracoccus rhizosphaerae sp. nov., isolated from the rhizosphere of the plant Crossostephium chinense (L.) Makino (Seremban)
    Kämpfer P, Lai WA, Arun AB, Young CC, Rekha PD, Martin K, et al.
    Int J Syst Evol Microbiol, 2012 Nov;62(Pt 11):2750-2756.
    PMID: 22286908 DOI: 10.1099/ijs.0.039057-0
    A Gram-negative, coccoid-shaped bacterium, strain CC-CCM15-8(T), was isolated from a rhizosphere soil sample of the plant Crossostephium chinense (L.) Makino (Seremban) from Budai Township, Chiayi County, Taiwan. 16S rRNA gene sequence analysis clearly allocated strain CC-CCM15-8(T) to the Paracoccus cluster, showing highest similarities to the type strains of 'Paracoccus beibuensis' (98.8%), Paracoccus homiensis (97.6%), Paracoccus aestuarii (97.7%) and Paracoccus zeaxanthinifaciens (97.7%). The fatty acid profile, comprising C(18:1)ω7c as the major component and C(10:0) 3-OH as the characteristic hydroxylated fatty acid, supported the placement of strain CC-CCM15-8(T) within the genus Paracoccus. The polyamine pattern consisted of putrescine and spermidine as major components. Ubiqinone Q-10 was the major quinone type (95%); ubiquinone Q-9 was also detected (5%). The complex polar lipid profile consisted of diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, and unidentified phospholipids, lipids and glycolipids. Levels of DNA-DNA relatedness between strain CC-CCM15-8(T) and 'P. beibuensis' LMG 25871(T), P. aestuarii DSM 19484(T), P. zeaxanthinifaciens LMG 21993(T) and P. homiensis KACC 11518(T) were 24.9% (34.8%, reciprocal analysis), 15.7% (17.5%), 17.7% (23.4%) and 16.0% (25.4%), respectively. Physiological and biochemical test results allowed the phenotypic differentiation of strain CC-CCM15-8(T) from its closest relatives in the genus Paracoccus. Based on the data presented, it is concluded that strain CC-CCM15-8(T) represents a novel species of the genus Paracoccus, for which the name Paracoccus rhizosphaerae sp. nov. is proposed. The type strain is CC-CCM15-8(T) (=LMG 26205(T)=CCM 7904(T)).
  10. Fulltext Innovation in Chinese internet companies: A meta-frontier analysis
    Hafeez S, Arshad NI, Rahim LBAB, Shabbir MF, Iqbal J
    PLoS One, 2020;15(5):e0233278.
    PMID: 32437383 DOI: 10.1371/journal.pone.0233278
    The innovation of a particular company benefits the whole industry when innovation technology transfers to others. Similarly, the development and innovation in internet companies influence the development and innovation of the industry. This investigation has applied a unique approach of meta-frontier analysis to estimate and analyze the innovation in internet companies in China. A unique dataset of Chinese internet companies from 2000 to 2017 has been utilized to estimate and compare the innovation over the period of study. The change in technology gap ratio (TGR) and a shift in production function have translated into innovation which was overlooked by previous studies. It is found that the production function of internet companies is moving upward in the presence of external factors such as smartphones invention, mobile internet, mobile payments, and artificial intelligence, etc. Consequently, a sudden increase in TGR is captured due to the innovation of some companies. Hence, the average TE of the industry falls caused by the increased distance of other companies form industry production function. However, the innovation advantage defused when other companies start imitating and the average TE elevates. A steady increase in the TGR index revealed that the continuous innovation-based growth of some companies lifting the production frontier upward. This provides the opportunity for other companies to imitate and provides continuous growth in the industry. This study provides a novel methodological approach to measure innovation and also provide practical implication by empirical estimation of innovation in Chinese internet companies.
  11. Pathogenicity of an Indigenous Strain of the Entomopathogenic Fungus Metarhizium anisopliae (Hypocreales: Clavicipitaceae) (MET-GRA4 Strain) as a Potential Biological Control Agent Against the Red Palm Weevil (Coleoptera: Dryophthoridae)
    Ishak I, Ng LC, Haris-Hussain M, Jalinas J, Idris AB, Azlina Z, et al.
    J Econ Entomol, 2020 02 08;113(1):43-49.
    PMID: 31586213 DOI: 10.1093/jee/toz233
    Metarhizium anisopliae Metchnikoff (Hypocreales: Clavicipitaceae) is a fungal pathogen that causes disease in various insect pests, and it can be exploited and developed as a biological control agent to combat the red palm weevil, Rhynchophorus ferrugineus Olivier (Coleoptera: Dryophthoridae). The study on indigenous isolates is crucial especially for development of bioinsecticides in the future. The M. anisopliae strain called MET-GRA4 was tested for pathogenicity against adult red palm weevil and treated in vitro with different spore viabilities. The isolates exhibited pathogenicity with 100% mortality 21 d postinfection. The median lethal time (LT50) for 85% viable spores was 8.6 d, while 39% viable spores had an LT50 value of 21.37 d, with 92 and 16.6% mycosis, respectively. The species MET-GRA4 strain was molecularly characterized using ITS1 and ITS4 from pure culture (Isolate A), mass-produced spores (Isolate B), and infected red palm weevil cadavers (Isolate C). The DNA sequences obtained matched M. anisopliae sequences, with 99% similarity. This new isolate of M. anisopliae has potential as a targeted bioinsecticide for management of red palm weevil.
  12. Examining students' intention to perform voluntary blood donation using a theory of planned behaviour: A structural equation modelling approach
    Hossain Parash M, Suki NM, Shimmi SC, Hossain ABMT, Murthy KD
    Transfus Clin Biol, 2020 Apr;27(2):70-77.
    PMID: 32139133 DOI: 10.1016/j.tracli.2020.02.002
    OBJECTIVE: This study aims to examine the behavioural intention of students to make voluntary blood donations. Moreover, it uses a theory of planned behaviour as its guiding principle and does so within the context of Malaysia, a developing nation.

    METHODS: Data were collected via a self-administered questionnaire from a sample of 500 students at a public higher learning institution in Malaysia. Structural equation modelling approach (SEM) was performed to assess the strength of the hypothesized relationships of the proposed model simultaneously via the two-stage model-building process.

    RESULTS: The SEM approach revealed that knowledge was the most influential predictor of students' intention to make a voluntary blood donation. With the knowledge that the more blood they donate, the more lives will be saved, the inclination to donate blood is intensifying among students. Moreover, all of the TPB constructs applied were also seen to significantly influence students' response to voluntary blood donation.

    CONCLUSIONS: The nexus of attitude, subjective norm, perceived behavioural control, and knowledge about students' intention to perform voluntary blood donation are evidenced in a developing nation. The implications of the study and directions for future research are provided.

  13. Novel Piperine compound AB05 (N-5-(3,4-dimethoxyphenyl) -2E,4E pentadienylpiperidine) inhibits H1N1 influenza virus propagation in vitro
    Mohammed A, Velu AB, Al-Hakami AM, Meenakshisundaram B, Esther P, Abdelwahid SA, et al.
    Trop Biomed, 2020 Dec 01;37(4):1062-1073.
    PMID: 33612758 DOI: 10.47665/tb.37.4.1062
    Pandemic H1N1 influenza virus respiratory illness has become an inevitable global health concern. With antigenic drift, it becomes necessary to have drugs over tailor-made HIN1 vaccine every year. In the current study, we screened many Piperine derivative in which, N-5-(3,4-dimethoxyphenyl)-2E,4E-pentadienylpiperidine (AB05) and was further studied for anti-H1N1influenza virus activity and compared with other stains in-vitro on MDCK cell line. Initial cytotoxic doses of AB05 for the MDCK cell line were > 25µM. The results showed a dose-dependent reduction of the viral plaque's in the adsorption assay with EC50 of 0.33 µM. The mechanism of AB05 was by inhibition of matured viral release as evaluated by the time of virus addition with incubation of 6-10 hours. With the promising H1N1 virucidal activity of AB05, we included various strains of human influenza virus to screen AB05 inhibition of Neuraminidase (NA). The result showed 70% NA inhibition in WSN (H1N1), 90% in H3N2 and Influenza B and 49% in Tamiflu resistant H1N1). Further our In silco docking studies substantiated experimental results by showing the difference in binding and cooperation between H1N1 and N3N2. Together these observations illustrate that Piperine derivative AB05 is a promising lead molecule which needs further evaluation in animal models.
  14. Fulltext Povidone iodine gargle and mouthwash
    Hassandarvish P, Tiong V, Sazaly AB, Mohamed NA, Arumugam H, Ananthanarayanan A, et al.
    Br Dent J, 2020 06;228(12):900.
    PMID: 32591671 DOI: 10.1038/s41415-020-1794-1
  15. Fulltext Iodine content in drinking water not an important determinant of endemic goitre
    Osman A, Khalida M, Azman AB, Jamil R, Tan TT, Wu LL, et al.
    Asia Pac J Clin Nutr, 1993 Sep;2(3):115-8.
    PMID: 24352141
    The prevalence of goitre was determined in several communities in rural parts of Pahang. Urine specimens were collected randomly among the participants. Drinking water from various sources such as river and spring, and water from gravity feed systems was also collected to determine the iodine content by using the ashing method. The results were compared to that of Kuala Lumpur City. lt was found that the prevalence of goitre in rural areas was between 20 and 70% depending on village, ethnic group, age and gender. The interior parts of the jungle where Aborigines lived was moderately endemic with goitre prevalence of goitre more than 20% and urinary iodine content 2.0-5.0 μg I/dl). A nearby Malay traditional village which was studied had mild endemia (prevalence 10-30% and urinary iodine content 5.0-10.0 μg I/dl) while a Felda Malay resettlement scheme and Kuala Lumpur City did not have endemic goitre. Endemic goitre in rural areas was associated with low iodine content in drinking water. Even though Kuala Lumpur had low iodine content in its drinking water there was no endemic goitre, indicating that other factors were more important.
  16. Fulltext Risk determinants of peripheral neuropathy in patients with type II diabetes mellitus attending follow-up clinics at Universiti Kebangsaan Malaysia Medical Center (UKMMC): a cross-sectional study
    Fatimah AB, Aziz N A, Amaramalar SN, Aznida FAA, Hamid MZA, Norlaila M
    Medicine & Health, 2010;5(1):34-40.
    MyJurnal
    Peripheral neuropathy is highly associated with foot complications among diabetics. This
    study aimed to identify risk factors associated with the development of peripheral neuropathy in diabetic patients and their association with degree of severity of peripheral neuropathy. A cross-sectional study was conducted in follow-up clinics at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Malaysia involving 72 diabetic patients and 19 controls. Exclusion criteria were those with amputated limbs, gross foot deformity and existing peripheral neuropathy. Controls were non diabetics who walked normally, had no history of foot problem and attended the clinic as subjects’ companion. Quantitative assessment of neuropathy was done using Semmes-Weinstein monofilament. Neuropathy Disability Score (NDS) were used to quantify severity of diabetic neuropathy. Spearman’s Rank test and Mann-Whitney test were used to determine correlation between variables and their differences. Logistic regression analysis was used to determine risk factors associated with peripheral neuropathy. The mean HbA1c among diabetics was 8.6% + 4.1, and mean NDS was 7.0 + 6.0. A total of 79.1% demonstrated various level of neuropathy with presence of callus was associated with higher NDS scores. Older age (P=0.02), body weight (P=0.03), HbA1c (P=0.005) and duration of diabetes (P <0.005) showed positive correlation with NDS. Proper foot care program for diabetics should include recognition of the callus, with special emphasis given to those with heavier weight and increasing age.
    Key words: diabetes mellitus, peripheral neuropathy, Neuropathy Disability Score
    (NDS), Semmes Weinstein monofilament (SWMF), callus

    Study site: follow-up clinics at the Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  17. Fulltext Nondestructive Determination of Strength of Concrete Incorporating Industrial Wastes as Partial Replacement for Fine Aggregate
    Odimegwu TC, Kaish ABMA, Zakaria I, Abood MM, Jamil M, Ngozi KO
    Sensors (Basel), 2021 Dec 10;21(24).
    PMID: 34960357 DOI: 10.3390/s21248256
    Schmidt rebound hammer test was employed in this study as a nondestructive test. This test method has been universally utilized due to its non-destructiveness for quick and easy assessment of material strength properties and quality of concrete of an existing structure. Industrial waste materials (air-dried alum sludge, treated alum sludge, limestone dust and quarry dust) were employed as replacement material for fine aggregates in this study. A normal strength concrete was designed to achieve 35 MPa at 28 days, with industrial waste materials replacing fine aggregate at different percentages (0%, 5%, 10% and 15%), and then cured for 7, 28 and 180 days. The compressive strength values and rebound numbers for all the mixes obtained were correlated, and a regression equation was established between compressive strength and Schmidt rebound number. The correlation result showed an excellent relationship between rebound number and compressive strength of concrete produced in this study at all curing ages, with correlation coefficients of R2 = 0.98, R2 = 0.99 and R2 = 0.98. The predicted equation showed a strong relationship with the experimental compressive strength. Therefore, it can be used for the prediction of compressive strength of concrete with industrial waste as a replacement for fine aggregate.
  18. An exposed Cardiovascular Implantable Electronic Device (CIED) complicated with infection: A case report of unconventional experience with 'Sealed CIED'
    Mohd Said MR, Gian Singh SS, Chea CY, Mohd Firdaus MAB, Narasamuloo KR, Krishinan S
    Med J Malaysia, 2022 Jan;77(1):119-120.
    PMID: 35087011
    The rate of infected Cardiovascular Implantable Electronic Device is alarming and causes substantial socio-economic burden. A common approach involves immediate extraction of the infected device. Here, we report an unorthodox approach to this problem by 'sealing' the generator inside a sterile container as a temporary permanent pacemaker while waiting for implantation of another device. We report a 66 years old emaciated lady with underlying Sick Sinus Syndrome, who had an implanted single chamber pacemaker and presented with partial protrusion of her device. She underwent sub-pectoral implantation of the new device but subsequently re-presented with pocket site infection after a month. A decision was made to extract the infected generator from the sub-pectoral pocket and it was sealed inside a sterile container as 'bridging therapy' while awaiting arrival of a leadless pacemaker for implantation together with total extraction of the old infected device. Our clinical vignette demonstrated the difficulties we encountered and influenced on our decision for this unconventional approach despite limited supporting evidence.
  19. Investigation of the Effects of Excipients in the Compounding of Amlodipine Besylate Orally Disintegrating Tablets
    Azmi NHS, Ming LC, Uddin ABMH, Sarker ZI, Bin LK
    Int J Pharm Compd, 2022 1 27;26(1):80-87.
    PMID: 35081048
    Oral drug delivery has been recognized as the most desirable drug administration method among other drug delivery routes due to its ease of administration, long shelf life, and low cost. Orally disintegrating tablets disintegrate within seconds in the mouth without the need of water for swallowing. This unique feature of orally disintegrating tablets is favorable to special populations such as geriatric and pediatric patients. Formulation optimization is significant to obtain the optimal combination of tablet constituents, as the tablet composition is influential on dosage-form characteristics. The objective of this study was to investigate the effect of different types of fillers and percentage on the physical properties of orally disintegrating tablets by using amlodipine as the model drug. Blank orally disintegrating tablets containing different fillers, namely, Sorbolac 400, Granulac 200, and CombiLac with different percentages, were prepared using the wet granulation method and were evaluated based on weight variation, hardness, thickness, friability, and disintegration time. Formulation 5 that consists of 25% Granulac 200 showed the optimal result among all formulations with the fastest disintegration time (96.17 s Å} 18.40) and sufficient tablet hardness (4.59 kg Å} 0.70). Hence, formulation 5 was selected as the optimal formulation and incorporated with amlodipine. From this study, it can be concluded that excipients have an essential role in determining the physical properties of orally disintegrating tablets.
  20. Determination of service key performance indicators for emergency departments of teaching hospitals in Malaysia: A fuzzy delphi method
    Nik Hisamuddin NAR, Normalinda Y, Abu Yazid MN, Mimi Azliha AB, Andey R, Mohd Hashairi F, et al.
    Med J Malaysia, 2021 Nov;76(6):792-798.
    PMID: 34806662
    INTRODUCTION: The most crucial step in forming a set of key performance indicators (KPI) for emergency department's (ED) staff is deciding the appropriate items for the KPI. This article demonstrates Fuzzy Delphi Method (FDM) as a scientific approach to consolidate consensus agreement within a panel of experts pertaining to each service related KPI item's appropriateness for ED. We aimed to develop framework of service key performance indicators for emergency departments of tertiary centres by using FDM.

    MATERIALS AND METHODS: The panel consists of ten experts from ED that was randomly chosen from list of specialists obtained from the National Specialist Registry for Emergency Medicine. A set of questionnaires that contains item constructs related to KPI based on structure, outcome and process was developed from initial literature search from Pubmed Central, Google Scholar, Cochrane Database and Public Library of Sciences. The construct then used for FDM session in second phase of the study. In FDM phase, the experts will rank each of the items created from nominal group technique (NGT) session by using Likert Scale ranged from 1 to 5 ("1" totally disagree and "5" extremely agree). FDM prerequisite must include threshold value (d) ≤0.2, expert consensus of >75% and average fuzzy numbers ("A" value) of >0.5.

    RESULTS: The initial item construct has produced 22 items proposed for the service KPI. Post FDM analysis for service KPI, 16 out of the 22 (72%) satisfied first prerequisite "d" value ≤0.2. For the second prerequisite, ten items (45%) from service KPI domain had expert consensus of more than 75%. For the third prerequisite, 16 out of the 22 (73%) fit the criteria of average fuzzy number ("A" value) of more than 0.5. In final model of FDM, 13 items (59%) were discarded and the remaining (n=9 items) that fulfilled all three prerequisites were retained for the final draft for content validation process.

    CONCLUSION: This study introduces that FDM can be used to obtain experts' opinion and consensus in order to achieve a decision. The experts' consensus on the suitability of the pre-selected items on the KPI set were obtained, hence it is now ready for further applicability in the clinical setting in ED.

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