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Current utilization patterns for long-acting insulin analogues including biosimilars among selected Asian countries and the implications for the future

Godman B, Haque M, Kumar S, Islam S, Charan J, Akter F, et al.

Curr Med Res Opin, 2021 09;37(9):1529-1545.
PMID: 34166174 DOI: 10.1080/03007995.2021.1946024

INTRODUCTION: Prevalence rates for diabetes mellitus continue to rise, which, coupled with increasing costs of complications, has appreciably increased expenditure in recent years. Poor glycaemic control including hypoglycaemia enhances complication rates and associated morbidity, mortality and costs. Consequently, this needs to be addressed. Whilst the majority of patients with diabetes have type-2 diabetes, a considerable number of patients with diabetes require insulin to help control their diabetes. Long-acting insulin analogues were developed to reduce hypoglycaemia associated with insulin and help improve adherence, which can be a concern. However, their considerably higher costs have impacted on their funding and use, especially in countries with affordability issues. Biosimilars can help reduce the costs of long-acting insulin analogues thereby increasing available choices. However, the availability and use of long-acting insulin analogues can be affected by limited price reductions versus originators and limited demand-side initiatives to encourage their use. Consequently, we wanted to assess current utilisation rates for long-acting insulin analogues, especially biosimilars, and the rationale for patterns seen, across multiple Asian countries ranging from Japan (high-income) to Pakistan (lower-income) to inform future strategies.
METHODOLOGY: Multiple approaches including assessing utilization and prices of insulins including biosimilars among six Asian countries and comparing the findings especially with other middle-income countries.
RESULTS: Typically, there was increasing use of long-acting insulin analogues among the selected Asian countries. This was especially the case enhanced by biosimilars in Bangladesh, India, and Malaysia reflecting their perceived benefits. However, there was limited use in Pakistan due to issues of affordability similar to a number of African countries. The high use of biosimilars in Bangladesh, India and Malaysia was helped by issues of affordability and local production. The limited use of biosimilars in Japan and Korea reflects limited price reductions and demand-side initiatives similar to a number of European countries.
CONCLUSIONS: Increasing use of long-acting insulin analogues across countries is welcomed, adding to the range of insulins available, which increasingly includes biosimilars. A number of activities are needed to enhance the use of long-acting insulin analogue biosimilars in Japan, Korea and Pakistan.
Fulltext The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future

Godman B, Haque M, Leong T, Allocati E, Kumar S, Islam S, et al.

Front Public Health, 2021;9:671961.
PMID: 34249838 DOI: 10.3389/fpubh.2021.671961

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers. Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders. Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries. Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production. Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities.
Gastrointestinal parasitic infections of buffaloes (Bubalus bubalis) in Sarawak Borneo: Prevalence, risk factors, and farming practices

Harizt AM, Malahubban M, Syed-Hussain SS, Ramanoon SZ, Sadiq MB, Sarbini SR, et al.

Trop Biomed, 2021 Sep 01;38(3):318-326.
PMID: 34508339 DOI: 10.47665/tb.38.3.072

The objectives of this study were to investigate the prevalence and associated risk factors for gastrointestinal (GI) parasites in buffaloes from various areas of Sarawak, and to assess current management practices of GI parasites among farmers. Faecal samples were collected from 15 farms and 129 animals, as well as data on farm and animal-based characteristics. A total of 129 faecal samples were examined for GI parasites using a modified McMaster and sedimentation. Association between potential risk factors and the prevalence of GI parasites was investigated using Chi-square statistic. The prevalence of Paramphistomum sp., strongyles, and coccidia were 75.2% (95% CI±7.5), 52.7% (95% CI±8.6) and 48.1% (95% CI±8.6), respectively. Farms which had a grazing area less than 50 acres in size had significantly higher prevalence of strongyles (70.5%, χ2 = 8.34, P = 0.004) and paramphistomes (88.6%, χ2 = 6.46, P = 0.01) relative to farms with a larger grazing area (43.5% and 68.2%, respectively). Prevalence of strongyles was lower in farms that did not implement a cut- and-carry system (45.6%, χ2 = 4.17, P = 0.04) in comparison to those that did (64%). The prevalence of paramphistomes was higher on farms with more than 40 animals (80.6%, χ2 = 3.18, P = 0.05) relative to farms with fewer animals. The majority of farmers surveyed (67.9%) showed awareness of GI parasite infection and reported that they recognized the associated symptoms. Most farmers practised deworming, and ivermectin was the most commonly used anthelminthic (60.4%); only 1.9% of farmers used albendazole. Overall this study revealed a high prevalence of GI parasites in buffalo in Sarawak. Although farmers report they are aware of parasitic diseases, further education is still required. This could include how they can successfully implement on-farm changes to reduce the prevalence of GI parasites in their herds.
Cytotoxic and antioxidant effects of methoxylated stilbene analogues on HepG2 hepatoma and Chang liver cells: Implications for structure activity relationship

Hasiah AH, Ghazali AR, Weber JF, Velu S, Thomas NF, Inayat Hussain SH

Hum Exp Toxicol, 2011 Feb;30(2):138-44.
PMID: 20385705 DOI: 10.1177/0960327110368739

Stilbenes possess a variety of biological activities including chemopreventive activity. This study was conducted to evaluate the structural activity relationships of six methoxylated stilbene analogues with respect to their cytotoxic effects and antioxidant activities on HepG2 hepatoma and Chang liver cells. The cytotoxic and total antioxidant activities of six stilbene analogues were determined by MTT and Ferric Reducing Antioxidant Power (FRAP) assays, respectively. We found that the cis-methoxylated stilbene: (Z)-3,4,4'-trimethoxystilbene was the most potent and selective antiproliferative agent (IC₅₀ 89 µM) in HepG2 cells. For the total antioxidant activity, compounds possessing hydroxyl groups at the 4' position namely (E)-3-methoxy-4'-hydroxystilbene, (E)-3,5-dimethoxy-4'-hydroxystilbene (pterostilbene), (E)-4-methoxy-4'-hydroxystilbene showed the highest antioxidant activity. Structure activity relationship studies of these compounds demonstrated that the cytotoxic effect and antioxidant activities of the tested compounds in this study were structurally dependent.
Fulltext Severe Developmental Delay, Epilepsy and Neonatal Diabetes (DEND) Syndrome: A Case Report

Helmi MAM, Hussain S

J ASEAN Fed Endocr Soc, 2020;35(1):125-128.
PMID: 33442181 DOI: 10.15605/jafes.035.01.22

Developmental delay, Epilepsy and Neonatal Diabetes (DEND) syndrome is the most severe form of Permanent Neonatal Diabetes with KCNJ11 gene mutation which accounts for most of the cases. We report the first DEND syndrome in Malaysia with heterozygous missense mutation Q52R at KCNJ11 (Kir6.2) gene with delayed presentation beyond 6 months of age and failure to transition to glibenclamide. This report signifies the phenotypical variability among patients with the same genetic mutation and the different response to treatment.
Fulltext Did the COVID-19 Pandemic Spark a Public Interest in Pet Adoption?

Ho J, Hussain S, Sparagano O

Front Vet Sci, 2021;8:647308.
PMID: 34046443 DOI: 10.3389/fvets.2021.647308

This study aimed to determine if there has been an increase of global interest on pet adoption immediately after the WHO declaration of the pandemic and if the effect has been sustainable in 8 months on. We conducted a Google Trends search using keywords related to pet adoption. Relative search volume (RSV) was scored between 0 and 100 for the lowest and the highest, respectively. Top countries contributing to the dataset included Australia, the United States, Canada, New Zealand, the United Kingdom, Singapore, the Philippines, and Malaysia. From 2015 through 2020, the worldwide RSV for the categories of pet, dog and cat adoption peaked between April and May 2020, the early epidemic phase of the pandemic. These were significantly higher than the 5-year worldwide average RSV for all three categories (P = 0.001). Comparing to the same period in 2019, the RSV ratio (2020/2019) for both dog and cat adoption increased by up to 250%. Nonetheless, the RSV for dog adoption has been decreasing since July 2020 and returned to the 5-year average by December 2020. In contrast, the interest in cat adoption remained sustainably high, possibly reflecting the feline acclimation to indoor living. In conclusion, the global interest in pet adoptions surged in the early phase of the pandemic but not sustainable. With the launch of COVID-19 vaccines, there is a concern for separation anxiety and possible abandonment of these newly adopted pets when the owners would leave their homes for work in the future.
Fulltext Multicriteria decision making attributes and estimation of physicochemical properties of kidney cancer drugs via topological descriptors

Husin MN, Khan AR, Awan NUH, Campena FJH, Tchier F, Hussain S

PLoS One, 2024;19(5):e0302276.
PMID: 38713692 DOI: 10.1371/journal.pone.0302276

Based on topological descriptors, QSPR analysis is an incredibly helpful statistical method for examining many physical and chemical properties of compounds without demanding costly and time-consuming laboratory tests. Firstly, we discuss and provide research on kidney cancer drugs using topological indices and done partition of the edges of kidney cancer drugs which are based on the degree. Secondly, we examine the attributes of nineteen drugs casodex, eligard, mitoxanrone, rubraca, and zoladex, etc and among others, using linear QSPR model. The study in the article not only demonstrates a good correlation between TIs and physical characteristics with the QSPR model being the most suitable for predicting complexity, enthalpy, molar refractivity, and other factors and a best-fit model is attained in this study. This theoretical approach might benefit chemists and professionals in the pharmaceutical industry to forecast the characteristics of kidney cancer therapies. This leads towards new opportunities to paved the way for drug discovery and the formation of efficient and suitable treatment options in therapeutic targeting. We also employed multicriteria decision making techniques like COPRAS and PROMETHEE-II for ranking of said disease treatment drugs and physicochemical characteristics.
Physico-chemical method for ammonia removal from synthetic wastewater using limestone and GAC in batch and column studies

Hussain S, Aziz HA, Isa MH, Adlan MN, Asaari FA

Bioresour Technol, 2007 Mar;98(4):874-80.
PMID: 16716587

The purpose of the present study was to examine the removal of ammoniacal nitrogen (NH4-N) from synthetic wastewater using limestone (LS) and granular activated carbon (GAC) mixture as low cost adsorbent. In batch study, optimum shaking and settling times were 150 and 120 min, respectively. The LS-GAC mixture ratio of 25:15 removed about 58% NH4-N. The smaller particle size of medium yielded higher adsorption capacity. The equilibrium adsorption data followed the Freundlich isotherm (R2 > 0.98) but it showed weak bond. Adsorption kinetics were well described by the pseudo second-order rate model (R2 > 0.93). The upflow column showed that higher flow rate and initial concentration resulted in shorter column saturation time. The study showed that the usage of GAC could be reduced by combining GAC with LS for the removal of NH4-N from wastewater; thus reducing the cost of treatment.
Fulltext Permanent neonatal diabetes due to a novel insulin signal peptide mutation

Hussain S, Mohd Ali J, Jalaludin MY, Harun F

Pediatr Diabetes, 2013 Jun;14(4):299-303.
PMID: 23350652 DOI: 10.1111/pedi.12011

We report a rare case of permanent neonatal diabetes (PND) due to insulin (INS) gene mutation in a 51-month-old girl who presented with hyperglycemia in the neonatal period. Mutational analysis of KCNJ11 and INS was performed and this detected a novel heterozygous c.38T>G (p.Leu13Arg) INS de novo mutation. The non-conservative change substitutes the highly conserved L(13) residue within the hydrophobic core region of the preproinsulin signal peptide. Given the frequent tendency of heterozygous INS mutations to exhibit dominant negative disease pathogenesis, it is likely that the mutant preproinsulin perturbed the non-mutant counterpart progression and processing within the β-cells, and this resulted to a permanent form of congenital diabetes.
IL36RN mutations define a severe autoinflammatory phenotype of generalized pustular psoriasis

Hussain S, Berki DM, Choon SE, Burden AD, Allen MH, Arostegui JI, et al.

J Allergy Clin Immunol, 2015 Apr;135(4):1067-1070.e9.
PMID: 25458002 DOI: 10.1016/j.jaci.2014.09.043
Cytotoxicity of Anchusa arvensis Against HepG-2 Cell Lines: Mechanistic and Computational Approaches

Hussain S, Ullah F, Sadiq A, Ayaz M, Shah AA, Ali Shah SA, et al.

Curr Top Med Chem, 2019;19(30):2805-2813.
PMID: 31702502 DOI: 10.2174/1568026619666191105103801

BACKGROUND: Liver cancer is a devastating cancer with increasing incidence and mortality rates worldwide. Plants possess numerous therapeutic properties, therefore the search for novel, naturally occurring cytotoxic compounds is urgently needed.
METHODS: The anticancer activity of plant extracts and isolated compounds from Anchusa arvensis (A. arvensis) were studied against the cell culture of HepG-2 (human hepatocellular carcinoma cell lines) using 3-(4,5-Dimethylthiazol-yl)-diphenyl tetrazoliumbromide (MTT) assay. Apoptosis was investigated by performing Acridine orange -ethidium bromide staining, styox green assay and DNA interaction study. We also used tools for computational chemistry studies of isolated compounds with the tyrosine kinase.
RESULTS: In MTT assay, the crude extract caused a significant cytotoxic effect with IC50 of 34.14 ± 0.9 μg/ml against HepG-2 cell lines. Upon fractionation, chloroform fraction (Aa.Chm) exhibited the highest antiproliferative activity with IC50 6.55 ± 1.2 μg/ml followed by ethyl acetate (Aa.Et) fraction (IC50, 24.59 ± 0.85 μg/ml) and n-hexane (Aa.Hex) fraction (IC50 29.53 ± 1.5μg/ml). However, the aqueous (Aa.Aq) fraction did not show any anti-proliferative activity. Bioactivity-guided isolation led to the isolation of two compounds which were characterized as para-methoxycatechol (1) and decane (2) through various spectroscopic techniques. Against HepG-2 cells, compound 1 showed marked potency with IC50 6.03 ± 0.75 μg/ml followed by 2 with IC50 18.52 ± 1.9 μg/ml. DMSO was used as a negative control and doxorubicin as a reference standard (IC50 1.3 ± 0.21 μg/ml). It was observed that compounds 1-2 caused apoptotic cell death evaluated by Acridine orange -ethidium bromide staining, styox green assay and DNA interaction study, therefore both compounds were tested for molecular docking studies against tyrosine kinase to support cytotoxic activity.
CONCLUSION: This study revealed that the plant extracts and isolated compounds possess promising antiproliferative activity against HepG-2 cell lines via apoptotic cell death.
Fulltext In Silico, Cytotoxic and Antioxidant Potential of Novel Ester, 3-hydroxyoctyl -5- trans-docosenoate Isolated from Anchusa arvensis (L.) M.Bieb. Against HepG-2 Cancer Cells

Hussain S, Ullah F, Ayaz M, Ali Shah SA, Ali Shah AU, Shah SM, et al.

Drug Des Devel Ther, 2019;13:4195-4205.
PMID: 31849451 DOI: 10.2147/DDDT.S228971

Background: Cancer is one of the chronic health conditions worldwide. Various therapeutically active compounds from medicinal plants were the current focus of this research in order to uncover a treatment regimen for cancer. Anchusa arvensis (A. anchusa) (L.) M.Bieb. contains many biologically active compounds.
Methods: In the current study, new ester 3-hydroxyoctyl -5- trans-docosenoate (compound-1) was isolated from the chloroform soluble fraction of A. anchusa using column chromatography. Using MTT assay, the anticancer effect of the compound was determined in human hepatocellular carcinoma cells (HepG-2) compared with normal epithelial cell line (Vero). DPPH and ABTS radical scavenging assays were performed to assess the antioxidant potential. The Molecular Operating Environment (MOE-2016) tool was used against tyrosine kinase.
Results: The structure of the compound was elucidated based on IR, EI, and NMR spectroscopy technique. It exhibited a considerable cytotoxic effect against HepG-2 cell lines with IC50 value of 6.50 ± 0.70 µg/mL in comparison to positive control (doxorubicin) which showed IC50 value of 1.3±0.21 µg/mL. The compound did not show a cytotoxic effect against normal epithelial cell line (Vero). The compound also exhibited significant DPHH scavenging ability with IC50 value of 12 ± 0.80 µg/mL, whereas ascorbic acid, used as positive control, demonstrated activity with IC50 = 05 ± 0.15 µg/mL. Similarly, it showed ABTS radical scavenging ability (IC50 = 130 ± 0.20 µg/mL) compared with the value obtained for ascorbic acid (06 ± 0.85 µg/mL). In docking studies using MOE-2016 tool, it was observed that compound-1 was highly bound to tyrosine kinase by having two hydrogen bonds at the hinge region. This good bonding network by the compound might be one of the reasons for showing significant activity against this enzyme.
Conclusion: Our findings led to the isolation of a new compound from A. anchusa which has significant cytotoxic activity against HepG-2 cell lines with marked antioxidant potential.
Fulltext A Novel Feature-Engineered-NGBoost Machine-Learning Framework for Fraud Detection in Electric Power Consumption Data

Hussain S, Mustafa MW, Al-Shqeerat KHA, Saeed F, Al-Rimy BAS

Sensors (Basel), 2021 Dec 17;21(24).
PMID: 34960516 DOI: 10.3390/s21248423

This study presents a novel feature-engineered-natural gradient descent ensemble-boosting (NGBoost) machine-learning framework for detecting fraud in power consumption data. The proposed framework was sequentially executed in three stages: data pre-processing, feature engineering, and model evaluation. It utilized the random forest algorithm-based imputation technique initially to impute the missing data entries in the acquired smart meter dataset. In the second phase, the majority weighted minority oversampling technique (MWMOTE) algorithm was used to avoid an unequal distribution of data samples among different classes. The time-series feature-extraction library and whale optimization algorithm were utilized to extract and select the most relevant features from the kWh reading of consumers. Once the most relevant features were acquired, the model training and testing process was initiated by using the NGBoost algorithm to classify the consumers into two distinct categories ("Healthy" and "Theft"). Finally, each input feature's impact (positive or negative) in predicting the target variable was recognized with the tree SHAP additive-explanations algorithm. The proposed framework achieved an accuracy of 93%, recall of 91%, and precision of 95%, which was greater than all the competing models, and thus validated its efficacy and significance in the studied field of research.
Fulltext Mathematical analysis of stochastic epidemic model of MERS-corona & application of ergodic theory

Hussain S, Tunç O, Rahman GU, Khan H, Nadia E

Math Comput Simul, 2023 May;207:130-150.
PMID: 36618952 DOI: 10.1016/j.matcom.2022.12.023

The "Middle East Respiratory" (MERS-Cov) is among the world's dangerous diseases that still exist. Presently it is a threat to Arab countries, but it is a horrible prediction that it may propagate like COVID-19. In this article, a stochastic version of the epidemic model, MERS-Cov, is presented. Initially, a mathematical form is given to the dynamics of the disease while incorporating some unpredictable factors. The study of the underlying model shows the existence of positive global solution. Formulating appropriate Lyapunov functionals, the paper will also explore parametric conditions which will lead to the extinction of the disease from a community. Moreover, to reveal that the infection will persist, ergodic stationary distribution will be carried out. It will also be shown that a threshold quantity exists, which will determine some essential parameters for exploring other dynamical aspects of the main model. With the addition of some examples, the underlying stochastic model of MERS-Cov will be studied graphically for more illustration.
Fulltext Synergistic Antibacterial Screening of Cymbopogon citratus and Azadirachta indica: Phytochemical Profiling and Antioxidant and Hemolytic Activities

Hussain S, Javed W, Tajammal A, Khalid M, Rasool N, Riaz M, et al.

ACS Omega, 2023 May 16;8(19):16600-16611.
PMID: 37214690 DOI: 10.1021/acsomega.2c06785

Current studies were performed to investigate the phytochemistry, synergistic antibacterial, antioxidant, and hemolytic activities of ethanolic and aqueous extracts of Azadirachta indica (EA and WA) and Cymbopogon citratus (EC and WC) leaves. Fourier transform infrared data verified the existence of alcoholic, carboxylic, aldehydic, phenyl, and bromo moieties in plant leaves. The ethanolic extracts (EA and EC) were significantly richer in phenolics and flavonoids as compared to the aqueous extracts (WA and WC). The ethanolic extract of C. citratus (EC) contained higher concentrations of caffeic acid (1.432 mg/g), synapic acid (6.743 mg/g), and benzoic acid (7.431 mg/g) as compared to all other extracts, whereas chlorogenic acid (0.311 mg/g) was present only in the aqueous extract of A. indica (WA). Food preservative properties of C. citratus can be due to the presence of benzoic acid (7.431 mg/g). -Gas chromatography-mass spectrometry analysis demonstrated the presence of 36 and 23 compounds in A. indica and C. citratus leaves, respectively. Inductively coupled plasma analysis was used to determine the concentration of 26 metals (Al, As, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Mo, Na, Ni, Pb, Sb, Se, Si, Sn, Sr, V, Zn, Zr, Ti); the metal concentrations were higher in aqueous extracts as compared to the ethanolic extracts. The extracts were generally richer in calcium (3000-7858 ppm), potassium (13662-53,750 ppm), and sodium (3181-8445 ppm) and hence can be used in food supplements as a source of these metals. Antioxidant potential (DDPH method) of C. citratus ethanolic extract was the highest (74.50 ± 0.66%), whereas it was the lowest (32.22 ± 0.28%) for the aqueous extract of A. indica. Synergistic inhibition of bacteria (Staphylococcus aureus and Escherichia coli) was observed when the aqueous extracts of both the plants were mixed together in certain ratios (v/v). The highest antibacterial potential was exhibited by the pure extract of C. citratus, which was even higher than that of the standard drug (ciprofloxacin). The plant extracts and their mixtures were more active against S. aureus as compared to E. coli. No toxic hemolytic effects were observed for the investigated extracts indicating their safe medicinal uses for human beings.
Fulltext Vibration-Based Fatigue Analysis of Octet-Truss Lattice Infill Blades for Utilization in Turbine Rotors

Hussain S, Ghopa WAW, Singh SSK, Azman AH, Abdullah S, Harun Z, et al.

Materials (Basel), 2022 Jul 14;15(14).
PMID: 35888355 DOI: 10.3390/ma15144888

Vibration fatigue characteristics are critical for rotating machinery components such as turbine rotor blades. Lattice structures are gaining popularity in engineering applications due to their unique ability to reduce weight and improve the mechanical properties. This study is an experimental investigation of octet-truss lattice structure utilization in turbine rotor blades for weight reduction and to improve vibration fatigue characteristics. One completely solid and three lattice infilled blades with variable strut thickness were manufactured via additive manufacturing. Both free and forced experimental vibration analyses were performed on the blades to investigate their modal and vibration fatigue characteristics. The blades were subjected to random vibration using a vibration shaker. The response was measured using a triaxial accelerometer in terms of vibration acceleration time histories in the X, Y, and Z directions. Results indicate a weight reduction of up to 24.91% and enhancement in the first natural frequency of up to 5.29% were achieved using lattice infilled blades. The fatigue life of the blades was investigated using three frequency domain approaches, namely, Lalanne, Dirlik and narrow band. The fatigue life results indicate that the 0.25 mm lattice blade exhibits the highest fatigue life, while the solid blade exhibits the lowest fatigue life of all four blades. The fatigue life of the 0.25 mm lattice blade was 1822-, 1802-, and 1819- fold higher compared to that of the solid blade, using the Lalanne, Dirlik, and narrow-band approaches, respectively. These results can serve as the first step towards the utilization of lattice structures in turbine blades, with thermal analysis as the next step. Therefore, apart from being light weight, the octet-truss lattice infilled blades exhibited superior vibration fatigue characteristics to vibration loads, thereby making them a potential replacement for solid blades in turbine rotors.
Fulltext Prevalence and Risk Factors for Hypovitaminosis D among Healthy Adolescents in Kota Bharu, Kelantan

Hussain S, Elnajeh M

J ASEAN Fed Endocr Soc, 2020;35(2):176-180.
PMID: 33442189 DOI: 10.15605/jafes.035.02.05

OBJECTIVE: We aim to study the prevalence and risk factors of hypovitaminosis D among healthy adolescents in Kota Bharu, Kelantan based on the most recent Paediatric Consensus guideline.
METHODOLOGY: Ten public schools were selected from Kota Bharu, Kelantan. We analysed their demography (age, gender, ethnicity, income), measured their anthropometry (height, weight, BMI) and finally analysed their vitamin D and intactParathyroid hormone levels.
RESULTS: The prevalence of hypovitaminosis D was 16.9% among healthy teenagers with mean age of 15.9±1.39 years. Multivariate analysis showed female gender (adjusted OR, 95% CI): 23.7 (5.64, 100.3) and Chinese 0.24 (0.07, 0.84) were the significant predictors for hypovitaminosis D.
CONCLUSION: The prevalence of healthy adolescents with hypovitaminosis D in Kota Bharu, Kelantan was 16.9% using the most recent cut off value of 30 nmol/L from the global consensus 2016. Female and Malay were the significant risk factors associated with hypovitaminosis D. Higher cut off value would result in overestimation of prevalence rate of hypovitaminosis D.
Fulltext Comparison of the Clinical and Biochemical Profile of Metabolic Syndrome Between Obese Children Below and Above 10-Years Old Attending Paediatric Clinic Hospital Universiti Sains Malaysia from 2006 to 2015

Hussain S, Men KK, Majid NA

J ASEAN Fed Endocr Soc, 2017;32(2):132-138.
PMID: 33442096 DOI: 10.15605/jafes.032.02.06

Objectives: We aim to compare the clinical and biochemical profile of metabolic syndrome between obese children below and above 10 years attending Paediatric clinic Hospital Universiti Sains Malaysia (HUSM) from 2006 to 2015. This is to determine if age, particularly the transition to puberty, modifies the prevalence of components of metabolic syndrome in obese children.
Methodology: The medical records of 84 obese children under 18 years of age seen at Paediatric clinic HUSM from 2006 to 2015 were reviewed. Demographic (age, gender, ethnicity), anthropometric (weight and height), clinical [body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP)] and biochemical [serum total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), fasting plasma glucose (FPG)] parameters were recorded, analyzed and compared.
Results: Majority of subjects in both age groups were boys, with 68.2% <10 years old. Mean age was 9.69 years (±3.36). The clinical and biochemical parameters of metabolic syndrome were similar between those <10 years old and >10 years, with the exception of BMI, waist circumference, SBP and TG level. Multivariate regression analysis showed that the parameters of metabolic syndrome significantly associated with age ≥10 years were systolic hypertension (adjusted OR 7.17, 95% CI, 1.48 to 34.8) and BMI >30 kg/m2 (adjusted OR 3.02, 95% CI, 1.16 to 7.86).
Conclusion: There were similar clinical and biochemical parameters of metabolic syndrome in both age groups. The proportions of children with metabolic syndrome were similar regardless of age group. The overall prevalence rate of metabolic syndrome was 27.3%. In view of the alarming presence of components of metabolic syndrome even in children less than 10 years of age, efforts aimed at the prevention of childhood obesity in the community should be intensified.
Fulltext Open reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel T-Plate

Hussain S, Gul M, Dhar S

Malays Orthop J, 2014 Mar;8(1):8-13.
PMID: 25279078 DOI: 10.5704/MOJ.1403.011

BACKGROUND: Proximal humeral fractures are considered the last unsolved fractures in orthopaedics. The treatment is controversial and various operative modalities have been reported in the literature. The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal humerus AO stainless steel T-plate. Twenty-five (25) patients with displaced proximal humerus fractures treated with proximal humerus T-plate between May 2005 and June 2008 were included in the study. Fractures were classified according to the Neer classification into displaced 2-part, 3-part, and 4-part fractures. Patients were followed-up for a minimum period of two years. Functional evaluation was done according to the Neer scoring system. Scores were compared with other studies in the literature using similar implant. Twenty patients had 2-part fracture, four had 3-part fracture, and one had 4-part fracture. Eighty-eight [88% (n = 22)] patients had good to excellent result, eight [8% (n = 2)] had fair, and four [4% (n = 1)] had poor result. Difference in Neer's score between 2-part and 3-part fractures was not significant. Complications encountered in this series were screw backout in 8% (n = 2), superficial infection in 12% (n = 3), and avascular necrosis in 4% (n = 1) of cases. We conclude that proximal humerus AO T- plate is a cheap and easily available implant, aspects which are particularly relevant in third world countries like India. It gives reliable fixation for 2-part and 3-part fractures. Its use in more complicated fracture patterns of 4-part fractures is not recommended.
KEY WORDS: Proximal humerus fractures, proximal humerus stainless steel T-plate, unstable fracture.
Characteristics and health implications of fine particulate matter near urban road site in Islamabad, Pakistan

Hussain S, Siddique A, Hassan M, Rasool K, Shahzad A, Asad Naqvi SA, et al.

Environ Res, 2024 Apr 02;252(Pt 1):118862.
PMID: 38574984 DOI: 10.1016/j.envres.2024.118862

The escalating issue of air pollution has become a significant concern in urban regions, including Islamabad, Pakistan, due to the rise in air pollutant emissions driven by economic and industrial expansion. To gain a deeper understanding of air pollution, a study was conducted during winter 2022-2023, assessing physical, chemical, and biological factors in Islamabad. The findings revealed that the average concentration of fine particulate matter (PM2.5) was notably greater than the World Health Organization (WHO) guidelines, reaching 133.39 μg/m³. Additionally, the average concentration of bacteria (308.64 CFU/m³) was notably greater than that of fungi (203.55 CFU/m³) throughout the study. Analytical analyses, including SEM-EDS and FTIR, showed that the PM2.5 in Islamabad is composed of various particles such as soot aggregates, coal fly ash, minerals, bio-particles, and some unidentified particles. EF analysis distinguished PM2.5 sources, enhancing understanding of pollutants origin, whereas Spearman's correlation analysis elucidated constituent interactions, further explaining air quality impact. The results from the Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-OES) indicated a gradual increase in the total elemental composition of PM2.5 from autumn to winter, maintaining high levels throughout the winter season. Furthermore, a significant variation was found in the mass concentration of PM2.5 when comparing samples collected in the morning and evening. The study also identified the presence of semi-volatile organic compounds (SVOCs) in PM2.5 samples, including polycyclic aromatic hydrocarbons (PAHs) and phenolic compounds, with notable variations in their concentrations. Utilizing health risk assessment models developed by the US EPA, we estimated the potential health risks associated with PM2.5 exposure, highlighting the urgency of addressing air quality issues. These findings provide valuable insights into the sources and composition of PM2.5 in Islamabad, contributing to a comprehensive understanding of air quality and its potential environmental and health implications.

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