Displaying publications 21 - 40 of 53 in total

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  1. Mahmood Zuhdi AS, Krackhardt F, Waliszewski MW, Ismail MD, Boxberger M, Wan Ahmad WA
    Cardiol Res Pract, 2018;2018:8053168.
    PMID: 29686890 DOI: 10.1155/2018/8053168
    Objective: Coronary revascularization in chronic total occlusion (CTO) is associated with improved clinical outcomes. The choice of the coronary stent is crucial in maintaining long-term vessel patency after CTO revascularization. We investigated the efficacy and safety of polymer-free ultrathin strut sirolimus-probucol coated drug-eluting stents (PF-SES) for CTO lesions.

    Methods: Patients with CTO lesions treated with PF-SES were identified from the prospective multicenter international ISAR 2000 registry. The primary endpoint was clinically driven target lesion revascularization (TLR) at 9 months. Secondary endpoints were 9-month major adverse cardiac events (death, myocardial infarction, or TLR) (MACE) and the occurrence of stent thrombosis.

    Results: A total of 111 patients with CTO lesions (n=127) were available for analysis. The 9-month clinical follow-up rate was 91%. The mean reference vessel diameter and lesion length were 2.76 mm ± 0.40 and 26.8 mm ± 13.1, respectively. The overall DAPT duration was 9.7 ± 2.8 months. Only one (1%) in-hospital MI was reported. The TLR and MACE rates at 9 months were 2% (2/101) and 5.9% (6/101), respectively. The 9-month accumulated rates of definite or probable stent thrombosis was 0% (0/101).

    Conclusion: Revascularizations for CTO with PF-SES are associated with low rates of TLR and MACE at 9 months with no stent thrombosis. These initial findings need to be compared with results of other new generation DES of larger studies.

  2. Ismail MD, Ahmad WA, Leschke M, Waliszewski M, Boxberger M, Abidin IZ, et al.
    Springerplus, 2016;5(1):1668.
    PMID: 27730026
    Percutaneous coronary interventions (PCI) in coronary artery disease (CAD) with very small vessel diameters remains controversial and challenging. These lesions are usually more diffuse, calcified and tortuous. The usage of thin strut bare metal stents (BMS) with excellent crossing profiles in a very small caliber coronary lesions has increased the likelihood of procedural success.
  3. Venkatason P, Zaharan NL, Ismail MD, Wan Ahmad WA, Mahmood Zuhdi AS
    Eur J Clin Pharmacol, 2018 Jul;74(7):953-960.
    PMID: 29582106 DOI: 10.1007/s00228-018-2451-3
    PURPOSE: Information is lacking on prescribing of preventative cardiovascular pharmacotherapies for patients with non-ST elevation myocardial infarction (NSTEMI) in the Asian region. This study examined the prescribing rate of these pharmacotherapies, comparing NSTEMI to STEMI, and variations across demographics and clinical factors within the NSTEMI group in the multi-ethnic Malaysian population.

    METHODS: This is a retrospective analysis of the Malaysian National Cardiovascular Disease Database-Acute Coronary Syndrome registry from year 2006 to 2013 (n = 30,873). On-discharge pharmacotherapies examined were aspirin, ADP-antagonists, statins, ACE-inhibitors, angiotensin-II-receptor blockers, and beta-blockers. Multivariate logistic regression was used to calculate adjusted odds ratio of receiving individual pharmacotherapies according to patients' characteristics in NSTEMI patients (n = 11,390).

    RESULTS: Prescribing rates for cardiovascular pharmacotherapies had significantly increased especially for ADP-antagonists (76%) in NSTEMI patients. More than 85% were prescribed statins and antiplatelets but rates remained significantly lower compared to STEMI. Women and those over 65 years old were less likely to be prescribed these pharmacotherapies compared to men and younger NSTEMI patients. Chinese and Indians were more likely to receive selected pharmacotherapies compared to Malays (main ethnicity). Geographical variations were observed; East Malaysian (Malaysian Borneo) patients were less likely to receive these compared to Western region of Malaysian Peninsular. Underprescribing in patients with risk factors such as diabetes were observed with other co-morbidities influencing prescribing selectively.

    CONCLUSION: This study uncovers demographic and clinical variations in cardiovascular pharmacotherapies prescribing for NSTEMI. Concerted efforts by policy makers, specialty societies, and physicians are required focusing on elderly, women, Malays, East Malaysians, and high-risk patients.

  4. Saleh U, Ismail MI, Sapiai NA, Loh KB, Abd Wahab N, Abdullah JM
    Cureus, 2022 Sep;14(9):e29795.
    PMID: 36340543 DOI: 10.7759/cureus.29795
    Neurofibromatosis type 1 (NF1) is a variable penetrance autosomal dominant condition predominantly involving the peripheral nervous system. NF1 exhibits a wide spectrum of clinical patterns involving the skin, eye, brain, spinal cord, and, to a lesser extent, long bones and arteries. Arterial stenosis or aneurysms have been variously studied, but the association with NF1 has not been firmly established. A 31-year-old gentleman with NF1 experienced progressive neck pain over a five-month period, associated with limited range of motion and dysphagia. Magnetic resonance imaging (MRI) of the cervical spine suggests paraspinal plexiform neurofibromas with excessive reverse cervical lordosis. Further workups revealed a large left vertebral artery fusiform aneurysm and a pseudoaneurysm. The patient made a full recovery following endovascular embolization. It is crucial to maintain a high index of suspicion for vascular malformations in patients with NF1. The pathogenesis of vascular manifestations in NF1 and options for therapeutic management were discussed.
  5. Primus PS, Ismail MH, Adnan NE, Wu CH, Kao CL, Choo YM
    J Asian Nat Prod Res, 2022 Feb;24(2):146-152.
    PMID: 33565351 DOI: 10.1080/10286020.2021.1883590
    Three new compounds, i.e. stenophyllols A-C (1-3), were isolated from the rhizome of Boesenbergia stenophylla. The structures were determined by spectroscopic analysis (UV, IR, NMR and HRESIMS). In-vitro neuroblastoma cell viability assay showed stenophyllol A (1) was able to reduce the N2A cell viability to 20% within 24 h.
  6. Azhari Z, Ismail MD, Zuhdi ASM, Md Sari N, Zainal Abidin I, Wan Ahmad WA
    BMJ Open, 2017 Nov 09;7(11):e017794.
    PMID: 29127228 DOI: 10.1136/bmjopen-2017-017794
    OBJECTIVE: To examine the relationship between body mass index (BMI) and outcomes after percutaneous coronary intervention (PCI) in a multiethnic South East Asian population.

    SETTING: Fifteen participating cardiology centres contributed to the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD-PCI) registry.

    PARTICIPANTS: 28 742 patients from the NCVD-PCI registry who had their first PCI between January 2007 and December 2014 were included. Those without their BMI recorded or BMI <11 kg/m2 or >70 kg/m2 were excluded.

    MAIN OUTCOME MEASURES: In-hospital death, major adverse cardiovascular events (MACEs), vascular complications between different BMI groups were examined. Multivariable-adjusted HRs for 1-year mortality after PCI among the BMI groups were also calculated.

    RESULTS: The patients were divided into four groups; underweight (BMI <18.5 kg/m2), normal BMI (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2) and obese (BMI ≥27.5 kg/m2). Comparison of their baseline characteristics showed that the obese group was younger, had lower prevalence of smoking but higher prevalence of diabetes, hypertension and dyslipidemia. There was no difference found in terms of in-hospital death, MACE and vascular complications after PCI. Multivariable Cox proportional hazard regression analysis showed that compared with normal BMI group the underweight group had a non-significant difference (HR 1.02, p=0.952), while the overweight group had significantly lower risk of 1-year mortality (HR 0.71, p=0.005). The obese group also showed lower HR but this was non-significant (HR 0.78, p=0.056).

    CONCLUSIONS: Using Asian-specific BMI cut-off points, the overweight group in our study population was independently associated with lower risk of 1-year mortality after PCI compared with the normal BMI group.

  7. Looi MC, Idris Z, Kumaran T, Thyagarajan D, Abdullah JM, Ghani ARI, et al.
    J Neurotrauma, 2023 Jan;40(1-2):94-101.
    PMID: 36017631 DOI: 10.1089/neu.2022.0031
    Traumatic brain injury (TBI) is one the major causes of death and morbidity in developing countries, where depression is a common psychiatric condition among individuals with TBI. The objectives were to investigate the occurrence and severity of depression one-year post-TBI; the association between radiological findings and depression; and the risk factors. We report a cross-sectional study among adult patients who were hospitalized because of TBI in the past one year. A structured data collection form was used to collect patients' demographic data during TBI, while the Patient Health Questionnaire (PHQ)-9 questionnaire was administered to assess the level of depression at one-year post-TBI. Of the 309 patients in this study; 46.6%, 26.2%, and 27.2% had mild, moderate, and severe TBI, respectively. The overall rate of depression was 33.7%, where 22.3%, 8.7%, and 2.6% had mild, moderate, and moderately severe depression, respectively. There was a significant, positive correlation between severity of TBI and level of depression; rs (0.427), p 
  8. Balachandran NR, Abdullah N, Ismail MI, Wong YP, Azmi MI
    Front Oncol, 2024;14:1377074.
    PMID: 38966061 DOI: 10.3389/fonc.2024.1377074
    Phyllodes tumours or cystosarcoma phyllodes are fibroepithelial tumours of the breast and represent 1% of breast tumours. A 20-year-old nullipara presented with an enlarging left breast mass over 6 months. Although widely excised, it was reported to be a 12 × 10 × 5.5-cm borderline phyllodes tumour with involvement of the superior and inferior margins. Seven months later, she presented with a new ipsilateral breast lump measuring 8.5 × 7.5 × 4.6 cm. She underwent a left mastectomy, a three-rib resection with titanic rods for the thoracic cage reconstruction, and a latissimus dorsi flap wound closure. Histopathology revealed a high-grade malignant phyllodes tumour with features of osteoid differentiation with the nearest deep margin measuring 3 mm. She developed metastasis to the ipsilateral axillary lymph nodes and contralateral lung 2 months postoperatively. She was given palliative radiotherapy 60 Gy in 30 fractions to the left axilla. She developed sudden lower-limb weakness due to spinal metastases. The symptoms resolved with radiotherapy to the thoracic spine (T4-T8). As the lesion continued to grow rapidly from the anterior chest wall encircling towards the back, it was deemed unresectable. She was given palliative chemotherapy (doxorubicin six cycles, followed by ifosfamide one cycle) but had disease progression. She passed away 3 months later. The mainstay of treatment for phyllodes tumour is excision with a minimal margin of 1 cm. Although margins were involved after the first surgery, she was followed up as the pathology was a borderline phyllodes. When the lump recurred and had transformed, despite extensive surgery, it returned shortly and progressed. A borderline phyllodes should be excised to obtain a minimal margin of 1 cm, even if it means performing a mastectomy, to minimise recurrence. A recurrence may undergo malignant transformation which is largely chemotherapy and radiotherapy resistant. This will result in a poor outcome and decreased survival.
  9. Tiew TC, Md Ali NA, Ismail MI, Abdul Rahman MR, Ding CH, Tzar MN
    Cureus, 2024 Jun;16(6):e62312.
    PMID: 39006712 DOI: 10.7759/cureus.62312
    Sternal osteomyelitis and mediastinitis are rare yet severe complications post-cardiac surgery, often associated with significant morbidity and mortality. Fungal etiologies, particularly those caused by Rhizopus spp., are infrequent but can lead to aggressive infections. Here, we present the case of a 68-year-old male who developed sternal osteomyelitis and mediastinitis caused by Rhizopus spp. two weeks following coronary artery bypass grafting surgery. Debridement and pectoralis flap reconstruction were performed following clinical identification and confirmation with microbiological examinations and a CT scan. Prompt recognition, aggressive surgical intervention, and targeted antifungal therapy were crucial for successful management. This case underscores the importance of considering fungal pathogens, such as Rhizopus, in the differential diagnosis of post-cardiac surgery infections, as well as aggressive treatment to improve outcomes for affected patients.
  10. Aili Hamzah AF, Hamzah MH, Che Man H, Jamali NS, Siajam SI, Ismail MH
    Heliyon, 2023 Jun;9(6):e16791.
    PMID: 37303543 DOI: 10.1016/j.heliyon.2023.e16791
    Organic loading influences the effectiveness of producing biogas through anaerobic digestion. This study set out to investigate the effect of organic loading on the anaerobic mesophilic digestion of cow dung, the parameters involved in the digestion process and to evaluate the kinetics. Anaerobic digestion of cow dung at different organic loading (gVS/L) of 14 gVS/L, 18gVS/L, 22 gVS/L, 26 gVS/L and 30 gVS/L were investigated. Increasing the organic loading increased the methane yield of the cow dung. The highest cumulative methane yield was observed at 30 gVS/L with 63.42 mL CH4/gVS while the highest biogas yield was reported at 192.53 mL/gVS with the highest methane content of 89%. In addition, the modified Gompertz model equation with an R2 of 0.9980 demonstrated strong consistency and a good fit between predicted and experimental data. The high number of substrates added to the systems when increasing the organic loading increased the λ and slow down the nutrient transport and hydrolysis. This study provides current information on the effects of organic loading on the anaerobic digestion of cow dung in batch mode, including experimental conditions and operational parameters.
  11. Ismail MI, Idris Z, Abdullah JM, Rahman NAA, Nordin M
    Malays J Med Sci, 2021 Aug;28(4):63-70.
    PMID: 34512131 DOI: 10.21315/mjms2021.28.4.7
    Background: Patients with severe traumatic brain injury (TBI) were expected to have poor Glasgow Coma Scale (GCS) recovery and prolonged intubation. Therefore, an early tracheostomy procedure was indicated for all severe TBI. In view of growing concern regarding the safety and outcome of early tracheostomy on these patients, it was deemed valid and needed to be addressed.

    Methods: This study was conducted to compare the outcomes of early and late tracheostomies in severe TBI. Only severe TBI patients who were admitted to the Neurosurgery High Dependency Unit (NHDU), Hospital Sultanah Aminah (HSA), Johor Bahru, Johor, Malaysia and who had underwent a tracheostomy were recruited. Three main outcomes noted: duration on ventilation, length of NHDU stay and rate of ventilator associated pneumonia (VAP).

    Results: Out of 155 patients, 72 (46.5%) were in early tracheostomy group (ETG) and 83 (53.5%) were in late tracheostomy group (LTG). The majority of the participants, 95 (61.3%) were ethnic Malays. The mean duration on ventilator use was 2.65 days (1.57) for ETG and 5.63 days (2.35) for LTG. While, mean NHDU stay was 4.75 days (1.98) for ETG and 9.77 days (2.70) for LTG. Upon independent t-test, early duration of tracheostomies had shown significant outcome in reducing length of NHDU stay, (P < 0.001) and had shortening participants' time on mechanical ventilator (P < 0.001). Then, based on forward multiple logistic regression test, there were significant association between comorbid (P = 0.003) and tracheostomy (P = 0.020) towards presence of VAP when adjusted for other variables.

    Conclusion: In this study it was found that early tracheostomy was significant in shortening the duration on ventilator, reducing the length of NHDU stay and reducing the rate of VAP.

  12. Mahmood Zuhdi AS, Zeymer U, Waliszewski M, Spiecker M, Ismail MD, Boxberger M, et al.
    Springerplus, 2016;5:373.
    PMID: 27066381 DOI: 10.1186/s40064-016-2014-y
    Paclitaxel-coated balloon (PCB) angioplasty in small vessel de novo lesions has favourable outcome and appears to be an alternative to stent implantation. However there is limitted data on its use specifically in small vessel acute coronary syndrome (ACS).
  13. Wan Ahmad WA, Nakayoshi T, Mahmood Zuhdi AS, Ismail MD, Zainal Abidin I, Ino Y, et al.
    Heart Vessels, 2020 Apr;35(4):463-473.
    PMID: 31587103 DOI: 10.1007/s00380-019-01516-9
    Recent clinical trials have raised concerns about the safety and efficacy of ABSORB™ bioresorbable vascular scaffolds (BVS). The difference in the vascular healing process between SYNERGY™ bioabsorbable polymer-coated everolimus-eluting stents (BP-EES) and BVS remains unclear. The aim of the ENHANCE study was to compare vascular healing on BP-EES versus BVS by optical coherence tomography (OCT) and coronary angioscopy (CAS) at 4- and 12-month follow-ups. This is a prospective, non-randomized, single center clinical trial. Thirteen eligible patients with multivessel disease were enrolled. BP-EES and BVS were simultaneously implanted in the same patients, but in different coronary vessels. Imaging follow-up with both OCT and CAS was completed in 11 patients at 12 months. Neointimal coverage rates were similar between the two groups based on OCT measurements. The neointimal thickness of BP-EES was significantly thicker at the 12th month than at the 4th month, whereas the neointimal thickness of BVS did not change between the measurements taken at the 4th and 12th month. Existence of intra-stent thrombus was significantly higher in the BVS group, compared to the BP-EES group. On the other hand, CAS revealed that red-thrombi and yellow-plaque were more frequently observed in BVS at 4 months and up to 12-month follow-ups than in BP-EES. These findings suggested that the evidence of instability remained up to 12 months in the vascular healing with BVS, compared to that with BP-EES. Vascular healing of the stented wall was recognized at the very early phase after BP-EES implantation. However, vascular healing with BVS was still incomplete after 12 months.
  14. Venkatason P, Zubairi YZ, Wan Ahmad WA, Hafidz MI, Ismail MD, Hadi MF, et al.
    BMJ Open, 2019 05 05;9(5):e025734.
    PMID: 31061031 DOI: 10.1136/bmjopen-2018-025734
    OBJECTIVES: Cardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome of STEMI patients with CS in our population.

    DESIGN: A retrospective analysis of STEMI patients from 18 hospitals across Malaysia contributing to the Malaysian National Cardiovascular Database-acute coronary syndrome) registry (NCVD-ACS) year 2006-2013.

    PARTICIPANTS: 16 517 patients diagnosed of STEMI from 18 hospitals in Malaysia from the year 2006 to 2013.

    PRIMARY OUTCOME MEASURES: In-hospital and 30 day post-discharge mortality.

    RESULTS: CS complicates 10.6% of all STEMIs in this study. They had unfavourable premorbid conditions and poor outcomes. The in-hospital mortality rate was 34.1% which translates into a 7.14 times mortality risk increment compared with STEMI without CS. Intravenous thrombolysis remained as the main urgent reperfusion modality. Percutaneous coronary interventions (PCI) in CS conferred a 40% risk reduction over non-invasive therapy but were only done in 33.6% of cases. Age over 65, diabetes mellitus, hypertension, chronic lung and kidney disease conferred higher risk of mortality.

    CONCLUSION: Mortality rates of CS complicating STEMI in Malaysia are high. In-hospital PCI confers a 40% mortality risk reduction but the rate of PCI among our patients with CS complicating STEMI is still low. Efforts are being made to increase access to invasive therapy for these patients.

  15. Isa SN, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, et al.
    Asian J Psychiatr, 2016 Oct;23:71-77.
    PMID: 27969083 DOI: 10.1016/j.ajp.2016.07.007
    Families caring for children with disabilities face particular challenges and demands compared to those caring for children without disabilities. Evidence suggests that there is considerable variation in how caregivers of children with disabilities adapt to their caregiving demands and stressors. The different adaptations to the children with disabilities may cause different impacts on the health and well-being of caregivers. This paper provides a brief overview of the literature on the impact of caring for children with disabilities on the health and quality of life of caregivers and the factors related to the health outcomes and quality of life. A literature search was conducted by using various electronic databases, including PsychINFO, ScienceDirect, ProQuest, and MEDLINE using specific key terms. Thirty-one articles published in peer-review journals from the last six years (2009-2014) were reviewed. Most of the studies were quantitative studies. Factors discussed that impact on caregivers' health and quality of life include the caregivers' sociodemographic background and child's disability-related factors. Several mediators and moderators including coping strategies, social support, parental stress, self-esteem and self-efficacy are described in this paper. This review highlighted the importance of these factors to better understand the complex nature of stress processes and the caregivers' adaptations to their children's disabilities.
  16. Ismail MD, Jalalonmuhali M, Azhari Z, Mariapun J, Lee ZV, Zainal Abidin I, et al.
    BMC Cardiovasc Disord, 2018 09 24;18(1):184.
    PMID: 30249197 DOI: 10.1186/s12872-018-0919-9
    BACKGROUND: Patients with renal impairment often left out from most major clinical trials assessing the optimal treatment for ST-elevation myocardial infarction (STEMI). Large body of evidence from various cardiovascular registries reflecting more 'real-world' experience might contribute to the knowledge on how best to treat this special cohort. We aim to analyze the outcomes of Malaysian STEMI patients with renal impairment treated with coronary angioplasty.

    METHODS: Utilizing the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014, STEMI patients treated with percutaneous coronary intervention (PCI) were stratified into presence (GFR 

  17. Chen K, Ng KH, Cheng CK, Cheng YW, Chong CC, Vo DN, et al.
    Chemosphere, 2022 Jan;287(Pt 2):132222.
    PMID: 34826917 DOI: 10.1016/j.chemosphere.2021.132222
    Biomass, which defined as plant- or animal-based materials, is intriguing tremendous scientific attentions due to its renewable attribute in serving energy security. Amongst, the plant-based biomasses, particularly those that co-generated in the agriculture activities, are commonly regarded as fuel for burning, which overlooked their hidden potentials for high-end applications. Organically, the plant-based biomass constitutes of lignocellulose components, which can be served as promising precursors for functionalized carbon materials. Meanwhile, its inorganic counterpart made up of various minerals, with Si being the most concerned one. With the advancement of biomass technologies and material synthesis in recent years, numerous attempts were endeavoured to obtain valorised products from biomass. Particularly, syntheses of catalytic and adsorptive materials are actively researched in the field of biomass reutilization. Herein, our work systematically summarized the advancements of biomass-materials for these applications in recent 10 years (2010-2020), with a special focus on the carbon-based and Si-based catalytic/adsorptive materials. Significantly, the deriving steps, inclusive of both pre-treatment and post-treatment of such materials, are incorporated in the discussion, alongside with their significances revealed too. The performance of the as-obtained materials in the respective application is systematically correlated to their physicochemical properties, hence providing valuable insights to the readers. Challenges and promising directions to be explored are raised too at the end of the review, aiming to advocate better-usage of biomass while offering great opportunities to sustain catalysis and adsorption in the industrial scale.
  18. Zuhdi AS, Ahmad WA, Zaki RA, Mariapun J, Ali RM, Sari NM, et al.
    Singapore Med J, 2016 Apr;57(4):191-7.
    PMID: 26768171 DOI: 10.11622/smedj.2015145
    The elderly are often underrepresented in clinical trials for acute coronary syndrome (ACS), and cardiologists commonly face management dilemmas in the choice of treatment for this group of patients, particularly concerning the use of invasive revascularisation. This study analysed the characteristics of hospitalised elderly patients with ACS, and compared the outcomes of treatments.
  19. Zuhdi AS, Mariapun J, Mohd Hairi NN, Wan Ahmad WA, Abidin IZ, Undok AW, et al.
    Ann Saudi Med, 2014 1 15;33(6):572-8.
    PMID: 24413861 DOI: 10.5144/0256-4947.2013.572
    BACKGROUND AND OBJECTIVES: Understanding the nature and pattern of young coronary artery disease (CAD) is important due to the tremendous impact on these patients' socio-economic and physical aspect. Data on young CAD in the southeast Asian region is rather patchy and limited. Hence we utilized our National Cardiovascular Disease Database (NCVD)-Percutaneous Coronary Intervention (PCI) Registry to analyze young patients who underwent PCI in the year 2007 to 2009.

    DESIGN AND SETTINGS: This is a retrospective study of all patients who had undergone coronary angioplasty from 2007 to 2009 in 11 hospitals across Malaysia.

    METHODS: Data were obtained from the NCVD-PCI Registry, 2007 to 2009. Patients were categorized into 2 groups-young and old, where young was defined as less than 45 years for men and less than 55 years for women and old was defined as more than or equals to 45 years for men and more than or equals to 55 years for women. Patients' baseline characteristics, risk factor profile, extent of coronary disease and outcome on dis.charge, and 30-day and 1-year follow-up were compared between the 2 groups.

    RESULTS: We analyzed 10268 patients, and the prevalence of young CAD was 16% (1595 patients). There was a significantly low prevalence of Chinese patients compared to other major ethnic groups. Active smoking (30.2% vs 17.7%) and obesity (20.9% vs 17.3%) were the 2 risk factors more associated with young CAD. There is a preponderance toward single vessel disease in the young CAD group, and they had a favorable clinical outcome in terms of all-cause mortality at discharge (RR 0.49 [CI 0.26-0.94]) and 1-year follow-up (RR 0.47 [CI 0.19-1.15]).

    CONCLUSION: We observed distinctive features of young CAD that would serve as a framework in the primary and secondary prevention of the early onset CAD.

  20. Iftikhar B, Alih SC, Vafaei M, Ali M, Javed MF, Asif U, et al.
    Heliyon, 2023 Jun;9(6):e17107.
    PMID: 37484238 DOI: 10.1016/j.heliyon.2023.e17107
    Plastic waste poses a significant hazard to the environment as a result of its high production rates, which endanger both the environment and its inhabitants. Similarly, another concern is the production of cement, which accounts for roughly 8% of global CO2 emissions. Thus, recycling plastic waste as a replacement for cementitious materials may be a more effective strategy for waste minimisation and cement elimination. Therefore, in this study, plastic waste (low-density polyethylene) is utilised in the production of plastic sand paver blocks without the use of cement. In addition to this, basalt fibers which is a green industrial material is also added in the production of eco-friendly plastic sand paver blocks to satisfy the standard of ASTM C902-15 of 20 N/mm2 for the light traffic. In order to make the paver blocks, the LDPE waste plastic was melted outside in the open air and then combined with sand. Variations were made to the ratio of LDPE to sand, the proportion of basalt fibers, and sand particle size. Paver blocks were evaluated for their compressive strength, water absorption, and at different temperatures. Including 0.5% percent basalt fiber of length 4 mm gives us the best result by enhancing compressive strength by 20.5% and decreasing water absorption by 50.5%. The best results were obtained with a ratio of 30:70 LDPE to sand, while the finest sand provides the greatest compressive strength. Moreover, the temperature effect was also studied from 0 to 60 °C, and the basalt fibers incorporated in plastic paver blocks showed only a 20% decrease in compressive strength at 60 °C. This research has produced eco-friendly paver blocks by removing cement and replacing it with plastic waste, which will benefit the environment, save money, reduce carbon dioxide emissions, and be suitable for low-traffic areas, all of which contribute to sustainable development.
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