Displaying publications 421 - 440 of 680 in total

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  1. Govoni V, Sanders TAB, Reidlinger DP, Darzi J, Berry SEE, Goff LM, et al.
    Eur J Nutr, 2017 Apr;56(3):1037-1044.
    PMID: 26746219 DOI: 10.1007/s00394-015-1151-3
    PURPOSE: Healthy microcirculation is important to maintain the health of tissues and organs, most notably the heart, kidney and retina. Single components of the diet such as salt, lipids and polyphenols may influence microcirculation, but the effects of dietary patterns that are consistent with current dietary guidelines are uncertain. It was hypothesized that compliance to UK dietary guidelines would have a favourable effect on skin capillary density/recruitment compared with a traditional British diet (control diet).

    METHODS: A 12-week randomized controlled trial in men and women aged 40-70 years was used to test whether skin microcirculation, measured by skin video-capillaroscopy on the dorsum of the finger, influenced functional capillary density (number of capillaries perfused under basal conditions), structural capillary density (number of anatomical capillaries perfused during finger cuff inflation) and capillary recruitment (percentage difference between structural and functional capillary density).

    RESULTS: Microvascular measures were available for 137 subjects out of the 165 participants randomized to treatment. There was evidence of compliance to the dietary intervention, and participants randomized to follow dietary guidelines showed significant falls in resting supine systolic, diastolic and mean arterial pressure of 3.5, 2.6 and 2.9 mmHg compared to the control diet. There was no evidence of differences in capillary density, but capillary recruitment was 3.5 % (95 % CI 0.2, 6.9) greater (P = 0.04) on dietary guidelines compared with control.

    CONCLUSIONS: Adherence to dietary guidelines may help maintain a healthy microcirculation in middle-aged men and women. This study is registered at www.isrctn.com as ISRCTN92382106.

  2. Marini M, Sasongko TH, Watihayati MS, Atif AB, Hayati F, Gunadi, et al.
    Indian J Med Res, 2012;135:31-5.
    PMID: 22382180
    Genetic diagnosis of spinal muscular atrophy (SMA) is complicated by the presence of SMN2 gene as majority of SMA patients show absence or deletion of SMN1 gene. PCR may amplify both the genes non selectively in presence of high amount of DNA. We evaluated whether allele-specific PCR for diagnostic screening of SMA is reliable in the presence of high amount of genomic DNA, which is commonly used when performing diagnostic screening using restriction enzymes.
  3. Abdul Aziz AF, Beh YQ, Farahiyah II, Syahrul Azmir S, Kee PE, Helal Uddin ABM, et al.
    Curr Pharm Biotechnol, 2024 Aug 22.
    PMID: 39177135 DOI: 10.2174/0113892010318519240813053106
    Transdermal Drug Delivery Systems (TDDS) have emerged as a promising method for administering therapeutic agents due to their non-invasive nature and patient-friendly approach. However, the effectiveness of this system is limited to drugs with specific physicochemical properties that allow for transdermal delivery as the skin acts as a barrier. To address this limitation, researchers have been exploring alternative approaches to improve drug delivery through the stratum corneum, ensuring consistent drug distribution at controlled rates. Thirdgeneration delivery systems have been developed to facilitate the delivery of various drugs across the skin barrier by disrupting the stratum corneum while protecting deeper skin tissues from injury. This review has explored various approaches that have gained popularity in enhancing drug delivery through TDDS, including microneedle-mediated, nanoparticle-enabled, thermal ablation-enhanced, and electroporation-driven delivery systems. It has discussed the mechanisms of drug delivery and potential applications for different types of drugs and detailed the clinical studies. This review has also highlighted the significant advancements in TDDS, offering valuable insights into both the pharmaceutical field and biomedical applications. The continued exploration and refinement of these delivery systems, particularly with the incorporation of Internet-of-Things (IoT) technology, Artificial Intelligence (AI), and machine learning, hold promise for expanding the scope of therapeutic interventions.
  4. Kaestli M, Farook S, Jilani MSA, Anwar S, Siddiqui TA, Mayo M, et al.
    Am J Trop Med Hyg, 2024 Sep 03.
    PMID: 39226893 DOI: 10.4269/ajtmh.24-0144
    Melioidosis is an emerging tropical infectious disease with a rising global burden caused by the environmental bacterium Burkholderia pseudomallei. It is endemic in Southeast and South Asia, including Bangladesh. A rare aminoglycoside-susceptible B. pseudomallei isolate (Y2019) has recently been reported from a melioidosis patient in Dhaka, Bangladesh. To understand the geographical origins of Y2019, we subjected it and 10 other isolates from Bangladesh to whole-genome sequencing. In a phylogenetic tree with a global set of B. pseudomallei genomes, most Bangladeshi genomes clustered tightly within the Asian clade. In contrast, Y2019 was closely related to ST881 isolates from Sarawak, Malaysian Borneo, a gentamicin-sensitive sequence type, suggesting infection in Borneo. Y2019 also contained the same gentamicin sensitivity conferring nonsynonymous mutation in the drug efflux pump encoding the amrB gene. In the absence of a full travel history, whole-genome sequencing and bioinformatics tools have revealed the likely origin of this rare isolate.
  5. Hashim S, Alajerami YS, Ramli AT, Ghoshal SK, Saleh MA, Abdul Kadir AB, et al.
    Appl Radiat Isot, 2014 Sep;91:126-30.
    PMID: 24929526 DOI: 10.1016/j.apradiso.2014.05.023
    Lithium potassium borate (LKB) glasses co-doped with TiO2 and MgO were prepared using the melt quenching technique. The glasses were cut into transparent chips and exposed to gamma rays of (60)Co to study their thermoluminescence (TL) properties. The TL glow curve of the Ti-doped material featured a single prominent peak at 230 °C. Additional incorporation of MgO as a co-activator enhanced the TL intensity threefold. LKB:Ti,Mg is a low-Z material (Z(eff)=8.89) with slow signal fading. Its radiation sensitivity is 12 times lower that the sensitivity of TLD-100. The dose response is linear at doses up to 10(3) Gy. The trap parameters, such as the kinetics order, activation energy, and frequency factor, which are related to the glow peak, were determined using TolAnal software.
  6. Awang MA, Firdaus MA, Busra MB, Chowdhury SR, Fadilah NR, Wan Hamirul WK, et al.
    Biomed Mater Eng, 2014;24(4):1715-24.
    PMID: 24948455 DOI: 10.3233/BME-140983
    Earlier studies in our laboratory demonstrated that collagen extracted from ovine tendon is biocompatible towards human dermal fibroblast. To be able to use this collagen as a scaffold in skin tissue engineering, a mechanically stronger scaffold is required that can withstand manipulation before transplantation. This study was conducted to improve the mechanical strength of this collagen sponge using chemical crosslinkers, and evaluate their effect on physical, chemical and biocompatible properties. Collagen sponge was crosslinked with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) and glutaraldehyde (GA). Tensile test, FTIR study and mercury porosimetry were used to evaluate mechanical properties, chemical property and porosity, respectively. MTT assay was performed to evaluate the cytotoxic effect of crosslinked collagen sponge on human dermal fibroblasts. The FTIR study confirmed the successful crosslinking of collagen sponge. Crosslinking with EDC and GA significantly increased the mechanical strength of collagen sponge, with GA being more superior. Crosslinking of collagen sponge significantly reduced the porosity and the effect was predominant in GA-crosslinked collagen sponge. The GA-crosslinked collagen showed significantly lower, 60% cell viability towards human dermal fibroblasts compared to that of EDC-crosslinked collagen, 80% and non-crosslinked collagen, 100%. Although the mechanical strength was better when using GA but the more toxic effect on dermal fibroblast makes EDC a more suitable crosslinker for future skin tissue engineering.
  7. Rani AQ, Malueka RG, Sasongko TH, Awano H, Lee T, Yagi M, et al.
    Mol Genet Metab, 2011 Jul;103(3):303-4.
    PMID: 21514860 DOI: 10.1016/j.ymgme.2011.04.002
    In Duchenne muscular dystrophy (DMD), identification of one nonsense mutation in the DMD gene has been considered an endpoint of genetic diagnosis. Here, we identified two closely spaced nonsense mutations in the DMD gene. In a Malaysian DMD patient two nonsense mutations (p.234S>X and p.249Q>X, respectively) were identified within exon 8. The proband's mother carried both mutations on one allele. Multiple mutations may explain the occasional discrepancies between genotype and phenotype in dystrophinopathy.
  8. Teo AE, Garg S, Shaikh LH, Zhou J, Karet Frankl FE, Gurnell M, et al.
    N Engl J Med, 2015 Oct 08;373(15):1429-36.
    PMID: 26397949 DOI: 10.1056/NEJMoa1504869
    Recent discoveries of somatic mutations permit the recognition of subtypes of aldosterone-producing adenomas with distinct clinical presentations and pathological features. Here we describe three women with hyperaldosteronism, two who presented in pregnancy and one who presented after menopause. Their aldosterone-producing adenomas harbored activating mutations of CTNNB1, encoding β-catenin in the Wnt cell-differentiation pathway, and expressed LHCGR and GNRHR, encoding gonadal receptors, at levels that were more than 100 times as high as the levels in other aldosterone-producing adenomas. The mutations stimulate Wnt activation and cause adrenocortical cells to de-differentiate toward their common adrenal-gonadal precursor cell type. (Funded by grants from the National Institute for Health Research Cambridge Biomedical Research Centre and others.).
  9. Zhou J, Shaikh LH, Neogi SG, McFarlane I, Zhao W, Figg N, et al.
    Hypertension, 2015 May;65(5):1103-10.
    PMID: 25776071 DOI: 10.1161/HYP.0000000000000025
    Common somatic mutations in CACNAID and ATP1A1 may define a subgroup of smaller, zona glomerulosa (ZG)-like aldosterone-producing adenomas. We have therefore sought signature ZG genes, which may provide insight into the frequency and pathogenesis of ZG-like aldosterone-producing adenomas. Twenty-one pairs of zona fasciculata and ZG and 14 paired aldosterone-producing adenomas from 14 patients with Conn's syndrome and 7 patients with pheochromocytoma were assayed by the Affymetrix Human Genome U133 Plus 2.0 Array. Validation by quantitative real-time polymerase chain reaction was performed on genes >10-fold upregulated in ZG (compared with zona fasciculata) and >10-fold upregulated in aldosterone-producing adenomas (compared with ZG). DACH1, a gene associated with tumor progression, was further analyzed. The role of DACH1 on steroidogenesis, transforming growth factor-β, and Wnt signaling activity was assessed in the human adrenocortical cell line, H295R. Immunohistochemistry confirmed selective expression of DACH1 in human ZG. Silencing of DACH1 in H295R cells increased CYP11B2 mRNA levels and aldosterone production, whereas overexpression of DACH1 decreased aldosterone production. Overexpression of DACH1 in H295R cells activated the transforming growth factor-β and canonical Wnt signaling pathways but inhibited the noncanonical Wnt signaling pathway. Stimulation of primary human adrenal cells with angiotensin II decreased DACH1 mRNA expression. Interestingly, there was little overlap between our top ZG genes and those in rodent ZG. In conclusion, (1) the transcriptome profile of human ZG differs from rodent ZG, (2) DACH1 inhibits aldosterone secretion in human adrenals, and (3) transforming growth factor-β signaling pathway is activated in DACH1 overexpressed cells and may mediate inhibition of aldosterone secretion in human adrenals.
  10. Mofijur M, Ahmed SF, Rahman SMA, Arafat Siddiki SY, Islam ABMS, Shahabuddin M, et al.
    Environ Res, 2021 04;195:110857.
    PMID: 33581088 DOI: 10.1016/j.envres.2021.110857
    The nature of micro- and nanoplastics and their harmful consequences has drawn significant attention in recent years in the context of environmental protection. Therefore, this paper aims to provide an overview of the existing literature related to this evolving subject, focusing on the documented human health and marine environment impacts of micro- and nanoplastics and including a discussion of the economic challenges and strategies to mitigate this waste problem. The study highlights the micro- and nanoplastics distribution across various trophic levels of the food web, and in different organs in infected animals which is possible due to their reduced size and their lightweight, multi-coloured and abundant features. Consequently, micro- and nanoplastics pose significant risks to marine organisms and human health in the form of cytotoxicity, acute reactions, and undesirable immune responses. They affect several sectors including aquaculture, agriculture, fisheries, transportation, industrial sectors, power generation, tourism, and local authorities causing considerable economic losses. This can be minimised by identifying key sources of environmental plastic contamination and educating the public, thus reducing the transfer of micro- and nanoplastics into the environment. Furthermore, the exploitation of the potential of microorganisms, particularly those from marine origins that can degrade plastics, could offer an enhanced and environmentally sound approach to mitigate micro- and nanoplastics pollution.
  11. Ude CC, Ng MH, Chen CH, Htwe O, Amaramalar NS, Hassan S, et al.
    Osteoarthritis Cartilage, 2015 Aug;23(8):1294-306.
    PMID: 25887366 DOI: 10.1016/j.joca.2015.04.003
    OBJECTIVES: Our previous studies on osteoarthritis (OA) revealed positive outcome after chondrogenically induced cells treatment. Presently, the functional improvements of these treated OA knee joints were quantified followed by evaluation of the mechanical properties of the engineered cartilages.
    METHODS: Baseline electromyogram (EMGs) were conducted at week 0 (pre-OA), on the locomotory muscles of nine un-castrated male sheep (Siamese long tail cross) divided into controls, adipose-derived stem cells (ADSCs) and bone marrow stem cells (BMSCs), before OA inductions. Subsequent recordings were performed at week 7 and week 31 which were post-OA and post-treatments. Afterwards, the compression tests of the regenerated cartilage were performed.
    RESULTS: Post-treatment EMG analysis revealed that the control sheep retained significant reductions in amplitudes at the right medial gluteus, vastus lateralis and bicep femoris, whereas BMSCs and ADSCs samples had no further significant reductions (P < 0.05). Grossly and histologically, the treated knee joints demonstrated the presence of regenerated neo cartilages evidenced by the fluorescence of PKH26 tracker. Based on the International Cartilage Repair Society scores (ICRS), they had significantly lower grades than the controls (P < 0.05). The compression moduli of the native cartilages and the engineered cartilages differed significantly at the tibia plateau, patella femoral groove and the patella; whereas at the medial femoral condyle, they had similar moduli of 0.69 MPa and 0.40-0.64 MPa respectively. Their compression strengths at all four regions were within ±10 MPa.
    CONCLUSION: The tissue engineered cartilages provided evidence of functional recoveries associated to the structural regenerations, and their mechanical properties were comparable with the native cartilage.
    KEYWORDS: Cartilage; Cell therapy; Function; Osteoarthritis; Regeneration
  12. Verheye S, Wlodarczak A, Montorsi P, Torzewski J, Bennett J, Haude M, et al.
    Catheter Cardiovasc Interv, 2021 Jul 01;98(1):E1-E8.
    PMID: 32881396 DOI: 10.1002/ccd.29260
    OBJECTIVES: We aimed to assess the safety and performance of the Magmaris sirolimus-eluting bioresorbable magnesium scaffold in a large patient population.

    BACKGROUND: Magmaris has shown good outcomes in small-sized controlled trials, but further data are needed to confirm its usability, safety, and performance.

    METHODS: BIOSOLVE-IV is an international, single arm, multicenter registry including patients with a maximum of two single de novo lesions. Follow-up is scheduled up to 5 years; the primary outcome is target lesion failure (TLF) at 12 months.

    RESULTS: A total of 1,075 patients with 1,121 lesions were enrolled. Mean patient age was 61.3 ± 10.5 years and 19.2% (n = 206) presented with non-ST-elevation myocardial infarction (NSTEMI). Lesions were 3.2 ± 0.3 mm in diameter and 14.9 ± 4.2 mm long; 5.1% (n = 57) were bifurcation lesions. Device success was 97.3% (n = 1,129) and procedure success 98.9% (n = 1,063). The Kaplan-Meier estimate of TLF at 12 months was 4.3% [95% confidence interval, CI: 3.2, 5.7] consisting of 3.9% target lesion revascularizations, 0.2% cardiac death, and 1.1% target-vessel myocardial infarction. Definite/probable scaffold thrombosis occurred in five patients (0.5% [95% CI: 0.2, 1.1]), thereof four after early discontinuation of antiplatelet/anticoagulation therapy.

    CONCLUSION: BIOSOLVE-IV confirms the safety and performance of the Magmaris scaffold in a large population with excellent device and procedure success and a very good safety profile up to 12 months in a low-risk population.

  13. Akhlaq M, Azad AK, Ullah I, Nawaz A, Safdar M, Bhattacharya T, et al.
    Polymers (Basel), 2021 Jul 14;13(14).
    PMID: 34301057 DOI: 10.3390/polym13142300
    The aim was to formulate and evaluate Gel/PVA hydrogels as a pH-sensitive matrix to deliver methotrexate (MTX) to colon. The primed Gel/PVA hydrogels were subjected to evaluation for swelling behavior, diffusion coefficient, sol-gel characteristic and porosity using an acidic (pH 1.2) and phosphate buffer (PBS) (pH 6.8 & pH 7.4) media. Fourier transform infrared spectroscopy (FTIR) and thermal gravimetric analysis (TGA) were performed to evaluate the chemical compatibility of the Gel/PVA hydrogel. The shape alteration and release of Gel/PVA hydrogel was conducted at pH 1.2, pH 6.8 and pH 7.4. The drug release kinetic mechanism was determined using various kinetic equations. The physicochemical evaluation tests and drug release profile results were found to be significant (p < 0.01). However, it was dependent on the polymers' concentration, the pH of the release media and the amount of the cross-linking agent. Hydrogels containing the maximum amount of gel showed a dynamic equilibrium of 10.09 ± 0.18 and drug release of 93.75 ± 0.13% at pH 1.2. The kinetic models showed the release of MTX from the Gel/PVA hydrogel was non-Fickian. The results confirmed that the newly formed Gel/PVA hydrogels are potential drug delivery systems for a controlled delivery of MTX to the colon.
  14. Khor GL, Noor Safiza MN, Jamalludin AB, Jamaiyah H, Geeta A, Kee CC, et al.
    Malays J Nutr, 2009 Sep;15(2):121-36.
    PMID: 22691811 MyJurnal
    The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over 21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the z-scores tables of the WHO standards. The overall prevalence of underweight and stunting of the children were 12.9% and 17.2% respectively. These levels included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores, the age group of 0-5.9 months showed the best nutritional status with mean WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98) for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months, suggesting a faltering in growth rate at an age that coincides with dependence on complementary feeding. Prevalence of overweight based on BMI-for-age for the sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  15. Jong WL, Ung NM, Wong JH, Ng KH, Wan Ishak WZ, Abdul Malik R, et al.
    Phys Med, 2016 Nov;32(11):1466-1474.
    PMID: 27842982 DOI: 10.1016/j.ejmp.2016.10.022
    The purpose of this study is to measure patient skin dose in tangential breast radiotherapy. Treatment planning dose calculation algorithm such as Pencil Beam Convolution (PBC) and in vivo dosimetry techniques such as radiochromic film can be used to accurately monitor radiation doses at tissue depths, but they are inaccurate for skin dose measurement. A MOSFET-based (MOSkin) detector was used to measure skin dose in this study. Tangential breast radiotherapies ("bolus" and "no bolus") were simulated on an anthropomorphic phantom and the skin doses were measured. Skin doses were also measured in 13 patients undergoing each of the techniques. In the patient study, the EBT2 measurements and PBC calculation tended to over-estimate the skin dose compared with the MOSkin detector (p<0.05) in the "no bolus radiotherapy". No significant differences were observed in the "bolus radiotherapy" (p>0.05). The results from patients were similar to that of the phantom study. This shows that the EBT2 measurement and PBC calculation, while able to predict accurate doses at tissue depths, are inaccurate in predicting doses at build-up regions. The clinical application of the MOSkin detectors showed that the average total skin doses received by patients were 1662±129cGy (medial) and 1893±199cGy (lateral) during "no bolus radiotherapy". The average total skin doses were 4030±72cGy (medial) and 4004±91cGy (lateral) for "bolus radiotherapy". In some cases, patient skin doses were shown to exceed the dose toxicity level for skin erythema. Hence, a suitable device for in vivo dosimetry is necessary to accurately determine skin dose.
  16. Albahri AS, Alnoor A, Zaidan AA, Albahri OS, Hameed H, Zaidan BB, et al.
    Complex Intell Systems, 2022;8(2):1781-1801.
    PMID: 34777975 DOI: 10.1007/s40747-021-00503-w
    Topical treatments with structural equation modelling (SEM) and an artificial neural network (ANN), including a wide range of concepts, benefits, challenges and anxieties, have emerged in various fields and are becoming increasingly important. Although SEM can determine relationships amongst unobserved constructs (i.e. independent, mediator, moderator, control and dependent variables), it is insufficient for providing non-compensatory relationships amongst constructs. In contrast with previous studies, a newly proposed methodology that involves a dual-stage analysis of SEM and ANN was performed to provide linear and non-compensatory relationships amongst constructs. Consequently, numerous distinct types of studies in diverse sectors have conducted hybrid SEM-ANN analysis. Accordingly, the current work supplements the academic literature with a systematic review that includes all major SEM-ANN techniques used in 11 industries published in the past 6 years. This study presents a state-of-the-art SEM-ANN classification taxonomy based on industries and compares the effort in various domains to that classification. To achieve this objective, we examined the Web of Science, ScienceDirect, Scopus and IEEE Xplore ® databases to retrieve 239 articles from 2016 to 2021. The obtained articles were filtered on the basis of inclusion criteria, and 60 studies were selected and classified under 11 categories. This multi-field systematic study uncovered new research possibilities, motivations, challenges, limitations and recommendations that must be addressed for the synergistic integration of multidisciplinary studies. It contributed two points of potential future work resulting from the developed taxonomy. First, the importance of the determinants of play, musical and art therapy adoption amongst autistic children within the healthcare sector is the most important consideration for future investigations. In this context, the second potential future work can use SEM-ANN to determine the barriers to adopting sensing-enhanced therapy amongst autistic children to satisfy the recommendations provided by the healthcare sector. The analysis indicates that the manufacturing and technology sectors have conducted the most number of investigations, whereas the construction and small- and medium-sized enterprise sectors have conducted the least. This study will provide a helpful reference to academics and practitioners by providing guidance and insightful knowledge for future studies.
  17. Xie CB, Shaikh LH, Garg S, Tanriver G, Teo AE, Zhou J, et al.
    Sci Rep, 2016 Apr 21;6:24697.
    PMID: 27098837 DOI: 10.1038/srep24697
    Aldosterone-producing adenomas (APAs) vary in phenotype and genotype. Zona glomerulosa (ZG)-like APAs frequently have mutations of an L-type calcium channel (LTCC) CaV1.3. Using a novel antagonist of CaV1.3, compound 8, we investigated the role of CaV1.3 on steroidogenesis in the human adrenocortical cell line, H295R, and in primary human adrenal cells. This investigational drug was compared with the common antihypertensive drug nifedipine, which has 4.5-fold selectivity for the vascular LTCC, CaV1.2, over CaV1.3. In H295R cells transfected with wild-type or mutant CaV1.3 channels, the latter produced more aldosterone than wild-type, which was ameliorated by 100 μM of compound 8. In primary adrenal and non-transfected H295R cells, compound 8 decreased aldosterone production similar to high concentration of nifedipine (100 μM). Selective CaV1.3 blockade may offer a novel way of treating primary hyperaldosteronism, which avoids the vascular side effects of CaV1.2-blockade, and provides targeted treatment for ZG-like APAs with mutations of CaV1.3.
  18. Goh CY, Visvanathan R, Leong CT, Hooi LS, Ch'ng CC, Yee SY, et al.
    Med J Malaysia, 2023 Nov;78(6):733-742.
    PMID: 38031214
    INTRODUCTION: The incidence of acute kidney injury (AKI) among hospitalised patients has not been well studied in Malaysia.

    MATERIALS AND METHODS: We conducted a prospective, multicentre study in seven hospitals in West Malaysia. All the adults admitted in March 2017 fulfilling Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI were included.

    RESULTS: Of the 34,204 patients screened, 2,457 developed AKI (7.18%), 13.1% of which occurred in intensive care unit (ICU). There were 60.2% males with a mean age of 57.8 (±17.5) years. The most common comorbidities were hypertension (55.0%), diabetes (46.6%), ischaemic heart disease (15.1%) and chronic kidney disease (12.0%). The commonest causes of AKI were sepsis (41.7%), pre-renal (24.2%) and cardiorenal syndrome (10.8%). Nephrotoxin exposure was reported in 31%. At diagnosis, the proportion of AKI stages 1, 2 and 3 were 79.1%, 9.7%, 11.2%, respectively. Referral to nephrologists was reported in 16.5%. Dialysis was required in 176 (7.2%) patients and 55.6% were performed in the ICU. Acidosis (46.2%), uraemia (31.6%) and electrolyte disturbance (11.1%) were the commonest indications. Continuous renal replacement therapy (CRRT) was required in 14%. The average length of hospital stay was 9.5 days. In-hospital mortality was 16.4%. Among survivors, full and partial renal recovery was seen in 74.7% and 16.4% respectively while 8.9% failed to recover. After a mean follow-up of 13.7 months, 593 (30.2%) of survivors died and 38 (1.9%) initiated chronic dialysis. Mortality was highest among those with malignancies (Hazard Ratio, HR 2.14), chronic liver disease (HR 2.13), neurological disease (HR 1.56) and cardiovascular disease (HR 1.17).

    CONCLUSION: AKI is common in hospitalised patients and is with associated high mortality during and after hospitalisation.

  19. Loke YH, Chew YL, Janakiraman AK, Lee SK, Uddin ABMH, Goh CF, et al.
    Drug Dev Ind Pharm, 2024 Jan;50(1):36-44.
    PMID: 38149637 DOI: 10.1080/03639045.2023.2294095
    INTRODUCTION: Orally disintegrating tablets (ODTs) are designed to dissolve in the oral cavity within 3 min, providing a convenient option for patients as they can be taken without water. Direct compression is the most common method used for ODTs formulations. However, the availability of single composite excipients with desirable characteristics such as good compressibility, fast disintegration, and a good mouthfeel suitable for direct compression is limited.

    OBJECTIVE: This research was proposed to develop a co-processed excipient composed of xylitol, mannitol, and microcrystalline cellulose for the formulation of ODTs.

    METHODS: A total of 11 formulations of co-processed excipients with different ratios of ingredients were prepared, which were then compressed into ODTs, and their characteristics were thoroughly examined. The primary focus was on evaluating the disintegration time and hardness of the tablets, as these factors are important in ensuring the ODTs meet the desired criteria. The model drug, Mirtazapine was then incorporated into the chosen optimized formulation.

    RESULTS: The results showed that the formulation comprised of 10% xylitol, 10% mannitol and 80% microcrystalline cellulose demonstrated the fastest disintegration time (1.77 ± 0.119 min) and sufficient hardness (3.521 ± 0.143 kg) compared to the other formulations. Furthermore, the drug was uniformly distributed within the tablets and fully released within 15 min.

    CONCLUSION: Therefore, the developed co-processed excipients show great potential in enhancing the functionalities of ODTs, offering a promising solution to improve the overall performance and usability of ODTs in various therapeutic applications.

  20. Santos GP, Miranda BM, Di-Medeiros MCB, Almeida VO, Ferreira RD, Morais DAB, et al.
    Carbohydr Res, 2024 Jan;535:109008.
    PMID: 38103463 DOI: 10.1016/j.carres.2023.109008
    This work presents the characterization of a novel naturally phosphorylated starch extracted from an unconventional and non-utilized source, the seeds of the stone fruit Syzygium malaccense. The morphology and chemical characteristics of the extracted starch were examined by scanning electron microscopy, FTIR, 1H/13C/31P NMR and 13C-CP/MAS-NMR, HPAEC-PAD chromatography, XRD, DSC, and RVA. The extraction yielded a highly pure starch (95.6 %) with an average granule size of 13 μm. The analysis of the starch components revealed an amylose content of 28.1 % and a predominance (65 %) of B-chains (B1-B3 65 %) in the amylopectin, as shown through HPAEC-PAD chromatography. The X-ray diffractogram was compatible with B-type starch, which was confirmed by the deconvolution of the C1 peak in the 13C-CP/MAS-NMR. X-Ray diffractogram also showed that S. malaccense has 28.5 % of crystallinity. DSC analysis showed values of 82.6 °C and -12.41 J g-1 for Tc and ΔH, respectively, which is compatible with a highly ordered starch granule structure. The values observed for peak (4678 mPa•s), trough (3055 mPa•s), and final viscosity (6526 mPa•s) indicated that S. malaccense may be used as a thickener in hot food.
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