Displaying publications 61 - 80 of 185 in total

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  1. Yusof AP, Yusoff NH, Suhaimi FW, Coote JH
    Auton Neurosci, 2009 Jun 15;148(1-2):50-4.
    PMID: 19349212 DOI: 10.1016/j.autneu.2009.03.005
    The aim of the present study was to determine if paraventricular-spinal vasopressin neurones participate in the sympatho-inhibitory effects of systemically administered atrial natriuretic peptide (ANP) on renal sympathetic nerve activity (RSNA). Experiments were carried out on male Sprague-Dawley rats anesthetized with 1.3 g/kg urethane. Changes in mean arterial pressure (mm Hg), heart rate (beats per minute) and RSNA (%) were measured following intravenous bolus administration of ANP (250 ng, 500 ng and 5 microg). Intrathecal application of selective V 1a receptor antagonist was performed to test for the involvement of supraspinal vasopressin pathways in mediating the effect on sympathetic outflow evoked by intravenous ANP administration. The results obtained demonstrated that both low and high doses of ANP caused renal sympathoinhibition (250 ng; - 7.5 +/- 1%, 500 ng; - 14.2 +/- 1%, 5 microg; - 16.4 +/- 2%), concomitant with vasodilation and bradycardia. After spinal vasopressin receptor blockade, the inhibitory effects of ANP were prevented and there was a small renal sympatho-excitation (250 ng; + 1.7 +/- 0.2%, 500 ng; + 6.1 +/- 0.03%, 5 microg; + 8.0 +/- 0.03%, P < 0.05). Therefore, the renal sympathetic nerve inhibition elicited by circulating ANP is dependent on the efficacy of a well established supraspinal vasopressin pathway. Since supraspinal vasopressin neurones without exception excite renal sympathetic neurones, it is suggested that ANP elicits this effect by activating cardiac vagal afferents that inhibit the spinally projecting vasopressin neurones at their origin in the paraventricular nucleus of the hypothalamus.
  2. Abdullah N, Mohamadin MI, Safwan AP, Tiekink ER
    PMID: 21588481 DOI: 10.1107/S1600536810030436
    The title complex, [Cu(C(7)H(3)N(2)O(6))(2)(C(10)H(8)N(2))(H(2)O)]·C(4)H(8)O, features a penta-coordinate Cu(II) atom bound by two monodentate carboxyl-ate ligands, a bidentate 2,2'-bipyridine mol-ecule [dihedral angle between pyridine rings = 5.0 (2)°] and a water mol-ecule. The resulting N(2)O(3) donor set defines a distorted square-pyramidal geometry with the coordinated water mol-ecule in the apical position. In the crystal, the presence of O-H(w)⋯O(c) (w = water and c = carbon-yl) hydrogen bonding leads to the formation of a supra-molecular chain propagating along the c axis, which associates into a double chain via C-H⋯ O and π-π contacts between pyridyl rings [centroid-centroid distance = 3.527 (3) Å]. The solvent mol-ecules, which are disordered over two orientations in a 0.678 (11):0.322 (11) ratio, occupy voids defined by the complex mol-ecules and are held in place via C-H⋯O inter-actions.
  3. Tan JH, Tan HC, Loke SC, Arulanantham SA
    Nephrology (Carlton), 2017 Apr;22(4):308-315.
    PMID: 26952689 DOI: 10.1111/nep.12761
    AIM: Calcium infusion is used after parathyroid surgery for renal hyperparathyroidism to treat postoperative hypocalcaemia. We compared a new infusion regimen to one commonly used in Malaysia based on 2003 K/DOQI guidelines.

    METHODS: Retrospective data on serum calcium and infusion rates was collected from 2011-2015. The relationship between peak calcium efflux (PER) and time was determined using a scatterplot and linear regression. A comparison between regimens was made based on treatment efficacy (hypocalcaemia duration, total infusion amount and time) and calcium excursions (outside target range, peak and trough calcium) using bar charts and an unpaired t-test.

    RESULTS: Fifty-one and 34 patients on the original and new regimens respectively were included. Mean PER was lower (2.16 vs 2.56 mmol/h; P = 0.03) and occurred earlier (17.6 vs 23.2 h; P = 0.13) for the new regimen. Both scatterplot and regression showed a large correlation between PER and time (R-square 0.64, SE 1.53, P P = 0.04), and required less calcium infusion (67.7 vs 127.2 mmol, P = 0.02) for a shorter duration (57.3 vs 102.9 h, P = 0.001). Calcium excursions, peak and trough calcium were not significantly different between regimens. Early postoperative high excursions occurred when the infusion was started in spite of elevated peri-operative calcium levels.

    CONCLUSION: The new infusion regimen was superior to the original in that it required a shorter treatment period and resulted in less hypocalcaemia. We found that early aggressive calcium replacement is unnecessary and raises the risk of rebound hypercalcemia.

  4. Carvalho PJ, Kurnia KA, Coutinho JA
    Phys Chem Chem Phys, 2016 06 01;18(22):14757-71.
    PMID: 27189669 DOI: 10.1039/c6cp01896c
    Ionic liquids have been objects of extensive research for physical sorption of CO2 and a number of myths have been perpetuated in the literature, for lack of a critical analysis, concerning their potential for CO2 capture. This study carries a critical analysis of a number of widely accepted ideas and others not so well accepted that have been repeatedly expressed in the literature concerning the CO2 physical sorption in ionic liquids. Using the CO2 solubility in eicosane as benchmark, it will be shown that there is no evidence that ILs display a physical sorption of CO2 larger than n-alkanes when analyzed in adequate concentration units; the fluorination of the ions has no impact on the CO2 solubility and the oxygenation will marginally contribute to a decrease of the solubility. Ionic liquid-based deep eutectic systems are also shown to have a poor CO2 solubility. Although these widely used approaches to physically enhance the CO2 solubility in ILs do not seem to have any positive influence, this does not mean that other types of interaction cannot provide enhanced CO2 solubility as in the case of the anion [B(CN)4] confirmed here by a critical analysis of the published data. The mechanism of CO2 physical sorption in ionic liquids is discussed based on the results analyzed, supported by spectroscopic measurements and molecular simulations previously reported and further suggestions of possibilities for enhanced physical sorption based on fluorinated aromatic rings, other cyano based anions, mixtures with other ILs or solvents or the use of porous liquids are proposed.
  5. Muhammad Redzwan SR, Ralph AP, Sivaraman Kannan KK, William T
    Med J Malaysia, 2015 Jun;70(3):200-4.
    PMID: 26248785 MyJurnal
    Clinical experience with extensively Drug Resistant tuberculosis (XDR-TB) has not been reported in Malaysia before. We describe the clinical characteristics, risk factors, progress and therapeutic regimen for a healthcare worker with XDR-TB, who had failed therapy for multidrug resistant TB (MDR TB) in our institution. This case illustrates the risk of TB among healthcare workers in high TB-burden settings, the importance of obtaining upfront culture and susceptibility results in all new TB cases, the problem of acquired drug resistance developing during MDR-TB treatment, the challenges associated with XDR-TB treatment regimens, the value of surgical resection in refractory cases, and the major quality of life impact this disease can have on young, economically productive individuals.
  6. Lim NL, Cheah IGS, Soosai AP
    Med J Malaysia, 2001 Mar;56(1):65-70.
    PMID: 11503299
    A prospective observational study of feeding in low birth weight (LBW) infants with birth weight (BW) of at least 1.8 kg admitted to the Neonatal Intensive Care Unit (NICU) showed that nearly 80% of mothers provided expressed breastmilk (EBM) and a further 14% breastfed their infants before discharge. Weight gain was overall poor at a mean of 9.48 +/- 7.82 grams per kg per day with those on predominant EBM feeding (EBM > 70%) doing worse than those on predominant preterm formula (PTF) feeding (EBM < 31%), weight gain being 5.40 +/- 6.88 and 11.10 +/- 8.15 grams per kg per day respectively (p < 0.01). Weight gain was also poorer (7.72 +/- 5.55 grams per kg per day) in patients with respiratory distress syndrome (RDS) compared to those who did not have RDS (12.02 +/- 9.58 grams per kg per day). p < 0.05. Incidence of infants < 10th centile body weight at birth was 16.8% and at discharge was 69.1%.
  7. Samud AM, Asmawi MZ, Sharma JN, Yusof AP
    Immunopharmacology, 1999 Sep;43(2-3):311-6.
    PMID: 10596868
    Crinum asiaticum Linn plant is used in Malaysia as a rheumatic remedy and to relieve local pain. In the present study, we examined the anti-inflammatory effects of this plant extract on carrageenan-induced hind paw oedema in mice. C. asiaticum was serially extracted with petroleum ether, followed by chloroform and lastly, methanol. The chloroform and methanol extracts of the plant given orally (50 mg kg-1) caused significant (p < 0.05; n = 7) reduction in paw oedema but the petroleum ether extract did not induce significant effect (p > 0.05) on paw oedema. The methanol extract was then dissolved in water and extracted consecutively with chloroform, ethyl acetate and butanol. The chloroform fraction of methanol extract (CFME) treatment (50 mg kg(-1)) significantly reduced (p < 0.05; n = 7) the acute paw oedema. This may indicate that active anti-inflammatory compounds are present in the CFME. In an attempt to study the mechanism of action of its anti-inflammatory activity, the effects of CFME on BK- and histamine-induced contractions were investigated in isolated rat uterus and guinea-pig ileum preparations, respectively. It was found that CFME caused dose-dependent reduction (p < 0.05; n = 6) of the contractile response induced by BK and shifted the log dose-response curve of histamine to the right. The present findings suggest that C. asiaticum possessed an anti-inflammatory activity as suggested by its use in traditional medicine. The anti-inflammatory activity of this plant could not have been due to its anti-bradykinin activities as CFME non-specifically inhibited BK-induced contraction. It also suggest that CFME may contain compound(s) with anti-histaminic properties. The significance of these findings is discussed.
  8. Akbar A, Sharma JN, Yusof AP, Gan EK
    Int J Tissue React, 1998;20(3):95-100.
    PMID: 9894182
    We studied the effect of indomethacin, a cyclooxygenase inhibitor, on bradykinin-induced responses in the intact and denuded epithelium of the isolated tracheal smooth muscle in guinea pigs. Epithelium removal alone did not alter the responsiveness to bradykinin. Indomethacin (2.8 microM) enhanced the sensitivity to bradykinin of both intact and denuded preparations. This finding suggests that the tracheal epithelial may have no protective effect on the contractile responses induced by bradykinin. This may be due to the presence of high amounts of bradykinin-inactivating enzymes in the tracheal smooth muscle. Indomethacin-medicated potentiation caused by bradykinin in epithelium intact and denuded preparations may be an indication of removal of the bronchodilator prostaglandin biosynthesis. The significance of these findings is discussed.
  9. Antony-Leo AP, Arun-Maiya G, Mohan-Kumar M, Vijayaraghavan PV
    Malays Orthop J, 2019 Jul;13(2):20-27.
    PMID: 31467647 DOI: 10.5704/MOJ.1907.004
    Introduction: The key important factor influencing the outcomes following rehabilitation is the surgical approach involved in Total Knee Replacement (TKR). Most studies have analysed the functional outcome in comparing the approaches on surgical perspective rather on post-operative therapeutic interventions. The current study was to analyse the effects of structured TKR rehabilitation programme on the quality of life and joint specific outcomes between two different surgical approaches. Materials and Methods: In this double-blind randomised controlled trial, participants were randomly allocated to one of two groups: Group 1- those who underwent medial parapatellar approach and Group 2- those who underwent mid-vastus approach. Both groups received three-phase structured rehabilitation protocol for 12 weeks. The outcome measures of SF-36, knee mobility, isometric knee musculature strength and six-minute walk distance were measured at baseline, on discharge and at review after three months. Results: The quality of life and joint specific outcome scores were better in mid-vastus approach than the popular medial parapatellar approach. The outcomes of knee flexion mobility (p=0.04), knee extension mobility (p=0.03), isometric muscle strength of quadriceps (p=0.001), isometric muscle strength of hamstrings (p=0.03), six-minute walk distance (p=0.001) and Physical Cumulative Scores (PCS) (p=0.03) were found to exhibit significant improvements at three months follow up. Conclusion: The mid-vastus approach was found to exhibit better improvements following structured rehabilitation care, in physical summary scores of quality of life and joint specific outcomes than medial parapatellar approach.
  10. Wilson AP, Matthews S, Bahl M, Efstratiou A, Cookson BD
    J Clin Pathol, 1992 Nov;45(11):1036-7.
    PMID: 1452782 DOI: 10.1136/jcp.45.11.1036
    A throat swab from a 9 year old girl with pharyngitis yielded a non-toxigenic strain of Corynebacterium diphtheriae var mitis and Streptococcus group G. C pseudodiphtheriticum was isolated from the throats of two of her four brothers. In each case the isolate was sent to the reference laboratory before full identification. The growth was found to be mixed for one brother; the other isolate being a toxin producing C diphtheriae var gravis. The child was asymptomatic and the case proves that all colonial types on the Hoyles plate should be identified.
  11. Yew MMT, Lip JQ, Ling APK
    Trop Biomed, 2021 Sep 01;38(3):435-445.
    PMID: 34608117 DOI: 10.47665/tb.38.3.086
    Ever since the first reported case series on SARS-CoV-2-induced neurological manifestation in Wuhan, China in April 2020, various studies reporting similar as well as diverse symptoms of COVID-19 infection relating to the nervous system were published. Since then, scientists started to uncover the mechanism as well as pathophysiological impacts it has on the current understanding of the disease. SARS-CoV-2 binds to the ACE2 receptor which is present in certain parts of the body which are responsible for regulating blood pressure and inflammation in a healthy system. Presence of the receptor in the nasal and oral cavity, brain, and blood allows entry of the virus into the body and cause neurological complications. The peripheral and central nervous system could also be invaded directly in the neurogenic or hematogenous pathways, or indirectly through overstimulation of the immune system by cytokines which may lead to autoimmune diseases. Other neurological implications such as hypoxia, anosmia, dysgeusia, meningitis, encephalitis, and seizures are important symptoms presented clinically in COVID-19 patients with or without the common symptoms of the disease. Further, patients with higher severity of the SARS-CoV-2 infection are also at risk of retaining some neurological complications in the long-run. Treatment of such severe hyperinflammatory conditions will also be discussed, as well as the risks they may pose to the progression of the disease. For this review, articles pertaining information on the neurological manifestation of SARS-CoV-2 infection were gathered from PubMed and Google Scholar using the search keywords "SARS-CoV-2", "COVID-19", and "neurological dysfunction". The findings of the search were filtered, and relevant information were included.
  12. Dhunputh P, Acharya R, Umakanth S, Shetty SM, Mohammed AP, Saraswat PP
    Kathmandu Univ Med J (KUMJ), 2021 11 26;19(74):248-252.
    PMID: 34819445
    Background Thrombocytopenia is a common haematological abnormality noted in clinical practice, however, it can be missed in cases where specific investigations are not asked for. Acute Febrile Illness with thrombocytopenia is a diagnostic and therapeutic challenge, as thrombocytopenia has an inverse relation to mortality and morbidity in various febrile illnesses. Vector-borne and zoonotic diseases (like malaria, dengue, scrub typhus, and leptospirosis), infections and sepsis are some of the common causes of fever with thrombocytopenia. Objective To identify the causes of fever with thrombocytopenia, assess the clinical complications associated with febrile thrombocytopenia, and overall study the clinical profile of thrombocytopenia in a tertiary care hospital Method Medical records of all adult patients, admitted to a tertiary level hospital, with fever and thrombocytopenia (platelet count < 1,00,000 /mm3 ) were assessed (from October 2009 to March 2011). Detailed case history, general physical examination findings, routine and specific examinations were recorded according to a pre-decided format. Data were analysed using SPSS 16.0 Result Acute febrile illness with thrombocytopenia was most commonly seen in Dengue patients. Headache and arthralgia were more commonly encountered in scrub typhus. Platelet transfusions were necessitated in a large number of patients, especially in scrub typhus. Malaria patients had the highest mortality rate. Conclusion Acute Febrile Illnesses (AFI) are of varied origins, and proper diagnosis is imperative. The degree of thrombocytopenia in infections has a prognostic value. It can also help in differential diagnosis and clear identification of aetiology of acute febrile illnesses. Timely identification and management of thrombocytopenia in acute febrile illness can positively impact the overall patient outcome.
  13. Mahendra Raj S, Ravindran S, Braganza MC, Kaur K, Kunnath AP
    Med J Malaysia, 2021 Nov;76(6):811-813.
    PMID: 34806665
    BACKGROUND: Coeliac disease, an autoimmune enteropathy related to gluten sensitivity was hitherto thought to be rare in Asia. Recent data however suggests that Celiac disease may be under-diagnosed in Asia.

    OBJECTIVE: The aim of this audit was to determine the frequency of histological changes compatible with Coeliac disease among patients undergoing elective diagnostic oesaphago-gastro-duodenoscopy (OGDS) under the care of a single practitioner in a Malaysian hospital.

    MATERIALS AND METHODS: The archived endoscopically obtained duodenal biopsy specimens of 241 consecutive Malaysian subjects undergoing elective diagnostic (OGDS) were reviewed by a pathologist blinded to the clinical data. Based on intra-epithelial lymphocyte counts, crypt hyperplasia and villous atrophy, each subject was assigned to one of the categories of the Modified Marsh classification for the histological diagnosis of Coeliac disease. The clinical charts of all subjects were reviewed by a single gastroenterologist blinded to the findings of the histological review.

    RESULTS: Of the 241 study subjects, 132 (54.8%) were females. There were 56 (23.2%) Malays, 90 (37.3%) Chinese, 88 (36.5%) Indians and seven (2.9%) from the other category. The median age of the study sample was 49 years (range 15- 88 years). The OGDS was done as part of screening in 15(6.2%) subjects while in the remaining it was part of the investigation of a clinical problem. Based on histological findings, none of the subjects could be assigned to a modified Marsh class of >1. The prevalence of histological changes compatible with Coeliac disease in the study was 0% (binomial exact one-sided 97.5 % confidence interval 0- 1.52%).

    CONCLUSION: In conclusion, this audit provides no evidence that active Coeliac disease is significantly under-detected among symptomatic patients presenting for diagnostic OGDS. The possibility that a significant number may have potential coeliac disease cannot be excluded.

  14. Alavi M, Mehrinezhad SA, Amini M, Parthaman Singh MKA
    Health Psychol Open, 2017 Dec 17;4(2):2055102917748461.
    PMID: 29379632 DOI: 10.1177/2055102917748461
    This study explored the relationship between family functioning and trait emotional intelligence among 547 respondents, between the age of 16 and 24 years from Malaysia, Iran, China, Sudan, Somalia, Morocco, the United Kingdom, Germany and the Netherlands. The questionnaires were Family Adaptability and Cohesion Evaluation Scale III and Trait Emotional Intelligence Questionnaire Short Form. Pearson correlation analysis revealed a significant relationship between family functioning and trait emotional intelligence. The higher the family functioning, the higher the trait emotional intelligence among youths. The findings provide a deeper understanding in the field of family functioning and trait emotional intelligence and have implications for parents, administrators and child relationships dealing with trait emotional intelligence.
  15. Johan NH, Oo AP, Pisharam JK, Rosalina S, Koh D, Tan J
    Med J Malaysia, 2023 Jan;78(1):54-60.
    PMID: 36715192
    INTRODUCTION: The Brunei Dialysis and Transplant Registry (BDTR) recorded data on patients with end-stage kidney disease (ESKD) from 2011 to 2020, mainly for planning of services and benchmarking of standards. We report the trends of epidemiologic and performance parameters, compare performances between modalities of Kidney Replacement Therapy and evaluate the survival of ESKD patients over the 10-year period.

    MATERIALS AND METHODS: Three groups of data were analysed from the BDTR over the 10-year period. Epidemiological data, blood parameters and dialysis are key performance indicators.

    RESULTS: There are increments in prevalence and incidence of treated ESKD patients in Brunei over 10 years, especially with haemodialysis (HD). The projected prevalence and incidence showed an anticipated annual increase of 42.2 per million population (pmp) and 9.9 pmp respectively. Diabetes mellitus (DM) (79%) was the main cause of ESKD. HD (86%), peritoneal dialysis (PD) (9%) and transplant (5%) were the main modalities of kidney replacement therapy in 2020. Cumulative results over the decade showed significant improvements in serum phosphate, peritonitis rates and HD blood flow rates. PD patients have better survival rates, lower systolic blood pressure and better adequacy. PD survival (patient survival of 91%, 73% and 56% at 1, 3 and 5 years respectively) was superior to HD survival (86% and 64% at 1 and 2 years, respectively), but patient demographics (age and DM status) were different. The 2020 dataset showed satisfactory anaemia management but mineral bone disease management was sub-optimal. Seventy percent of prevalent HD patients had arteriovenous fistula access. Thirty-two percent and fifty-two percent of HD and PD patients, respectively, achieved target dialysis adequacy. Peritonitis rate was 0.3 episodes per patient year.

    CONCLUSION: Brunei has a high incidence and prevalence of treated ESKD in the last decade, especially DM-related ESKD. This study has identified many specific areas to be targeted for improvements and provided evidence for further proliferation of PD and transplant preference policy.

  16. Azzani M, Muagan GAP, Atroosh WM, Ng IZ
    BMJ Open, 2024 Apr 30;14(4):e084454.
    PMID: 38688667 DOI: 10.1136/bmjopen-2024-084454
    BACKGROUND: Cardiovascular disease (CVD) is the major cause of mortality worldwide. Recent studies showed that there is increasing CVD incidence at younger ages. Therefore, this study aimed to estimate the risk of CVD and its associated factors among young adults.

    METHODS: A cross-sectional study was conducted among university students in Selangor, Malaysia, using a self-administered questionnaire along with anthropometric measurements. The sample size was calculated using a single proportion formula. The CVD risk was calculated using the non-laboratory-based Inter-Heart Modifiable Risk Score (IHMRS). Participants aged 18 years and above, with no CVD history, were recruited using a convenience sampling method between February and May 2022. CVD risk was classified as low (scores between 0 and 9 points), moderate (scores between 10 and 15 points) and high (scores between 16 and 48 points). The factors associated with the CVD risk were identified using χ2 analysis.

    RESULTS: A total of 241 participants were included in this study. The median age was 28 years and the majority were females (75.1%). The IHMRS revealed that 46.5%, 44.4% and 9% of the respondents have low, moderate and high CVD risk, respectively. The CVD risk associated factors were education, the history of heart attacks among parents, feeling sad or depressed for 2 weeks or more in a row, having several episodes/permanent stress, expose to secondhand smoke and consuming meat and poultry more than two times daily.

    CONCLUSIONS: This study found that more than 50% of study participants had moderate to high risk of CVD. Family history and lifestyle factors are the most likely determinants of CVD risk among the young age group. These findings support the development and implementation of targeted prevention programmes as well as provide useful information for action planning and policymaking to curb the disease in the future.

  17. Kuek CY, Gurmukh Singh SKA, Tay PS
    Asian Bioeth Rev, 2021 Jun;13(2):167-178.
    PMID: 33968213 DOI: 10.1007/s41649-021-00166-2
    The conception of saviour siblings using preimplantation genetic diagnosis coupled with human leukocyte antigen (HLA) typing or HLA typing alone is controversial and receives a wide divergence of legal responses among countries around the world. The resulting child conceived through this procedure is dubbed a 'saviour sibling' as the child can potentially act as a compatible donor for an elder ailing sibling who needs a haematopoietic stem cell transplantation. At present, the acceptability of this procedure in Malaysia is ambiguous as there is no specific statute governing assisted reproductive technology, and the guideline issued by the Malaysian Medical Council does not expressly address this issue. The ethical arguments relating to the conception of saviour siblings in the current literature are mainly thought to reflect a liberal viewpoint which is predominantly Western in nature. This paper seeks to explore the perception of selected key stakeholders on the acceptability of and ethical concerns related to this procedure in the Malaysian context. The findings indicate that stakeholders generally support the conception of saviour siblings and some of their concerns echo the Western viewpoint. Interestingly, many were highly anxious about its economic implication, which is rarely discussed in the current literature on saviour siblings.
  18. Muhamad II, Zulkifli N, Selvakumaran SA, Lazim NAM
    Curr Pharm Des, 2019;25(11):1147-1162.
    PMID: 31258069 DOI: 10.2174/1381612825666190618152133
    BACKGROUND: In recent decades, there has been an increased interest in the utilization of polysaccharides showing biological activity for various novel applications owing to their biocompatibility, biodegradability, non-toxicity, and some specific therapeutic activities. Increasing studies have started in the past few years to develop algal polysaccharides-based biomaterials for various applications.

    METHODS: Saccharide mapping or enzymatic profiling plays a role in quality control of polysaccharides. Whereby, in vitro and in vivo tests as well as toxicity level discriminating polysaccharides biological activities. Extraction and purification methods are performed in obtaining algal derived polysaccharides followed by chromatographic profiles of their active compounds, structural features, physicochemical properties, and reported biological activities.

    RESULTS: Marine algae are capable of synthesizing Glycosaminoglycans (GAGs) and non-GAGs or GAG mimetics such as sulfated glycans. The cell walls of algae are rich in sulfated polysaccharides, including alginate, carrageenan, ulvan and fucoidan. These biopolymers are widely used algal-derived polysaccharides for biological and biomedical applications due to their biocompatibility and availability. They constitute biochemical compounds that have multi-functionalization, therapeutic potential and immunomodulatory abilities, making them promising bioactive products and biomaterials with a wide range of biomedical applications.

    CONCLUSION: Algal-derived polysaccharides with clearly elucidated compositions/structures, identified cellular activities, as well as desirable physical properties have shown the potential that may create new opportunities. They could be maximally exploited to serve as therapeutic tools such as immunoregulatory agents or drug delivery vehicles. Hence, novel strategies could be applied to tailor multi-functionalization of the polysaccharides from algal species with vast biomedical application potentials.

  19. Yong CM, Yehgambaram PAP, Lee SWH
    PLoS One, 2024;19(2):e0298130.
    PMID: 38300930 DOI: 10.1371/journal.pone.0298130
    INTRODUCTION: Ovarian cancer is one of the most common cancer among women in Malaysia. Patients with ovarian cancer are often diagnosed at an advanced stage. Despite initial response to surgery and chemotherapy, most patients will experience a relapse. Olaparib has been reported have promising effects among BRCA mutated ovarian cancer patients. This study aimed to evaluate the cost-effectiveness of olaparib as a maintenance therapy for BRCA ovarian cancer in Malaysia.

    METHODS: We developed a four-state partitioned survival model which compared treatment with olaparib versus routine surveillance (RS) from a Malaysian healthcare perspective. Mature overall survival (OS) data from the SOLO-1 study were used and extrapolated using parametric models. Medication costs and healthcare resource usage costs were derived from local inputs and publications. Deterministic and probabilistic sensitivity analyses (PSA) were performed to explore uncertainties.

    RESULTS: In Malaysia, treating patients with olaparib was found to be more costly compared to RS, with an incremental cost of RM149,858 (USD 33,213). Patients treated with olaparib increased life years by 3.05 years and increased quality adjusted life years (QALY) by 2.76 (9.45 years vs 6.40 years; 7.62 vs 4.86 QALY). This translated to an incremental cost-effectiveness ratio (ICER) of RM 49,159 (USD10,895) per life year gained and RM54,357 (USD 12,047) per QALY gained, respectively. ICERs were most sensitive to time horizon of treatment, discount rate for outcomes, cost of treatment and health state costs, but was above the RM53,770/QALY threshold.

    CONCLUSION: The use of olaparib is currently not a cost-effective strategy compared to routine surveillance based upon the current price in Malaysia for people with ovarian cancer with BRCA mutation, despite the improvement in overall survival.

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