Displaying publications 81 - 100 of 314 in total

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  1. Nasir MSM, Ab-Kadir MZA, Radzi MAM, Izadi M, Ahmad NI, Zaini NH
    PLoS One, 2019;14(7):e0219326.
    PMID: 31295278 DOI: 10.1371/journal.pone.0219326
    The Sustainable Energy Development Authority of Malaysia (SEDA) regularly receives complaints about damaged components and distribution boards of PV systems due to lightning strikes. Permanent and momentary interruptions of distribution circuits may also occur from the disturbance. In this paper, a solar PV Rooftop system (3.91 kWp) provided by SEDA was modelled in the PSCAD/EMTDC. The Heidler function was used as a lightning current waveform model to analyse the transient current and voltage at two different points susceptible to the influence of lightning events such as different lightning current wave shape, standard lightning current and non-standard lightning current. This study examines the effect on the system components when lightning directly strikes at two different points of the installation. The two points lie between the inverter and the solar PV array and between inverter and grid. Exceptionally high current and voltage due to the direct lightning strike on a certain point of a PV Rooftop system was also studied. The result of this case study is observed with and without the inclusion of surge protective devices (SPDs). The parameters used were 31 kA of peak current, 10 metres cable length and lightning impulse current wave shape of 8/20μs. The high current and voltage at P1 striking point were 31 kA and 2397 kV, respectively. As for the AC part, the current and voltage values were found to be 5.97 kA and 5392 kV, respectively.Therefore, SPDs with suitable rating provided by SEDA were deployed. Results showed that high transient current voltage is expected to clamp sharply at the values of 1.915 kV and 0 A at the P1 striking point. As for the AC part, the current and voltage values were found to be 0 kA and 0.751 V, respectively. Varying lightning impulse current wave shapes at striking point P2 showed that the highest voltage was obtained at waveshape 10/350 μs at 11277 kV followed by wave shapes of 2/70 μs, 8/20 μs and 0.7/6 μs. The high value of transient voltage was clamped at a lower level of 2.029 kV. Different lightning amplitudes were also applied, ranging from 2-200 kA selected based on the CIGRE distribution. It showed that the current and voltage at P1 and P2 were directly proportional. Therefore, the SPD will be designed at an acceptable rating and proper position of SPD installation at solar PV Rooftop will be proposed. The results obtained in this study can then be utilised to appropriately assign a SPD to protect the PV systems that are connected to the grid. Installing SPDs without considering the needs of lightning protection zones would expose the expensive equipment to potential damage even though the proper energy coordination of SPDs is in place. As such, the simulation results provide a basis for controlling the impacts of direct lightning strikes on electrical equipment and power grids and thus justify SPD coordination to ensure the reliability of the system.
  2. Ahmad N, Anouar EH, Tajuddin AM, Ramasamy K, Yamin BM, Bahron H
    PLoS One, 2020;15(4):e0231147.
    PMID: 32287324 DOI: 10.1371/journal.pone.0231147
    This paper reports the synthesis, characterization, anticancer screening and quantum chemical calculation of a tetradentate Schiff base 2,2'-((1E,1'E)-((2,2-dimethylpropane-1,3-diyl)bis- (azanylylidene))bis(methanylylidene))bis(4-fluorophenol) (L2F) and its Pd (II) complex (PdL2F). The compounds were characterized via UV-Visible, NMR, IR spectroscopy and single crystal x-ray diffraction. Density Functional Theory (DFT) and time-dependent DFT calculations in gas and solvent phases were carried out using B3LYP, B3P86, CAM-B3LYP and PBE0 hybrid functionals combined with LanL2DZ basis set. Complexation of L2F to form PdL2F was observed to cause a bathochromic shift of the maximum absorption bands of n-π* from 327 to 410 nm; an upfield shift for δ (HC = N) from 8.30 to 7.96 ppm and a decreased wavenumber for ν(C = N) from 1637 to 1616 cm-1. Overall, the UV-Vis, NMR and IR spectral data are relatively well reproduced through DFT and TD-DFT methods. L2F and PdL2F showed IC50 of 90.00 and 4.10 μg/mL, respectively, against human colorectal carcinoma (HCT116) cell lines, signifying increased anticancer activity upon complexation with Pd (II).
  3. Mansor N, Ahmad N, Rahman HA
    PLoS One, 2020;15(10):e0240842.
    PMID: 33119620 DOI: 10.1371/journal.pone.0240842
    INTRODUCTION: The increasing trend of sexually transmitted infections (STIs) among the young population is a significant public health problem. This study aimed to determine the level of knowledge on STIs among students in higher education institutions and its predicting factors, in Melaka.

    METHODOLOGY: A cross-sectional study was conducted among 600 students from higher education institutions in Melaka aged between 18 to 30 years old. Multistage sampling of the institutions was performed. Valid and reliable self-administered questionnaire in the national language, Bahasa Malaysia, was used as to collect data on sociodemographic, personal background, knowledge on STIs and sources of information for STIs. Univariate, bivariate and multivariate analyses were conducted using IBM SPSS software version 25.

    RESULTS: The response rate for this study was 88%. The mean knowledge score was 24.1 ±5.1 out of 38. HIV was the most known STIs while gonorrhoea, trichomoniasis and chlamydial infections were among the least known STIs. Oral intercourse was the least known sexual activity that could transmit STIs. Higher proportion of respondents had correct knowledge on control and preventive measures of STIs (between 78% and 95%) compared to correct knowledge on sign and symptoms of STIs (between 8.5% and 67.8%). More than 90% of the respondents were unaware that a person infected with STIs could be symptom free. Four variables were identified as the determinants of the knowledge on STIs, which were level of education, place of stay, history of sexual and reproductive health education and involvement in STIs awareness programs (F (4,445) = 11.405, p <0.001, R2 = 0.093).

    CONCLUSIONS: The knowledge on STIs among students in higher education institutions was unsatisfactory. The existing sexual education programs can be strengthened by delivering more information on other STIs rather than focusing on HIV only. The future program should focus on students of diploma and/or skill certificate and staying off-campus.

  4. Ahmad N, Baharom M, Aizuddin AN, Ramli R
    PLoS One, 2021;16(1):e0245304.
    PMID: 33417609 DOI: 10.1371/journal.pone.0245304
    Smear-positive pulmonary tuberculosis (PTB) is more infectious compared to smear-negative PTB and have great significance for epidemiology and infection control. The prevalence of smear-positive PTB rarely affects males and females equally. Hence, we aimed to identify the sex-related differences in the prevalence of smear-positive PTB and its associated factors in Kuala Lumpur, Malaysia. A cross-sectional study was conducted using data from the National Tuberculosis Information System (TBIS) from 1 January, 2015, to 31 December, 2019. The study population was selected using simple random sampling from the list of registered PTB patients in TBIS. The criteria for inclusion were all Malaysian adults aged ≥18 years residing in Kuala Lumpur and registered as PTB in TBIS. Factors associated with smear-positive PTB in male and female patients were determined using multiple logistic regression analysis. Overall prevalence of smear-positive PTB was 68.6%, and male patients predominated (71%). The male:female prevalence ratio of smear-positive PTB was 2.4:1. Male patients who worked as machine operators and elementary workers (adjusted odds ratio (aOR) 2.23, 95% confidence interval (CI) 1.24-4.02, p = 0.007), were self-employed (aOR 2.58, 95% CI 1.46-4.56, p = 0.001), lived in a residence categorized as 'other' (aOR 2.49, 95% CI 1.28-4.86, p = 0.007) and were smokers (aOR 1.37, 95% CI 1.01-1.87, p = 0.045) had higher odds for smear-positive PTB. Meanwhile, female patients with diabetes mellitus had higher odds for smear-positive PTB (aOR 1.92, 95% CI 1.05-3.54, p = 0.035), while female patients who were healthcare workers had lower odds (aOR 0.33, 95% CI 0.12, 0.94, p = 0.039). The prevalence of smear-positive PTB is higher in males compared to females. The factors associated with smear-positive PTB differed based on sex. The current TB control program, especially on smear-positive PTB, should likely be strategized and stratified by sex.
  5. Ahmad N, Javaid A, Syed Sulaiman SA, Basit A, Afridi AK, Jaber AA, et al.
    PLoS One, 2016 Jul 28;11(7):e0159560.
    PMID: 27467560 DOI: 10.1371/journal.pone.0159560
    At present, within the management of multidrug resistant tuberculosis (MDR-TB) much attention is being paid to the traditional microbiological and clinical indicators. Evaluation of the impact of MDR-TB treatment on patients' Health Related Quality of Life (HRQoL) has remained a neglected area.
  6. Sado F, Yap HJ, Ghazilla RAR, Ahmad N
    PLoS One, 2018;13(7):e0200193.
    PMID: 30001415 DOI: 10.1371/journal.pone.0200193
    Prolong walking is a notable risk factor for work-related lower-limb disorders (WRLLD) in industries such as agriculture, construction, service profession, healthcare and retail works. It is one of the common causes of lower limb fatigue or muscular exhaustion leading to poor balance and fall. Exoskeleton technology is seen as a modern strategy to assist worker's in these professions to minimize or eliminate the risk of WRLLDs. Exoskeleton has potentials to benefit workers in prolong walking (amongst others) by augmenting their strength, increasing their endurance, and minimizing high muscular activation, resulting in overall work efficiency and productivity. Controlling exoskeleton to achieve this purpose for able-bodied personnel without impeding their natural movement is, however, challenging. In this study, we propose a control strategy that integrates a Dual Unscented Kalman Filter (DUKF) for trajectory generation/prediction of the spatio-temporal features of human walking (i.e. joint position, and velocity, and acceleration) and an impedance cum supervisory controller to enable the exoskeleton to follow this trajectory to synchronize with the human walking. Experiment is conducted with four subjects carrying a load and walking at their normal speed- a typical scenario in industries. EMG signals taken at two muscles: Right Vastus Intermedius (on the thigh) and Right Gastrocnemius (on the calf) indicated reduction in muscular activation during the experiment. The results also show the ability of the control system to predict spatio-temporal features of the pilots' walking and to enable the exoskeleton to move in concert with the pilot.
  7. Fiidow OA, Minhat HS, Zulkefli NAM, Ahmad N
    PLoS One, 2022;17(2):e0263372.
    PMID: 35113927 DOI: 10.1371/journal.pone.0263372
    INTRODUCTION: Khat is a flowering plant with stimulant effect on the nervous system and produce psychological dependence. Despite its harmful effects, the ingestion of khat has been part of cultural norms and the legality of khat varies by region.

    OBJECTIVE: This systematic review aimed at critically evaluating the available evidence on the risk factors of khat chewing among adolescents.

    METHODS: A systematic review was conducted on published research studies from five databases Scopus, PubMed, Science-direct, Ovid and google scholar using keywords khat chewing OR qat chewing AND associated factors OR risk factors OR contributing factors AND adolescents OR teenagers. Articles included were either cross-sectional, cohort, case-control or qualitative studies which were published between the year 1990 till present. Excluded articles were the non-English written articles, descriptive studies and irrelevant topics being studied.

    RESULTS: Out of 2617 records identified and screened, six were included for the analysis and interpretation of the data. All included studies were cross-sectional study design. All six studies reported having family members who chewed khat significantly predict khat chewing among adolescents, followed by five articles for friends or peers who also chewed khat and four articles for male gender. Smoking was also found to have the highest odds (OR = 18.2; 95% CI: 12.95-25.72) for khat chewing among adolescents.

    CONCLUSION: The review highlights the crucial role of family members, friends or peers and male gender to predict khat chewing among adolescents. Effectiveness of health promotion programs to educate and reduce khat chewing among adolescents will require active participation of family members and friends.

  8. Jane Ling MY, Ahmad N, Mohd Yusoff MF, Lim KH
    PLoS One, 2022;17(1):e0263355.
    PMID: 35100321 DOI: 10.1371/journal.pone.0263355
    BACKGROUND: Adolescent e-cigarette use has increased dramatically. Most e-cigarette liquids contain nicotine, which can harm the developing adolescent brain. Local studies examining the risk factors of adolescent e-cigarette use and interactions between its risk factors are limited. This study was aimed at determining the prevalence of current e-cigarette use and its associated factors among in-school adolescents in West Malaysia. We also examined the possible sociodemographic characteristic, lifestyle risk behaviour and parental factor interactions that affect the probability of current e-cigarette use.

    METHODS: We conducted a cross-sectional study using data from the National Health and Morbidity Survey 2017. Respondents aged 13-18 years were included in the study. The data were analysed using STATA (v.15).

    RESULTS: The prevalence of current e-cigarette use was 9.1%. Male gender, older age, Malay ethnicity, schooling in urban area, current smoking, current alcohol use, current drug use, having parents that are not married and living together and parental tobacco product use were significantly associated with current e-cigarette use. There were significant interactions between: i) gender with age, ethnicity, current smoking, current alcohol use and current drug use, ii) ethnicity with current smoking and current alcohol use, iii) locality with ethnicity, current smoking and current alcohol use, iv) current drug use with age, ethnicity, current smoking and current alcohol use, v) parental marital status with gender, age and ethnicity, and vi) parental tobacco use with ethnicity and current smoking.

    CONCLUSION: Our findings identify significant associations between sociodemographic characteristics, lifestyle risk behaviours and parental factors with current e-cigarette use. They also provide new insight into the interactions between these factors that affect the probability of current e-cigarette use among West Malaysian adolescents. Efforts to tackle e-cigarette use in Malaysian adolescents should target sociodemographic characteristics, lifestyle risk behaviours and parental factors such as smoking cessation intervention for parents.
  9. Galadima AN, Mohd Zulkefli NA, Said SM, Ahmad N, Garba SN
    PLoS One, 2022;17(12):e0263436.
    PMID: 36480545 DOI: 10.1371/journal.pone.0263436
    BACKGROUND: Childhood immunisation coverage is very low in Nigeria (31%) with Zamfara State being amongst the states with the poorest coverage (<10%). Lack of maternal knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions of religious regulations of antenatal mothers towards childhood immunisation are the contributory factors to poor childhood immunisation uptake. This study aims is to develop, implement and evaluate the effects of an immunisation health educational intervention with application of Social Cognitive Theory on pregnant women to improve knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions on religious regulations regarding childhood immunization uptake in Federal Medical Centre Gusau, Zamfara State, Nigeria.

    METHODOLOGY: The study will be a single-blind parallel-group randomised controlled trial, where baseline data will be collected from 392 estimated antenatal mothers, after that they will be evenly randomised using randomly generated permuted block sizes (each containing two intervention and two control assignments). The study participants will be antenatal mothers of ages 18 years and above who are in third trimesters and attending Federal Medical Centre Gusau, Zamfara State, Nigeria; during the study period and fulfilled all the inclusion and exclusion criteria. The intervention group will undergo five-health education sessions on immunisation, which will be strictly guided by Social Cognitive Theory-based intervention module: while the control group will receive usual care (standard care). Follow-up data will be collected using the same questionnaire at 6-weeks post-delivery, 10-weeks post-delivery and 14-weeks post-delivery. The generalized linear mixed model will be carried-out to determine the overall effect of the intervention after controlling for 14 potential confounding variables. An intention to treat analysis will also be carried-out. Childhood immunisation uptake is the primary outcome while the secondary outcomes are: improved knowledge scores, attitude scores, outcomes expectation, self-efficacy scores, cultural beliefs scores and assumptions on religious regulations scores.

    DISCUSSION: The study will be a randomised controlled trial, that focuses on the effects of an immunisation health educational intervention with application of Social Cognitive Theory on pregnant women to improve knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions on religious regulations regarding childhood immunisation uptake in Federal Medical Centre Gusau, Zamfara State, Nigeria.

    TRIAL REGISTRATION: Pan African Clinical Trial Registry PACTR202006722055635. Protocol registered on 09 June 2020.

  10. Mud Shukri MI, Minhat HS, Ahmad N, Ismail F, Kanthavelu C, Nurfarahin D, et al.
    PLoS One, 2023;18(7):e0288618.
    PMID: 37471310 DOI: 10.1371/journal.pone.0288618
    BACKGROUND: The COVID-19 pandemic has had severe impacts on mental health status worldwide. Several studies have investigated the prevalence and factors associated with depression, anxiety, and stress in different countries, however, a systematic review on the research topic during COVID-19 is presently lacking in Malaysia's context. To fill this gap, electronic databases including PubMed, Scopus, Science Direct, Sagepub, CINAHL, Psychology, and Behavioral Sciences Collection were searched for relevant studies. A total of 16 studies were included in the systematic review.

    METHODS: To fill this gap, electronic databases including PubMed, Scopus, Science Direct, Sagepub, CINAHL, Psychology, and Behavioral Sciences Collection were searched for relevant studies. A total of 16 studies were included in the systematic review.

    RESULTS: The analyses showed that the prevalence of depression, anxiety, and stress ranged from 14.3% to 81.7%, 8.0% to 81.7%, and 0.9% to 56.5% respectively. Adult populations demonstrated the highest prevalence of depression, whereas university students reported the highest prevalence of anxiety and stress. Several factors were associated with mental health conditions including age, gender, family income, and perception of COVID-19.

    CONCLUSION: Differentials in mental health screening practices call for standardised screening practices. Mental health intervention should be targeted at high-risk populations with effective risk communication.

  11. Jane Ling MY, Ahmad N, Aizuddin AN
    PLoS One, 2023;18(6):e0286518.
    PMID: 37262079 DOI: 10.1371/journal.pone.0286518
    BACKGROUND: The burden of non-communicable diseases (NCDs) is increasing. Risk perception of NCDs is an important factor towards the uptake of preventive health interventions. There are various questionnaires assessing risk perception of NCDs, but no internationally standardized questionnaire has been available. Identification of factors associated with risk perception of NCDs may facilitate the development of targeted interventions. This systematic review aims to identify available questionnaire assessing risk perception of NCDs and the factors associated with risk perception of NCDs.

    METHODS: The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original article published in English between 2012 and 2021. Quality appraisal of the eligible articles was conducted using the Mixed Methods Appraisal Tool. Findings were synthesized using content analysis.

    RESULTS: A total of 86 studies were included. We found a variety of questionnaires assessing risk perception of NCDs, with many differences in their development, domains, items and validity. We also identified several personal, sociopsychological and structural factors associated with risk perception of NCDs.

    LIMITATIONS: Most of the included studies were of cross-sectional design, and therefore the quality of evidence was considered low and exhibit a high risk of bias. The role of publication bias within this systematic review should be acknowledged as we did not include grey literature. Additionally, language bias must be considered as we only included English-language publications.

    CONCLUSION: Further development and testing of available questionnaire is warranted to ensure their robustness and validity in measuring risk perception of NCDs. All the identified factors deserve further exploration in longitudinal and experimental studies.

  12. Hayat M, Ahmad N, Mohkumuddin S, Ali Khan SL, Khan AH, Haq NU, et al.
    PLoS One, 2023;18(4):e0284439.
    PMID: 37058504 DOI: 10.1371/journal.pone.0284439
    BACKGROUND: Drug therapy problems (DTPs) are common among patients suffering from chronic kidney disease (CKD). However, there is a lack of information about DTPs and its predictors among CKD patients from Pakistan.

    OBJECTIVES: To evaluate the frequency, type and predictors of various types of DTPs among CKD patients at a tertiary-care hospital in Pakistan.

    METHODOLOGY: This was a cross-sectional study carried out at Sandeman Provincial Hospital, Quetta between 1-11-2020 and 31-1-2021. It included 303 non-dialysis ambulatory patients of CKD-stage 3 and above. Cipolle et al., criterion was used for classifying the DTPs and a clinician at the study site checked the identified DTPs for accuracy. Data were analyzed by SPSS 23. Multivariate analysis was conducted to find the predictors of individual types of DTPs. A p-value <0.05 was considered statistically significant.

    RESULTS: The patients received a total of 2265 drugs with a median of eight drugs per patient (range: 3-15 drugs). A total of 576 DTPs were identified among 86.1% patients with a median of two DTPs (interquartile range 1-3) per patient. Dosage too high (53.5%) was the most common DTP followed by adverse drug reactions (ADRs) (50.5%) and need of additional drug therapy (37.6%). In multivariate analysis, patients' age of >40 years emerged as a predictor of unnecessary drug therapy and dosage too high. The odds of needing a different drug product was significantly high in patients with cardiovascular diseases (CVD) and diabetes mellitus (DM). The dosage too low had significant association with CVD. The risk of ADRs was significantly high in elderly patients (>60 years) and those with CVD. The presence of hypertension, DM and CKD stage-5 emerged as predictors of dosage too high.

    CONCLUSION: This study revealed a high prevalence of DTPs among CKD patients. Targeted interventions in high risk patients may reduce the frequency of DTPs at the study site.

  13. Wan Ghazali WS, Minhat HS, Mohd Zulkefli NA, Ahmad N, Ismail F, Mashudi DN, et al.
    PLoS One, 2023;18(8):e0285366.
    PMID: 37616287 DOI: 10.1371/journal.pone.0285366
    BACKGROUND: Despite evidence of depression among mothers of children with cancer, there appears to be a lack of studies or concern regarding factors associated with depression among these mothers.

    OBJECTIVE: To review the factors associated with depression among mothers of children with cancer.

    METHOD: Pubmed, Medline, Cochrane, CINAHL, Psychology, and Behavioural Sciences Collection, and Academic Search Complete were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies published between 2010 to 2022 on the associated risk factors of depression among mothers of children with cancer. The keywords used included mothers OR maternal' AND 'Child*' AND 'cancer OR tumo*r OR neoplasm' AND 'factors OR facilitators AND barriers OR predictors OR determinants AND 'depression'. Selected studies were evaluated by quality assessment.

    RESULT: Five articles fulfilled the eligibility criteria. The factors associated with depression among mothers of children were socio-demographic risk factors (marital status, education level, annual income, child cancer diagnosis), and stress factors (caregiving stress, cancer-related stress, general stress). There were other factors associated with depression that act as mediators along the process which were emotion-focused coping and perceived social support.

    CONCLUSION: Besides the commonly reported socio-demographic risk factors (marital status, education level, and annual income), other factors include stress factors (caregiving stress, cancer-related stress, and general stress). Furthermore, emotion-focused coping and perceived social support act as mediators along the process. More studies are warranted to explore depression among these mothers to ensure the most appropriate and effective preventive measures.

  14. Massud A, Khan AH, Syed Sulaiman SA, Ahmad N, Shafqat M, Ming LC
    PLoS One, 2023;18(8):e0287966.
    PMID: 37561810 DOI: 10.1371/journal.pone.0287966
    INTRODUCTION: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcomes among drug-resistant tuberculosis (DR-TB) patients treated at a programmatic management unit of drug resistant tuberculosis (PMDT) unit, Punjab, Pakistan.

    METHODS: This prospective observational study was conducted at a a PMDT unit in Multan, Punjab, Pakistan. A total of 271 eligible culture positive DR-TB patients enrolled for treatment at the study site between January 2016 and May 2017 were followed till their treatment outcomes were recorded. World Health Organization's (WHO) defined criteria was used for categorizing treatment outcomes. The outcomes of cured and treatment completed were collectively placed as successful outcomes, while death, lost to follow-up (LTFU) and treatment failure were grouped as unsuccessful outcomes. Multivariable binary logistic regression analysis was employed for getting predictors of unsuccessful treatment outcomes. A p-value <0.05 was considered statistically significant.

    RESULTS: Of the 271 DR-TB patients analysed, nearly half (51.3%) were males. The patient's (Mean ± SD) age was 36.75 ± 15.69 years. A total of 69% patients achieved successful outcomes with 185 (68.2%) patients being cured and 2 (0.7%) completed therapy. Of the remaining 84 patients with unsuccessful outcomes, 48 (17.7%) died, 2 (0.7%) were declared treatment failure, 34 (12.5%) were loss to follow up. After adjusting for confounders, patients' age > 50 years (OR 2.149 (1.005-4.592) with p-value 0.048 and baseline lung cavitation (OR 7.798 (3.82-15.919) with p-value <0.001 were significantly associated with unsuccessful treatment outcomes.

    CONCLUSIONS: The treatment success rate (69%) in the current study participants was below the target set by WHO (>75%). Paying special attention and timely intervention in patients with high risk of unsuccessful treatment outcomes may help in improving treatment outcomes at the study site.

  15. Ibrahim A, Ali RAR, Manaf MRA, Ahmad N, Tajurruddin FW, Qin WZ, et al.
    PLoS One, 2020;15(12):e0244680.
    PMID: 33382780 DOI: 10.1371/journal.pone.0244680
    OBJECTIVE: We determined the effectiveness of a multi-strain probiotic (Hexbio®) containing microbial cell preparation MCP®BCMC® on constipation symptoms and gut motility in PD patients with constipation.

    METHODS: PD patients with constipation (ROME III criteria) were randomized to receive a multi-strain probiotic (Lactobacillus sp and Bifidobacterium sp at 30 X 109 CFU) with fructo-oligosaccaride or placebo (fermented milk) twice daily for 8 weeks. Primary outcomes were changes in the presence of constipation symptoms using 9 items of Garrigues Questionnaire (GQ), which included an item on bowel opening frequency. Secondary outcomes were gut transit time (GTT), quality of life (PDQ39-SI), motor (MDS-UPDRS) and non-motor symptoms (NMSS).

    RESULTS: Of 55 recruited, 48 patients completed the study: 22 received probiotic and 26 received placebo. At 8 weeks, there was a significantly higher mean weekly BOF in the probiotic group compared to placebo [SD 4.18 (1.44) vs SD 2.81(1.06); (mean difference 1.37, 95% CI 0.68, 2.07, uncorrected p<0.001)]. Patients in the probiotic group reported five times higher odds (odds ratio = 5.48, 95% CI 1.57, 19.12, uncorrected p = 0.008) for having higher BOF (< 3 to 3-5 to >5 times/week) compared to the placebo group. The GTT in the probiotic group [77.32 (SD55.35) hours] reduced significantly compared to placebo [113.54 (SD 61.54) hours]; mean difference -36.22, 95% CI -68.90, -3.54, uncorrected p = 0.030). The mean change in GTT was 58.04 (SD59.04) hour vs 20.73 (SD60.48) hours respectively (mean difference 37.32, 95% CI 4.00, 70.63, uncorrected p = 0.028). No between-groups differences were observed in the NMSS, PDQ39-SI, MDS-UPDRS II and MDS-UPDRS III scores. Four patients in the probiotics group experienced mild reversible side effects.

    CONCLUSION: This study showed that consumption of a multi-strain probiotic (Hexbio®) over 8 weeks improved bowel opening frequency and whole gut transit time in PD patients with constipation.

  16. Hazni H, Ahmad N, Hitotsuyanagi Y, Takeya K, Choo CY
    Planta Med, 2008 Dec;74(15):1802-5.
    PMID: 18991205 DOI: 10.1055/s-0028-1088340
    The methanolic extract of the leaves of CASSIA ALATA was sequentially partitioned in increasing polarity to afford the hexane, chloroform, butanol and residual extract. Crude extracts were evaluated against MRSA using the agar well diffusion assay. The butanol and chloroform extracts both exhibited inhibition against MRSA with inhibition indexes of 1.03 +/- 0.16 and 0.78 +/- 0.07 at the concentration of 50 mg/mL. The butanol extracts were further purified using silica gel and reverse phase chromatography to afford kaempferol ( 1), kaempferol 3- O-beta-glucopyranoside ( 2), kaempferol 3- O-gentiobioside ( 3) and aloe emodin ( 4). The four constituents showed varying degrees of inhibition against MRSA. Both 1 and 4 exhibited MIC (50) values of 13.0 +/- 1.5 microg/mL and 12.0 +/- 1.5 microg/mL, respectively. The kaempferol glycosides 2 and 3 were less active with MIC (50) values of 83.0 +/- 0.9 microg/mL and 560.0 +/- 1.2 microg/mL, respectively. A free hydroxyl group at C-3 of the flavonol structure is a structural requirement for the inhibition of MRSA.
  17. Ahmad N, Samiulla DS, Teh BP, Zainol M, Zolkifli NA, Muhammad A, et al.
    Pharmaceutics, 2018 Jul 11;10(3).
    PMID: 29997335 DOI: 10.3390/pharmaceutics10030090
    Eurycoma longifolia is one of the commonly consumed herbal preparations and its major chemical compound, eurycomanone, has been described to have antimalarial, antipyretic, aphrodisiac, and cytotoxic activities. Today, the consumption of E. longifolia is popular through the incorporation of its extract in food items, most frequently in drinks such as tea and coffee. In the current study, the characterisation of the physicochemical and pharmacokinetic (PK) attributes of eurycomanone were conducted via a series of in vitro and in vivo studies in rats and mice. The solubility and chemical stability of eurycomanone under the conditions of the gastrointestinal tract environment were determined. The permeability of eurycomanone was investigated by determining its distribution coefficient in aqueous and organic environments and its permeability using the parallel artificial membrane permeability assay system and Caco-2 cultured cells. Eurycomanone's stability in plasma and its protein-binding ability were measured by using an equilibrium dialysis method. Its stability in liver microsomes across species (mice, rat, dog, monkey, and human) and rat liver hepatocytes was also investigated. Along with the PK evaluations of eurycomanone in mice and rats, the PK parameters for the Malaysian Standard (MS: 2409:201) standardised water extract of E. longifolia were also evaluated in rats. Both rodent models showed that eurycomanone in both the compound form and extract form had a half-life of 0.30 h. The differences in the bioavailability of eurycomanone in the compound form between the rats (11.8%) and mice (54.9%) suggests that the PK parameters cannot be directly extrapolated to humans. The results also suggest that eurycomanone is not readily absorbed across biological membranes. However, once absorbed, the compound is not easily metabolised (is stable), hence retaining its bioactive properties, which may be responsible for the various reported biological activities.
  18. Dinshaw IJ, Ahmad N, Salim N, Leo BF
    Pharmaceutics, 2021 Jul 06;13(7).
    PMID: 34371716 DOI: 10.3390/pharmaceutics13071024
    Psoriasis is a skin disease that is not lethal and does not spread through bodily contact. However, this seemingly harmless condition can lead to a loss of confidence and social stigmatization due to a persons' flawed appearance. The conventional methods of psoriasis treatment include taking in systemic drugs to inhibit immunoresponses within the body or applying topical drugs onto the surface of the skin to inhibit cell proliferation. Topical methods are favored as they pose lesser side effects compared to the systemic methods. However, the side effects from systemic drugs and low bioavailability of topical drugs are the limitations to the treatment. The use of nanotechnology in this field has enhanced drug loading capacity and reduced dosage size. In this review, biosurfactants were introduced as a 'greener' alternative to their synthetic counterparts. Glycolipid biosurfactants are specifically suited for anti-psoriatic application due to their characteristic skin-enhancing qualities. The selection of a suitable oil phase can also contribute to the anti-psoriatic effect as some oils have skin-healing properties. The review covers the pathogenic pathway of psoriasis, conventional treatments, and prospective ingredients to be used as components in the nanoemulsion formulation. Furthermore, an insight into the state-of-the-art methods used in formulating nanoemulsions and their progression to low-energy methods are also elaborated in detail.
  19. Teh BP, Ahmad N, Ibnu Rasid EN, Zolkifli NA, Sastu Zakaria UR, Mohamed Yusoff N, et al.
    Pharmaceuticals (Basel), 2021 Feb 10;14(2).
    PMID: 33579048 DOI: 10.3390/ph14020142
    A combined polyherbal formulation containing tongkat ali (Eurycoma longifolia) and kacip fatimah (Labisia pumila) aqueous extracts was evaluated for its safety aspect. A repeated dose 28-day toxicity study using Wistar rats was conducted where the polyherbal formulation was administered at doses 125, 500 and 2000 mg/kg body weight to male and female treatment groups daily via oral gavage, with rats receiving only water as the control group. In-life parameters measured include monitoring of food and water consumption and clinical and functional observations. On day 29, blood was collected for haematological and biochemical analysis. The rats were necropsied and the organs were collected for histopathological examination. This study showed that the combined formulation did not induce any significant toxicity effect at any dose level in terms of morbidity, mortality, behaviour, functional observation, body weight, food and water consumption, whole blood haematology and serum biochemistry. However, there were some microscopic changes in the histopathological examinations of some organs given 2000 mg/kg body weight, which may suggest an early response to the polyherbal formulation. From this study, the no observed adverse effect level is estimated to be more than 500 mg/kg body weight but not exceeding 2000 mg/kg body weight. The observed effects at the highest dose indicate the need for further study of longer dosing duration.
  20. Megat Nabil Mohsin S, Ahmad N, Yusof YA
    Pest Manag Sci, 2023 Oct;79(10):4094-4099.
    PMID: 37300851 DOI: 10.1002/ps.7610
    BACKGROUND: Evaporation inhibition of water-based space spray insecticides is necessary to prevent the drifting away of fog droplets and the release of insecticidal actives and to prolong suspension time. To address this problem, hygroscopic alcohols, namely propylene glycol and glycerol, were included as adjuvants in water-based d-phenothrin formulations. The performances of glycerol-added formulation (D1) and propylene glycol-added formulation (D2) in terms of droplet size and efficacy against larvae, pupae and adult Aedes aegypti in an open-field environment were examined and compared to the performance of a formulation without adjuvant (negative control).

    RESULTS: No significant difference in droplet size was observed between the formulations and fogging methods. The efficacy of cold fogs was significantly higher than thermal fogs for all formulations. D2 was found to be most effective against adult Ae. aegypti, followed by D1 and the negative control. D1 and D2 provided complete knockdown and mortality in adult Ae. aegypti at 10 and 25 m for cold and thermal fogging, respectively. However, all d-phenothrin formulations possessed minimal efficacy on immature Ae. aegypti.

    CONCLUSION: The incorporation of non-toxic alcohols as adjuvants in water-based space spray insecticides increased efficacy against adult Ae. aegypti, a major vector for dengue. Propylene glycol was discovered to induce higher adulticidal efficacy than glycerol. © 2023 Society of Chemical Industry.

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