Displaying publications 121 - 140 of 342 in total

Abstract:
Sort:
  1. 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.

  2. Mansor N, Ahmad N, Md Said S, Tan KA, Sutan R
    J Med Internet Res, 2023 Oct 20;25:e48968.
    PMID: 37862090 DOI: 10.2196/48968
    BACKGROUND: Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults.

    OBJECTIVE: This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting.

    METHODS: This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention.

    RESULTS: There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; P

  3. Yusof YA, Ahmad N, Das S, Sulaiman S, Murad NA
    Afr J Tradit Complement Altern Med, 2008 Oct 25;6(1):87-93.
    PMID: 20162046
    Ginger (Zingiber officinale Rosco) is widely used in foods as a spice all around the world. It has been reported to have antioxidant and anticarcinogenic properties. We investigated the effect of ginger in ethionine induced rat hepatocarcinogenesis. Male Wistar rats were divided into 5 groups: group 1 and 2 served as controls and they received normal rat chow and olive oil respectively. Group 3 was fed with ginger oleoresin dissolved in olive oil at 100 mg/kg body wt. Group 4 was fed with choline deficient diet and 0.1% ethionine in drinking water (CDE diet), and group 5 received ginger with CDE diet. Blood samples were taken from the orbital sinus at 0 and 8 weeks of experiment for the determination of antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase and lipid peroxidation end product, malondialdehyde (MDA). Rats were also killed at 8 weeks for the observation of liver tumor formation. CDE diet induced the formation of liver nodules in rats and increased SOD activity. However, it had no effect on catalase, GPx and MDA levels when compared to both controls at 8 weeks of experiment. When CDE rats were treated with ginger, the formation of liver tumour, SOD activity and MDA level reduced, catalase activity was increased but no change was observed for GPx activity when compared to CDE group. In conclusion, ginger supplementation suppressed liver carcinogenesis by scavenging the free radical formation, and by reducing lipid peroxidation.
  4. Bibi N, Rahman N, Ali MQ, Ahmad N, Sarwar F
    Nat Prod Res, 2023 Dec 03.
    PMID: 38043118 DOI: 10.1080/14786419.2023.2284862
    A member of the Moringaceae family, Moringa Oleifera Lam is a perennial deciduous tropical tree known as the 'Miracle Tree' for its medicinal and nutritional benefits. Food and nutrition are crucial aspects of the development and maintenance of healthy health. Moringa oleifera is a multi-purpose herbal bush that is used as both human food and a medical alternative all over the world. Various parts of the tree are used to treat chronic diseases such as hypertension, heart disease, inflammation, oxidative stress, diabetes, and cancer. Moringa is an excellent source of essential nutrients and has been found to have a significant impact on improving nutritional deficiencies in populations with limited access to food. Moringa oleifera contains essential amino acids, carotenoids, minerals, fats, carbohydrates, proteins, phytochemicals, vitamins, and fibre. Moringa offers nutritional and economic advantages, medicinal and therapeutic uses, and future biological potential for human well-being.
  5. Khan HHA, Ahmad N, Yusof NM, Chowdhury MAM
    Environ Sci Pollut Res Int, 2024 Feb;31(6):9784-9794.
    PMID: 38194178 DOI: 10.1007/s11356-023-31809-6
    This study critically examines the dynamic interplay between green finance and environmental sustainability using a systematic review and bibliometric analysis. The analysis is centered on 507 scholarly articles published between 2013 and 2023 in the Scopus database and leverages Microsoft Excel, Harzing Publish or Perish, and VOSviewer to identify publication trends, key contributors, research impact, and emergent themes in this rapidly evolving field. The findings reveal that research on green finance and environmental sustainability has increased exponentially over the past decade, with China and institutions in Asia emerging as prominent contributors compared to other regions. This study also identified the Environmental Science and Pollution Research journal as the most active source title, demonstrating its commitment to publishing current findings on the topic. Through keyword analysis, several research avenues have been proposed to guide future research on enhancing the strategic role of green finance in promoting environmental sustainability. These avenues include broadening the geographical scope of research, exploring the synergies between green finance and emerging fintech innovations, developing robust metrics to quantify the socioeconomic impacts of green finance, establishing a risk and resilience framework to protect green finance against uncertainties, and creating a Green Finance Performance Index to evaluate the dual returns of environmental and financial performance.
  6. 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.

  7. Mohd Adzlan F, Mohd K, Ahmad N, Ramli R
    BMJ Case Rep, 2024 May 22;17(5).
    PMID: 38782440 DOI: 10.1136/bcr-2024-259861
    Obstructed Hemi Vagina with Ipsilateral Renal Agenesis (OHVIRA) syndrome is a rarely encountered müllerian duct anomaly. Delayed diagnosis is common due to normal onset of puberty and menstruation. We report a case of a woman in her early 20s with a background history of multiple emergency department visits, ward admissions and surgeries for chronic abdominal pain. She was reviewed at 1 month postlaparotomy for recurrent pelvic abscess and was finally diagnosed to have an OHVIRA syndrome, 11 years after her first clinical presentation. Excision of the vaginal septum completely resolved her symptoms. We are reporting this case to highlight the clinical implications resulting from the delayed diagnosis, to look into factors contributing to the delay and to highlight the importance of having a high index of suspicion to diagnose this unique condition.
  8. Shaharudin R, Ahmad N, Kamaluddin MA, Veloo Y
    PMID: 29620800
    Burkholderia pseudomallei is an important causative organism of fatal community bacteremia especially in Southeast Asia and northern Australia. Outbreaks of melioidosis have been reported post-floods and -typhoons. A cross sectional study was conducted in January 2015, following a major flood in Kelantan, Malaysia to detect presence of B. pseudomallei from soil. A total of 89 soil samples were cultured for B. pseudomallei on Ashdown agar. Putative colonies underwent further staining and biochemical testing prior to confirmation by PCR. Rate of detection was 1%, although low, it nevertheless indicated a risk for melioidosis among flood victims in Kelantan. Flood affected individuals should be made aware of symptoms of melioidosis and healthcare providers must have a high index of suspicion of patients presenting with fever. Such subjects should be screened for the possibility of melioidosis and given prompt treatment to avoid preventable death.
  9. Ahmad N, Cheong SM, Ibrahim N, Rosman A
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):63S-9S.
    PMID: 25005932 DOI: 10.1177/1010539514540746
    Adolescence is the time of greatest risk for the first onset of suicidal behaviors. This study aimed to identify the risk and protective factors associated with suicidal ideation among Malaysian adolescents. Data from the 2012 Malaysia Global School-based Student Health Survey, a nationwide study using a 2-stage cluster sampling design, were analyzed. The survey used a self-administered validated bilingual questionnaire and the Depression Anxiety and Stress Scale. The prevalence of suicidal ideation was 7.9%. Analysis revealed that suicidal ideation was positively associated with depression, anxiety, stress, substance use, being bullied, and being abused at home, either physically or verbally. In addition, suicidal ideation was significantly higher among females and among the Indians and Chinese. Having close friends and married parents were strongly protective against suicidal ideation. Understanding the risk and protective factors is important in providing comprehensive management for suicidal ideation.
    Study name: Global School-Based Student Health Survey (GSHS)
  10. Ahmad N, Awaluddin SM, Ismail H, Samad R, NikAbdRashid N
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):44S-52S.
    PMID: 25070693 DOI: 10.1177/1010539514544700
    This study aimed to identify risk and protective factors associated with sexual activity among Malaysian adolescents. Data from the World Health Organization Global School-based Student Health Survey 2012 were analyzed. A total of 23 645 students aged 12 to 17 years responded using self-administered validated questionnaire. The overall prevalence of reported ever-had sex was 8.3%. Logistic regression analysis revealed that ever-had sex was positively significantly associated with ever-used drugs (adjusted odds ratio [aOR] = 7.71; 95% confidence interval [CI] = 6.51-9.13), and to a lesser extent, ever-smoked (aOR = 1.83; 95% CI = 1.62-2.07) and ever-consumed alcohol (aOR = 1.33; 95% CI = 1.15-2.53). Protective factors against ever-had sex were having a close friend (aOR = 0.63; 95% CI = 0.50-0.81), parental bonding (aOR = 0.72; 95% CI = 0.65-0.81), supportive peers (aOR = 0.77; 95% CI = 0.69-0.86), and parental connectedness (aOR = 0.88; 95% CI = 0.78-0.99). Although the prevalence of sexual activity among school-going adolescents in Malaysia is relatively low, identifying the risk and protective factors is crucial toward developing an integrated multiple approach to preventing sexual-related problems.
    Study name: Global School-Based Student Health Survey (GSHS)
  11. Karim N, Hod R, Wahab MIA, Ahmad N
    BMJ Open, 2024 May 07;14(5):e079826.
    PMID: 38719294 DOI: 10.1136/bmjopen-2023-079826
    OBJECTIVES: Climate change is a major global issue with significant consequences, including effects on air quality and human well-being. This review investigated the projection of non-communicable diseases (NCDs) attributable to air pollution under different climate change scenarios.

    DESIGN: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. A population-exposure-outcome framework was established. Population referred to the general global population of all ages, the exposure of interest was air pollution and its projection, and the outcome was the occurrence of NCDs attributable to air pollution and burden of disease (BoD) based on the health indices of mortality, morbidity, disability-adjusted life years, years of life lost and years lived with disability.

    DATA SOURCES: The Web of Science, Ovid MEDLINE and EBSCOhost databases were searched for articles published from 2005 to 2023.

    ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The eligible articles were evaluated using the modified scale of a checklist for assessing the quality of ecological studies.

    DATA EXTRACTION AND SYNTHESIS: Two reviewers searched, screened and selected the included studies independently using standardised methods. The risk of bias was assessed using the modified scale of a checklist for ecological studies. The results were summarised based on the projection of the BoD of NCDs attributable to air pollution.

    RESULTS: This review included 11 studies from various countries. Most studies specifically investigated various air pollutants, specifically particulate matter <2.5 µm (PM2.5), nitrogen oxides and ozone. The studies used coupled-air quality and climate modelling approaches, and mainly projected health effects using the concentration-response function model. The NCDs attributable to air pollution included cardiovascular disease (CVD), respiratory disease, stroke, ischaemic heart disease, coronary heart disease and lower respiratory infections. Notably, the BoD of NCDs attributable to air pollution was projected to decrease in a scenario that promotes reduced air pollution, carbon emissions and land use and sustainable socioeconomics. Contrastingly, the BoD of NCDs was projected to increase in a scenario involving increasing population numbers, social deprivation and an ageing population.

    CONCLUSION: The included studies widely reported increased premature mortality, CVD and respiratory disease attributable to PM2.5. Future NCD projection studies should consider emission and population changes in projecting the BoD of NCDs attributable to air pollution in the climate change era.

    PROSPERO REGISTRATION NUMBER: CRD42023435288.

  12. Jane Ling MY, Ahmad N, Mohd Radi MF, Aizuddin AN
    PLoS One, 2025;20(1):e0311834.
    PMID: 39775213 DOI: 10.1371/journal.pone.0311834
    BACKGROUND: The burden of type 2 diabetes is increasing globally. Risk perception of type 2 diabetes plays an important role in motivating adoption of healthy lifestyle and preventive health interventions. To address the increasing burden of type 2 diabetes in Malaysia, a better understanding on its risk perception is needed as a guide for preventive interventions. This study was aimed at developing and validating a Malay-language questionnaire to assess the risk perception of type 2 diabetes (RPDM) among Malaysians.

    METHODS: The questionnaire (RPDM) was developed based on the Health Belief Model and previous literature. A 59-item question pool was initially developed, reviewed by experts for content validity and pretested on five respondents. Different samples were used for pilot study (n = 100) and subsequent validation study (n = 158). Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to evaluate construct validity and construct reliability of the questionnaire.

    RESULTS: The EFA yielded five-factors model, including 48 items with good factor loadings of > 0.40. CFA was carried out using item parceling. The final model shows acceptable model fit and had sufficient convergent and discriminant validity. The value of construct reliability ranged between 0.76 and 0.90.

    CONCLUSION: This newly developed and validated Malay-language RPDM questionnaire is valid and reliable for measuring the five constructs (perceived self-efficacy, perceived severity, perceived benefit, perceived susceptibility and perceived barrier) of risk perception of type 2 diabetes among Malaysians. This Malay-language questionnaire may contribute to a better understanding of risk perception of type 2 diabetes among Malaysians, as well as enhancement of diabetes prevention communication between healthcare providers and their clients.

  13. Usir E, Ahmad A, Mat NSN, Ahmad N
    Curr Pharm Teach Learn, 2025 Jan;17(1):102214.
    PMID: 39426009 DOI: 10.1016/j.cptl.2024.102214
    INTRODUCTION: Emotional Intelligence (EI) involves skills to recognise, comprehend, and manage emotions that influence thinking. Using EI allows for the integration of emotion into reasoning and problem-solving. If applied effectively, EI can foster positive emotions that promote the deployment of telepharmacy, which involves delivering pharmaceutical services remotely via telecommunication. High acceptance of telepharmacy among users, particularly patients or healthcare providers is associated with their high knowledge, positive perception, and readiness, all influenced by EI. This study investigates undergraduate students' levels of EI, knowledge, degree of perception, and readiness for telepharmacy, examines EI's correlation with all other variables, and compares them across various sociodemographic groups.

    METHODS: A cross-sectional online study involving 455 undergraduate students at Universiti Teknologi MARA Cawangan Selangor (UCS) was conducted using a 74-item survey distributed via Google Forms. Data were analyzed using SPSS version 29.

    RESULTS: Most participants exhibited high EI (53.3 %), average knowledge (53.2 %), positive perception, and high readiness for telepharmacy. EI positively correlated with both perception (p 

  14. Awang Ahmad N, Lai SK, Suboh R, Hussin H
    Malays J Med Sci, 2023 Oct;30(5):81-90.
    PMID: 37928785 DOI: 10.21315/mjms2023.30.5.7
    BACKGROUND: Mast cells influence tumour growth, neo-angiogenesis and the propensity for metastasis by contributing to innate and adaptive immune responses in the tumour microenvironment. The number of mast cells has increased in various malignant tumours and their abundance has been associated with either a favourable or unfavourable prognosis. This study investigated the significant difference in stromal mast cell density among multiple prognostic factor groups in invasive breast carcinoma.

    METHODS: CD117 (c-KIT) antibodies were used to stain 160 formalin-fixed and paraffin-embedded invasive breast carcinoma tissues to demonstrate the presence of mast cells. Then the labelled mast cells were counted in 10 fields at 400× magnification and the mean value was used to represent the mast cell density.

    RESULTS: The demographic distribution revealed that most patients were 40 years old or older (92.5%) and of Malay ethnicity (66.3%). With regard to prognostic factors, the most prevalent subtype was invasive carcinoma of no special type (80.6%), followed by tumour grade 3 (41.3%), T2 tumour size (63.1%), N0 lymph node stage (51.3%), presence of lymphovascular invasion (59.4%), positive oestrogen (64.4%) and progesterone receptors (53.1%), and negative human epidermal growth factor receptor 2 (HER2) expression (75.0%). However, there was no significant difference in stromal mast cell density among the different demographic and prognostic factor groups in invasive breast carcinoma.

    CONCLUSION: The findings from this study suggest that stromal mast cells do not play a significant role in preventing or promoting tumour growth in invasive breast carcinoma.

  15. Kamarudin SS, Idris IB, Sharip S, Ahmad N
    JMIR Res Protoc, 2025 Jan 27;14:e63564.
    PMID: 39869891 DOI: 10.2196/63564
    BACKGROUND: Postpartum depression remains a significant concern, posing substantial challenges to maternal well-being, infant health, and the mother-infant bond, particularly in the face of barriers to traditional support and interventions. Previous studies have shown that mobile health (mHealth) interventions offer an accessible means to facilitate early detection and management of mental health issues while at the same time promoting preventive care.

    OBJECTIVE: This study aims to evaluate the effectiveness of the Leveraging on Virtual Engagement for Maternal Understanding & Mood-enhancement (LoVE4MUM) mobile app, which was developed based on the principles of cognitive behavioral therapy and psychoeducation and serves as an intervention to prevent postpartum depression.

    METHODS: This single-blinded, pilot randomized controlled trial includes 64 mothers recruited from the postnatal ward and randomized using a 1:1 ratio to receive either postpartum care (treatment as usual) or postpartum care (treatment as usual) plus the self-guided LoVE4MUM mobile app. The primary outcome is the effectiveness of the mobile app at improving postpartum depression. Secondary outcomes are changes in the mental health literacy score and negative automatic thoughts, which are collected using a self-reported questionnaire.

    RESULTS: Patient recruitment began on September 1, 2024. As of January 1, 2025, recruitment was successfully completed, with a total of 72 participants enrolled: 36 in the intervention group and 36 in the control group . The final results are anticipated to be available by March 2025, and publication is expected by the end of 2025.

    CONCLUSIONS: By examining the LoVE4MUM app alongside standard postpartum care, this pilot randomized controlled trial seeks to offer preliminary evidence on the potential of mHealth tools to improve maternal mental health as well as to reduce postpartum depression symptoms. The findings are expected to contribute to the future development of effective, accessible, and scalable interventions for mothers.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT06366035; https://clinicaltrials.gov/study/NCT06366035.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/63564.

  16. Kamarudin SS, Idris IB, Ahmad N, Sharip S
    Digit Health, 2024;10:20552076241292679.
    PMID: 39817043 DOI: 10.1177/20552076241292679
    BACKGROUND: Mental health care during the postpartum period is notably underexplored within Asian demographics, with barriers such as stigma, privacy concerns, logistical challenges, and a shortage of mental health professionals that limits access to optimal mental healthcare. Previous studies found that mobile health (mHealth) technology has been offering a promising solution to these issues. However, the perspectives of mothers on existing mental health services and their mHealth needs are still not well understood and warrant further exploration.

    OBJECTIVE: This study aimed to explore the postpartum experiences of Malaysian mothers with postpartum depression (PPD) symptoms and their perspectives on using an mHealth technology to improve mental health care during the postpartum period.

    METHODS: We carried out in-depth interviews with six mothers, which were transcribed verbatim and thematically analysed. Collaborative discussions and consensus were employed to enhanced reliability.

    FINDINGS: Five main themes related to mothers' postpartum experiences and perspectives emerged, namely, the existing circumstances of mothers, psychosociological reactions, maternal needs, innovation of care, and suggestions for pragmatic mHealth elements. These themes emphasized the emotional challenges of meeting societal, cultural, and personal expectations. The essential resources identified to be included in the mHealth technology were education on PPD, professional guided self-care, cognitive restructuring, validation of diverse infant feeding practices, and fostering partner support. Furthermore, interactive mHealth features such as mood trackers, notifications, platforms to share, and motivational tools aimed at elevating maternal well-being were also sought.

    CONCLUSIONS: Mothers expressed a desire for mHealth services emphasizing the need for these educational tools to be culturally sensitive, accommodating local language and religious practices, and offering support during confinement, to effectively address the unique needs of postpartum mothers. This study highlights the importance of prioritizing practical mHealth interventions as strategic support services to enhance positive postpartum mental care in resource-stricken countries.

  17. Abbott CA, Chatwin KE, Foden P, Hasan AN, Sange C, Rajbhandari SM, et al.
    Lancet Digit Health, 2019 10;1(6):e308-e318.
    PMID: 33323253 DOI: 10.1016/S2589-7500(19)30128-1
    BACKGROUND: Prevention of diabetic foot ulcer recurrence in high risk patients, using current standard of care methods, remains a challenge. We hypothesised that an innovative intelligent insole system would be effective in reducing diabetic foot ulcer recurrence in such patients.

    METHODS: In this prospective, randomised, proof-of-concept study, patients with diabetes, and with peripheral neuropathy and a recent history of plantar foot ulceration were recruited from two multidisciplinary outpatient diabetic foot clinics in the UK, and were randomly assigned to either intervention or control. All patients received an insole system, which measured plantar pressure continuously during daily life. The intervention group received audiovisual alerts via a smartwatch linked to the insole system and offloading instructions when aberrant pressures were detected; the control group did not receive any alerts. The primary outcome was plantar foot ulcer occurrence within 18 months. This trial is registered with ISRCTN, ISRCTN05585501, and is closed to accrual and complete.

    FINDINGS: Between March 18, 2014, and Dec 20, 2016, 90 patients were recruited and consented to the study, and 58 completed the study. At follow-up, ten ulcers from 8638 person-days were recorded in the control group and four ulcers from 11 835 person-days in the intervention group: a 71% reduction in ulcer incidence in the intervention group compared with the control group (incidence rate ratio 0·29, 95% CI, 0·09-0·93; p=0·037). The number of patients who ulcerated was similar between groups (six of 26 [control group] vs four of 32 [intervention group]; p=0·29); however, individual plantar sites ulcerated more often in the control group (ten of 416) than in the intervention group (four of 512; p=0·047). In an exploratory analysis of good compliers (n=40), ulcer incidence was reduced by 86% in the intervention group versus control group (incidence rate ratio 0·14, 95% CI 0·03-0·63; p=0·011). In the exploratory analysis, plantar callus severity (change from baseline to 6 months) was greater in re-ulcerating patients (6·5, IQR 4·0-8·3) than non-re-ulcerating patients (2·0, 0·0-4·8; p=0·040).

    INTERPRETATION: To our knowledge, this study is the first to show that continuous plantar pressure monitoring and dynamic offloading guidance, provided by an innovative intelligent insole system, can lead to a reduction in diabetic foot ulcer site recurrence.

    FUNDING: Diabetes UK and Orpyx Medical Technologies.

  18. Ahmad N, Adam SI, Nawi AM, Hassan MR, Ghazi HF
    Int J Prev Med, 2016;7:82.
    PMID: 27330688 DOI: 10.4103/2008-7802.183654
    BACKGROUND: Waist circumference (WC) is an accurate and simple measure of abdominal obesity as compared to waist-hip ratio (WHR). The aim of this study was to determine the correlation between body mass index (BMI) with WC and WHR and suggest cutoff points for WC among Rural Malaysian adults.
    METHODS: A cross-sectional study was conducted among 669 respondents from three villages in Tanjung Karang, located in the district of Kuala Selangor. Data collection was carried out by guided questionnaires and anthropometric measures.
    RESULTS: The prevalence of abdominal obesity for BMI was almost similar for both gender across Caucasian and Asian BMI cutoff points. Based on Caucasian cutoff points, the prevalence of abdominal obesity for WC was 23.8% (male) and 66.4% (female) while for WHR was 6.2% (male) and 54.2% (female). Asian cutoff points gave higher prevalence of abdominal obesity compared to that of WC among male respondents and WHR for both genders. WC showed strong and positive correlation with BMI compared to WHR (in male WC r = 0.78, WHR r = 0.24 and in female WC r = 0.72, WHR r = 0.19; P < 0.001). Receiver operating characteristic curve analysis suggested WC cutoff points of 92.5 cm in men and 85.5 cm in women is the optimal number for detection of abdominal obesity.
    CONCLUSIONS: WC is the best indicator as compared with WHR for abdominal obesity for Malaysian adults.
    KEYWORDS: Abdominal obesity; adults; body mass index; waist circumference; waist-to-hip ratio
  19. Ghobadi Y, Pradhan B, Shafri HZ, bin Ahmad N, Kabiri K
    Environ Monit Assess, 2015 Jan;187(1):4156.
    PMID: 25421858 DOI: 10.1007/s10661-014-4156-0
    Wetlands are regarded as one of the most important ecosystems on Earth due to various ecosystem services provided by them such as habitats for biodiversity, water purification, sequestration, and flood attenuation. The Al Hawizeh wetland in the Iran-Iraq border was selected as a study area to evaluate the changes. Maximum likelihood classification was used on the remote sensing data acquired during the period of 1985 to 2013. In this paper, five types of land use/land cover (LULC) were identified and mapped and accuracy assessment was performed. The overall accuracy and kappa coefficient for years 1985, 1998, 2002, and 2013 were 93% and 0.9, 92% and 0.89, 91% and 0.9, and 92% and 0.9, respectively. The classified images were examined with post-classification comparison (PCC) algorithm, and the LULC alterations were assessed. The results of the PCC analysis revealed that there is a drastic change in the area and size of the studied region during the period of investigation. The wetland lost ~73% of its surface area from 1985 to 2002. Meanwhile, post-2002, the wetland underwent a restoration, as a result of which, the area increased slightly and experienced an ~29% growth. Moreover, a large change was noticed at the same period in the wetland that altered ~62% into bare soil in 2002. The areal coverage of wetland of 3386 km(2) in 1985 was reduced to 925 km(2) by 2002 and restored to 1906 km(2) by the year 2013. Human activities particularly engineering projects were identified as the main reason behind the wetland degradation and LULC alterations. And, lastly, in this study, some mitigation measures and recommendations regarding the reclamation of the wetland are discussed. Based on these mitigate measures, the discharge to the wetland must be kept according to the water requirement of the wetland. Moreover, some anthropogenic activities have to be stopped in and around the wetland to protect the ecology of the wetland.
  20. Amin MC, Ahmad N, Pandey M, Abeer MM, Mohamad N
    Expert Opin Drug Deliv, 2015 Jul;12(7):1149-61.
    PMID: 25547588 DOI: 10.1517/17425247.2015.997707
    Supramolecular hydrogels, formed by noncovalent crosslinking of polymeric chains in water, constitute an interesting class of materials that can be developed specifically for drug delivery and biomedical applications. The biocompatibility, stimuli responsiveness to various external factors, and powerful functionalization capacity of these polymeric networks make them attractive candidates for novel advanced dosage form design.
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links