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  1. Khan MUA, Aslam MA, Yasin T, Abdullah MFB, Stojanović GM, Siddiqui HM, et al.
    Biomed Mater, 2024 Jul 16;19(5).
    PMID: 38976990 DOI: 10.1088/1748-605X/ad6070
    Wound healing is a critical but complex biological process of skin tissue repair and regeneration resulting from various systems working together at the cellular and molecular levels. Quick wound healing and the problems associated with traditional wound repair techniques are being overcome with multifunctional materials. Over time, this research area has drawn significant attention. Metal-organic frameworks (MOFs), owning to their peculiar physicochemical characteristics, are now considered a promising class of well-suited porous materials for wound healing in addition to their other biological applications. This detailed literature review provides an overview of the latest developments in MOFs for wound healing applications. We have discussed the synthesis, essential biomedical properties, wound-healing mechanism, MOF-based dressing materials, and their wound-healing applications. The possible major challenges and limitations of MOFs have been discussed, along with conclusions and future perspectives. This overview of the literature review addresses MOFs-based wound healing from several angles and covers the most current developments in the subject. The readers may discover how the MOFs advanced this discipline by producing more inventive, useful, and successful dressings. It influences the development of future generations of biomaterials for the healing and regeneration of skin wounds.
  2. Dapari R, Mohd Fadzil MF, Hanzir MY, Mohamed Jais JS, Safarudin NF, Albar A
    PLoS One, 2024;19(5):e0303330.
    PMID: 38718075 DOI: 10.1371/journal.pone.0303330
    INTRODUCTION: Workers in the construction industry frequently work in construction sites with numerous areas that can potentially accumulate water, such as tanks, wet cement surfaces, or water puddles. These water collection sites become ideal breeding grounds for mosquito infestation, which leads to a higher prevalence of mosquito-borne diseases, especially malaria and dengue among construction workers. Despite that numerous factors have been identified in controlling vector-borne diseases, the specific factors that influence mosquito control at construction sites have yet to be explored.

    AIMS: This systematic review aims to determine the factors associated with mosquito control among construction workers.

    METHODS: Primarily, articles related to factors associated with mosquito control among construction workers were collected from two different online databases (ScienceDirect and EBSCOhost). Two independent reviewers were assigned to screen the titles and abstracts of the collected data, stored in Microsoft Excel, against the inclusion and exclusion criteria. Afterwards, the quality of the included articles was critically assessed using the Mixed Method Appraisal Tool (MMAT). Of the 171 articles identified, 4 were included in the final review.

    RESULTS: Based on the thorough evaluation, mosquito-related knowledge, practical mosquito prevention measures, and Larval Source Management (LSM) were identified as vital factors associated with mosquito control among construction workers. The significant association between mosquito-related knowledge and control practices indicates higher knowledge linked to effective practices, particularly among female workers and those who were recently infected with malaria. Concurrently, there were notable challenges regarding sustainable preventive measures and larval control methods in construction settings.

    CONCLUSION: Implementing effective mosquito control, including knowledge and practice on mosquito control together with vector control, is highly required to suppress the expanding mosquito population. It is recommended that employers provide continuous mosquito control education and training to their employees and reward them with incentives, while employees should comply with the guidelines set by their employers to ensure successful mosquito control and reduce the spread of mosquito-borne diseases in the construction industry.

  3. Khan MUA, Aslam MA, Rahman RA, Abdullah MFB, Mehmood A, Stojanović GM
    PMID: 39018238 DOI: 10.1080/09205063.2024.2380570
    Protein-based wound dressings have garnered increasing interest in recent years owing to their distinct physical, chemical, and biological characteristics. The intricate molecular composition of proteins gives rise to unique characteristics, such as exceptional biocompatibility, biodegradability, and responsiveness, which contribute to the promotion of wound healing. Wound healing is an intricate and ongoing process influenced by multiple causes, and it consists of four distinct phases. Various treatments have been developed to repair different types of skin wounds, thanks to advancements in medical technology and the recognition of the diverse nature of wounds. This review has literature reviewed within the last 3-5 years-the recent progress and development of protein in wound dressings and the fundamental properties of an ideal wound dressing. Herein, the recent strides in protein-based state-of-the-art wound dressing emphasize the significant challenges and summarize future perspectives for wound healing applications.
  4. Ahmad S, Hussain A, Hussain A, Abdullah I, Ali MS, Froeyen M, et al.
    Antioxidants (Basel), 2019 Jun 19;8(6).
    PMID: 31248160 DOI: 10.3390/antiox8060185
    Cisplatin is amongst the most potent chemotherapeutic drugs with applications in more than 50% of cancer treatments, but dose-dependent side effects limit its usefulness. Berberis vulgaris L. (B. vulgaris) has a proven role in several therapeutic applications in the traditional medicinal system. High-performance liquid chromatography was used to quantify berberine, a potent alkaloid in the methanolic root extract of B. vulgaris (BvRE). Berberine chloride in BvRE was found to be 10.29% w/w. To assess the prophylactic and curative protective effects of BvRE on cisplatin-induced nephrotoxicity, hepatotoxicity, and hyperlipidemia, in vivo toxicity trials were carried out on 25 healthy male albino Wistar rats (130-180 g). Both prophylactic and curative trials included a single dose of cisplatin (4 mg/kg, i.p.) and nine doses of BvRE (500 mg/kg/day, orally). An array of marked toxicity effects appeared in response to cisplatin dosage evident by morphological condition, biochemical analysis of serum (urea, creatinine, total protein, alanine transaminase, aspartate transaminase, total cholesterol, and triglyceride), and organ tissue homogenates (malondialdehyde and catalase). Statistically-significant (p < 0.05) variations were observed in various parameters. Moreover, histological studies of liver and kidney tissues revealed that the protective effect of BvRE effectively minimized and reversed nephrotoxic, hepatotoxic, and hyperlipidemic effects caused by cisplatin in both prophylactic and curative groups with relatively promising ameliorative effects in the prophylactic regimen. The in vitro cell viability effect of cisplatin, BvRE, and their combination was determined on HeLa cells using the tetrazolium (MTT) assay. MTT clearly corroborated that HeLa cells appeared to be less sensitive to cisplatin and berberine individually, while the combination of both at the same concentrations resulted in growth inhibition of HeLa cells in a remarkable synergistic way. The present study validated the use of BvRE as a protective agent in combination therapy with cisplatin.
  5. Ozir MA, Nordin MH, Hashim SE, Adzahar S, Ahmad MA, Ng KS, et al.
    Cureus, 2024 Oct;16(10):e71210.
    PMID: 39525159 DOI: 10.7759/cureus.71210
    Leber hereditary optic neuropathy (LHON) is a rare maternally inherited mitochondrial disorder that predominantly affects young men, leading to optic nerve degeneration and subsequent vision loss. The rarity of LHON and its clinical similarity to optic neuritis complicates diagnosis, necessitating genetic testing to confirm specific point mutations and predict visual outcomes. We report a rare case of an 18-year-old Malay male with m.14484T>C/MT-ND6 mutation of LHON, who demonstrated remarkable spontaneous visual recovery over a three-year follow-up period. This report highlights the pivotal role of genetic testing in diagnosing LHON, explores the variability in visual outcomes associated with different mutations, and underscores the potential for spontaneous recovery in specific mutation variants. Early diagnosis, genetic counseling, and supportive management are critical for optimizing outcomes and improving quality of life.
  6. Abdulkadir MK, Osman ND, Achuthan A, Nasirudin RA, Ahmad MZ, Zain NHM, et al.
    J Med Phys, 2024;49(3):456-463.
    PMID: 39526162 DOI: 10.4103/jmp.jmp_26_24
    BACKGROUND AND PURPOSE: Size-specific dose estimates (SSDE) have been introduced into computed tomography (CT) dosimetry to tailor patients' unique sizes to facilitate accurate CT radiation dose quantification and optimization. The purpose of this study was to develop and validate an automated algorithm for the determination of patient size (effective diameter) and SSDE.

    MATERIALS AND METHODS: A MATLAB platform was used to develop software of algorithms based on image segmentation techniques to automate the calculation of patient size and SSDE. The algorithm was used to automatically estimate the individual size and SSDE of four CT dose index phantoms and 80 CT images of pediatric patients comprising head, thorax, and abdomen scans. For validation, the American Association of Physicists in Medicine (AAPM) manual methods were used to determine the patient's size and SSDE for the same subjects. The accuracy of the proposed algorithm in size and SSDE calculation was evaluated for agreement with the AAPM's estimations (manual) using Bland-Altman's agreement and Pearson's correlation coefficient. The normalized error, system bias, and limits of agreement (LOA) between methods were derived.

    RESULTS: The results demonstrated good agreement and accuracy between the automated and AAPM's patient size estimations with an error rate of 1.9% and 0.27% on the patient and phantoms study, respectively. A 1% percentage difference was found between the automated and manual (AAPM) SSDE estimates. A strong degree of correlation was seen with a narrow LOA between methods for clinical study (r > 0.9771) and phantom study (r > 0.9999).

    CONCLUSION: The proposed automated algorithm provides an accurate estimation of patient size and SSDE with negligible error after validation.

  7. Tahir MJ, Saqlain M, Tariq W, Waheed S, Tan SHS, Nasir SI, et al.
    BMC Public Health, 2021 09 26;21(1):1759.
    PMID: 34565351 DOI: 10.1186/s12889-021-11814-5
    BACKGROUND: While vaccine development is itself a challenge; ensuring optimal vaccine uptake at population level can present an even more significant challenge. Therefore, this study aimed to assess the Pakistani population's attitude and preferences towards the Coronavirus disease 2019 (COVID-19) vaccine.

    METHOD: A cross-sectional study was carried out through an online self-administered questionnaire from 27 September 2020 to 11 October 2020. A total of 883 people responded to the survey. The questionnaire included the participants' socio-demographic variables, attitudes, beliefs towards the COVID-19 vaccine and acceptance and rejection of vaccination, and reasons for them. Logistic regression analysis was used to analyze the predictors for vaccine acceptance and willingness to pay for the vaccine.

    RESULTS: A majority (70.8%) of respondents will accept the COVID-19vaccine if available, and 66.8% showed a positive attitude towards vaccination. Monthly family income, education level, self-diagnosis of COVID-19 or a friend, family member, or colleague are significant factors influencing the acceptance of COVID-19 vaccination. The dogma of being naturally immune to COVID-19 was a key reason for the refusal of the vaccine. Less than half (48%) of those who refuse will vaccinate themselves if government officials have made it compulsory. A third (33.9%) of participants were willing to pay up to (7 USD) 1000 Pkr (Pakistani Rupees) for the vaccine.

    CONCLUSION: The population's positive attitude should be improved by increasing awareness and eradicating false myths about vaccines through large-scale campaigns.

  8. Kim YJ, Aslam MS, Fahim SM, Khan WA, Qian L
    J Res Pharm Pract, 2021;10(2):78-82.
    PMID: 34527612 DOI: 10.4103/jrpp.JRPP_20_108
    OBJECTIVE: The present research is the first comprehensive cross-sectional study of consumer satisfaction with community pharmacies in Sindh, Pakistan. Moreover, the study has also designed a nonorder theoretical model for consumer satisfaction with community pharmacies.

    METHODS: This is a cross-sectional descriptive study from a general population of Sindh, Pakistan, with a total of four hundred and fifteen (n = 415) participants. A confirmatory factor analysis was used to verify the factor structure between Pharmaceutical services (PS), the Skill of Pharmacists, Non-pharmaceutical services (NPS), and pricing (P). Pearson correlation analysis, Kendall's tau correlation analysis, and Spearman's rho correlation analysis were used to identify the correlation between different factors, such as PS, SKP, NPS, and P.

    FINDINGS: The 23-item scale that consisted of four elements have shown an acceptable root mean squared error of approximation (0.076), Cronbach's alpha (0.787), and Chi-square value (3.381) (P < 0.001). Of the respondents, 56.4% rated their satisfaction on pharmacist attitude, whereas 67.2%, 41.4%, and 51.8% were satisfied with other services, such as receipt provided on medication they take, prescription drug service and availability of pharmacies on the weekend and public holidays, respectively.

    CONCLUSION: This cross-sectional study confirms that there are relationships among PS, SPK, NPS, and P. Moreover, there is a lack of facilities in community pharmacies in Sindh, such as the unavailability of a consultation room, immunization services, information on routine health matters, and medication record.

  9. Yousaf MZ, Abbas M, Nazir T, Abdullah FA, Birhanu A, Emadifar H
    Sci Rep, 2024 Mar 17;14(1):6410.
    PMID: 38494490 DOI: 10.1038/s41598-024-55786-z
    The present research investigates the double-chain deoxyribonucleic acid model, which is important for the transfer and retention of genetic material in biological domains. This model is composed of two lengthy uniformly elastic filaments, that stand in for a pair of polynucleotide chains of the deoxyribonucleic acid molecule joined by hydrogen bonds among the bottom combination, demonstrating the hydrogen bonds formed within the chain's base pairs. The modified extended Fan sub equation method effectively used to explain the exact travelling wave solutions for the double-chain deoxyribonucleic acid model. Compared to the earlier, now in use methods, the previously described modified extended Fan sub equation method provide more innovative, comprehensive solutions and are relatively straightforward to implement. This method transforms a non-linear partial differential equation into an ODE by using a travelling wave transformation. Additionally, the study yields both single and mixed non-degenerate Jacobi elliptic function type solutions. The complexiton, kink wave, dark or anti-bell, V, anti-Z and singular wave shapes soliton solutions are a few of the creative solutions that have been constructed utilizing modified extended Fan sub equation method that can offer details on the transversal and longitudinal moves inside the DNA helix by freely chosen parameters. Solitons propagate at a consistent rate and retain their original shape. They are widely used in nonlinear models and can be found everywhere in nature. To help in understanding the physical significance of the double-chain deoxyribonucleic acid model, several solutions are shown with graphics in the form of contour, 2D and 3D graphs using computer software Mathematica 13.2. All of the requisite constraint factors that are required for the completed solutions to exist appear to be met. Therefore, our method of strengthening symbolic computations offers a powerful and effective mathematical tool for resolving various moderate nonlinear wave problems. The findings demonstrate the system's potentially very rich precise wave forms with biological significance. The fundamentals of double-chain deoxyribonucleic acid model diffusion and processing are demonstrated by this work, which marks a substantial development in our knowledge of double-chain deoxyribonucleic acid model movements.
  10. Sakhawat A, Awan SJ, Khan MU, Shahid S, Maqbool T, Zubair HM, et al.
    J Taibah Univ Med Sci, 2024 Aug;19(4):775-789.
    PMID: 39149519 DOI: 10.1016/j.jtumed.2024.06.008
    OBJECTIVES: This study was conducted to evaluate the effects of vitamin C on apoptotic and proliferative genes in injured HepG2 cells.

    METHODS: In silico analysis was performed using molecular docking of chemical compounds with vascular endothelial growth factor (VEGF). The different computational tools used were AutoDock Vina, BIOVIA DISCOVERY studio, and PyMOL. Drug likeness and toxicity were analyzed by SWISS ADMET. Cells that were 60-70% confluent were treated with different concentrations of hydrogen peroxide (H2O2) (100-2000 μM) and ascorbic acid (30, 60, 90 μg/mL). The MTT cell proliferation assay was performed to compare the proliferative potential of HepG2 cells treated with H2O2 or ascorbic acid with untreated HepG2 cells using 96-well plates.

    RESULTS: The lowest binding energy of VEGF with vitamin C -5.2 kcal/mol and L-ascorbic acid-2 glycoside -4.7 kcal/mol was observed by in silico analysis. Vitamin C was selected because it exhibited a high interaction with VEGF and fulfilled Lipinski's rule, and had better oral viability and pharmacokinetics compared to L-ascorbic acid-2 glycoside. Cell viability assays showed that vitamin C had significant apoptotic effects (P 

  11. Aslam Khan MU, Aslam MA, Bin Abdullah MF, Stojanović GM
    ACS Appl Bio Mater, 2024 Aug 19;7(8):5082-5106.
    PMID: 39007509 DOI: 10.1021/acsabm.4c00362
    In view of their exceptional approach, excellent inherent biocompatibility and biodegradability properties, and interaction with the local extracellular matrix, protein-based polymers have received attention in bone tissue engineering, which is a multidisciplinary field that repairs and regenerates fractured bones. Bone is a multihierarchical complex structure, and it performs several essential biofunctions, including maintaining mineral balance and structural support and protecting soft organs. Protein-based polymers have gained interest in developing ideal scaffolds as emerging biomaterials for bone fractured healing and regeneration, and it is challenging to design ideal bone substitutes as perfect biomaterials. Several protein-based polymers, including collagen, keratin, gelatin, serum albumin, etc., are potential materials due to their inherent cytocompatibility, controlled biodegradability, high biofunctionalization, and tunable mechanical characteristics. While numerous studies have indicated the encouraging possibilities of proteins in BTE, there are still major challenges concerning their biodegradability, stability in physiological conditions, and continuous release of growth factors and bioactive molecules. Robust scaffolds derived from proteins can be used to replace broken or diseased bone with a biocompatible substitute; proteins, being biopolymers, provide excellent scaffolds for bone tissue engineering. Herein, recent developments in protein polymers for cutting-edge bone tissue engineering are addressed in this review within 3-5 years, with a focus on the significant challenges and future perspectives. The first section discusses the structural fundamentals of bone anatomy and ideal scaffolds, and the second section describes the fabrication techniques of scaffolds. The third section highlights the importance of proteins and their applications in BTE. Hence, the recent development of protein polymers for state-of-the-art bone tissue engineering has been discussed, highlighting the significant challenges and future perspectives.
  12. Anwar A, Malik N, Siddiqui A, Shrestha S, Bhutta OA, Mazhar S, et al.
    J Oncol Pharm Pract, 2024 Aug 28.
    PMID: 39196917 DOI: 10.1177/10781552241279027
    INTRODUCTION: Opioid medications are crucial for managing pain among patients with cancer. Yet, inappropriate prescribing and medication issues can compromise patient safety and quality of care. Clinical pharmacists play a significant role in optimizing opioid therapy and addressing issues related to opioid medication use.

    OBJECTIVES: This study aimed to examine clinical pharmacist interventions and identify opioid medication-related issues in patients with cancer.

    METHOD: We conducted a retrospective observational study at Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan, conducting a chart review from 1st July 2021 to 31st December 2021.

    RESULTS: Out of 10,534 opioid medication orders, we documented a total of 974 interventions based on our inclusion criteria. Tramadol and morphine accounted for most of these interventions, comprising 49.27% (n = 475) and 40.04% (n = 386), respectively. Regarding clinical significance, 41.70% (n = 406) were deemed significant, while 37.36% (n = 365) were somewhat significant. The majority of interventions, i.e., 54.05% (n = 521), primarily aimed at optimizing patient outcomes, followed by a secondary aim of improvements in communication, i.e., 25.52% (n = 246).

    CONCLUSION: This study establishes the evaluation of clinical pharmacist interventions on opioid medication use in patients with cancer, an issue particularly in oncology settings in Pakistan. The findings emphasize the crucial role of clinical pharmacists in addressing issues related to opioid issue medications, thus improving patient safety and optimizing opioid use for patient well-being.

  13. Abbas A, Ahmad MS, Cheng YH, AlFaify S, Choi S, Irfan RM, et al.
    Chemosphere, 2024 Aug 16;364:143083.
    PMID: 39154761 DOI: 10.1016/j.chemosphere.2024.143083
    Chiral drugs play an important role in modern medicine, but obtaining pure enantiomers from racemic mixtures can pose challenges. When a drug is chiral, only one enantiomer (eutomer) typically exhibits the desired pharmacological activity, while the other (distomer) may be biologically inactive or even toxic. Racemic drug formulations introduce additional health risks, as the body must still process the inactive or detrimental enantiomer. Some distomers have also been linked to teratogenic effects and unwanted side effects. Therefore, developing efficient and scalable methods for separating chiral drugs into their pure enantiomers is critically important for improving patient safety and outcomes. Metal-organic frameworks (MOFs) show promise as novel materials for chiral separation due to their highly tunable structures and interactions. This review summarizes recent advancements in using MOFs for chromatographic and spectroscopic resolution of drug enantiomers. Both the opportunities and limitations of MOF-based separation techniques are discussed. A thorough understanding of these methods could aid the continued development of pure enantiomer formulations and help reduce health risks posed by racemic drug mixtures.
  14. Khan A, Khan A, Khan MM, Farid K, Alam MM, Su'ud MBM
    Diagnostics (Basel), 2022 Oct 26;12(11).
    PMID: 36359438 DOI: 10.3390/diagnostics12112595
    Cardiovascular disease includes coronary artery diseases (CAD), which include angina and myocardial infarction (commonly known as a heart attack), and coronary heart diseases (CHD), which are marked by the buildup of a waxy material called plaque inside the coronary arteries. Heart attacks are still the main cause of death worldwide, and if not treated right they have the potential to cause major health problems, such as diabetes. If ignored, diabetes can result in a variety of health problems, including heart disease, stroke, blindness, and kidney failure. Machine learning methods can be used to identify and diagnose diabetes and other illnesses. Diabetes and cardiovascular disease both can be diagnosed using several classifier types. Naive Bayes, K-Nearest neighbor (KNN), linear regression, decision trees (DT), and support vector machines (SVM) were among the classifiers employed, although all of these models had poor accuracy. Therefore, due to a lack of significant effort and poor accuracy, new research is required to diagnose diabetes and cardiovascular disease. This study developed an ensemble approach called "Stacking Classifier" in order to improve the performance of integrated flexible individual classifiers and decrease the likelihood of misclassifying a single instance. Naive Bayes, KNN, Linear Discriminant Analysis (LDA), and Decision Tree (DT) are just a few of the classifiers used in this study. As a meta-classifier, Random Forest and SVM are used. The suggested stacking classifier obtains a superior accuracy of 0.9735 percent when compared to current models for diagnosing diabetes, such as Naive Bayes, KNN, DT, and LDA, which are 0.7646 percent, 0.7460 percent, 0.7857 percent, and 0.7735 percent, respectively. Furthermore, for cardiovascular disease, when compared to current models such as KNN, NB, DT, LDA, and SVM, which are 0.8377 percent, 0.8256 percent, 0.8426 percent, 0.8523 percent, and 0.8472 percent, respectively, the suggested stacking classifier performed better and obtained a higher accuracy of 0.8871 percent.
  15. Tariq MH, Sulaiman SAS, Farrukh MJ, Goh KW, Ming LC
    Front Med (Lausanne), 2022;9:956449.
    PMID: 36304188 DOI: 10.3389/fmed.2022.956449
    BACKGROUND: Chronic Kidney Disease (CKD) is a complex condition leading to loss of kidney function. The objective of this study was to develop and validate a Knowledge, Attitude, and Practice questionnaire on CKD (CKD-KAP) among practicing physicians in Pakistan since no validated tool was available for the said purpose.

    METHODS: The study consisted of four phases with phase-I focusing on literature review, phase II was the actual questionnaire development phase, face and content validity was determined in phase III, and finally pilot testing was performed in phase IV to determine validity and reliability. The development phase encompassed a thorough review of literature, focus-group discussion, expert review, and evaluation. The validation phase consisted of content validity, face validity, construct validity, convergent validity, and reliability. The pilot testing was performed by studying the KAP of 100 practicing physicians in tertiary care hospitals in Pakistan. The knowledge section of the validation phase utilized Item Response Theory (IRT) analysis. The attitude and practices sections utilized Exploratory Factor Analysis (EFA) theory. The reliability analysis utilized Cronbach's alpha and correlations.

    RESULTS: The CKD-KAP questionnaire had three main sections: knowledge, attitude, and practice. During the validation, IRT analysis was performed on knowledge, which focused on the measure of the coefficient of discrimination and difficulty of the items; 40 out of 41 knowledge items have both discrimination and difficulty coefficients within an acceptable range. The EFA model was also fitted in the attitude and practices section, and scree plot and Eigenvalues suggested three and four dimensions within the attitude and practices section. The factor loading of all items was found to be acceptable except for one item in attitude which was deleted. The convergent validity demonstrated a significant association between all three sections except knowledge and practices. The reliability (internal consistency) analysis demonstrated Cronbach's alpha values above 0.7 and significant inter-item correlation. The final model of CKD-KAP had 40 knowledge, 13 attitude, and 10 practice items with a combination of both positive as well as negative questions and statements.

    CONCLUSIONS: The CKD-KAP was found to be psychometrically valid and reliable, hence can be used to determine the knowledge, attitude, and practices of physicians toward chronic kidney disease.

  16. Adlim M, Surbakti MS, Omar AF, Rahmayani RFI, Hasmar AH, Ozmen I, et al.
    RSC Adv, 2024 Aug 29;14(38):27504-27513.
    PMID: 39221122 DOI: 10.1039/d4ra04901b
    A simple preparation of a paper strip test with a smartphone-based instrument for detecting dissolved mercury is still in development. This study aims to develop a smartphone-based colorimetric paper strip test using chitosan-stabilized silver nanoparticles for detecting dissolved mercury. The method demonstrated high sensitivity and selectivity for Hg2+ ions, with detection limits comparable to UV-vis spectrophotometry. Silver ions embedded in the chitosan matrix were reduced by either sodium NaBH4 or N2H4. Both chi-AgNP colloidal and chi-AgNP paper strips were tested for sensitivity of mercury(ii) solution detection with and without ion interference. The accuracy of colour change responding to the mercury concentration was recorded with several smartphones in a handmade cubical and a T-shape micro-studio. Only NaBH4 gives colloidal chi-AgNPs relatively dispersed, and the colloidal chi-AgNPs become aggregated when AgNP interacts with mercury(ii) ions. The colour change of chi-AgNP paper strips responding to the concentration of mercury(ii) and quantified using a smartphone is consistent when confirmed with UV-vis spectrophotometric determination with a comparable limit of detection (0.76 μM). The inferring ions do not significantly affect mercury(ii) analyses. Therefore, the paper strip integrated with the smartphone is effectively used for mercury(ii) detection in water as long as the mercury concentration is >1 μM. This finding might inspire advanced technology with a larger number of data references, and machine learning involvement to develop more compatible and simple mercury detection.
  17. Ayaz A, Saeed S, Farooq MU, Ahmad I, Ali Bahoo ML, Saeed M
    Malays J Med Sci, 2009 Jan;16(1):34-8.
    PMID: 22589646
    The efficacy and safety of oral versus vaginal misoprostol for elective induction of labor in post date multigravida with an unfavourable cervix was compared over a period of one year in the Bahawal Victoria Hospital, Bahawalpur, Pakistan. Eightyeight multigravida post date women were divided into two groups and given 50 mg misoprostol orally and 50 mg intravaginally, respectively. The induction to onset of significant uterine contractions and delivery intervals were lower in the first group (7.8 h vs. 8.9 h) when compared to (10.4 h vs. 12 h). The first group had a higher rate of Caesarean section (7% vs. 4%; p>0.05), uterine hyperstimulation (9% vs. 5%; p>0.05), uterine tachysystole (23% vs. 14%; p>0.05) and neonatal admissions to intensive care unit (12% vs. 4%; p>0.05) when compared to second group. Fifty mg oral misoprostol has the potential to induce labor as safely and effectively as the intravaginal route.
  18. Jahangeer SMA, Hasnain N, Tariq MT, Jamil A, Zia SY, Amir W
    Malays J Med Sci, 2021 Aug;28(4):113-122.
    PMID: 34512136 DOI: 10.21315/mjms2021.28.4.12
    Introduction: This study aimed at determining the frequency and association of stress levels with modes of transportation and was likely to reveal the contributing transportation-related factors for stress in medical students.

    Methods: This was a questionnaire-based, cross-sectional study that included undergraduate medical students of a public sector medical university in Karachi, Pakistan. A total of 573 students participated voluntarily, of which 300 were provided a manual questionnaire and 273 filled it online. The reliability of the questionnaire was assessed using Cronbach's alpha at 0.791. The collected data were analysed using IBM SPSS Statistics for Windows, version 21.0.

    Results: Out of 573 participants, 99.3% (n = 298) of students filled the questionnaire manually, whereas 100% of students filled the questionnaire online. Almost two-thirds of students used university transport; more than 90% lived more than 5 km from the university and 56% had a traveling time of more than an hour. Approximately 15.4% of students reported physical trauma and some form of harassment. Sheldon Cohen's stress scale surprisingly revealed 90% of students to be within the moderate-to-high stress category. Risk factors were associated with stress levels and significant associations were observed with noise exposure (P = 0.023) and sleep quality (P = 0.001). The most common reported stressors associated with commuting included overcrowding, long travel, and air and noise pollution. Noise pollution was the main predictor of stress among commuters.

    Conclusion: Poor transportation has adverse effects on health and academic performance. Administration in their respective jurisdictions is needed to investigate this matter to make commuting a routine rather than a hassle.

  19. Sukiman H, Mohamad AM, Raduan MFN, Yasim MNAM, Lazim MIM
    Malays J Med Sci, 2021 Oct;28(5):130-136.
    PMID: 35115895 DOI: 10.21315/mjms2021.28.5.13
    Background: Appendicitis is common and delayed presentation results in complicated appendicitis with increased morbidity. This study investigates the effect of the Movement Control Order (MCO) during the COVID-19 pandemic on the presentation and severity of appendicitis.

    Methods: A cross-sectional study including 193 patients diagnosed with appendicitis was conducted at four hospitals in Pahang, Malaysia. Those who presented between 1 February 2020 and 17 March 2020 were included in the pre-MCO group and those between 18 March 2020 and 30 April 2020 in the MCO group. The definitions of simple and complicated appendicitis were based on the Sunshine Appendicitis Grading Score. The primary outcome was the incidence of complicated appendicitis, and the secondary outcomes were length of stay, a composite of surgical morbidities and a composite of organ failure.

    Results: A total of 105 patients in the pre-MCO group and 88 in the MCO group were analysed. The incidence of complicated appendicitis was 33% and it was higher in the MCO than in the pre-MCO group (44% versus 23%, P = 0.002). The MCO period was independently associated with complicated appendicitis in the logistic regression (P = 0.001). It was also associated with prolonged length of stay (3.5 days versus 2.4 days, P < 0.001) and higher overall surgical morbidity (19% versus 5%, P = 0.002).

    Conclusion: The MCO imposed during the COVID-19 pandemic was associated with a higher incidence of complicated appendicitis and surgical morbidity.

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