Displaying publications 161 - 180 of 273 in total

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  1. Autologous implantation of bilayered tissue-engineered respiratory epithelium for tracheal mucosal regenesis in a sheep model
    Mohd Heikal MY, Aminuddin BS, Jeevanan J, Chen HC, Sharifah SH, Ruszymah BH
    Cells Tissues Organs, 2010;192(5):292-302.
    PMID: 20616535 DOI: 10.1159/000318675
    The objective of this study was to regenerate the tracheal epithelium using autologous nasal respiratory epithelial cells in a sheep model. Respiratory epithelium and fibroblast cells were harvested from nasal turbinates and cultured for 1 week. After confluence, respiratory epithelium and fibroblast cells were suspended in autologous fibrin polymerized separately to form a tissue-engineered respiratory epithelial construct (TEREC). A 3 × 2 cm² tracheal mucosal defect was created, and implanted with TEREC and titanium mesh as a temporary scaffold. The control groups were divided into 2 groups: polymerized autologous fibrin devoid of cells (group 1), and no construct implanted (group 2). All sheep were euthanized at 4 weeks of implantation. Gross observation of the trachea showed minimal luminal stenosis formation in the experimental group compared to the control groups. Macroscopic evaluation revealed significant mucosal fibrosis in control group 1 (71.8%) as compared to the experimental group (7%). Hematoxylin and eosin staining revealed the presence of minimal overgrowth of fibrous connective tissue covered by respiratory epithelium. A positive red fluorescence staining of PKH26 on engineered tissue 4 weeks after implantation confirmed the presence of cultured nasal respiratory epithelial cells intercalated with native tracheal epithelial cells. Scanning electron microscopy showed the presence of short microvilli representing immature cilia on the surface of the epithelium. Our study showed that TEREC was a good replacement for a tracheal mucosal defect and was able to promote natural regenesis of the tracheal epithelium with minimal fibrosis. This study highlighted a new technique in the treatment of tracheal stenosis.
  2. Fulltext Biodegradable Gelatin-Carrageenan Sponges: High-Potential Functional Nasal Packs for Efficient Secretome Delivery
    Razali RA, Muhammad Firdaus FI, Fauzi MB, Mobarak NN, Aminuddin S, Lokanathan Y
    Polymers (Basel), 2024 Nov 30;16(23).
    PMID: 39684132 DOI: 10.3390/polym16233387
    Nasal packing is a critical procedure in postoperative care and trauma management aimed at controlling bleeding, providing structural support, and promoting tissue healing. However, conventional nasal packs often lead to discomfort, infection risks, and secondary tissue damage. To address these challenges, this study explores the potential use of biodegradable and biocompatible gelatin-carrageenan composite scaffolds as an alternative nasal packing material. Five compositions of gelatin-carrageenan scaffolds (ratios 10:0, 7:3, 5:5, 3:7, and 0:10) were fabricated and evaluated for physicochemical properties, hemocompatibility, and cytocompatibility. Results suggest that balanced ratios, such as 7:3 and 5:5, may provide a combination of structural integrity, improved biocompatibility, and controlled degradation, making them a potential candidate for nasal packing applications. The scaffolds exhibited low cytotoxicity and reasonable blood compatibility, which could reduce the risks associated with conventional materials. While these findings are promising, further in vivo studies are necessary to validate the efficacy and safety of these scaffolds in clinical settings. If proven effective, gelatin-carrageenan scaffolds may help address some of the limitations of conventional nasal packing materials and improve postoperative care outcomes.
  3. Fulltext The Role of Tocotrienol in Arthritis Management-A Scoping Review of Literature
    Tejpal Singh HS, Aminuddin AA, Pang KL, Ekeuku SO, Chin KY
    Pharmaceuticals (Basel), 2023 Mar 02;16(3).
    PMID: 36986484 DOI: 10.3390/ph16030385
    Arthritis is a cluster of diseases impacting joint health and causing immobility and morbidity in the elderly. Among the various forms of arthritis, osteoarthritis (OA) and rheumatoid arthritis (RA) are the most common. Currently, satisfying disease-modifying agents for arthritis are not available. Given the pro-inflammatory and oxidative stress components in the pathogenesis of arthritis, tocotrienol, a family of vitamin E with both anti-inflammatory and antioxidant properties, could be joint-protective agents. This scoping review aims to provide an overview of the effects of tocotrienol on arthritis derived from the existing scientific literature. A literature search using PubMed, Scopus and Web of Science databases was conducted to identify relevant studies. Only cell culture, animal and clinical studies with primary data that align with the objective of this review were considered. The literature search uncovered eight studies investigating the effects of tocotrienol on OA (n = 4) and RA (n = 4). Most of the studies were preclinical and revealed the positive effects of tocotrienol in preserving joint structure (cartilage and bone) in models of arthritis. In particular, tocotrienol activates the self-repair mechanism of chondrocytes exposed to assaults and attenuates osteoclastogenesis associated with RA. Tocotrienol also demonstrated strong anti-inflammatory effects in RA models. The single clinical trial available in the literature showcases that palm tocotrienol could improve joint function among patients with OA. In conclusion, tocotrienol could be a potential anti-arthritic agent pending more results from clinical studies.
  4. Navigating the completing cancer treatment incentive in Malaysia: patient insights and implementation challenges
    Halim NHA, Zainuddin NA, Aminuddin F, Naserrudin NA, Hassan NZAM
    BMC Health Serv Res, 2025 Mar 26;25(1):435.
    PMID: 40140817 DOI: 10.1186/s12913-025-12544-9
    BACKGROUND: Cancer diagnosis imposes a significant economic burden on healthcare systems, patients, and their families particularly those from low-income households. To mitigate these challenges, Malaysia introduced the completing cancer treatment incentive (CCTI) under the PeKa B40 healthcare scheme to support cancer patients in completing their treatment. This study explores patients' experiences with the CCTI program to provide insights for refining policy interventions and enhancing the program's effectiveness in meeting the needs of its beneficiaries.

    METHODS: This qualitative study examined the experiences of cancer patients with the CCTI program in Malaysia. Semi-structured interviews were conducted with 23 respondents, both CCTI recipients and non-applicants, from eight public hospitals. Data were anlaysed using the RE-AIM framework, focusing on the dimensions of reach, adoption, and implementation.

    RESULTS: Patients' awareness of the CCTI varied, with recipients mostly informed through acquaintances, media, or healthcare providers. Non-recipients lacked awareness, with limited information provided by healthcare personnel. While the CCTI was perceived as valuable for alleviating financial burdens, particularly transportation costs, it did not appear to significantly influence treatment-seeking behaviours, as most patients expressed willingness to continue treatment even without financial aid. Implementation challenges included a burdensome application process requiring mandatory health screening, lack of clarity regarding procedures, and inadequate communication about claim approvals. Patients frequently encountered delays and confusion, exacerbated by insufficient support from healthcare providers. Additionally, many were unaware that transport incentives could be claimed for every hospital visit, further limiting the program's usefulness.

    CONCLUSIONS: The study highlights critical gaps in the CCTI program's design and delivery, including inadequate communication strategies, complex administrative processes, and a lack of transparency. Addressing these challenges are essential to improve program reach and ensuring equitable access to CCTI. Policymakers should prioritise streamlining application process, enhancing information dissemination, and leveraging digital tools to improve patient experiences. Future studies should assess the program's long-term sustainability and impact on treatment adherence and outcomes. The findings underscore the importance of adopting patient-centred approaches in designing financial aid programs to enhance healthcare equity and access.

  5. Fulltext Shelf-life evaluation of bilayered human skin equivalent, MyDerm™
    Seet WT, Manira M, Maarof M, Khairul Anuar K, Chua KH, Ahmad Irfan AW, et al.
    PLoS One, 2012;7(8):e40978.
    PMID: 22927903 DOI: 10.1371/journal.pone.0040978
    Skin plays an important role in defense against infection and other harmful biological agents. Due to its fragile structure, skin can be easily damaged by heat, chemicals, traumatic injuries and diseases. An autologous bilayered human skin equivalent, MyDerm™, was engineered to provide a living skin substitute to treat critical skin loss. However, one of the disadvantages of living skin substitute is its short shelf-life, hence limiting its distribution worldwide. The aim of this study was to evaluate the shelf-life of MyDerm™ through assessment of cell morphology, cell viability, population doubling time and functional gene expression levels before transplantation. Skin samples were digested with 0.6% Collagenase Type I followed by epithelial cells dissociation with TrypLE Select. Dermal fibroblasts and keratinocytes were culture-expanded to obtain sufficient cells for MyDerm™ construction. MyDerm™ was constructed with plasma-fibrin as temporary biomaterial and evaluated at 0, 24, 48 and 72 hours after storage at 4°C for its shelf-life determination. The morphology of skin cells derived from MyDerm™ remained unchanged across storage times. Cells harvested from MyDerm™ after storage appeared in good viability (90.5%±2.7% to 94.9%±1.6%) and had short population doubling time (58.4±8.7 to 76.9±19 hours). The modest drop in cell viability and increased in population doubling time at longer storage duration did not demonstrate a significant difference. Gene expression for CK10, CK14 and COL III were also comparable between different storage times. In conclusion, MyDerm™ can be stored in basal medium at 4°C for at least 72 hours before transplantation without compromising its functionality.
  6. Differential osteogenic activity of osteoprogenitor cells on HA and TCP/HA scaffold of tissue engineered bone
    Ng AM, Tan KK, Phang MY, Aziyati O, Tan GH, Isa MR, et al.
    J Biomed Mater Res A, 2008 May;85(2):301-12.
    PMID: 17688285
    Biomaterial, an essential component of tissue engineering, serves as a scaffold for cell attachment, proliferation, and differentiation; provides the three dimensional (3D) structure and, in some applications, the mechanical strength required for the engineered tissue. Both synthetic and naturally occurring calcium phosphate based biomaterial have been used as bone fillers or bone extenders in orthopedic and reconstructive surgeries. This study aims to evaluate two popular calcium phosphate based biomaterial i.e., hydroxyapatite (HA) and tricalcium phosphate/hydroxyapatite (TCP/HA) granules as scaffold materials in bone tissue engineering. In our strategy for constructing tissue engineered bone, human osteoprogenitor cells derived from periosteum were incorporated with human plasma-derived fibrin and seeded onto HA or TCP/HA forming 3D tissue constructs and further maintained in osteogenic medium for 4 weeks to induce osteogenic differentiation. Constructs were subsequently implanted intramuscularly in nude mice for 8 weeks after which mice were euthanized and constructs harvested for evaluation. The differential cell response to the biomaterial (HA or TCP/HA) adopted as scaffold was illustrated by the histology of undecalcified constructs and evaluation using SEM and TEM. Both HA and TCP/HA constructs showed evidence of cell proliferation, calcium deposition, and collagen bundle formation albeit lesser in the former. Our findings demonstrated that TCP/HA is superior between the two in early bone formation and hence is the scaffold material of choice in bone tissue engineering.
  7. Pediatric auricular chondrocytes gene expression analysis in monolayer culture and engineered elastic cartilage
    Ruszymah BH, Lokman BS, Asma A, Munirah S, Chua K, Mazlyzam AL, et al.
    Int J Pediatr Otorhinolaryngol, 2007 Aug;71(8):1225-34.
    PMID: 17531328
    This study was aimed at regenerating autologous elastic cartilage for future use in pediatric ear reconstruction surgery. Specific attentions were to characterize pediatric auricular chondrocyte growth in a combination culture medium and to assess the possibility of elastic cartilage regeneration using human fibrin.
  8. Fulltext Bone graft substitute using hydroxyapatite scaffold seeded with tissue engineered autologous osteoprogenitor cells in spinal fusion: early result in a sheep model
    Tan KK, Tan GH, Shamsul BS, Chua KH, Ng MHA, Ruszymah BHI, et al.
    Med J Malaysia, 2005 Jul;60 Suppl C:53-8.
    PMID: 16381285
    Spinal fusion using autologous bone graft is performed in an increasing rate for many spinal disorders. However, graft harvesting procedure is associated with prolonged operation time and potential donor site morbidity. We produced an engineered 'bone graft' substitute by using porous hydroxyapatite (HA) scaffold seeded with autologous bone marrow osteoprogenitor cells (OPCs) and fibrin. This obviates bone graft harvesting, thus eliminates donor site morbidity and shortens the operation time. The aim of this study is to evaluate Hydroxyapatite (HA) ceramics as scaffold for autologous tissue engineered bone construct for spinal fusion in a sheep model. The sheep's marrow was aspirated from iliac crest. The bone marrow mesenchymal stem cells (BMMSCs) were cultured for several passages in the presence of growth and differentiation factors to increase the number of OPCs. After the cultures reached confluence, they were trypsinized and seeded on Hydroxyapatite scaffold (HA). Approximately 5 million cells were generated after 3 weeks of culture. Microscopically, very tight Colony Forming Units (CFU-Fs) were seen on monolayer culture. The Von Kossa and Alizarin Red staining of monolayer culture showed positive mineralization areas; indicating the presence of OPCs. Sheep underwent a posterolateral spinal fusion in which scaffolds with or without OPCs seeded were implanted on both sides of the lumbar spine (L1-L2). Intended fusion segments were immobilized using wires. At the end of third month, the fusion constructs were harvested for histological examination. Fibrous tissue infiltration found in the inter-connecting pores of plain HA ceramics indicates inefficient new bone regeneration. New bone was found surrounding the HA ceramics seeded with autologous cells. The new bone is probably formed by the sheep BMMSCs that were initially encapsulating HA while it remained intact. The new bone is naturally fused with the vertebrae. In conclusion, the incorporation of autologous bone marrow cells improved the effectiveness of HA ceramics as 'bone graft' substitute for spinal fusion.
  9. In vitro development of autologous tissue engineered human articular neocartilage for orthopaedic surgery
    Samsudin OC, Aminuddin BS, Munirah S, Chua KH, Fuzina NH, Isa MR, et al.
    Med J Malaysia, 2004 May;59 Suppl B:15-6.
    PMID: 15468796
    Treatment of articular cartilage lesions remains a clinical challenge. The uses of prosthetic joint replace allograft and/or autograft transplant carry a risk of complications due to infection, loosening of its component, immunological rejection and morbidity at the donor site. There has been an increasing interest in the management of cartilage damages, owing to the introduction of new therapeutic options. Tissue engineering as a method for tissue restoration begins to provide a potential alternative therapy for autologous grafts transplantations. We aimed to evaluate how well a tissue engineered neocartilage implant, consist of human articular chondrocytes cultured with the presence of autologous serum and mixed in a fresh fibrin derived from patient, would perform in subcutaneous implantation in athymic mice.
  10. cagA gene variants in Malaysian Helicobacter pylori strains isolated from patients of different ethnic groups
    Ramelah M, Aminuddin A, Alfizah H, Isa MR, Jasmi AY, Tan HJ, et al.
    FEMS Immunol. Med. Microbiol., 2005 May 1;44(2):239-42.
    PMID: 15866222
    Helicobacter pylori infection of a distinct subtype of cagA may lead to different pathological manifestation. The aim of this study is to determine the presence of cagA gene and its variants in H. pylori infection among different ethnic groups and its effect on gastroduodenal diseases. Overall detection of cagA among the 205 clinical isolates of H. pylori was 94%. Variations in size of the 3' region of cagA gene were examined among 192 Malaysian H. pylori cagA-positive strains. Results showed that three cagA variants differing in fragment length of PCR products were detected and designated as type A (621-651bp), type B (732-735bp) and type C (525 bp). Although there was no association between any of the cagA subtypes with peptic ulcer disease (p>0.05), an association between cagA subtypes with a specific ethnic group was observed. Specific-cagA subtype A strains were predominantly isolated from Chinese compared to Malays and Indians (p<0.0005), and cagA subtype B strains were predominantly isolated from Malays and Indians compared to Chinese (p<0.05). The cagA type A strains of H. pylori is commonly found in the Chinese patients who have a higher risk of peptic ulcer disease, thus indicating that it could be used as an important clinical biomarker for a more severe infection.
  11. Fulltext The association between bone health indicated by calcaneal quantitative ultrasound and metabolic syndrome in Malaysian men
    Chin KY, Ima-Nirwana S, Mohamed IN, Ahmad F, Mohd Ramli ES, Aminuddin A, et al.
    J Diabetes Metab Disord, 2015;14:9.
    PMID: 25789255 DOI: 10.1186/s40200-015-0136-3
    BACKGROUND: Previous studies on the relationship between bone health and metabolic syndrome (MS) have revealed heterogeneous results. There are limited studies employing bone quantitative ultrasonometry in evaluating this relationship. This study aimed to determine the relationship between MS and bone health in a group of Malaysian middle-aged and elderly men using bone quantitative ultrasonometry.

    METHODS: This cross-sectional study recruited 309 free living Chinese and Malay men aged 40 years and above residing in Klang Valley, Malaysia. Their demographic and anthropometric data were collected. Their calcaneal speed of sound (SOS) was measured using a CM-200 bone ultrasonometer. Their blood was collected for the evaluation of lipid profile, total testosterone and sex hormone-binding globulin. The joint interim MS definition was used for the classification of subjects. Multiple linear regression analysis was used to assess the association between SOS and indicators of MS and the presence of MS, with suitable adjustment for confounders.

    RESULTS: There was no significant difference in SOS value between MS and non-MS subjects (p > 0.05). The SOS values among subjects with different MS scores did not differ significantly (p > 0.05). There were no significant associations between SOS values and indicators of MS or the presence of MS (p > 0.05).

    CONCLUSIONS: The relationship between bone health and MS is not significant in Malaysian middle-aged and elderly men. A longitudinal study should be conducted to evaluate the association between bone loss and MS to confirm this finding.

  12. Development of monoclonal antibodies against recombinant LipL21 protein of pathogenic Leptospira through phage display technology
    Mohd Ali MR, Sum JS, Aminuddin Baki NN, Choong YS, Nor Amdan NA, Amran F, et al.
    Int J Biol Macromol, 2021 Jan 31;168:289-300.
    PMID: 33310091 DOI: 10.1016/j.ijbiomac.2020.12.062
    Leptospirosis is a potentially fatal zoonosis that is caused by spirochete Leptospira. The signs and symptoms of leptospirosis are usually varied, allowing it to be mistaken for other causes of acute febrile syndromes. Thus, early diagnosis and identification of a specific agent in clinical samples is crucial for effective treatment. This study was aimed to develop specific monoclonal antibodies against LipL21 antigen for future use in leptospirosis rapid and accurate immunoassay. A recombinant LipL21 (rLipL21) antigen was optimized for expression and evaluated for immunogenicity. Then, a naïve phage antibody library was utilized to identify single chain fragment variable (scFv) clones against the rLipL21 antigen. A total of 47 clones were analysed through monoclonal phage ELISA. However, after taking into consideration the background OD405 values, only 4 clones were sent for sequencing to determine human germline sequences. The sequence analysis showed that all 4 clones are identical. The in silico analysis of scFv-lip-1 complex indicated that the charged residues of scFv CDRs are responsible for the recognition with rLipL21 epitopes. The generated monoclonal antibody against rLipL21 will be evaluated as a detection reagent for the diagnosis of human leptospirosis in a future study.
  13. Fulltext The Association between Inflammation and Pulse Wave Velocity in Dyslipidemia: An Evidence-Based Review
    Aminuddin A, Lazim MRMLM, Hamid AA, Hui CK, Mohd Yunus MH, Kumar J, et al.
    Mediators Inflamm, 2020;2020:4732987.
    PMID: 32908450 DOI: 10.1155/2020/4732987
    Dyslipidemia is associated with increased arterial stiffness (AS) which may lead to hypertension. Among the methods to assess AS are carotid-femoral and brachial-ankle pulse wave velocity. Dyslipidemia is also known to trigger inflammation. C-reactive protein (CRP) is one of the commonest inflammatory markers measured in the clinical setting. However, the association between inflammation and pulse wave velocity (PWV) in people with dyslipidemia is less studied. Therefore, this review investigated the association between inflammation (as measured by CRP) and PWV in dyslipidemia patients. The search of the literature was conducted via PubMed and Scopus database. The keywords used were "aortic stiffness" OR "arterial stiffness" OR "pulse wave velocity" OR "vascular stiffness" OR "carotid femoral pulse wave velocity" OR "pulse wave analysis" AND "inflammation" OR "c reactive protein" OR "c-reactive protein" OR "high sensitivity c reactive protein" AND "dyslipidemia" OR "hyperlipidemia" OR "hypercholesterolemia" OR "hyperlipoproteinemia" OR "hypertriglyceridemia". The following criteria were used: (1) only full-length original articles published in English language, (2) articles that reported the association between arterial stiffness measured as carotid-femoral PWV (cfPWV) or brachial-ankle PWV (baPWV) and CRP or high-sensitivity CRP, and (3) study involving human subjects. The search identified 957 articles published between 1980 and February 2020. Only eight articles fulfilled the inclusion criteria and were used for data extraction. Five of the studies were cross-sectional studies while another three studies were interventional studies. Seven out of eight papers found a significant positive association between AS and CRP, and the correlation ranged from mild to moderate association (Pearson r = 0.33 to r = 0.624). In conclusion, inflammation is associated with increased PWV in patients with dyslipidemia. This supports the involvement of inflammation in the development of AS in dyslipidemia.
  14. One-step, multiplex, dual-function oligonucleotide of loop-mediated isothermal amplification assay for the detection of pathogenic Burkholderia pseudomallei
    Wong Tzeling JM, Engku Nur Syafirah EAR, Irekeola AA, Yusof W, Aminuddin Baki NN, Zueter A, et al.
    Anal Chim Acta, 2021 Aug 01;1171:338682.
    PMID: 34112436 DOI: 10.1016/j.aca.2021.338682
    This study highlights the development of a multiplex real-time loop-mediated isothermal amplification assay. The developed assay employed a dual-function oligonucleotide (DFO) which simultaneously monitors the emitted amplification signals and accelerates the amplification process. The DFO was a modification of loop primer (LP); the 5'-end and 3'-end of the LP was tagged with fluorophore and quencher, respectively. The DFO was quenched in its unbound state and fluoresces only when it anneals to the specific target during the amplification process. With the same working mechanism as LP, DFO allowed the detection of target genes in less than 1 h in a real time monitoring system. We demonstrated this detection platform with Burkholderia pseudomallei, the causative agent of melioidosis. An internal amplification control (IAC) was incorporated in the assay to rule out false negative result and to demonstrate that the assay was successfully developed in a multiplex system. The assay was 100% specific when it was evaluated against 96 B. pseudomallei clinical isolates and 48 other bacteria species. The detection limit (sensitivity) of the developed assay was 1 fg/μl of B. pseudomallei genomic DNA and 18.2 CFU/ml at the bacterial cell level. In spiked blood samples, the assay's detection limit was 14 CFU/ml. The assay's diagnostic evaluation showed 100% diagnostic sensitivity, diagnostic specificity, positive predictive value, and negative predictive value. An integrated multiplex LAMP and real-time monitoring system was successfully developed, simplifying the workflow for the rapid and specific nucleic acid diagnostic test.
  15. Fulltext Cost-Effectiveness Analysis of High-Risk Groups Tuberculosis Screening in Malaysia
    Mohd Hassan NZA, Razali A, Shahari MR, Mohd Nor Sham Kunusagaran MSJ, Halili J, Zaimi NA, et al.
    Front Public Health, 2021;9:699735.
    PMID: 34322473 DOI: 10.3389/fpubh.2021.699735
    Screening of high-risk groups for Tuberculosis (TB) is considered as the cornerstone for TB elimination but the measure of cost-effectiveness is also crucial in deciding the strategy for TB screening. This study aims to measure the cost-effectiveness of TB screening between the various high-risk groups in Malaysia. A decision tree model was developed to assess the cost-effectiveness of TB screening among the high-risk groups from a provider perspective using secondary data from the year 2016 to 2018. The results are presented in terms of an Incremental Cost-Effectiveness Ratio (ICER), expressed as cost per TB case detected. Deterministic and Probabilistic Sensitivity Analysis was also performed to measure the robustness of the model. TB screening among Person Living with Human Immunodeficiency Virus (PL HIV) was the most cost-effective strategy, with MYR 2,597.00 per TB case detected. This was followed by elderly, prisoners and smokers with MYR 2,868.62, MYR 3,065.24, and MYR 4,327.76 per one TB case detected, respectively. There was an incremental cost of MYR 2.49 per screening, and 3.4 TB case detection per 1,000 screening for TB screening among PL HIV in relation to TB screening among prisoners. The probability of symptomatic cases diagnosed as TB was the key driver for increasing cost-effectiveness efficacy among PL HIV. Results of the study suggest prioritization of high-risk group TB screening program by focusing on the most cost-effective strategy such as screening among PL HIV, prisoners and elderly, which has a lower cost per TB case detected.
  16. The Effects of Annatto Tocotrienol on Bone Biomechanical Strength and Bone Calcium Content in an Animal Model of Osteoporosis Due to Testosterone Deficiency
    Chin KY, Gengatharan D, Mohd Nasru FS, Khairussam RA, Ern SL, Aminuddin SA, et al.
    Nutrients, 2016 Dec 14;8(12).
    PMID: 27983628
    Osteoporosis reduces the skeletal strength and increases the risk for fracture. It is an underdiagnosed disease in men. Annatto tocotrienol has been shown to improve bone structural indices and increase expression of bone formation genes in orchidectomized rats. This study aimed to evaluate the effects of annatto tocotrienol on biomechanical strength and calcium content of the bone in orchidectomized rats. Thirty three-month-old male Sprague-Dawley rats were randomly assigned to five groups. The baseline control (BC) group was sacrificed at the onset of the study. The sham-operated group (SHAM) received olive oil (the vehicle of tocotrienol) orally daily and peanut oil (the vehicle of testosterone) intramuscularly weekly. The remaining rats were orchidectomized and treated with three different regimens, i.e., (1) daily oral olive oil plus weekly intramuscular peanut oil injection; (2) daily oral annatto tocotrienol at 60 mg/kg plus weekly intramuscular peanut oil injection; (3) daily oral olive oil plus weekly intramuscular testosterone enanthate injection at 7 mg/kg. Blood, femur and tibia of the rats were harvested at the end of the two-month treatment period for the evaluation of serum total calcium and inorganic phosphate levels, bone biomechanical strength test and bone calcium content. Annatto-tocotrienol treatment improved serum calcium level and tibial calcium content (p < 0.05) but it did not affect femoral biomechanical strength (p > 0.05). In conclusion, annatto-tocotrienol at 60 mg/kg augments bone calcium level by preventing calcium mobilization into the circulation. A longer treatment period is needed for annatto tocotrienol to exert its effects on bone strength.
  17. Ionic liquids toxicity on fresh water microalgae, Scenedesmus quadricauda, Chlorella vulgaris &Botryococcus braunii; selection criterion for use in a two-phase partitioning bioreactor (TPPBR)
    Quraishi KS, Bustam MA, Krishnan S, Aminuddin NF, Azeezah N, Ghani NA, et al.
    Chemosphere, 2017 Oct;184:642-651.
    PMID: 28624742 DOI: 10.1016/j.chemosphere.2017.06.037
    A promising method of Carbon dioxide (CO2) valorization is to use green microalgae photosynthesis to process biofuel. Two Phase Partitioning Bioreactors (TPPBR) offer the possibility to use non-aqueous phase liquids (NAPL) to enhance CO2 solubility; thus making CO2 available to maximize algae growth. This requires relatively less toxic hydrophobic Ionic Liquids (ILs) that comprise a new class of ionic compounds with remarkable physicochemical properties and thus qualifies them as NAPL candidates. This paper concerns the synthesis of ILs with octyl and butyl chains as well as different cations containing aromatic (imidazolium, pyridinium) and non-aromatic (piperidinum, pyrrolidinium) rings for CO2 absorption studies. The authors measured their respective toxicity levels on microalgae species, specifically, Scenedesmus quadricauda, Chlorella vulgaris and Botryococcus braunii. Results revealed that octyl-based ILs were more toxic than butyl-based analogues. Such was the case for bmim-PF6 at double saturation with an absorbance of 0.11, compared to Omim-PF6 at 0.17, bmim-NTf2 at 0.02, and Omim-NTf2 at 0.14, respectively. CO2 uptake results for ILs bearing octyl-based chains compared to the butyl analog were 54% (nCO2/nIL) (i.e., moles of CO2 moles of IL) and 38% (nCO2/nIL), respectively. Conclusively, 1-butyl-1-methylpiperidinium absorbed 13% (nCO2/nIL) and appeared the least toxic, having an absorbance of 0.25 at 688 nm (double saturation at 7 d) compared to 1-butyl-3-methylimidazolium, which showed the highest toxicity with zero absorbance. Accordingly, these findings suggest that 1-butyl-1-methylpiperidinium is capable of transporting CO2 to a system containing green microalgae without causing significant harm; thus allowing its use in TPPBR technology.
  18. Fulltext Effect of increasing heart rate on finger photoplethysmography fitness index (PPGF) in subjects with implanted cardiac pacemakers
    Aminuddin A, Tan I, Butlin M, Avolio AP, Kiat H, Barin E, et al.
    PLoS One, 2018;13(11):e0207301.
    PMID: 30485318 DOI: 10.1371/journal.pone.0207301
    Finger photoplethysmography (PPG) is a noninvasive method that measures blood volume changes in the finger. The PPG fitness index (PPGF) has been proposed as an index of vascular risk and vascular aging. The objectives of the study were to determine the effects of heart rate (HR) on the PPGF and to determine whether PPGF is influenced by blood pressure (BP) changes. Twenty subjects (78±8 years, 3 female) with permanent cardiac pacemakers or cardioverter defibrillators were prospectively recruited. HR was changed by pacing, in a random order from 60 to 100 bpm and in 10 bpm increments. At each paced HR, the PPGF was derived from a finger photoplethysmogram. Cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) were derived from the finger arterial pressure waveform. Brachial blood pressure (BP) was measured by the oscillometric method. This study found that as HR was increased from 60 to 100 bpm, brachial diastolic BP, brachial mean BP and CO were significantly increased (p<0.01), whilst the PPGF and SV were significantly decreased (p<0.001). The effects of HR on the PPGF were influenced by BP, with a decreasing HR effect on the PPGF that resulted from a higher BP. In conclusion, HR was a significant confounder for PPGF and it must be taken into account in analyses of PPGF, when there are large changes or differences in the HR. The magnitude of this effect was BP dependent.
  19. Fulltext Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review
    Md Lazin Md Lazim MR, Aminuddin A, Chellappan K, Ugusman A, Hamid AA, Wan Ahmad WAN, et al.
    Int J Environ Res Public Health, 2020 04 10;17(7).
    PMID: 32290168 DOI: 10.3390/ijerph17072591
    Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a known factor that affects vascular function. Individual resting HR variation may affect RI, SI and SDPPG. This review aims to identify studies about the relationship between HR with RI, SI and SDPPG among humans. A literature search was conducted in Medline via the Ebscohost and Scopus databases to find relevant articles published within 11 years. The main inclusion criteria were articles in the English language that discuss the relationship between HR with RI, SI and SDPPG using PPG among humans. The search found 1960 relevant articles but only six articles that met the inclusion criteria. SI and RI showed an association with HR. SDPPG (SDPPG-b/SDPPG-a ratio, SDPPG-d/SDPPG-a ratio, aging index (AGI) and revised aging index (RAGI)) also had an association with HR. Only RI had a considerable association with HR, the association between SI and HR was non-considerable and the association between HR and SDPPG was inconclusive. Further interventional studies should be conducted to investigate this issue, as a variation in resting HR may challenge the validity of PPG-based CVD markers.
  20. Fulltext Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
    Mohd Hassan NZA, Bahari MS, Aminuddin F, Mohd Nor Sham Kunusagaran MSJ, Zaimi NA, Mohd Hanafiah AN, et al.
    Front Public Health, 2022;10:959812.
    PMID: 36684911 DOI: 10.3389/fpubh.2022.959812
    INTRODUCTION: Ambulance services are pivotal in any country's healthcare system. An efficient ambulance service not only decreases patient mortality rate but also allows resource prioritization for better outputs. This study aims to measure the efficiency of ambulance services provided by health facilities in the Ministry of Health (MOH), Malaysia.

    METHODS: This cross-sectional study analyzed the efficiency of 76 Decision-Making Units (DMUs) or health facilities, consisting of 62 health clinics and 14 hospitals. Data Envelopment Analysis (DEA) was used for computing efficiency scores while adopting the Variable Return to Scale (VRS) approach. The analysis was based on input orientation. The input was the cost of ambulance services, while the output for this analysis was the distance coverage (in km), the number of patients transferred, and hours of usage (in hours). Subsequent analysis was conducted to test the Overall Technical Efficiency (OTE), the Pure Technical Efficiency (PTE), the Scale Efficiency (SE), and the Return to Scale with the type of health facilities and geographical areas using a Mann-Whitney U-test and a chi-square test.

    RESULTS: The mean scores of OTE, PTE, and SE were 0.508 (±0.207), 0.721 (±0.185), and 0.700 (±0.200), respectively. Approximately, 14.47% of the total health facilities were PTE. The results showed a significant difference in OTE and SE between ambulance services in hospitals and health clinics (p < 0.05), but no significant difference in PTE between hospitals and clinics (p>0.05). There was no significant difference in efficiency scores between urban and rural health facilities in terms of ambulance services except for OTE (p < 0.05).

    DISCUSSION: The ambulance services provided in healthcare facilities in the MOH Malaysia operate at 72.1% PTE. The difference in OTE between hospitals and health clinics' ambulance services was mainly due to the operating size rather than PTE. This study will be beneficial in providing a guide to the policymakers in improving ambulance services through the readjustment of health resources and improvement in the outputs.

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