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Fulltext Differential Patterns of Adherence to Opioid Therapy in Opioid Naïve and Opioid Existing Patients With Different Age Groups

Zin CS, Taufek NH, Ahmad MM

Front Pharmacol, 2019;10:1286.
PMID: 31736760 DOI: 10.3389/fphar.2019.01286

Limited data are available on the adherence to opioid therapy and the influence of different patient groups on adherence. This study examined the patterns of adherence in opioid naïve and opioid existing patients with varying age and gender. This retrospective cohort study was conducted using the prescription databases in tertiary hospital settings in Malaysia from 2010 to 2016. Adult patients aged ≥18 years, receiving at least two opioid prescriptions, were included and stratified into the opioid naïve and existing patient groups. Adherence to opioid therapy was measured using the proportion of days covered (PDC), which was derived by dividing the total number of days covered with any opioids by the number of days in the follow-up period. Generalized linear modeling was used to assess factors associated with PDC. A total of 10,569 patients with 36,650 prescription episodes were included in the study. Of these, 91.7% (n = 9,696) were opioid naïve patients and 8.3% (n = 873) were opioid existing patients. The median PDC was 35.5% (interquartile range (IQR) 10.3-78.7%) and 26.8% (IQR 8.8-69.5%) for opioid naïve and opioid existing patients, respectively. A higher opioid daily dose (coefficient 0.010, confidence interval (CI) 0.009, 0.012 p < 0.0001) and increasing age (coefficient 0.002, CI 0.001, 0.003 p < 0.0001) were associated with higher levels of PDC, while lower PDC values were associated with male subjects (coefficient -0.0041, CI -0.072, -0.010 p = 0.009) and existing opioid patients (coefficient -0.134, CI -0.191, -0.077 p < 0.0001). The suboptimal adherence to opioid medications was commonly observed among patients with non-cancer pain, and the opioid existing patients were less adherent compared to opioid naïve patients. Increasing age and a higher daily opioid dose were factors associated with higher levels of adherence, while male and opioid existing patients were potential determinants for lower levels of adherence to opioid medications.
Catalytic cracking of bio-oil to organic liquid product (OLP)

Hew KL, Tamidi AM, Yusup S, Lee KT, Ahmad MM

Bioresour Technol, 2010 Nov;101(22):8855-8.
PMID: 20621470 DOI: 10.1016/j.biortech.2010.05.036

The main objective of this paper is to find the optimum operating condition to upgrade the EFB-derived pyrolysis oil (bio-oil) to liquid fuel, mainly gasoline using Taguchi Method. From the analysis that has been done, it is found that the optimum operating condition for heterogeneous catalytic cracking process is at 400 degrees C, 15min of reaction time using 30g of catalyst weight where operating at this condition produced the highest yield of gasoline fraction which is 91.67 wt.%. This observation proves that EFB-derived pyrolysis oil could be upgraded via heterogeneous catalytic cracking to produce gasoline.
Sex differences in high opioid dose escalation among Malaysian patients with long term opioid therapy

Zin CS, Alias NE, Taufek NH, Ahmad MM

J Pain Res, 2019;12:1251-1257.
PMID: 31118748 DOI: 10.2147/JPR.S199243

Purpose: This study evaluated the risk of opioid dose escalation as it relates to sex differences among patients receiving opioids for long-term therapy. Patients and methods: This retrospective cohort study was conducted in tertiary hospital settings in Malaysia using electronic prescription records. Opioid naïve patients, aged ≥18 years, who were undergoing long-term opioid therapy of ≥90 days, with at least one opioid prescription (buprenorphine, morphine, oxycodone, fentanyl, dihydrocodeine or tramadol) between 1st January 2011 and 31st December 2016, were included in the study. They were followed until (i) the end of the study period, (ii) death from any cause or (iii) discontinuation of therapy from their first opioid prescription without any intervals of ≥120 days between successive prescriptions. The risk of high opioid dose escalation to ≥100 mg/day and ≥200 mg/day relative to men and women was measured. Results: A total of 4688 patients (58.8% women, 41.3% men) on long-term opioid therapy were identified. Among these patients, 248 (5.29%) were escalated to high opioid doses of ≥100 mg/day and 69 (1.47%) were escalated to ≥200 mg/day. The escalation to high-dose opioid therapy was more likely to occur in men than in women, even after adjustment for age (dose ≥100 mg/day [adjusted hazard ratio 2.32; 95% confidence interval (CI), 1.79 to 3.00; p<0.0001] and ≥200 mg/day [adjusted hazard ratio 6.10; 95% CI, 3.39 to 10.98; p<0.0001]). Conclusion: The risk of opioid dose escalation differed between men and women, as men were at higher risk than women for high opioid dose escalation.
Fulltext Accident characteristics of injured motorcyclists in Malaysia

Pang TY, Radin Umar RS, Azhar AA, Ahmad MM, Nasir MTM, Harwant S

Med J Malaysia, 2000 Mar;55(1):45-50.
PMID: 11072490 MyJurnal

This study examines the accident characteristics of injured motorcyclists in Malaysia. The aim of this study is to identify the characteristics of motorcyclists who are at higher fatality risk and subsequently be the targeted group for the fatality-reduction countermeasures. A total of 412 motorcycle crash victims with serious or fatal injuries were analysed. The results showed that the injured motorcyclists were predominant young, novice riders of less than 3 years licensure and male. A fatal outcome was more likely to be associated with a larger engine capacity motorcycle, collision with a heavy vehicle, head on collision, and collision at a non-junction road. In contrast, a non-fatal outcome was more likely to be associated with a small engine capacity motorcycle, collision with another motorcycle or passenger car, junction accidents, and side or rear collisions.
Fulltext Holistic approach to microwave-reflux extraction and thermo-analytical fingerprints of under-utilized Artocarpus heterophyllus seed wastes

Olalere OA, Gan CY, Abdurahman HN, Adeyi O, Ahmad MM

Heliyon, 2020 Aug;6(8):e04770.
PMID: 32923719 DOI: 10.1016/j.heliyon.2020.e04770

The increase in wastes generated from jackfruit seeds has been largely under-utilized in Malaysia. Due to the high nutritional and medicinal content embedded in the cellulosic structure of jackfruit wastes, a need then arises for their physicochemical elucidations. In this study, the extraction of Artocarpus heterophyllus seed was carefully investigated using Taguchi orthogonal optimization design. Complete functional group characteristics and chemical profile of the A. heterophyllus seed extracts were obtained using different physicochemical characterization. The optimal conditions of the microwave extraction parameters were determined at 5 min of irradiation time, 450 W of power and 50 °C of temperature. Under this condition, the optimal yield of 17.34 (mg/g) % was achieved at an SNR ratio of 24.78. The mass spectrometry analysis tentatively identified a total of 90 and 148 secondary metabolites at positive and negative ESI modes, respectively. The chemical profile obtained provided a baseline reference for further investigation on the food and medicinal bioactive from Artocarpus heterophyllus seed oleoresins. The FT-infrared emission spectrum shows the presence of some specific carbohydrates and amide protein functional groups directly linked to C-O (1008 cm-1) the carbonyl (C=O) groups, respectively. Moreover, the morphological characteristics of the jackfruit raw and crude extracts conspicuously revealed large-sized globules which suggest the carbohydrates and protein contents. The result of this study indicates that the use of microwave extraction technology produced high-quality extracts with lower degradation of the thermal labile constituents. This will assist in determining the suitable conditions necessary for the total recovery of medicinal and nutritional constituents and conversion of agricultural waste products into useful products.
Evaluation of ligustrazine based synthetic compounds for mechanism based antiproliferative effects

Bukhari SNA, Alotaibi NH, Ahmad W, Alharbi KS, Abdelgawad MA, Al-Sanea MM, et al.

Med Chem, 2020 Sep 05.
PMID: 32888274 DOI: 10.2174/1573406416666200905125038

BACKGROUND: Ligustrazine and chalcones have been reported previously for various biological activities including anticancer effects.
OBJECTIVES: Based on the multitargeted biological activities approach of ligustrazine based chalcones, in current study 18 synthetic ligustrazine-containing α, β-unsaturated carbonyl-based 1, 3-Diphenyl-2-propen-1-one derivatives were evaluated for their inhibitory effects on growth of five different types of cancer cells.
METHODS: All compounds were evaluated for anticancer effects on various cancer cell lines by propidium iodide fluorescence assay and various other assays were performed for mechanistic studies.
RESULTS: Majority of compounds exhibited strong inhibition of cancer cells especially synthetic compounds 4a and 4b bearing 1-Pyridin-3-yl-ethanone as a ketone moiety in main structural backbone were found most powerful inhibitors of cancer cell growth. Most active 9 compounds among whole series were selected for further studies related to different cancer targets including EGFR TK kinases, tubulin polymerization, KAF and BRAFV600E.
CONCLUSION: Synthetic derivatives including 4a-b and 5a-b showed multitarget approach and showed strong inhibitory effects on EGFR, FAK and BRAF while three compounds including 3e bearing methoxy substitution, 4a and 4b with 1- pyridin-3-yl-ethanone moiety showed the inhibition of tubulin polymerization.