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Fulltext Assessing the cost effectiveness of an anticoagulation clinic in comparison with the usual medical clinic In Kuala Lumpur Hospital [Abstract]

Thanimalai S, Shafie AA, Ahmad HM, Sinnadurai J

Value Health, 2014 Nov;17(7):A487.
PMID: 27201439 DOI: 10.1016/j.jval.2014.08.1428

Objectives: Systematic anticoagulation management clinic is now recommended to manage warfarinized atrial fibrillation (AF) patient. In Malaysia, the service is recently introduced as pharmacist managed Warfarin Medication Therapy Adherence Clinic (WMTAC). The objective of the present study was to assess the cost effectiveness of anticoagulation clinic in comparison with usual medical in Kuala Lumpur Hospital.
Methods: A Markov model built using the provider perspective and 20 year time horizon was used to assess the cost effectiveness. The base case analysis assumed a cohort of patients with AF 57 years of age with comorbid illnesses. Data sources include a 6 month retrospective cohort analysis of the effectiveness of the clinics, the cost of drugs, cost of personnel and space of the clinics, cost of monitoring and cost of adverse events were obtained from the local source and publications. The transition probabilities of these clinics outcomes were obtained from a literature search. Future costs were discounted by 3% to convert to present values. All costs were in Ringgit Malaysia (RM) based on year 2012.
Results: The results of a 20-year period model showed that UMC was dominated by the WMTAC in the same time period. The mean cost of the WMTAC was RM 5864 whereas the UMC cost was RM 6550. The sensitivity analysis showed that clinic treatment costs and effectiveness influenced the cost-effectiveness. If the cost of WMTAC was increased by 50% of the current cost, the WMTAC would not be a dominant intervention. WMTAC was also cost effective for a willingness to pay of RM32000.
Conclusions: The anticoagulation management service appears to cost less and provide greater effectiveness than usual care. In conclusion, the Markov model suggests that from the provider perspective the anticoagulation clinic is a more cost effective option than the usual medical clinic in Kuala Lumpur Hospital.
Study site: Medication Therapy Adherence Clinic, Hospital Kuala Lumpur, Malaysia
Fulltext Enhancing the urea-N use efficiency in maize (Zea mays) cultivation on acid soils amended with zeolite and TSP

Ahmed OH, Hussin A, Ahmad HM, Rahim AA, Majid NM

ScientificWorldJournal, 2008 Apr 20;8:394-9.
PMID: 18454247 DOI: 10.1100/tsw.2008.68

Ammonia loss significantly reduces the urea-N use efficiency in crop production. Efforts to reduce this problem are mostly laboratory oriented. This paper reports the effects of urea amended with triple superphosphate (TSP) and zeolite (Clinoptilolite) on soil pH, nitrate, exchangeable ammonium, dry matter production, N uptake, fresh cob production, and urea-N uptake efficiency in maize (Zea mays) cultivation on an acid soil in actual field conditions. Urea-amended TSP and zeolite treatments and urea only (urea without additives) did not have long-term effect on soil pH and accumulation of soil exchangeable ammonium and nitrate. Treatments with higher amounts of TSP and zeolite significantly increased the dry matter (stem and leaf) production of Swan (test crop). All the treatments had no significant effect on urea-N concentration in the leaf and stem of the test crop. In terms of urea-N uptake in the leaf and stem tissues of Swan, only the treatment with the highest amount of TSP and zeolite significantly increased urea-N uptake in the leaf of the test crop. Irrespective of treatment, fresh cob production was statistically not different. However, all the treatments with additives improved urea-N uptake efficiency compared to urea without additives or amendment. This suggests that urea amended with TSP and zeolite has a potential of reducing ammonia loss from surface-applied urea.
Applied K fertilizer use efficiency in pineapples grown on a tropical peat soil under residues removal

Ahmed OH, Ahmad HM, Musa HM, Rahim AA, Rastan SO

ScientificWorldJournal, 2005 Jan 21;5:42-9.
PMID: 15674449

In Malaysia, pineapples are grown on peat soils, but most K fertilizer recommendations do not take into account K loss through leaching. The objective of this study was to determine applied K use efficiency under a conventionally recommended fertilization regime in pineapple cultivation with residues removal. Results showed that K recovery from applied K fertilizer in pineapple cultivation on tropical peat soil was low, estimated at 28%. At a depth of 0-10 cm, there was a sharp decrease of soil total K, exchangeable K, and soil solution K days after planting (DAP) for plots with K fertilizer. This decline continued until the end of the study. Soil total, exchangeable, and solution K at the end of the study were generally lower than prior values before the study. There was no significant accumulation of K at depths of 10-25 and 25-45 cm. However, K concentrations throughout the study period were generally lower or equal to their initial status in the soil indicating leaching of the applied K and partly explained the low K recovery. Potassium losses through leaching in pineapple cultivation on tropical peat soils need to be considered in fertilizer recommendations for efficient recovery of applied K.
Fulltext The enlightenment from Malaysian consumers' perspective toward cosmetic products

Ayob A, Awadh AI, Jafri J, Jamshed S, Ahmad HM, Hadi H

J Pharm Bioallied Sci, 2016 Jul-Sep;8(3):229-34.
PMID: 27413352 DOI: 10.4103/0975-7406.174232

Variety of cosmetic products was used in our daily life, yet the amount and types of the cosmetic products used by the consumers were varied, which may be due to the different perspectives held by each of the consumers.
Fulltext Malaysian consumers' awareness, perception, and attitude toward cosmetic products: Questionnaire development and pilot testing

Ayob A, Awadh AI, Hadi H, Jaffri J, Jamshed S, Ahmad HM

J Pharm Bioallied Sci, 2016;8(3):203-9.
PMID: 27413348 DOI: 10.4103/0975-7406.171681

BACKGROUND: Increased usage of cosmetic products has caused a growing concern about the safety of these products, and yet little is known about cosmetics from the consumers' perspective. Hence, this study's aim is to develop a valid and reliable tool for assessing consumers' awareness, perceptions, and attitudes toward cosmetic products.
MATERIALS AND METHODS: A questionnaire was developed in the English language based on information collected from a literature search, in-depth interviews conducted with consumers prior to this study and consultations with experts. Subsequently, the questionnaire was subjected to translation, validation, and test-retest reliability. A final version of the questionnaire was piloted among 66 consumers via convenient sampling. A descriptive analysis was performed, and the internal consistency and the differences between variables in the questionnaire were analyzed.
RESULTS: The developed and translated questionnaire produced repeatable data for each of the domains (Spearman's correlation ≥ 0.7, P < 0.001). The internal consistency for awareness, perceptions and attitudes indicates good internal consistency (Cronbach's alpha value of more than 0.7 for each domain). Significant differences were found between the perception scores for the race, religion, and monthly expenses for cosmetic products, respectively, and the same pattern was found for the attitude scores, but monthly expenses for cosmetic products was replaced by monthly income.
CONCLUSION: The results achieved via the Bahasa Malaysia questionnaire indicated that the developed and translated questionnaire can be used as a valid and reliable tool for assessing consumers' awareness, perceptions, and attitudes toward cosmetic products in Malaysia in future studies.
Source, occurrence, distribution, fate, and implications of microplastic pollutants in freshwater on environment: A critical review and way forward

Kurniawan TA, Haider A, Ahmad HM, Mohyuddin A, Umer Aslam HM, Nadeem S, et al.

Chemosphere, 2023 Jun;325:138367.
PMID: 36907482 DOI: 10.1016/j.chemosphere.2023.138367

The generation of microplastics (MPs) has increased recently and become an emerging issue globally. Due to their long-term durability and capability of traveling between different habitats in air, water, and soil, MPs presence in freshwater ecosystem threatens the environment with respect to its quality, biotic life, and sustainability. Although many previous works have been undertaken on the MPs pollution in the marine system recently, none of the study has covered the scope of MPs pollution in the freshwater. To consolidate scattered knowledge in the literature body into one place, this work identifies the sources, fate, occurrence, transport pathways, and distribution of MPs pollution in the aquatic system with respect to their impacts on biotic life, degradation, and detection techniques. This article also discusses the environmental implications of MPs pollution in the freshwater ecosystems. Certain techniques for identifying MPs and their limitations in applications are presented. Through a literature survey of over 276 published articles (2000-2023), this study presents an overview of solutions to the MP pollution, while identifying research gaps in the body of knowledge for further work. It is conclusive from this review that the MPs exist in the freshwater due to an improper littering of plastic waste and its degradation into smaller particles. Approximately 15-51 trillion MP particles have accumulated in the oceans with their weight ranging between 93,000 and 236,000 metric ton (Mt), while about 19-23 Mt of plastic waste was released into rivers in 2016, which was projected to increase up to 53 Mt by 2030. A subsequent degradation of MPs in the aquatic environment results in the generation of NPs with size ranging from 1 to 1000 nm. It is expected that this work facilitates stakeholders to understand the multi-aspects of MPs pollution in the freshwater and recommends policy actions to implement sustainable solutions to this environmental problem.
Tackling microplastics pollution in global environment through integration of applied technology, policy instruments, and legislation

Kurniawan TA, Haider A, Mohyuddin A, Fatima R, Salman M, Shaheen A, et al.

J Environ Manage, 2023 Nov 15;346:118971.
PMID: 37729832 DOI: 10.1016/j.jenvman.2023.118971

Microplastic pollution is a serious environmental problem that affects both aquatic and terrestrial ecosystems. Small particles with size of less than 5 mm, known as microplastics (MPs), persist in the environment and pose serious threats to various species from micro-organisms to humans. However, terrestrial environment has received less attention than the aquatic environment, despite being a major source of MPs that eventually reaches water body. To reflect its novelty, this work aims at providing a comprehensive overview of the current state of MPs pollution in the global environment and various solutions to address MP pollution by integrating applied technology, policy instruments, and legislation. This review critically evaluates and compares the existing technologies for MPs detection, removal, and degradation, and a variety of policy instruments and legislation that can support the prevention and management of MPs pollution scientifically. Furthermore, this review identifies the gaps and challenges in addressing the complex and diverse nature of MPs and calls for joint actions and collaboration from stakeholders to contain MPs. As water pollution by MPs is complex, managing it effectively requires their responses through the utilization of technology, policy instruments, and legislation. It is evident from a literature survey of 228 published articles (1961-2023) that existing water technologies are promising to remove MPs pollution. Membrane bioreactors and ultrafiltration achieved 90% of MPs removal, while magnetic separation was effective at extracting 88% of target MPs from wastewater. In biological process, one kg of wax worms could consume about 80 g of plastic/day. This means that 100 kg of wax worms can eat about 8 kg of plastic daily, or about 2.9 tons of plastic annually. Overall, the integration of technology, policy instrument, and legislation is crucial to deal with the MPs issues.