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Fulltext Inactivation of Different Salmonella enteriditis Phage Types and Safety and Efficacy of Inactivated Products in Chicken

Akhtar A, Hair-Bejo M, Hussein EA, Zakaria Z

Vet Med Int, 2021;2021:8818308.
PMID: 34055283 DOI: 10.1155/2021/8818308

This study was conducted to inactivate Salmonella enteriditis phage types (SE pt) and to determine the safety and efficacy of inactivated SE pt in chickens. SE pt 1, 3A, 6A, 7, and 35 were inactivated and inoculated (0.20 mL) in 124 chickens divided into 6 groups (CV1, CV3A, CV6A, CV7, CV35, and CV0 as a control). Sampling was conducted on day 14 after inoculation (pi). Eight chickens from each group were separated on day 14 pi for oral challenge with 0.20 mL/chicken (1010 cfu/mL) SE pt 6A and designated CV1C, CV3AC, CV6AC, CV7C, CV35C, and CV0C as control chickens. On days 7 and 14 postchallenge (pc), 4 chickens from every group were sacrificed for sampling. There was no significant difference in the body weight between different groups. In challenged groups, there was no significant association between different tissues and isolation of Salmonella on days 7 and 14 pc. There was significance (p
Fulltext Impact of Cigarette and Alcohol Use on Adverse Drug Reactions of Haart Therapy Among HIV/AIDS Patients

Khan AH, Syed Sulaiman SA, Khan K, Soo CT, Akhtar A

Value Health, 2014 Nov;17(7):A802-3.
PMID: 27203019 DOI: 10.1016/j.jval.2014.08.503
Fulltext Adverse Drug Reactions in HIV/AIDS Patients at a Tertiary Care Hospital in Penang, Malaysia

Khan K, Khan AH, Sulaiman SA, Soo CT, Akhtar A

Jpn J Infect Dis, 2016;69(1):56-9.
PMID: 26073728 DOI: 10.7883/yoken.JJID.2014.246

In the current study we explored the occurrence of adverse drug reactions (ADRs) to antiretroviral therapy among human immune-deficiency virus (HIV)/AIDS patients. We concluded an observational retrospective study in all patients who were diagnosed with HIV infection and were receiving highly active antiviral therapy from Jan. 2007 to Dec. 2012 at Hospital Pulau Pinang, Malaysia. Patient socio-demographic details along with clinical features and susceptible ADRs were observed during the study period. Out of 743 patients, 571 (76.9%) were men, and 172 (23.1%) were women. Overall 314 (42.2%) patients experienced ADRs. A total of 425 ADRs were reported, with 311 (73.1%) occurring in men and 114 (26.8%) in women, with a significant statistical relationship (P value (P) = 0.02, OR = 1.21). Overall 239 (56.2%) ADRs were recorded among Chinese, 94 (22.1%) in Malay, and 71 (16.7%) in Indian patients, which had a statistically significant association with ADRs (P = 0.05, OR = 1.50). Out of a total 425 among ADRs, lipodystrophy was recorded in 151 (35.5%) followed by skin rashes in 80 (18.8%), anemia in 74 (17.4%), and peripheral neuropathy in 27 (6.3%) patients. These findings suggest a need of intensive monitoring of ADRs in HIV treatment centres across Malaysia.
Prevalence and treatment outcomes of skin infections among elderly population: a retrospective cross-sectional study

Akhtar A, Ahmad Hassali MA, Zainal H, Khan AH

J Dermatolog Treat, 2021 Nov;32(7):778-782.
PMID: 31916477 DOI: 10.1080/09546634.2020.1714539

BACKGROUND: Geriatric population is increasing day by day throughout the world and there is a critical need to provide them the best health services including dermatological care due to their weakened immune system. The main objective of this study is to determine the prevalence and factors affecting the treatment outcomes of skin infections among elderly population.
METHODS: A 5-year retrospective cross-sectional study was conducted at the Department of Dermatology, Hospital Pulau Pinang. Patients aged ≥65 years of age with confirmed diagnosis of skin infection were included in the study.
RESULTS: A total of 455 patients were included and the most prevalent skin infections were eczema (27.6%) followed by dermatitis (13.8%), xerosis (13.8%), and bullous pemphigoid (8.8%). Cloxacillin (18%), Tetracycline (7.9%), and Unasyn (Ampicillin and Sulbactam) (5.7%) are the common antibiotics prescribed to treat skin infections. Age, alcohol consumption, polypharmacy, and presence of other co-morbidities are the most important factors that affected the treatment outcomes of skin infections among geriatrics.
CONCLUSION: Eczema is the most prevalent skin infection among the elderly population. Age, consumption of alcohol, usage of more than five medicines simultaneously, and presence of co-morbidities are the main factors that are involved in better treatment outcomes of skin infections among study population.
Fulltext HIV-HCV Coinfection: Prevalence and Treatment Outcomes in Malaysia

Akhtar A, Fatima S, Saeed H, Soo CT, Khan AH

Intervirology, 2021 Aug 26.
PMID: 34515142 DOI: 10.1159/000518836

BACKGROUND: Around 130 million infections of hepatitis C virus with 3% overall prevalence are there worldwide. There are approximately 4-5 million persons coinfected with HIV. The main objectives of this study were to determine the prevalence of HCV among HIV-positive individuals and to assess the predictors involved in the outcomes of HIV-HCV coinfected patients.
METHODS: A retrospective, cross-sectional study was conducted on patients enrolled from 2007 to 2012 at Infectious Disease Unit, Hospital Palau Pinang, Pinang, Malaysia. Sociodemographic da%)ta as well as clinical data were collected with the help of a valid data collection form from the patients' records. Data were entered and analyzed by using statistical software SPSS version 20.0, and p < 0.05 was considered significant.
RESULTS: The overall prevalence of hepatitis C among 708 HIV-infected patients was 130 (16.1 including 541 (76.4%) males and 167 (23.6%) females. High prevalence of HIV-HCV coinfection was significantly observed in males (122 [17.2%]) compared to females (8 [1.1%]) (p < 0.001). The main route of transmission among HIV-HCV coinfected patients was heterosexual contact (98 [13.8%]), followed by homosexual contact (4 [0.4%]). The statistically significant predictors involved in treatment outcomes of HIV-HCV coinfected patients are gender (OR = 2.015, p = 0.002) and intravenous drug users (OR = 2.376, p ≤ 0.001).
CONCLUSION: The current study shows that HCV infection has an impact on the recovery of CD4 cells of the patients on HAART. Screening of HCV among HIV patients who were smokers and intravenous drug users should be monitored before starting HAART.
Fulltext Impact of Hepatitis B on Human Immunodeficiency Virus Patients in Malaysia: A Retrospective Study

Khan AH, Syed Sulaiman SA, Akhtar A, Adnan AS, Aftab RA

Value Health, 2014 Nov;17(7):A803.
PMID: 27203024 DOI: 10.1016/j.jval.2014.08.505
Fulltext Chronic Hepatitis C Prevalence and its Correlation with CD4 Cells and Liver Enzymes Among HIV Positive Patients: A Malaysian Scenario

Khan AH, Sulaiman SA, Soo CT, Akhtar A, Hamzah DA, Khan K

Value Health, 2014 Nov;17(7):A803.
PMID: 27203023 DOI: 10.1016/j.jval.2014.08.506
HBV and HIV co-infection: Prevalence and clinical outcomes in tertiary care hospital Malaysia

Akhtar A, Khan AH, Sulaiman SA, Soo CT, Khan K

J Med Virol, 2016 Mar;88(3):455-60.
PMID: 26255632 DOI: 10.1002/jmv.24347

According to WHO, Malaysia has been classified as a concentrated epidemic country due to progression of HIV infection in the population of injecting drug users. The main objectives of current study are to determine the prevalence of HBV among HIV-positive individuals in a tertiary care hospital of Malaysia and to assess the predictors involved in the outcomes of HIV-HBV co-infected patients. A retrospective, cross-sectional study is conducted at Hospital Palau Pinang, Malaysia. The collection of socio-demographic data as well as clinical data is done with the help of data collection form. Data were analyzed after putting the collected values of required data by using statistical software SPSS version 20.0 and P > 0.05 is considered as significant. Results show that the overall prevalence of HBV was 86 (13%) including 495 (74.5%) males and 169 (25.5%) females among a total of 664 HIV-infected patients. It was observed that there is a high prevalence of HIV-HBV co-infection in males 76 (11.4%) as compared to females 10 (1.5%) (P = 0.002). The median age of the study population was 39 years. The statistical significant risk factors involved in the outcomes of HIV-HBV co-infected patients were observed in the variables of gender, age groups, and injecting drug users. The findings of the present study shows that the prevalence of HBV infection among HIV-positive patients was 13% and the risk factors involved in the outcomes of HIV-HBV co-infected patients were gender, age, and intravenous drug users.
Fulltext Physicians' Perspective on Prescribing Patterns and Knowledge on Antimicrobial Use and Resistance in Penang, Malaysia: A Qualitative Study

Akhtar A, Khan AH, Zainal H, Ahmad Hassali MA, Ali I, Ming LC

Front Public Health, 2020;8:601961.
PMID: 33324603 DOI: 10.3389/fpubh.2020.601961

Background: Unnecessary antimicrobial use is an emerging problem throughout the world. To design future interventions to ensure rational antimicrobial use and decrease the risk of antimicrobial resistance, physician's knowledge and prescribing practices of antimicrobials should be assessed. Therefore, the main objective of this study is to investigate the physician's knowledge along with their prescribing patterns of antimicrobials in their health care system. Methods: The present qualitative study was conducted in a tertiary care public hospital located at Penang island, situated in Northwest of Malaysia. A total of 12 semi-structured, face to face interviews were conducted with purposive sampling technique. Physicians recruited had different specialties. All interviews were audio recorded, then transcribed into English language and analyze by thematic content analysis. Results: Four major themes were identified: (1) prescribing patterns of physicians regarding antimicrobials; (2) physician's knowledge about antimicrobials; (3) antimicrobial resistance; (4) satisfaction with management of infections. Physicians believed in regular educational activities and updates about the latest antimicrobial guidelines may change the prescribing behavior of physicians to optimize the use of antimicrobials. This may lead to decrease in burden of antimicrobial resistance in their health care system. Physicians emphasized that stricter rules and regular monitoring of antimicrobial use should be implemented to overcome the main challenges of antimicrobial resistance. Conclusion: Different factors were identified to assist optimized use of antimicrobials and decrease the risk of antimicrobial resistance. The present study helps to design targeted future interventions to ensure rational antimicrobial use and decrease the impact of antimicrobial resistance in Malaysia.
Fulltext Respiratory-tract infections among geriatrics: prevalence and factors associated with the treatment outcomes

Akhtar A, Hassali MAA, Zainal H, Ali I, Iqbal MS, Khan AH

Ther Adv Respir Dis, 2021 4 30;15:1753466620971141.
PMID: 33910420 DOI: 10.1177/1753466620971141

BACKGROUND: Geriatric individuals are more susceptible to different infections, especially respiratory-tract infections (RTIs) due to their compromised immune system. Hence, the objectives of the present study were to evaluate the prevalence, medication regimen complexity and factors associated with the treatment outcomes of different RTIs among geriatrics.
METHODS: A retrospective cross-sectional study (5 years) was conducted at the respiratory department, Hospital Pulau Pinang. Patients aged ⩾65 years with confirmed diagnosis of RTI were included in the study.
RESULTS: A total of 474 patients were included, and the most prevalent RTIs were community-acquired pneumonia (65.6%) followed by chronic obstructive pulmonary disease (20.7%), bronchitis (8.2%) and hospital-acquired pneumonia (5.5%). Amoxicillin/clavulanate (69.8%), ampicillin/sulbactam (9.1%) and cefuroxime (6.5%) are the most common antibiotics prescribed to treat RTIs among geriatrics. Smoking, alcohol consumption, polypharmacy and presence of other co-morbidities are statistically significant factors associated with treatment outcomes of RTIs among geriatrics.
CONCLUSION: Prevalence of community-acquired pneumonia (65.6%) among older patients aged 65 years and older higher than other RTIs. Smoking, alcohol use, presence of polypharmacy and other co-morbidities are important factors associated with the treatment outcomes of RTIs.The reviews of this paper are available via the supplemental material section.
Fulltext A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes

Akhtar A, Ahmad Hassali MA, Zainal H, Ali I, Khan AH

Front Public Health, 2021;9:657199.
PMID: 34733812 DOI: 10.3389/fpubh.2021.657199

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population. Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.
Fulltext Preclinical Models for Alzheimer's Disease: Past, Present, and Future Approaches

Akhtar A, Gupta SM, Dwivedi S, Kumar D, Shaikh MF, Negi A

ACS Omega, 2022 Dec 27;7(51):47504-47517.
PMID: 36591205 DOI: 10.1021/acsomega.2c05609

A robust preclinical disease model is a primary requirement to understand the underlying mechanisms, signaling pathways, and drug screening for human diseases. Although various preclinical models are available for several diseases, clinical models for Alzheimer's disease (AD) remain underdeveloped and inaccurate. The pathophysiology of AD mainly includes the presence of amyloid plaques and neurofibrillary tangles (NFT). Furthermore, neuroinflammation and free radical generation also contribute to AD. Currently, there is a wide gap in scientific approaches to preventing AD progression. Most of the available drugs are limited to symptomatic relief and improve deteriorating cognitive functions. To mimic the pathogenesis of human AD, animal models like 3XTg-AD and 5XFAD are the primarily used mice models in AD therapeutics. Animal models for AD include intracerebroventricular-streptozotocin (ICV-STZ), amyloid beta-induced, colchicine-induced, etc., focusing on parameters such as cognitive decline and dementia. Unfortunately, the translational rate of the potential drug candidates in clinical trials is poor due to limitations in imitating human AD pathology in animal models. Therefore, the available preclinical models possess a gap in AD modeling. This paper presents an outline that critically assesses the applicability and limitations of the current approaches in disease modeling for AD. Also, we attempted to provide key suggestions for the best-fit model to evaluate potential therapies, which might improve therapy translation from preclinical studies to patients with AD.
Fulltext i-Propylammonium Lead Chloride Based Perovskite Photocatalysts for Depolymerization of Lignin Under UV Light

Kausar S, Altaf AA, Hamayun M, Rasool N, Hadait M, Akhtar A, et al.

Molecules, 2020 Jul 31;25(15).
PMID: 32752133 DOI: 10.3390/molecules25153520

Lignin depolymerization for the purpose of synthesizing aromatic molecules is a growing focus of research to find alternative energy sources. In current studies, the photocatalytic depolymerization of lignin has been investigated by two new iso-propylamine-based lead chloride perovskite nanomaterials (SK9 and SK10), synthesized by the facile hydrothermal method. Characterization was done by Powder X-Ray Diffraction (PXRD), Scanning Electron Microscopy (SEM), UV-Visible (UV-Vis), Photoluminescence (PL), and Fourier-Transform Infrared (FTIR) Spectroscopy and was used for the photocatalytic depolymerization of lignin under UV light. Lignin depolymerization was monitored by taking absorption spectra and catalytic paths studied by applying kinetic models. The %depolymerization was calculated for factors such as catalyst dose variation, initial concentration of lignin, and varying temperatures. Pseudo-second order was the best suited kinetic model, exhibiting a mechanism for lignin depolymerization that was chemically rate controlled. The activation energy (Ea) for the depolymerization reaction was found to be 15 kJ/mol, which is remarkably less than conventional depolymerization of the lignin, i.e., 59.75 kJ/mol, exhibiting significant catalytic efficiencies of synthesized perovskites. Products of lignin depolymerization obtained after photocatalytic activity at room temperature (20 °C) and at 90 °C were characterized by GC-MS analysis, indicating an increase in catalytic lignin depolymerization structural subunits into small monomeric functionalities at higher temperatures. Specifically, 2-methoxy-4-methylphenol (39%), benzene (17%), phenol (10%) and catechol (7%) were detected by GC-MS analysis of lignin depolymerization products.

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