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Fulltext Hypertensive bipolar: chronic lithium toxicity in patients taking ACE inhibitor

Masiran R, Abdul Aziz MF

BMJ Case Rep, 2017 Aug 28;2017.
PMID: 28847993 DOI: 10.1136/bcr-2017-220631

A patient with bipolar I disorder has been treated with lithium and haloperidol for the last 20 years and received an ACE inhibitor for his hypertension since 9 years ago. Despite regular clinic follow-ups and blood monitoring, he recently developed tremors and delirium. On hospital admission, serum level of lithium was far above toxic level. Mental state examination revealed an anxious and disorientated man with irrelevant speech. Immediate discontinuation of lithium resulted in slow reduction of serum lithium levels and gradual resolution of tremor but his delirium persisted for 2 weeks. His condition took a turn for the worse when he developed acute renal failure and arm abscess. We discussed about lithium toxicity and the vulnerability factors which have induced delirium and renal failure in this patient.
Fulltext Can dynamic consent facilitate the protection of biomedical big data in biobanking in Malaysia?

Abdul Aziz MF, Mohd Yusof AN

Asian Bioeth Rev, 2019 Jun;11(2):209-222.
PMID: 33717312 DOI: 10.1007/s41649-019-00086-2

As with many other countries, Malaysia is also developing and promoting biomedical research to increase the understanding of human diseases and possible interventions. To facilitate this development, there is a significant growth of biobanks in the country to ensure continuous collection of biological samples for future research, which contain extremely important personal information and health data of the participants involved. Given the vast amount of samples and data accumulated by biobanks, they can be considered as reservoirs of precious biomedical big data. It is therefore imperative for biobanks to have in place regulatory measures to ensure ethical use of the biomedical big data. Malaysia has yet to introduce specific legislation for the field of biobanking. However, it can be argued that its existing Personal Data Protection Act 2010 (PDPA) has laid down legal principles that can be enforced to protect biomedical big data generated by the biobanks. Consent is a mechanism to enable data subjects to exercise their autonomy by determining how their data can be used and ensure compliance with legal principles. However, there are two main concerns surrounding the current practice of consent in biomedical big data in Malaysia. First, it is uncertain that the current practice would be able to respect the underlying notion of autonomy, and second, it is not in accordance with the legal principles of the PDPA. Scholars have deliberated on different strategies of informed consent, and a more interactive approach has recently been introduced: dynamic consent. It is argued that a dynamic consent approach would be able to address these concerns.
Influenza B outbreak in female psychiatric ward of Hospital Kuala Lumpur, Malaysia

Mohamad Isa MF, Tan JM, Abdul Aziz MF, Leong CL

Med J Malaysia, 2018 12;73(6):405-406.
PMID: 30647214

Influenza outbreaks in tropical countries are rarely reported. This article reports four cases of influenza within a psychiatric ward of a tertiary hospital in Malaysia. These were patients with severe mental illness who were involuntarily admitted and did not show the classical triad of influenza-like-illness (ILI) at the beginning. However, severe respiratory complications developed requiring intubation. Referral and cooperation with the infectious disease team was initiated to help manage the outbreak while continuing psychiatric treatment. Incidences of influenza among hospitalised psychiatric patients should be treated seriously with immediate multidisciplinary approach to prevent severe unwanted complications.
Creative regulatory practices to develop stem-cell technology: the way forward for Malaysia

Bin Abdul Aziz MF, Morrison M, Kaye J

Regen Med, 2022 Feb;17(2):91-105.
PMID: 34905952 DOI: 10.2217/rme-2021-0068

Malaysia aspires to develop regenerative medicine through stem-cell technology. It needs a regulatory system that could facilitate development and prevent unethical practices. A comparative legal analysis on the regulation of stem-cell technology, with a focus on stem-cell research in Malaysia and selected Commonwealth countries that are experienced in regulating this complex technology, demonstrates that the selected Commonwealth countries have adopted a hybrid of different regulatory mechanisms. This paper argues that Malaysia should consider adopting a similar approach to equip relevant authorities with different regulatory mechanisms that are able to promote innovation in stem-cell research activities and cultivate a successful and profitable regenerative medicine industry in the future. Such a strategic action can produce an optimal regulatory outcome and help Malaysia to realize its aspiration.
Fulltext Morphometric study of Kalophrynus palmatissimus at two forest reserves in Malaysia

Abdul Aziz MF, Mohd Top Mohd Tah M, Shohaimi S, Ab Ghani NI, Fletcher C

Ecol Evol, 2021 Aug;11(16):10741-10753.
PMID: 34429877 DOI: 10.1002/ece3.7721

A research study on morphometrics of Kalophrynus palmatissimus (commonly known as Lowland Grainy Frog) at Ayer Hitam Forest Reserve (AHFR), Selangor and Pasoh Forest Reserve (PFR), Negeri Sembilan was carried out from 12 November 2016 to 13 September 2017. The study was to examine data on the morphometric traits of K. palmatissimus at the two forest reserves. 15 morphometric traits of K. palmatissimus that were taken by using vernier calipers. Frog surveys were done by using 15 and 18 nocturnal 400 m transect lines with an interval distance of 20 m at AHFR and PFR, respectively. The GPS coordinates for all frog samples were recorded to ensure the precise geographic location. In addition, five climatic data were recorded. The results showed that most morphometric traits in AHFR (n = 34) and PFR (n = 31) were positively correlated with each other. On the other hand, climatic factor, which was soil pH, had a significant positive influence on most of the morphometric traits (p .05). Later, it was found that the snout-vent length of K. palmatissimus at AHFR was slightly larger than at PFR (AHFR: μ = 37.00 mm, SE = 1.16 c.f. PFR: μ = 30.29 mm, SE = 1.07). It showed that there were variations in morphometric traits of K. palmatissimus at AHFR and PFR. From PCA analysis, morphometric traits are grouped into two components for AHFR and PFR, respectively. In AHFR, head length, eye diameter, head width, internarial distance, interorbital distance, forearm length, tibia length, foot length, and thigh length were strongly correlated, while snout length and eye-nostril distance were strongly correlated. In PFR, eye diameter, head width, internarial distance, interorbital distance, foot length, and thigh length were strongly correlated, though snout length and eye-nostril distance were strongly correlated, hence, suggested that all morphometric traits grow simultaneously in K. palmatissimus with eye-nostril distance (EN), and snout length (SL) growing almost simultaneously at AHFR (r = .91) and PFR (r = .97). There is still a lack of available information regarding the distribution and morphometric studies of K. palmatissimus in Malaysia, especially at AHFR and PFR. This study showed 15 different morphometric traits of K. palmatisssimus between AHFR and PFR, with K. palmatissimus at AHFR were found to be slightly larger than at PFR.
Fulltext Green Extraction of Bioactive Compounds from Plant Biomass and Their Application in Meat as Natural Antioxidant

Awad AM, Kumar P, Ismail-Fitry MR, Jusoh S, Ab Aziz MF, Sazili AQ

Antioxidants (Basel), 2021 Sep 15;10(9).
PMID: 34573097 DOI: 10.3390/antiox10091465

Plant extracts are rich in various bioactive compounds exerting antioxidants effects, such as phenolics, catechins, flavonoids, quercetin, anthocyanin, tocopherol, rutin, chlorogenic acid, lycopene, caffeic acid, ferulic acid, p-coumaric acid, vitamin C, protocatechuic acid, vitamin E, carotenoids, β-carotene, myricetin, kaempferol, carnosine, zeaxanthin, sesamol, rosmarinic acid, carnosic acid, and carnosol. The extraction processing protocols such as solvent, time, temperature, and plant powder should be optimized to obtain the optimum yield with the maximum concentration of active ingredients. The application of novel green extraction technologies has improved extraction yields with a high concentration of active compounds, heat-labile compounds at a lower environmental cost, in a short duration, and with efficient utilization of the solvent. The application of various combinations of extraction technologies has proved to exert a synergistic effect or to act as an adjunct. There is a need for proper identification, segregation, and purification of the active ingredients in plant extracts for their efficient utilization in the meat industry, as natural antioxidants. The present review has critically analyzed the conventional and green extraction technologies in extracting bioactive compounds from plant biomass and their utilization in meat as natural antioxidants.
Fulltext Physico-Chemical Characteristics and Microbiological Quality of Broiler Chicken Pectoralis major Muscle Subjected to Different Storage Temperature and Duration

Ab Aziz MF, Hayat MN, Kaka U, Kamarulzaman NH, Sazili AQ

Foods, 2020 Jun 04;9(6).
PMID: 32512753 DOI: 10.3390/foods9060741

Storage temperature and duration plays an important role in meat processing. Observations in poultry processing plants have shown a serious deviation in storage condition compared to the recommended procedures. Furthermore, there is still a paucity of evidence on the effects of storage temperature and duration on meat quality and microbial population. The aim of this study was to determine the effects of different temperature and duration during storage on physico-chemical properties and microbiological quality of broiler chicken Pectoralis major muscle. Eighty birds were slaughtered and processed, following which the packed boneless breast (PBB) (each bird was to provide two breast muscle samples; left breast and right breast) was divided into four groups, each consisted of 40 PBB. Each group was subsequently assigned to storage either at 4 °C, -10 °C, -18 °C or -40 °C, for 24 h before 20 PBB samples from each group were transported to the respective laboratory for meat quality and microbiological analysis. The remaining 20 PBB from each storage temperature were stored for 72 h before being transported for analysis. Results have shown significant increases in drip loss and cooking loss as the storage temperature decreases. Similarly, storage duration significantly affected cooking loss, of which, samples stored for 72 h exhibited higher cooking loss compared to those stored for 24 h. For color, significant differences were only observed in lightness (L*) and redness (a*) values. Longer duration of storage had significantly improved tenderness whereby, samples that have been stored for a shorter duration presented higher pH values. Populations of coliform and Salmonella decreased significantly with decreasing temperature and increasing storage duration.
Fulltext Validation of the general Framingham Risk Score (FRS), SCORE2, revised PCE and WHO CVD risk scores in an Asian population

Kasim SS, Ibrahim N, Malek S, Ibrahim KS, Aziz MF, Song C, et al.

Lancet Reg Health West Pac, 2023 Jun;35:100742.
PMID: 37424687 DOI: 10.1016/j.lanwpc.2023.100742

BACKGROUND: Cardiovascular risk prediction models incorporate myriad CVD risk factors. Current prediction models are developed from non-Asian populations, and their utility in other parts of the world is unknown. We validated and compared the performance of CVD risk prediction models in an Asian population.
METHODS: Four validation groups were extracted from a longitudinal community-based study dataset of 12,573 participants aged ≥18 years to validate the Framingham Risk Score (FRS), Systematic COronary Risk Evaluation 2 (SCORE2), Revised Pooled Cohort Equations (RPCE), and World Health Organization cardiovascular disease (WHO CVD) models. Two measures of validation are examined: discrimination and calibration. Outcome of interest was 10-year risk of CVD events (fatal and non-fatal). SCORE2 and RPCE performances were compared to SCORE and PCE, respectively.
FINDINGS: FRS (AUC = 0.750) and RPCE (AUC = 0.752) showed good discrimination in CVD risk prediction. Although FRS and RPCE have poor calibration, FRS demonstrates smaller discordance for FRS vs. RPCE (298% vs. 733% in men, 146% vs. 391% in women). Other models had reasonable discrimination (AUC = 0.706-0.732). Only SCORE2-Low, -Moderate and -High (aged <50) had good calibration (X2 goodness-of-fit, P-value = 0.514, 0.189, 0.129, respectively). SCORE2 and RPCE showed improvements compared to SCORE (AUC = 0.755 vs. 0.747, P-value <0.001) and PCE (AUC = 0.752 vs. 0.546, P-value <0.001), respectively. Almost all risk models overestimated 10-year CVD risk by 3%-1430%.
INTERPRETATION: In Malaysians, RPCE are evaluated be the most clinically useful to predict CVD risk. Additionally, SCORE2 and RPCE outperformed SCORE and PCE, respectively.
FUNDING: This work was supported by the Malaysian Ministry of Science, Technology, and Innovation (MOSTI) (Grant No: TDF03211036).
A Review of Regulatory Frameworks for Biobanking in Southeast Asia

Medina PB, Armon S, Bin Abdul Aziz MF, Cheong IH, de Leon MP, Drobysz S, et al.

Biopreserv Biobank, 2024 Sep 09.
PMID: 39248001 DOI: 10.1089/bio.2024.0044

Southeast Asian countries are at the forefront of public health pressures due to a confluence of factors such as population growth, urbanization, environmental pollution, and infectious diseases (re)emergence. Therefore, the ability to be able to conduct research addressing local and regional needs is of paramount importance. As such, biobanking activities, the standardized collection of biological samples, and associated data, developed over the past few decades supporting ongoing biomedical and clinical research, as well as surveillance are of critical importance. However, the regulatory landscape of biobanking is not widely understood and reported, which this narrative review aims to address for the ASEAN member states. It is evident that there are specific regulatory arrangements within each ASEAN member state, which though may be sufficient for the current level of operations, are unlikely to support a regional sharing of biological samples, data, and eventually benefits from the conducted research. Additionally, legacy and often-overlapping regulatory frameworks exist, which raise the need of an eventual consolidation under a single framework. Thus, this field requires further study as well as the creation of viable, practical proposals that would allow for biobanking harmonization and thus the exchange of biological samples and data to be achieved regionally, if not further afield.