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  1. Kadir NA, Sarmiento ME, Acosta A, Norazmi MN
    Int J Mycobacteriol, 2016 Mar;5(1):7-13.
    PMID: 26927984 DOI: 10.1016/j.ijmyco.2015.09.006
    The search for new vaccines more efficacious than bacille Calmette-Guérin for tuberculosis prevention is of paramount importance for the control of the disease. The expression of Mycobacterium tuberculosis antigens in Mycobacterium smegmatis is one of the current strategies for the development of new-generation vaccines against tuberculosis. The objective of this study was to evaluate the immunogenicity in mice of M. smegmatis expressing epitopes from Ag85B antigen.
  2. Abdul-Kadir NA, Mat Safri N, Othman MA
    Comput Methods Programs Biomed, 2016 Nov;136:143-50.
    PMID: 27686711 DOI: 10.1016/j.cmpb.2016.08.021
    BACKGROUND: Atrial fibrillation (AF) can cause the formation of blood clots in the heart. The clots may move to the brain and cause a stroke. Therefore, this study analyzed the ECG features of AF and normal sinus rhythm signals for AF recognition which were extracted by using a second-order dynamic system (SODS) concept.
    OBJECTIVE: To find the appropriate windowing length for feature extraction based on SODS and to determine a machine learning method that could provide higher accuracy in recognizing AF.
    METHOD: ECG features were extracted based on a dynamic system (DS) that uses a second-order differential equation to describe the short-term behavior of ECG signals according to the natural frequency (ω), damping coefficient, (ξ), and forcing input (u). The extracted features were windowed into 2, 3, 4, 6, 8, and 10 second episodes to find the appropriate windowing size for AF signal processing. ANOVA and t-tests were used to determine the significant features. In addition, pattern recognition machine learning methods (an artificial neural network (ANN) and a support vector machine (SVM)) with k-fold cross validation (k-CV) were used to develop the ECG recognition system.
    RESULTS: Significant differences (p 
  3. Abdul-Kadir NA, Mat Safri N, Othman MA
    Int J Cardiol, 2016 Nov 01;222:504-8.
    PMID: 27505342 DOI: 10.1016/j.ijcard.2016.07.196
    BACKGROUND: The feasibility study of the natural frequency (ω) obtained from a second-order dynamic system applied to an ECG signal was discovered recently. The heart rate for different ECG signals generates different ω values. The heart rate variability (HRV) and autonomic nervous system (ANS) have an association to represent cardiovascular variations for each individual. This study further analyzed the ω for different ECG signals with HRV for atrial fibrillation classification.

    METHODS: This study used the MIT-BIH Normal Sinus Rhythm (nsrdb) and MIT-BIH Atrial Fibrillation (afdb) databases for healthy human (NSR) and atrial fibrillation patient (N and AF) ECG signals, respectively. The extraction of features was based on the dynamic system concept to determine the ω of the ECG signals. There were 35,031 samples used for classification.

    RESULTS: There were significant differences between the N & NSR, N & AF, and NSR & AF groups as determined by the statistical t-test (p<0.0001). There was a linear separation at 0.4s(-1) for ω of both databases upon using the thresholding method. The feature ω for afdb and nsrdb falls within the high frequency (HF) and above the HF band, respectively. The feature classification between the nsrdb and afdb ECG signals was 96.53% accurate.

    CONCLUSIONS: This study found that features of the ω of atrial fibrillation patients and healthy humans were associated with the frequency analysis of the ANS during parasympathetic activity. The feature ω is significant for different databases, and the classification between afdb and nsrdb was determined.

  4. Abdul Kadir NA, Rahmat A, Jaafar HZ
    J Obes, 2015;2015:846041.
    PMID: 26171246 DOI: 10.1155/2015/846041
    This study aims to investigate the protective effect of Cyphomandra betacea in adult male Sprague-Dawley rats fed with high fat diet. Rats were fed on either normal chow or high fat diet for 10 weeks for obesity induction phase and subsequently received C. betacea extract at low dose (150 mg kg(-1)), medium dose (200 mg kg(-1)), or high dose (300 mg kg(-1)) or placebo via oral gavages for another 7 weeks for treatment phase. Treatment of obese rats with C. betacea extracts led to a significant decrease in total cholesterol and significant increase in HDL-C (p < 0.05). Also there was a trend of positive reduction in blood glucose, triglyceride, and LDL-C with positive reduction of body weight detected in medium and high dosage of C. betacea extract. Interestingly, C. betacea treated rats showed positive improvement of superoxide dismutase (SOD) activity and glutathione peroxidase (GPx) activity along with a significant increase of total antioxidant status (TAS) (p < 0.05). Further, rats treated with C. betacea show significantly lower in TNF-α and IL-6 activities (p < 0.05). This study demonstrates the potential use of Cyphomandra betacea extract for weight maintenance and complimentary therapy to suppress some obesity complication signs.
  5. Paydar M, Wong YL, Wong WF, Hamdi OA, Kadir NA, Looi CY
    J Food Sci, 2013 Dec;78(12):T1940-7.
    PMID: 24279333 DOI: 10.1111/1750-3841.12313
    Edible bird nests (EBNs) are important ethnomedicinal commodity in the Chinese community. Recently, But and others showed that the white EBNs could turn red by vapors from sodium nitrite (NaNO2) in acidic condition or from bird soil, but this color-changing agent remained elusive. The aim of this study was to determine the prevalence of nitrite and nitrate contents and its affects on EBN's color. EBNs were collected from swiftlet houses or caves in Southeast Asia. White EBNs were exposed to vapor from NaNO2 in 2% HCl, or bird soil. The levels of nitrite (NO2-) and nitrate (NO3-) in EBNs were determined through ion chromatography analysis. Vapors from NaNO2 in 2% HCl or bird soil stained white bird nests to brown/red colors, which correlated with increase nitrite and nitrate levels. Moreover, naturally formed cave-EBNs (darker in color) also contained higher nitrite and nitrate levels compared to white house-EBNs, suggesting a relationship between nitrite and nitrate with EBN's color. Of note, we detected no presence of hemoglobin in red "blood" nest. Using infrared spectra analysis, we demonstrated that red/brown cave-EBNs contained higher intensities of C-N and N-O bonds compared to white house-EBNs. Together, our study suggested that the color of EBNs was associated with the prevalence of the nitrite and nitrate contents.
  6. Iberahim S, Aizuddin MJ, Kadir NA, Rameli N, Adzahar S, Noor NHM, et al.
    Oman Med J, 2020 Nov;35(6):e206.
    PMID: 33335745 DOI: 10.5001/omj.2020.135
    The majority of hemolytic disease of the fetus and newborn (HDFN) reported in the literature is due to ABO and rhesus incompatibility. However, there are also other minor blood groups that have been identified as a cause of HDFN, although the occurrence is much rarer. The antibody screening program for D negative mother and the anti-D immunoglobulin treatment showed a significant reduction of the occurrence of HDFN secondary to anti-D. In a developed country, the screening for red blood cell antibody in the pregnant mother other than anti-D reduced the possibility of HDFN occurrence hence reduced the fetal morbidity and subsequently increased the fetal well being during pregnancy and after the postnatal period. In this case report, we discuss HDFN in a primigravida patient secondary to multiple alloantibodies (anti-Jka and anti-E). The baby developed jaundice with bilirubin levels approaching the exchange transfusion level. However, with extensive phototherapy and immunoglobulin treatment, the child did not require exchange transfusion. We also included the importance of the routine antenatal antibody screening program. This practice will help the transfusion center to find the antigen negative blood in a timely manner and reduce the morbidities and mortalities of HDFN among the newborns.
  7. Abd Kadir NA, Azzeri A, Jaafar H, Mohd Noor MI, Kefeli Z
    JMIR Res Protoc, 2024 Jan 29;13:e51851.
    PMID: 38285500 DOI: 10.2196/51851
    BACKGROUND: Protected areas are crucial for the maintenance of human health and well-being. They aim to preserve biodiversity and natural resources to secure various ecosystem services that are beneficial to human health. Their ecological characteristics can influence local health literacy. Typically, communities surrounding protected areas have limited economic opportunities due to restriction policies to protect the ecosystem, resulting in socioeconomic disparities. The local community faces obstacles in gaining access to health care facilities and health information due to these limitations. It is difficult for them to locate, comprehend, and apply information and services to make better health-related decisions for themselves and others.

    OBJECTIVE: This study protocol examines the impact of the ecosystem on health literacy among rural communities in protected areas.

    METHODS: This study comprises 5 phases. In phase 1, we conduct a systematic review to identify the issue of health literacy in protected areas. In phase 2, we will collect data from stakeholders in a protected area of Pahang National Park and analyze the results using Net-Map analysis. In phase 3, we will conduct a survey among the adult community in Pahang National Park related to health literacy, socioeconomic status, health expenditure, and quality of life. In phase 4, informed by the results of the survey, we will determine suitable intervention programs to improve health literacy through a focus group discussion. Finally, in phase 5, we will conduct a costing analysis to analyze which intervention program is the most cost-effective.

    RESULTS: This study was funded by Universiti Sains Islam Malaysia (USIM) and strategic research partnership grants, and enrollment is ongoing. The first results are expected to be submitted for publication in 2024.

    CONCLUSIONS: This is one of the first studies to explore health literacy among rural communities in protected areas and will provide the first insights into the overall level of health literacy in the protected community, potential determinants, and a suitable intervention program with expected cost analysis. The results can be used to promote health literacy in other protected areas and populations.

    TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number Registry ISRCTN40626062; http://tinyurl.com/4kjxuwk5.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51851.

  8. Tok PSK, Liew SM, Wong LP, Razali A, Loganathan T, Chinna K, et al.
    PLoS One, 2020;15(4):e0231986.
    PMID: 32320443 DOI: 10.1371/journal.pone.0231986
    INTRODUCTION: The monitoring of tuberculosis (TB) treatment outcomes and examination of the factors affecting these outcomes are important for evaluation and feedback of the national TB control program. This study aims to assess the TB treatment outcomes among patients registered in the national TB surveillance database in Malaysia from 2014 until 2017 and identify factors associated with unsuccessful treatment outcomes and all-cause mortality.

    MATERIALS AND METHODS: Using registry-based secondary data, a retrospective cohort study was conducted. TB patients' sociodemographic characteristics, clinical disease data and treatment outcomes at one-year surveillance were extracted from the database and analyzed. Logistic regression analysis was used to determine factors associated with unsuccessful treatment outcomes and all-cause mortality.

    RESULTS: A total of 97,505 TB cases (64.3% males) were included in this study. TB treatment success (cases categorized as cured and completed treatment) was observed in 80.7% of the patients. Among the 19.3% patients with unsuccessful treatment outcomes, 10.2% died, 5.3% were lost to follow-up, 3.6% had outcomes not evaluated while the remaining failed treatment. Unsuccessful TB treatment outcomes were found to be associated with older age, males, foreign nationality, urban dwellers, lower education levels, passive detection of TB cases, absence of bacille Calmette-Guerin (BCG) scar, underlying diabetes mellitus, smoking, extrapulmonary TB, history of previous TB treatment, advanced chest radiography findings and human immunodeficiency virus (HIV) infection. Factors found associated with all-cause mortality were similar except for nationality (higher among Malaysians) and place of residence (higher among rural dwellers), while smoking and history of previous TB treatment were not found to be associated with all-cause mortality.

    CONCLUSIONS: This study identified various sociodemographic characteristics and TB disease-related variables which were associated with unsuccessful TB treatment outcomes and mortality; these can be used to guide measures for risk assessment and stratification of TB patients in future.

  9. Abd Kadir NA, Azzeri A, Mohd Noor MI, Kefeli Z, Abdullah MF, Ramlee MNA, et al.
    Medicine (Baltimore), 2023 Apr 25;102(17):e33590.
    PMID: 37115076 DOI: 10.1097/MD.0000000000033590
    BACKGROUND: Adequate health literacy is necessary for individuals as it enables them to readily acquire information, process it, and apply it to health-related decisions. Various factors including geographical area will determine the disparity in health literacy status. Communities living in protected areas have limited health literacy and health status owing to a lack of access to infrastructure and medical facilities. Existing studies have discussed health literacy among various populations disproportionately affected by certain diseases. However, research remains underdeveloped, and the causal factors are largely untested. This research aims to better understand how population living conditions especially those who are living in protected areas are affected and exposed to limited health literacy.

    METHOD: This study will comprehensively review full-text papers published between 2013 and 2023. We will search 3 databases, PubMed, SCOPUS, and Web of Science, using the keyword search strategy to find articles related to the issue. Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used to guide the selection of relevant studies. The results will then be assessed using the standard Cochrane Quality assessment method. The outcome is addressed in light of a narrative synthesis that utilizes a theme category and focuses on each component's main conclusions.

    RESULT: This protocol describes the planned scope and methodology for the systematic review and meta-analysis that will provide current evidence on; The status of health literacy among the community in protected areas and; The effect of Protected Areas on health literacy according to their types and characteristics.

    CONCLUSION: Meta-analysis of low-to-high health literacy status will benefit the development of policy recommendations for protected areas.

  10. Azlan A, Khoo HE, Sajak AAB, Aizan Abdul Kadir NA, Yusof BNM, Mahmood Z, et al.
    Food Sci Nutr, 2020 Sep;8(9):5048-5062.
    PMID: 32994965 DOI: 10.1002/fsn3.1803
    Minimally refined brown sugar (MRBS) is a brown sugar derived from sugarcane that has a low glycemic index. This study aimed to determine and compare the antioxidant contents and nutritional and physicochemical properties of MRBS, refined sugar (RS), and brown sugar (BS). In addition, the toxicity of these sugars was evaluated via in vitro cytotoxicity method and by using a zebrafish model. Results showed that MRBS was better than the two other sugars because it has a lower moisture content and higher ash content. The contents of potassium and manganese of MRBS were higher than those of the two other sugars. Surprisingly, MRBS also contained selenium, which was not detected in RS and BS. The major phenolics in MRBS are 4-hydroxybenzoic acid, chlorogenic acid, protocatechuic acid, trans-Ferulic acid, and apigenin. All sugar solutions and their antioxidant-containing extracts were not cytotoxic to 3T3-L1 adipocytes.
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