Displaying publications 1 - 20 of 38 in total

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  1. Jaafar MHM, Hamid KA
    Curr Drug Deliv, 2019;16(7):672-686.
    PMID: 31250754 DOI: 10.2174/1567201816666190620110748
    BACKGROUND: In this study, four nanoparticle formulations (F1 to F4) comprising varying ratios of alginate, Pluronic F-68 and calcium chloride with a constant amount of insulin and chitosan as a coating material were prepared using polyelectrolyte complexation and ionotropic gelation methods to protect insulin against enzymatic degradation.

    METHODS: This study describes the formulation design, optimisation, characterisation and evaluation of insulin concentration via oral delivery in rats. A reversed-phase high-performance liquid chromatography (HPLC) method was developed and validated to quantify insulin concentration in rat plasma. The proposed method produced a linear response over the concentration range of 0.39 to 50 µg/ml.

    RESULTS: In vitro release study showed that dissolution of insulin in simulated gastric juice of pH 1.2 was prevented by alginate core and chitosan coating but rapidly released in simulated intestinal fluid (pH 6.8). Additionally, Formulation 3 (F3) has a particle size of 340.40 ± 2.39 nm with narrow uniformity exhibiting encapsulation efficiency (EE) of 72.78 ± 1.25 % produced highest absorption profile of insulin with a bioavailability of 40.23 ±1.29% and reduced blood glucose after its oral administration in rats.

    CONCLUSION: In conclusion, insulin oral delivery system containing alginate and chitosan as a coating material has the ability to protect the insulin from enzymatic degradation thus enhance its absorption in the intestine. However, more work should be done for instance to involve human study to materialise this delivery system for human use.

  2. Abdul-Aziz MH, Lipman J, Roberts JA
    Curr. Opin. Infect. Dis., 2017 Apr;30(2):231-239.
    PMID: 28030371 DOI: 10.1097/QCO.0000000000000348
    PURPOSE OF REVIEW: Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens.

    RECENT FINDINGS: Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections. Antibiotic dosing can be guided by plasma drug concentrations, which do not reflect the concentrations at the site of infection. The application of aggressive dosing regimens, in accordance to the antibiotic's pharmacokinetic/pharmacodynamic characteristics, may be required to ensure rapid and effective drug exposure in infected lung tissues.

    SUMMARY: Conventional antibiotic dosing increases the likelihood of therapeutic failure in critically ill patients with nosocomial pneumonia. Alternative dosing strategies, which exploit the pharmacokinetic/pharmacodynamic properties of an antibiotic, should be strongly considered to ensure optimal antibiotic exposure and better therapeutic outcomes in these patients.

  3. Sulaiman H, Abdul-Aziz MH, Roberts JA
    Semin Respir Crit Care Med, 2017 06;38(3):271-286.
    PMID: 28578552 DOI: 10.1055/s-0037-1602716
    Hospital-acquired pneumonia and ventilator-associated pneumonia continue to cause significant morbidity and mortality. With increasing rates of antimicrobial resistance, the importance of optimizing antibiotic treatment is key to maximize treatment outcomes. This is especially important in critically ill patients in intensive care units, in whom the infection is usually caused by less susceptible organisms. In addition, the marked physiological changes that can occur in these patients can cause serious changes in antibiotic pharmacokinetics which in turn alter the attainment of therapeutic drug exposures. This article reviews the various aspects of the pharmacokinetic changes that can occur in the critically ill patients, the barriers to achieving therapeutic drug exposures in pneumonia for systemically delivered antibiotics, the optimization for commonly used antibiotics in hospital- and ventilator-associated pneumonia, the agents that should be avoided in the treatment regimen, as well as the use of adjunctive therapy in the form of nebulized antibiotics.
  4. Sulaiman H, Roberts JA, Abdul-Aziz MH
    Farm Hosp, 2022 Mar 26;46(3):182-190.
    PMID: 36183212
    Optimal antibiotic therapy for critically ill patients can be complicated bythe altered physiology associated with critical illness. Antibiotic pharmacokineticsand exposures can be altered driven by the underlying critical illnessand medical interventions that critically ill patients receive in the intensivecare unit. Furthermore, pathogens that are usually isolated in the intensivecare unit are commonly less susceptible and "resistant" to common antibiotics.Indeed, antibiotic dosing that does not consider these unique differenceswill likely fail leading to poor clinical outcomes and the emergenceof antibiotic resistance in the intensive care unit. The aims of this narrativereview were to describe the pharmacokinetics of beta-lactam antibiotics incritically ill patients, to highlight pharmacokinetic/pharmacodynamic targetsfor both non-critically ill and critically ill patients, and to discuss importantstrategies that can be undertaken to optimize beta-lactam antibiotic dosingfor critically ill patients in the intensive care unit.
  5. Cheng V, Abdul-Aziz MH, Roberts JA, Shekar K
    Expert Opin Drug Metab Toxicol, 2019 Feb;15(2):103-112.
    PMID: 30582435 DOI: 10.1080/17425255.2019.1563596
    INTRODUCTION: One major challenge to achieving optimal patient outcome in extracorporeal membrane oxygenation (ECMO) is the development of effective dosing strategies in this critically ill patient population. Suboptimal drug dosing impacts on patient outcome as patients on ECMO often require reversal of the underlying pathology with effective pharmacotherapy in order to be liberated of the life-support device. Areas covered: This article provides a concise review of the effective use of antibiotics, analgesics, and sedative by characterizing the specific changes in PK secondary to the introduction of the ECMO support. We also discuss the barriers to achieving optimal pharmacotherapy in patients on ECMO and also the current and potential research that can be undertaken to address these clinical challenges. Expert opinion: Decreased bioavailability due to sequestration of drugs in the ECMO circuit and ECMO induced PK alterations are both significant barriers to optimal drug dosing. Evidence-based drug choices may minimize sequestration in the circuit and would enable safety and efficacy to be maintained. More work to characterize ECMO related pharmacodynamic alterations such as effects of ECMO on hepatic cytochrome system are still needed. Novel techniques to increase target site concentrations should also be explored.
  6. Mah HY, Ishak WS, Abd Rahman MH
    Geriatr Gerontol Int, 2020 Oct;20(10):911-916.
    PMID: 32820857 DOI: 10.1111/ggi.14011
    The present study aimed to examine the prevalence of dual sensory impairment, and to identify its risk factors among community-dwelling older adults in Selangor.

    METHODS: Secondary analysis was carried out on data collected by the Grand Challenge Project among older adults aged ≥65 years from Selangor. Data on sociodemographic information, medical history, cognitive function and functional performance were obtained through face-to-face interviews using standardized questionnaires. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart while hearing was assessed using pure-tone audiometry. Descriptive analysis was used to measure the prevalence of the impairments, and logistic regression analysis was used to identify the risk factors.

    RESULTS: The prevalence of dual sensory impairment and hearing impairment were at 10.5% and 76.2% respectively. Multivariate logistic regression analysis revealed that participants with lower cognitive scores were associated with dual sensory impairment (odds ratio, 0.90; 95% confidence interval, 0.83-0.98), while smoking was found associated with hearing impairment (odds ratio, 6.58; 95% confidence interval, 1.51-28.65).

    CONCLUSION: Dual sensory impairment is common among older adults in Selangor. The association between dual sensory impairment and cognitive function suggests the need to have visual and hearing screening on older adults for early detection particularly those at risk of cognitive impairment. The prevalence of hearing impairment was reported high among older adults and smokers appeared to be at higher risk of the impairment. Geriatr Gerontol Int 2020; 20: 911-916.

  7. Mustafa MA, Fauzi MH, Wahab SFA
    Ann Emerg Med, 2020 06;75(6):776-794.
    PMID: 32471577 DOI: 10.1016/j.annemergmed.2019.12.004
  8. Samad AH, Usul MH, Zakaria D, Ismail R, Tasset-Tisseau A, Baron-Papillon F, et al.
    J Occup Health, 2006 Jan;48(1):1-10.
    PMID: 16484757
    This study was designed to evaluate the health and economic benefits of a workplace vaccination programme against influenza funded by the employer. Employees of a Malaysian petrochemical plant volunteered to take part in this prospective, non-randomised, non-placebo-controlled study. Demographic and health information, including influenza-like symptoms, sick leave and post-vaccination adverse events were collected via questionnaires. Cost-benefit analyses were performed from the employer's perspective.

    RESULTS: A total of 1,022 employees took part in the study, with 504 choosing to be vaccinated against influenza, and 518 remaining unvaccinated. The rate of influenza-like illness (ILI) was lower among vaccinated (8.13%) than non-vaccinated subjects (30.31%). Fever and respiratory symptoms were associated with all ILI cases. ILI-related sick leave was taken by 58.54% of vaccinated employees with ILI and 71.34% of non-vaccinated employees with ILI. Vaccination was financially beneficial, with the employer saving up to US dollar 53.00 per vaccinated employee when labour costs only were considered. Savings rose to up to US dollar 899.70 when the operating income of each employee was also considered. Workplace vaccination of healthy adults against influenza had a clear impact on ILI rates, absenteeism and reduced productivity in this Malaysian company. The health benefits translated into financial benefits for the employer, with cost savings significantly outweighting the costs of the vaccination programme.
  9. Mustafa MA, Fauzi MH, Abu Bakar MA, Mohd Noor N, Mohamed Hussain M
    Ann Emerg Med, 2020 Sep;76(3):362-378.
    PMID: 32828330 DOI: 10.1016/j.annemergmed.2020.03.024
  10. Sohaimi NM, Bejo MH, Omar AR, Ideris A, Isa NM
    J Vet Sci, 2018 Nov 30;19(6):759-770.
    PMID: 30173491 DOI: 10.4142/jvs.2018.19.6.759
    Fowl adenovirus (FAdV) is distributed worldwide and causes economic losses in the poultry industry. The objectives of this study were to determine the hexon and fiber gene changes in an attenuated FAdV isolate from Malaysia in specific pathogen-free chicken embryonated eggs (SPF CEE) and its infectivity in commercial broiler chickens. SPF CEE were inoculated with 0.1 mL FAdV inoculum via the chorioallantoic membrane (CAM) for 20 consecutive passages. The isolate at passage 20 (E20), with a virus titer of 108.7TCID50/mL (TCID50, 50% tissue culture infective dose), was inoculated (0.5 mL) into one-day-old commercial broiler chicks either via oral or intraperitoneal routes. The study demonstrated that 100% embryonic mortality was recorded from E2 to E20 with a delayed pattern at E17 onwards. The lesions were confined to the liver and CAM. Substitutions of amino acids in the L1 loop of hexon at positions 49 and 66, and in the knob of fiber at positions 318 and 322 were recorded in the E20 isolate. The isolate belongs to serotype 8b and is non-pathogenic to broiler chickens, but it is able to induce a FAdV antibody titer. It appears that molecular changes in the L1 loop of hexon and the knob of fiber are markers for FAdV infectivity.
  11. Hassan MA, Ahmad Farid MA, Shirai Y, Ariffin H, Othman MR, Samsudin MH, et al.
    Biotechnol J, 2019 Jun;14(6):e1800394.
    PMID: 30925022 DOI: 10.1002/biot.201800394
    Oil palm biomass is widely known for its potential as a renewable resource for various value-added products due to its lignocellulosic content and availability. Oil palm biomass biorefinery is an industry that comes with sociopolitical benefits through job opportunities, as well as potential environmental benefits. Many studies have been conducted on the technological advancements of oil-palm biomass-derived renewable materials, which are discussed comprehensively in this review. Recent technological developments have made it possible to bring new and innovative technologies to commercialization, such as compost, biocharcoal, biocomposites, and bioplastics.
  12. Mohd Ali MR, Mohamad Safiee AW, Yusof NY, Fauzi MH, Yean Yean C, Ismail N
    J Infect Public Health, 2017 12 23;11(4):578-580.
    PMID: 29277333 DOI: 10.1016/j.jiph.2017.12.008
    BACKGROUND: Environmental sampling provides important information that enhances the understanding of the leptospiral human-environment-animal relationship. Several studies have described the distribution of Leptospira in the environment. However, more targeted sites, that is, areas surrounding leptospirosis patients' houses, remain under-explored. Therefore, this study aims to detect the presence of Leptospira spp. in the residential areas of patients with leptospirosis.

    METHODS: Soil and water samples near leptospirosis patients' residences were collected, processed and cultured into EMJH media. Partial 16S rRNA gene sequencing was performed to confirm the identity of Leptospira.

    RESULTS: EMJH culture and partial 16S rRNA gene sequencing revealed predominant growth of pathogenic Leptospira kmetyi (17%, n=7/42). All tested locations had at least one Leptospira sp., mostly from the soil samples.

    CONCLUSION: More than one species of Leptospira may be present in a sampling area. The most common environmental isolates were pathogenic L. kmetyi.

  13. Zainuddin NH, Chee HY, Ahmad MZ, Mahdi MA, Abu Bakar MH, Yaacob MH
    J Biophotonics, 2018 08;11(8):e201700363.
    PMID: 29570957 DOI: 10.1002/jbio.201700363
    This paper presents the development of tapered optical fiber sensor to detect a specific Leptospira bacteria DNA. The bacteria causes Leptospirosis, a deadly disease but with common early flu-like symptoms. Optical single mode fiber (SMF) of 125 μm diameter is tapered to produce 12 μm waist diameter and 15 cm length. The novel DNA-based optical fiber sensor is functionalized by incubating the tapered region with sodium hydroxide (NaOH), (3-Aminopropyl) triethoxysilane and glutaraldehyde. Probe DNA is immobilized onto the tapered region and subsequently hybridized by its complementary DNA (cDNA). The transmission spectra of the DNA-based optical fiber sensor are measured in the 1500 to 1600 nm wavelength range. It is discovered that the shift of the wavelength in the SMF sensor is linearly proportional with the increase in the cDNA concentrations from 0.1 to 1.0 nM. The sensitivity of the sensor toward DNA is measured to be 1.2862 nm/nM and able to detect as low as 0.1 fM. The sensor indicates high specificity when only minimal shift is detected for non-cDNA testing. The developed sensor is able to distinguish between actual DNA of Leptospira serovars (Canicola and Copenhageni) against Clostridium difficile (control sample) at very low (femtomolar) target concentrations.
  14. Asari MA, Zulkaflee MH, Sirajudeen KNS, Mohd Yusof NA, Mohd Sairazi NS
    J Taibah Univ Med Sci, 2019 Aug;14(4):317-323.
    PMID: 31488962 DOI: 10.1016/j.jtumed.2019.06.004
    OBJECTIVES: The aim of the present study was to investigate the effects of Tualang honey (TH), DHA-rich fish oil, and their combination on the concentrations of selected pro-inflammatory cytokines in rat brains following exposure to chronic stress.

    METHODS: Fifty male Sprague-Dawley rats were divided into (i) control, (ii) stress-exposed, (iii) stress-exposed and treated with TH (1 g/kg body weight twice daily via oral gavage), (iv) stress-exposed and treated with DHA-rich fish oil (450 mg/kg body weight twice daily via oral gavage), and (v) stress-exposed and treated with a combination of TH and DHA-rich fish oil. The chronic stress regimen consisted of a combination of restraint stress and a swim stress test for 28 days. The concentrations of selected pro-inflammatory cytokines in brain homogenates (TNF-α, IL6, and IFN-γ) were measured by ELISA.

    RESULTS: The concentrations of TNF-α, IL6, and IFN-γ in brain homogenates from the DHA, TH, and TH + DHA-treated groups were significantly lower compared to the control and stress-only-exposed groups (p 

  15. Jawi ZM, Deros BM, Rashid AAA, Isa MHM, Awang A
    Sultan Qaboos Univ Med J, 2017 Aug;17(3):e277-e285.
    PMID: 29062549 DOI: 10.18295/squmj.2017.17.03.004
    This review article aimed to analyse existing literature regarding the roles and performance of professional driving instructors (PDIs) in novice driver education (DE). A systematic classification scheme was adopted to analyse identified articles to determine the study context of PDIs in novice DE, the competency level of PDIs in relation to experienced and learner drivers and the contributions of PDIs to the novice driver learning process. A total of 14 original research articles were identified, with no systematic reviews or meta-analyses available. Overall, all of the articles were found to be inadequate in providing an in-depth understanding of the roles and performance of PDIs in novice DE. There is an urgent need to improve current understanding of the roles of PDIs in novice DE and to work towards an internationally recognised PDI management approach.
  16. Pakri Mohamed RM, Mokhtar MH, Yap E, Hanim A, Abdul Wahab N, Jaffar FHF, et al.
    Front Neurosci, 2018;12:244.
    PMID: 29706864 DOI: 10.3389/fnins.2018.00244
    The long-term binge intake of ethanol causes neuroadaptive changes that lead to drinkers requiring higher amounts of ethanol to experience its effects. This neuroadaptation can be partly attributed to the modulation of numerous neurotransmitter receptors by the various protein kinases C (PKCs). PKCs are enzymes that control cellular activities by regulating other proteins via phosphorylation. Among the various isoforms of PKC, PKCε is the most implicated in ethanol-induced biochemical and behavioral changes. Ethanol exposure causes changes to PKCε expression and localization in various brain regions that mediate addiction-favoring plasticity. Ethanol works in conjunction with numerous upstream kinases and second messenger activators to affect cellular PKCε expression. Chauffeur proteins, such as receptors for activated C kinase (RACKs), cause the translocation of PKCε to aberrant sites and mediate ethanol-induced changes. In this article, we aim to review the following: the general structure and function of PKCε, ethanol-induced changes in PKCε expression, the regulation of ethanol-induced PKCε activities in DAG-dependent and DAG-independent environments, the mechanisms underlying PKCε-RACKε translocation in the presence of ethanol, and the existing literature on the role of PKCε in ethanol-induced neurobehavioral changes, with the goal of creating a working model upon which further research can build.
  17. Alrashdan MS, Arzmi MH, Ahmad Kamil WN, Al Kawas S, Leao JC
    Ital J Dermatol Venerol, 2023 Oct;158(5):408-418.
    PMID: 37916401 DOI: 10.23736/S2784-8671.23.07676-4
    The oral mucosa can be involved in a wide variety of mucocutaneous conditions that may present primarily in the mouth or affect other cutaneous or mucosal sites. Many of these conditions are immune mediated and typically present as inflammatory mucosal pathology. Patients experiencing such conditions usually seek medical evaluation and treatment due to the associated pain and discomfort and occasionally taste disturbance or dysphagia and the overall deterioration in the oral health-related quality of life. These conditions share some common features and there could be some overlapping in their clinical presentation, which can lead to delays in diagnosis and proper management of patients. Clinicians dealing with such disorders, including dermatologists, need to be aware of the oral manifestations of mucocutaneous conditions, their clinical features, underlying mechanisms, diagnostic approaches, and treatment options, as well as the recent advances in the research on these conditions. This review provides a comprehensive, evidence-based reference for clinicians, with updated insights into a group of immune mediated conditions known to cause oral mucosal pathology. Part one will cover oral lichen planus, erythema multiforme and systemic lupus erythematosus, while part two will cover pemphigus vulgaris and mucous membrane pemphigoid, recurrent aphthous stomatitis, in addition to the less common disorders linear IgA disease, dermatitis herpetiformis and epidermolysis bullosa.
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