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Effect of age, weight, race and sex on blood pressure and erythrocyte sodium pump characteristics

Adeeb N, Ton SH, Muslim N

Clin Exp Hypertens A, 1990;12(6):1115-34.
PMID: 2173984

In order to examine whether erythrocyte membrane handling of sodium is influenced by factors other than hypertension, measurements of red cell sodium transport were studied in one hundred normotensive volunteers. Erythrocyte sodium content was found to increase with increasing age, body weight and mean arterial pressure (MAP). It is also significantly correlated with age, body weight and MAP. Total sodium efflux was found to be reduced and negatively correlated with age and body weight. A reduction in ouabain-sensitive sodium efflux was also observed with increasing age and body weight. In males, the rate of ouabain-sensitive sodium efflux is higher than in females. Race was found to have no effect on erythrocyte electrolyte content and cationic flux rates of subjects. These data suggest that when studies in hypertension are going to be carried out, control subjects carefully matched for age, body weight and sex should be used if confounding results are not to be obtained.
Electrolyte profile of Malaysian mothers' milk

Alaudeen S, Muslim N, Faridah K, Azman A, Arshat H

Malays J Reprod Health, 1988 Dec;6(2):102-7.
PMID: 12342169

PIP: The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's).
Fulltext Determination of mineral, parathyroid hormone, and 6-keto-prostaglandin-F1 alpha levels in pregnant women with hypertension and pre-eclampsia

Sulaiman S, Adeeb N, Muslim N, Adeeb N, Ho CM

Singapore Med J, 1995 Dec;36(6):637-40.
PMID: 8781637

Determinations of total calcium, total magnesium, calcium ion, parathyroid hormone and 6-keto-prostaglandin-F1 alpha levels were carried out on 84 blood samples from 4 groups of women categorised as non-pregnant normotensive (NNP), pregnant normotensive (NP), pregnancy-induced hypertension (PIH) and pre-eclampsia (PE). PIH was clinically diagnosed when the diastolic pressure was more than 90 mmHg and was only hypertensive during pregnancy while PE was with additional proteinuria after 20 weeks of gestation. Compared to NNP women, total calcium and parathyroid hormone levels were of lower levels (p < 0.05) in NP women while in PIH women, total calcium and 6-keto-prostaglandin-F1 alpha levels were also lowered (p < 0.05). Compared to NNP women, PE women's levels of total calcium, calcium ion and 6-keto-prostaglandin-F1 alpha decreased (p < 0.05) while parathyroid hormone level increased (p < 0.05). When compared to the NP women, PE women had decreased levels (p < 0.05) of total calcium as well as calcium ion and increased level (p < 0.05) of parathyroid hormone. Calcium ion was found to be negatively correlated (NNP : r = -0.883, p = 0.008/NP : r = -0.931, p = 0.000) while parathyroid hormone was positively correlated (NNP : r = 0.904, p = 0.013/NP : r = 0.913, p = 0.000) with mean arterial pressure.
alpha-Tocopherol increased nitric oxide synthase activity in blood vessels of spontaneously hypertensive rats

Newaz MA, Nawal NN, Rohaizan CH, Muslim N, Gapor A

Am J Hypertens, 1999 Aug;12(8 Pt 1):839-44.
PMID: 10480480

Antioxidant protection provided by different doses of alpha-tocopherol was compared by determining nitric oxide synthase (NOS) activity in blood vessels of spontaneously hypertensive rats (SHR) treated with alpha-tocopherol. SHR were divided into four groups namely hypertensive control (C), treatment with 17 mg of alpha-tocopherol/kg diet (alpha1), 34 mg of alpha-tocopherol/kg diet (alpha2), and 170 mg of alpha-tocopherol/kg diet (alpha3). Wister Kyoto (WKY) rats were used as normal control (N). Blood pressure were recorded from the tail by physiography every other night for the duration of the study period of 3 months. At the end of the trial, animals were sacrificed. The NOS activity in blood vessels was measured by [3H]arginine radioactive assay and the nitrite concentration in plasma by spectrophotometry at wavelength 554 nm using Greiss reagent. Analysis of data was done using Student's t test and Pearson's correlation. The computer program Statistica was used for all analysis. Results of our study showed that for all the three alpha-tocopherol-treated groups, blood pressure was significantly (P < .001) reduced compared to the hypertensive control and maximum reduction of blood pressure was shown by the dosage of 34 mg of alpha-tocopherol/kg diet (C: 209.56 +/- 8.47 mm Hg; alpha2: 128.83 +/- 17.13 mm Hg). Also, NOS activity in blood vessels of SHR was significantly lower than WKY rats (N: 1.54 +/- 0.26 pmol/mg protein, C: 0.87 +/- 0.23 pmol/mg protein; P < .001). Although alpha-tocopherol in doses of alpha1, alpha2, and alpha3 increased the NOS activity in blood vessels, after treatment only that of alpha2 showed a statistical significance (P < .01). Plasma nitrite concentration was significantly reduced in SHR compared to normal WKY rats (N: 54.62 +/- 2.96 mol/mL, C: 26.24 +/- 2.14 mol/mL; P < .001) and accordingly all three groups showed significant improvement in their respective nitrite level (P < .001). For all groups, NOS activity and nitrite level showed negative correlation with blood pressure. It was significant for NOS activity in hypertensive control (r = -0.735, P = .038), alpha1 (r = -0.833, P = .001), and alpha2 (r = -0.899, P = .000) groups. For plasma nitrite, significant correlation was observed only in group alpha1 (r = -0.673, P = .016) and alpha2 (r = -0.643, P = .024). Only the alpha2 group showed significant positive correlation (r = 0.777, P = .003) between NOS activity and nitrite level. In conclusion it was found that compared to WKY rats, SHR have lower NOS activity in blood vessels, which upon treatment with antioxidant alpha-tocopherol increased the NOS activity and concomitantly reduced the blood pressure. There was correlation of lipid peroxide in blood vessels with NOS and nitric oxide, which implies that free radicals may be involved in the pathogenesis of hypertension.
Uric acid, xanthine oxidase and other risk factors of hypertension in normotensive subjects

Newaz MA, Adeeb NN, Muslim N, Razak TA, Htut NN

Clin Exp Hypertens, 1996 Nov;18(8):1035-50.
PMID: 8922344

Uric acid produced by xanthine oxidase (also a source of superoxide radicals) has been known to increase in hypertensive patients. In this study we evaluated the possible involvement of uric acid and xanthine oxidase in the pathogenesis of hypertension by examining their association with mean arterial pressure (MAP) and factors related to blood pressure. These factors include age, quetelet index (weight/height2), cholesterol, creatinine, calcium (Ca), magnesium (Mg), sodium (Na), potassium (K) and urea. Fifty Two (male-19, female-33) normal healthy individuals were studied. Correlation studies of demographic variables showed that age was positively correlated with MAP [r = 0.309, p = 0.026] and cholesterol [r = 0.503, p = 0.000] while quetelet index was positively correlated with age [r = 422, p = 0.000] MAP [r = 0.331, p = 0.016] and xanthine oxidase [r = 0.331, p = 0.016]. MAP was positively correlated with uric acid [r = 0.511, p = 0.000], cholesterol [r = 0.492, p = 0.000] and xanthine oxidase enzyme activity [r = 0.388, p = 0.004] and negatively correlated with plasma calcium [r = 0.603, p = 0.000]. Correlation studies of measured parameters with uric acid and xanthine oxidase showed that uric acid was positively correlated with creatinine [r = 0.627, p = 0.000], plasma magnesium [r 0.442, p = 0.001] and negatively correlated with plasma calcium [r = 0.546, p = 0.000] while xanthine oxidase was negatively correlated with plasma calcium [r = -0.404, p = 0.003] and plasma sodium [r = -0.288, p = 0.038]. Stepwise multiple regression with MAP as dependent variable showed that 65% of total variability of blood pressure can be accounted for by plasma calcium, cholesterol, creatinine, plasma K, plasma Na, uric acid and xanthine oxidase in order of increasing R2 [xanthine oxidase: T-value = 3.26, R2 = 0.653]. It can be concluded that in normotensive subjects, uric acid and xanthine oxidase have significant association with blood pressure and thus are one of the many factors which are involved in the cause or effect of hypertension.
Fulltext The Mediating Effect of Model-Based Learning on Attitude and Pain Management Awareness Among Nurses During COVID 19 Pandemic in Saudi Arabia

Issa MR, Awanis Muslim N, Mat Sharif Z

SAGE Open Nurs, 2021 12 09;7:23779608211065213.
PMID: 35155775 DOI: 10.1177/23779608211065213

Background: All hospitals are required to provide high-quality pain management; one of the most critical issues in achieving high-quality pain management is that the hospitals have a clear plan to manage the patients' pain and improve the nurses' awareness of pain management during the COVID 19 pandemic. However, there is a significant gap in the literature that this study can cover.
Aim: This study aimed to investigate the mediating effect of model-based learning on nurses' attitudes toward nurses' pain management awareness during the COVID 19 pandemic in Saudi Arabia government hospitals.
Method: The Heath Beliefs Model was used, with a quasi-experimental design, with per experimental one group pre-test post-test design, and a quantitative approach using self-administered questionnaires obtained from 330 nurses working with patients suffering from pain. IBM SPSS V23 and Analysis of Moment Structures (AMOS)V23 were applied to analyze the causal relationships between the variables.
Results: A two-step approach to analyze the study: the first step was to test the measurement models' constructs' reliability and validity. The second step was to test research hypotheses in the structural models. The results show a significant positive relationship between model-based learning and pain management awareness among nurses during COVID 19 pandemic. Furthermore, model-based learning fully mediated the relationship between nurses' attitudes and pain management awareness.
Conclusions: The study successfully improved nurses' attitudes toward pain management awareness among nurses during COVID 19 pandemic. These findings will help strengthen the debate in the existing literature, and this is a new development window in the pain management area.