Displaying publications 1 - 20 of 47 in total

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  1. Carboxymethyl cellulose wafers containing antimicrobials: a modern drug delivery system for wound infections
    Ng SF, Jumaat N
    Eur J Pharm Sci, 2014 Jan 23;51:173-9.
    PMID: 24076463 DOI: 10.1016/j.ejps.2013.09.015
    Lyophilised wafers have been shown to have potential as a modern dressing for mucosal wound healing. The wafer absorbs wound exudates and transforms into a gel, thus providing a moist environment which is essential for wound healing. The objective of this study was to develop a carboxymethyl cellulose wafer containing antimicrobials to promote wound healing and treat wound infection. The pre-formulation studies began with four polymers, sodium carboxymethyl cellulose (NaCMC), methylcellulose (MC), sodium alginate and xanthan gum, but only NaCMC and MC were chosen for further investigation. The wafers were characterised by physical assessments, solvent loss, microscopic examination, swelling and hydration properties, drug content uniformity, drug release and efficacy of antimicrobials. Three of the antimicrobials, neomycin trisulphate salt hydrate, sulphacetamide sodium and silver nitrate, were selected as model drugs. Among the formulations, NaCMC wafer containing neomycin trisulphate exhibited the most desirable wound dressing characteristics (i.e., flexibility, sponginess, uniform wafer texture, high content drug uniformity) with the highest in vitro drug release and the greatest inhibition against both Gram positive and Gram negative bacteria. In conclusion, we successfully developed a NaCMC lyophilised wafer containing antimicrobials, and this formulation has potential for use in mucosal wounds infected with bacteria.
  2. Development and in vitro assessment of alginate bilayer films containing the olive compound hydroxytyrosol as an alternative for topical chemotherapy
    Ng SF, Tan SL
    Int J Pharm, 2015 Nov 30;495(2):798-806.
    PMID: 26434999 DOI: 10.1016/j.ijpharm.2015.09.057
    Topical chemotherapy is the application of cancer drugs directly onto the skin, which has become a standard treatment for basal cell carcinoma. Due to the promising results in the treatment of skin cancer, topical chemotherapy has recently been applied to breast cancer patients because some breast cancer tissues are only superficial. Hydroxytyrosol, a phenolic compound from olives that is present in high amounts in Hidrox(®) olive extract, has been shown to have a protective effect on normal cells and selective antitumor activities on cancerous cells. The aims of the present study were to develop an alginate bilayer film containing Hidrox(®) and to investigate its potential use as a topical chemotherapeutic agent. Alginate films were characterized for swelling and for physical, thermal, rheological, and mechanical properties. Drug content uniformity and in vitro drug release tests were also investigated. The alginate bilayer films containing Hidrox(®), HB2, showed controlled release of hydroxytyrosol at a flux of 0.094±0.009 mg/cm(2)/h. The results of the cytotoxic assay showed that the HB2 films were dose-dependent and could significantly reduce the growth of breast cancer cells (MCF-7) at 150 μg/mL for a cell viability of 29.34±4.64%. In conclusion, an alginate bilayer film containing Hidrox(®) can be a potential alternative for topical chemotherapeutic agent for skin and breast cancer treatment.
  3. Gelatine enhances drug dispersion in alginate bilayer film via the formation of crystalline microaggregates
    Thu HE, Ng SF
    Int J Pharm, 2013 Sep 15;454(1):99-106.
    PMID: 23856162 DOI: 10.1016/j.ijpharm.2013.06.082
    In our previous study, a novel alginate-based bilayer film for slow-release wound dressings was successfully developed. We found that alginate alone yielded poor films; however, the addition of gelatine had significantly enhanced the drug dispersion as well as the physical properties. Here, an investigation of the drug-polymer interactions in the bilayer films was carried out. Drug content uniformity test and microscopy observation revealed that the addition of gelatine generated bilayer films with a homogenous drug distribution within the matrix. The FTIR and XRD data showed an increase in film crystallinity which might infer the presence of drug-polymer crystalline microaggregates in the films. DSC confirmed the drug-polymer interaction and indicated that the gelatine has no effect on the thermal behaviour of the microaggregates, suggesting the compatibility of the drug and excipients in the bilayer films. In conclusion, the addition of gelatine can promote homogenous dispersion of hydrophobic drugs in alginate films possibly through the formation of crystalline microaggregates.
  4. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections
    Ng SF, Leow HL
    Drug Dev Ind Pharm, 2015;41(11):1902-9.
    PMID: 25758412 DOI: 10.3109/03639045.2015.1019888
    It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection.
  5. Alginate based bilayer hydrocolloid films as potential slow-release modern wound dressing
    Thu HE, Zulfakar MH, Ng SF
    Int J Pharm, 2012 Sep 15;434(1-2):375-83.
    PMID: 22643226 DOI: 10.1016/j.ijpharm.2012.05.044
    The aims of this research were to develop a novel bilayer hydrocolloid film based on alginate and to investigate its potential as slow-release wound healing vehicle. The bilayer is composed of an upper layer impregnated with model drug (ibuprofen) and a drug-free lower layer, which acted as a rate-controlling membrane. The thickness uniformity, solvent loss, moisture vapour transmission rate (MVTR), hydration rate, morphology, rheology, mechanical properties, in vitro drug release and in vivo wound healing profiles were investigated. A smooth bilayer film with two homogenous distinct layers was produced. The characterisation results showed that bilayer has superior mechanical and rheological properties than the single layer films. The bilayers also showed low MVTR, slower hydration rate and lower drug flux in vitro compared to single layer inferring that bilayer may be useful for treating low suppurating wounds and suitable for slow release application on wound surfaces. The bilayers also provided a significant higher healing rate in vivo, with well-formed epidermis with faster granulation tissue formation when compared to the controls. In conclusions, a novel alginate-based bilayer hydrocolloid film was developed and results suggested that they can be exploited as slow-release wound dressings.
  6. Life cycle assessment of environmental impacts associated with oxidative desulfurization of diesel fuels catalyzed by metal-free reduced graphene oxide
    Lin S, Ng SF, Ong WJ
    Environ Pollut, 2021 Nov 01;288:117677.
    PMID: 34273765 DOI: 10.1016/j.envpol.2021.117677
    This study aimed to analyze the environmental impacts of the oxidative desulfurization (ODS) process catalyzed by metal-free reduced graphene oxide (rGO) through life cycle assessment (LCA). The environmental impacts study containing the rGO production process, the ODS process, the comparison of different oxidants and solvents was developed. This study was performed by using ReCiPe 2016 V1.03 Hierarchist midpoint as well as endpoint approach and SimaPro software. For the production of 1 kg rGO, the results showed that hydrochloric acid (washing), sulfuric acid (mixing), hydrazine (reduction) and electricity were four main contributors in this process, and this process showed a significant impact on human health 14.21 Pt followed by ecosystem 0.845 Pt and resources 0.164 Pt. For the production of 1 kg desulfurized oil (400 ppm), main environmental impacts were terrestrial ecotoxicity (43.256 kg 1,4-DCB), global warming (41.058 kg CO2), human non-carcinogenic toxicity (19.570 kg 1,4-DCB) and fossil resource scarcity (13.178 kg oil), and the main contributors were electricity, diesel oil and acetonitrile. The whole ODS process also showed a greatest effect on human health. For two common oxidants hydrogen peroxide and oxygen used in ODS, hydrogen peroxide showed a greater impact than oxygen. On the other hand, for three common solvents employed in ODS, N-methyl-2-pyrrolidone had a more serious impact on human health followed by acetonitrile and N,N-dimethylformamide. As such, LCA results demonstrated the detailed environmental impacts originated from the catalytic ODS, hence elucidating systematic guidance for its future development toward practicality.
  7. Simvastatin-loaded lyophilized wafers as a potential dressing for chronic wounds
    Rezvanian M, Tan CK, Ng SF
    Drug Dev Ind Pharm, 2016 Dec;42(12):2055-2062.
    PMID: 27237190
    Wafers are an established drug delivery system for application to suppurating wounds. They can absorb wound exudates and are converted into a gel, offering a moist environment that is vital for wound healing. Simvastatin-loaded lyophilized wafers were developed using sodium carboxymethyl cellulose (CMC) and methyl cellulose (MC) and evaluated for their potential in the management of chronic wounds. Simvastatin (SIM) was chosen as the model drug since it is known to accelerate wound healing by promoting angiogenesis and lymphangiogenesis. Pre-formulation studies were carried out with CMC, MC, and a mixture of CMC and MC. Wafers obtained from aqueous gels of 3% CMC and blend of CMC-MC in the % weight ratio of 2:1 and 1.5:1.5 were selected for further analysis. The formulated wafers were characterized by microscopic examination, texture analysis, hydration test, rheological studies, FTIR spectroscopy, water vapor transmission and drug release test. Among the selected formulations, simvastatin-loaded CMC-MC (2:1) wafers exhibited the most desired characteristics for wound dressing application, such as good flexibility, hardness, sponginess, and viscosity. It showed a sustained drug release, which is desirable in wound healing, and was more appropriate for suppurating wounds. In conclusion, simvastatin-loaded CMC-MC (2:1) wafers showing potential for wound dressing applications were successfully developed.
  8. Hydrogel-gauze dressing for moderate-to-severe atopic dermatitis: development and efficacy study on atopic dermatitis-like skin lesions in NC/Nga mice
    Ng SF, Lew PC, Sin YB
    Drug Dev Ind Pharm, 2014 Nov;40(11):1538-46.
    PMID: 24025072 DOI: 10.3109/03639045.2013.836214
    Topical emollients are known to provide symptomatic relief for atopic dermatitis. In hospitals, wet-wrap therapy has been shown to benefit children with moderate-to-severe atopic dermatitis (AD), but the application of wet-wraps is tedious and time-consuming. Topical emollients have low residence time and often dry out easily. The aim of this work was to develop a hydrogel-gauze dressing that is not only easy to apply but also rehydrates and traps moisture to provide longer relief for AD patients. In this study, a prototype hydrogel-gauze dressing was developed with varying ratios of sodium carboxymethylcellulose (NaCMC) and propylene glycol. The hydrogel-gauze dressings were assessed based on the moisture vapor transmission rate, moisture absorption, mechanical properties and storage stability over three months. Then, the efficacy of the hydrogel-gauze dressing was compared to topical emollients using transgenic NC/Nga mice with AD-like lesions. The NaCMC hydrogel-gauze dressings significantly lowered transepidermal water loss, and the animals displayed a faster recovery, which indicates that hydrogel-gauze dressings can trap moisture more effectively and accelerate AD healing. Hence, we propose that hydrogel-gauze dressings can potentially become an alternative to wet-wrap therapy due to the ease of application and the higher efficacy compared to topical products.
  9. Transdermal anti-inflammatory activity of bilayer film containing olive compound hydroxytyrosol: physical assessment, in vivo dermal safety and efficacy study in Freund's adjuvant-induced arthritic rat model
    Ng SF, Tan LS, Buang F
    Drug Dev Ind Pharm, 2017 Jan;43(1):108-119.
    PMID: 27588411 DOI: 10.1080/03639045.2016.1224893
    Previous studies have shown that hydroxytyrosol (HT) can be a potential alternative therapeutic agent for the treatment of rheumatoid arthritis (RA). However, HT is extensively metabolized following oral administration, which leads to formulating HT in a topical vehicle to prolong drug action as well as to provide a localized effect. Hidrox-6 is a freeze-dried powder derived from fresh olives and contains a high amount of HT (∼3%) and other polyphenols. Alginate bilayer films containing 5% and 10% Hidrox-6 were formulated. The films were characterized with respect to their physical, morphology, rheological properties; drug content uniformity; and in vitro drug release. Acute dermal irritancy tests and a skin sensitization study were carried out in rats. An efficacy study of the bilayer films for RA was conducted using Freund's adjuvant-induced polyarthritis rats. Animal data showed that the bilayer film formulations did not cause skin irritancy. The efficacy in vivo results showed that the Hidrox-6 bilayer films lowered the arthritic scores, paw and ankle circumference, serum IL-6 level and cumulative histological scores compared with those measured for controls. The topical Hidrox-6 bilayer films improve synovitis and inflammatory symptoms in RA and can be a potential alternative to oral RA therapy.
  10. Hydrogels Containing Antibiofilm and Antimicrobial Agents Beneficial for Biofilm-Associated Wound Infection: Formulation Characterizations and In vitro Study
    Anjum A, Sim CH, Ng SF
    AAPS PharmSciTech, 2018 Apr;19(3):1219-1230.
    PMID: 29280044 DOI: 10.1208/s12249-017-0937-4
    Bacterial biofilm which adheres onto wound surface is shown to be impervious to antibiotics and this in turn delays wound healing. Previous studies showed that antibiofilm agents such as xylitol and ethylenediaminetetraacetic acid (EDTA) prevent bacterial adherence onto surfaces. Formulation of a wound dressing containing antibiofilm agents may be a plausible strategy in breaking the biofilm on wound surfaces and at the same time increase the efficacy of the antibiotic. The purpose of this study was to develop hydrogel formulations containing antibiofilm agents along with antibiotic (gentamicin) for bacterial biofilm-associated wound infection. Sodium carboxymethyl cellulose (NaCMC) hydrogels loaded with antibiofilm agents and antibiotic were prepared. The hydrogels were characterized for their physical properties, rheology, Fourier transform infrared spectroscopy (FTIR), drug content uniformity, differential scanning calorimetry (DSC) and in vitro drug release study. The antibiofilm (Crystal Violet staining and XTT assay) and antibacterial performances of the hydrogels against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, and Escherichia coli were assessed in vitro. The formulated hydrogels showed adequate release of both antibiofilm agents (xylitol and EDTA). Both antimicrobial and antibiofilm tests showed promising results and demonstrated that the combination of xylitol, EDTA, and gentamicin had an additive effect against both Gram-positive and Gram-negative bacteria. In summary, NaCMC (sodium carboxymethyl cellulose) hydrogels containing the combination of antimicrobial and antibiofilm agents were successfully developed and this can be a new strategy in combating biofilm in wound infection which in turn accelerate wound healing.
  11. Moringa oleifera standardised aqueous leaf extract-loaded hydrocolloid film dressing: in vivo dermal safety and wound healing evaluation in STZ/HFD diabetic rat model
    Chin CY, Ng PY, Ng SF
    Drug Deliv Transl Res, 2019 04;9(2):453-468.
    PMID: 29560587 DOI: 10.1007/s13346-018-0510-z
    Previously, Moringa oleifera leaf (MOL) standardised aqueous extract-loaded films were successfully developed and they showed potential wound healing activity in vitro. The objective of this study was to evaluate in vivo dermal safety as well as wound healing efficacy of these MOL film dressings (containing 0.1, 0.5 and 1% MOL) on diabetic rat model. The acute dermal toxicity was carried out on healthy rats, and signs of toxicity over 14 days were observed. For wound healing studies, excision and abrasion wounds were created out on the STZ/HFD-induced diabetic rat model and the wound healing was studied over 21 days. The wound healing evaluation determined by histology staining, hydroxyproline assay and ELISA assays on wound healing related-growth factors, cytokines and chemokines. MOL film formulations exhibited no signs of dermal toxicities. In excision wound model, 0.5% film significantly enhanced the wound closure by 77.67 ± 7.28% at day 7 compared to control group. While in abrasion wounds, 0.5% MOL films accelerated wound closure significantly at 81 ± 4.5% as compared to the control. The histology findings and hydroxyproline assay revealed that high collagen deposition and complete re-epithelialisation were observed for the wounds treated with 0.5 and 1% MOL films. All MOL film dressings had successfully tested non-toxic via in vivo safety dermal toxicity. It was concluded that the 0.5% MOL extract-loaded film had proven to be the most promising approach to accelerate diabetic wound healing process in both full-thickness excision and partial thickness abrasion wounds on the HFD/STZ-induced diabetic type II model.
  12. Isotype heterojunction: tuning the heptazine/triazine phase of crystalline nitrogen-rich C3N5 towards multifunctional photocatalytic applications
    Ng SF, Foo JJ, Ong WJ
    Mater Horiz, 2024 Jan 22;11(2):408-418.
    PMID: 37791413 DOI: 10.1039/d3mh01115a
    Photocatalytic technology has been well studied as a means to achieve sustainable energy generation through water splitting or chemical synthesis. Recently, a low C/N atomic ratio carbon nitride allotrope, C3N5, has been found to be highly prospective due to its excellent electronic properties and ample N-active sites compared to g-C3N4. Tangentially, crystalline g-C3N4 has also been a prospective candidate due to its improved electron transport and extended π-conjugated system. For the first time, our group successfully employed a one-step molten salt calcination method to prepare novel N-rich crystalline C3N5 and elucidate the effect of calcination temperature on the heptazine/triazine phase. Calcination temperatures of 500 °C (CC3N5-500) and 550 °C (CC3N5-550) lead to crystalline carbon nitride with both heptazine and triazine phases, forming an intimate isotype heterojunction for robust interfacial charge separation. An excellent photocatalytic hydrogen evolution rate (359.97 μmol h-1; apparent quantum efficiency (AQE): 12.86% at 420 nm) was achieved using CC3N5-500, which was 15-fold higher than that of pristine C3N5. Furthermore, CC3N5-500 exhibited improved activity for simultaneous benzyl alcohol oxidation and hydrogen production, as well as H2O2 production (AQE: 9.49% at 420 nm), signifying its multitudinous photoredox capabilities. Moreover, the recyclability tests of the optimal CC3N5-500 on a 3D-printed substrate also showed a 92% performance retention after 4 cycles (16 h). This highlights that crystalline C3N5 significantly augmented the reaction performance for diverse multifunctional solar-driven applications. As such, these results serve as a guide toward the structural tuning of 2D metal-free carbon nanomaterials with tunable crystallinity toward achieving boosted photocatalysis.
  13. Development and physicochemical characterization of alginate composite film loaded with simvastatin as a potential wound dressing
    Rezvanian M, Amin MCIM, Ng SF
    Carbohydr Polym, 2016 Feb 10;137:295-304.
    PMID: 26686133 DOI: 10.1016/j.carbpol.2015.10.091
    Previously, studies have demonstrated that topical application of simvastatin can promote wound healing in diabetic mice via augmentation of angiogenesis and lymphangiogenesis. This study aimed to formulate and characterize simvastatin in alginate-based composite film wound dressings. Biopolymers used for composite films were sodium alginate blended with pectin or gelatin. The films were prepared and characterized based on their physical properties, surface morphology, mechanical strength and rheology. Then, in vitro drug releases from the films were investigated and, finally, the cell viability assay was performed to assess the cytotoxicity profile. From the pre-formulation studies, alginate/pectin composite film showed to possess desirable wound dressing properties and superior mechanical properties. The in vitro drug release profile revealed that alginate/pectin film produced a controlled release drug profile, and cell viability assay showed that the film was non-toxic. In summary, alginate/pectin composite film is suitable to be formulated with simvastatin as a potential wound dressing.
  14. Fulltext Topical Lyogel Containing Corticosteroid Decreases IgE Expression and Enhances the Therapeutic Efficacy Against Atopic Eczema
    Ng SF, Anuwi NA, Tengku-Ahmad TN
    AAPS PharmSciTech, 2015 Jun;16(3):656-63.
    PMID: 25511806 DOI: 10.1208/s12249-014-0248-y
    Hydrocortisone cream intended for atopic eczema often produces unwanted side effects after long-term use. These side effects are essentially due to repeated percutaneous administration of the medication for skin dermatitis, as atopic eczema is a relapsing disorder. Hence, there is a need to develop a new hydrocortisone formulation that will deliver the drug more effectively and require a reduced dosing frequency; therefore, the side effects could be minimized. In this study, a hydroxypropyl methylcellulose (HPMC) lyogel system based on 80% organic and 20% aqueous solvents containing 1% hydrocortisone was formulated. The hydrocortisone lyogel physicochemical characteristics, rheological properties, stability profile, and in vitro Franz cell drug release properties, as well as the in vivo therapeutic efficacies and dermal irritancy in Balb/c mice were investigated. The HPMC lyogel appeared clear and soft and was easy to rub on the skin. The lyogel also showed a higher drug release profile compared with commercial hydrocortisone cream. Similar to the cream, HPMC lyogels exhibited pseudoplastic behavior. From the mouse model, the hydrocortisone lyogel showed higher inflammatory suppressive effects than the cream. However, it did not reduce the transepidermal water loss as effectively as the control did. The dermal irritancy testing revealed that the hydrocortisone lyogel caused minimal irritation. In conclusion, HPMC lyogel is a promising vehicle to deliver hydrocortisone topically, as it showed a higher drug release in vitro as well as enhanced therapeutic efficacy in resolving eczematous inflammatory reaction compared with commercial cream.
  15. Fulltext Audit of newborn screening programme for congenital hypothyroidism
    Zarina AL, Rahmah R, Bador KM, Ng SF, Wu LL
    Med J Malaysia, 2008 Oct;63(4):325-8.
    PMID: 19385494 MyJurnal
    Newborn screening for congenital hypothyroidism (CH) was implemented in Hospital UKM in December 2004 using cord blood sample. From the audit over a period of 25 months, a total of 13,875 newborn babies were screened with a coverage of 98.8%. From this cohort, the mean recall rate was 0.32%; unfortunately the mean percentage of recalled babies that came for retesting was only 79.5%. In addition, the mean sample rejection rate was high, i.e. 2.2%. Two babies were diagnosed to have CH. These findings implied that whilst the coverage of screening was good, there is a need for regular surveillance of performance of both clinical and laboratory personnel. In addition, a more concerted effort should be carried out to promote community awareness of such a programme.
  16. Working memory and literacy as predictors of performance on algebraic word problems
    Lee K, Ng SF, Ng EL, Lim ZY
    J Exp Child Psychol, 2004 Oct;89(2):140-58.
    PMID: 15388303 DOI: 10.1016/j.jecp.2004.07.001
    Previous studies on individual differences in mathematical abilities have shown that working memory contributes to early arithmetic performance. In this study, we extended the investigation to algebraic word problem solving. A total of 151 10-year-olds were administered algebraic word problems and measures of working memory, intelligence quotient (IQ), and reading ability. Regression results were consistent with findings from the arithmetic literature showing that a literacy composite measure provided greater contribution than did executive function capacity. However, a series of path analyses showed that the overall contribution of executive function was comparable to that of literacy; the effect of executive function was mediated by that of literacy. Both the phonological loop and the visual spatial sketchpad failed to contribute directly; they contributed only indirectly by way of literacy and performance IQ, respectively.
  17. Identifying HIV/AIDS primary care development needs
    Foong AL, Ng SF, Lee CK
    J Adv Nurs, 2005 Apr;50(2):134-42.
    PMID: 15788077 DOI: 10.1111/j.1365-2648.2005.03372.x
    AIM: This paper reports a study aimed at identifying the primary health care experiences of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Malaysia. The rationale behind the study was to enable informed action for developing more responsive and effective primary care.
    BACKGROUND: Reports such as from the World Health Organisation forecast sharp escalations in the incidence of HIV/AIDS in Malaysia and the Asia-Pacific region within the next few years. With sparse information on the course of infection on the local population and an understanding of health care needs of those afflicted, health services would be ill-prepared for projected increases.
    METHOD: Semi-structured interviews were conducted with a convenience sample of 99 patients attending two major HIV/AIDS clinics in Malaysia.
    FINDINGS: Several gaps in care provision were highlighted, such as with treatment/consultation facilities and availability and accessibility of information. What is also evident is that there are a number of good support services available but not well publicized to those in need of them. That includes health professionals who could be making appropriate referrals. The lack of communications and inter-professional working appears to be part of the problem.
    CONCLUSION: The findings provide baseline data and preliminary insights to government and other service providers towards advancing, optimizing and refining existing policies and infrastructure. Although the availability of a number of primary care facilities have been identified, the study indicates the need for more effective co-ordinated efforts with clear leadership to pull together scarce resources towards the aim of some degree of seamless primary care provision. It is suggested that nurses would be well placed for such a role in view of the nature of their education and training that helps prepare them for the multi-faceted role.

    Study site: One is located
    in the main general hospital in the capital city of Kuala
    Lumpur, and the other in an outpatient clinic on the outskirts
    of the city
  18. Fulltext Gene expression in rat models for inter-generational transmission of islet dysfunction and obesity
    Lin RC, Ng SF, Morris MJ
    Genom Data, 2014 Dec;2:351-3.
    PMID: 26484128 DOI: 10.1016/j.gdata.2014.09.013
    Paternal high fat diet (HFD) consumption triggers unique gene signatures, consistent with premature aging and chronic degenerative disorders, in both white adipose tissue (RpWAT) and pancreatic islets of daughters. In addition to published data in Nature, 2010, 467, 963-966 (GSE: 19877, islet) and FASEB J 2014, 28, 1830-1841 (GSE: 33551, RpWAT), we describe here additional details on systems-based approaches and analysis to develop our observations. Our data provides a resource for exploring the complex molecular mechanisms that underlie intergenerational transmission of obesity.
  19. Treatment for diabetic ulcer wounds using a fern tannin optimized hydrogel formulation with antibacterial and antioxidative properties
    Lai JC, Lai HY, Nalamolu KR, Ng SF
    J Ethnopharmacol, 2016 08 02;189:277-89.
    PMID: 27208868 DOI: 10.1016/j.jep.2016.05.032
    ETHNOPHARMACOLOGICAL RELEVANCE: Blechnum orientale Linn. (B. orientale) is a fern traditionally used by the natives as a poultice to treat wounds, boils, ulcers, blisters, abscesses, and sores on the skin.

    AIM OF THE STUDY: To investigate the wound healing ability of a concentrated extract of B. orientale in a hydrogel formulation in healing diabetic ulcer wounds.

    MATERIALS AND METHODS: The water extract from the leaves of B. orientale was separated from the crude methanolic extract and subjected to flash column chromatography techniques to produce concentrated fractions. These fractions were tested for phytochemical composition, tannin content, antioxidative and antibacterial activity. The bioactive fraction was formulated into a sodium carboxymethylcellulose hydrogel. The extract-loaded hydrogels were then characterized and tested on excision ulcer wounds of streptozotocin-induced diabetic rats. Wound size was measured for 14 days. Histopathological studies were conducted on the healed wound tissues to observe for epithelisation, fibroblast proliferation and angiogenesis. All possible mean values were subjected to statistical analysis using One-way ANOVA and post-hoc with Tukey's T-test (P<0.05).

    RESULTS: One fraction exhibited strong antioxidative and antibacterial activity. The fraction was also highly saturated with tannins, particularly condensed tannins. Fraction W5-1 exhibited stronger antioxidant activity compared to three standards (α-Tocopherol, BHT and Trolox-C). Antibacterial activity was also present, and notably bactericidal towards Methicillin-resistant Staphylococcus aureus (MRSA) at 0.25mg/ml. The extract-loaded hydrogels exhibited shear-thinning properties, with high moisture retention ability. The bioactive fraction at 4% w/w was shown to be able to close diabetic wounds by Day 12 on average. Other groups, including controls, only exhibited wound closure by Day 14 (or not at all). Histopathological studies had also shown that extract-treated wounds exhibited re-epithelisation, higher fibroblast proliferation, collagen synthesis, and angiogenesis.

    CONCLUSION: The ethnopharmacological effects of using B. orientale as a topical treatment for external wounds was validated and was also significantly effective in treating diabetic ulcer wounds. Thus, B. orientale extract hydrogel may be presented as a potential treatment for diabetic ulcer wounds.

  20. In-vivo evaluation of Alginate-Pectin hydrogel film loaded with Simvastatin for diabetic wound healing in Streptozotocin-induced diabetic rats
    Rezvanian M, Ng SF, Alavi T, Ahmad W
    Int J Biol Macromol, 2021 Feb 28;171:308-319.
    PMID: 33421467 DOI: 10.1016/j.ijbiomac.2020.12.221
    Previously we developed and characterized a novel hydrogel film wound dressing containing Sodium Alginate and Pectin loaded with Simvastatin with multi-functional properties. This study investigated the in-vivo efficacy of the developed wound dressing on type I diabetic wound model. Experiments were performed on male Wistar rats for the period of 21-days. Animals developed diabetes after intraperitoneal injection (50 mg/kg) of Streptozotocin then randomly divided into different groups. On days 7, 14, and 21 of post-wounding, animals were euthanized and the wounds tissue were harvested for analysis. The wound healing rate, hematology and histological analysis, hydroxyproline assay, and Vascular Endothelial Growth Factor A measurements were noted. The results revealed that the wound dressing healed the wounded area significantly (p 
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