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Fulltext Factors Associated with Good Seizure Control in Patients on Valproic Acid

Ahmad M, Rahman AFA, Sapuan S

Eurasian J Med, 2020 Feb;52(1):41-46.
PMID: 32158313 DOI: 10.5152/eurasianjmed.2020.19039

Objective: This study aims to generate a reference range for valproic acid (VPA) in this cohort and determine the factors associated with good seizure control in patients taking this drug.
Materials and Methods: We conducted a prospective, cohort, observational study among patients with epilepsy who received VPA treatment at Hospital Kuala Lumpur. The patients were considered to have good control if they had a 50% or higher seizure reduction in the one-year study period compared with the previous year. The VPA reference range was generated from those patients who had good control and whose drug concentration values were available. Multiple logistic regression analysis with a backward likelihood ratio method was applied to assess the predicting factors for good seizure control.
Results: A total of 242 patients were recruited and followed up for one year. The VPA reference range was determined to be 40-85 mg/L. After multivariate analysis, significant predictive variables for good control were monotherapy [adjusted OR 4.74, 95% CI: 2.258, 9.947, p<0.001], non-smoking [adjusted OR 3.23, 95% CI: 1.099, 9.473, p=0.033], normal brain imaging results [adjusted OR 5.83, 95% CI: 2.507, 13.552, p<0.001], and the absence of stress [adjusted OR 19.98, 95% CI: 9.255, 42.764, p<0.001].
Conclusion: Monotherapy, non-smoking, normal brain imaging results, and the absence of stress are predictive of good seizure control in patients on VPA. However, a serum concentration of VPA in the reference range failed to predict good seizure control.
Enhanced visible-light driven multi-photoredox Cr(VI) and p-cresol by Si and Zr interplay in fibrous silica-zirconia

Aziz FFA, Jalil AA, Hassan NS, Hitam CNC, Rahman AFA, Fauzi AA

J Hazard Mater, 2021 Jan 05;401:123277.
PMID: 33113710 DOI: 10.1016/j.jhazmat.2020.123277

Multiple contaminants including heavy metals and phenolic compounds are normally co-exist in wastewater, which caused the treatment process is rather complicated. Herein, the synergistic photoredox of Cr(VI) and p-cresol (pC) by innovative fibrous silica zirconia (FSZr) photocatalyst was reported. The high surface area of FSZr comprised of microspheres with a bicontinuous concentric lamella structure morphology consisted of silica, while its core consisted of ZrO2 structure. The rearrangement of FSZr framework increased the crystallinity, formed Si-O-Zr bonds and narrowed the band gap of ZrO2 for enhanced of photoredox of Cr(VI) and pC. Compared to the reaction, the photoredox efficiency of FSZr for removing Cr(VI) and pC in simultaneous system was found to be 96 % and 59 %, respectively which are higher than that in its single system owing to the efficient electron-hole charge separation. Phenolic compound with high degree of electron donating group gave beneficial effect to photoreduction of Cr(VI). Consequently, a proposed mechanism involving multi-photoredox pathway were proposed based on photoredox reaction and scavengers studies. FSZr sustained the simultaneous photoredox activities after five runs demonstrating its possibility to be use in the wastewater treatment of various pollutants.
Altering fiber density of cockscomb-like fibrous silica-titania catalysts for enhanced photodegradation of ibuprofen

Fauzi AA, Jalil AA, Mohamed M, Triwahyono S, Jusoh NWC, Rahman AFA, et al.

J Environ Manage, 2018 Dec 01;227:34-43.
PMID: 30172157 DOI: 10.1016/j.jenvman.2018.08.073

Fibrous silica-titania (FST) catalysts were synthesized by microemulsion followed by silica seed-crystal crystallization methods under various molar ratios of toluene to water (T/W). The catalysts were characterized by XRD, UV-DRS, FESEM, TEM, AFM, N2 adsorption-desorption, FTIR, and ESR. The results revealed that altering the T/W ratio affected the growth of the silica and titania and led to different size, fiber density, silica-titania structure, and number of hydroxyl groups, as well as oxygen vacancies in the FSTs, which altered their behavior toward subsequent application. Photodegradation of ibuprofen (IBP) are in the following order: FST(6:1) (90%) > FST(5:1) (84%) > FST(7:1) (79%) > commercial TiO2 (67%). A kinetics study using Langmuir-Hinshelwood model illustrated that the photodegradation followed the pseudo-first-order and adsorption was the rate-limiting step. Optimization by response surface methodology (RSM) showed that the pH, initial concentration, and catalyst dosage were the remarkable parameters in photodegradation of IBP. The FST (6:1) maintained its photocatalytic activities for up to five cycles reaction without serious catalyst deactivation, and was also able to degrade other endocrine-disrupting chemicals, indicating its potential use for the treatment of those chemicals in wastewater.
Association between medication adherence and blood pressure control and factors associated with antihypertensive medication adherence in the Melaka Tengah District: A cross-sectional survey

Suleiman SZ, Htay MNN, Soe HHK, Low LYC, Alias SH, Yussof S, et al.

Malays Fam Physician, 2024;19:56.
PMID: 39534762 DOI: 10.51866/oa.651

INTRODUCTION: The burden of cardiovascular disease and early morbidity and mortality is exacerbated by hypertension. According to the 2019 National Health and Morbidity Survey, 30% of adults in Malaysia aged over 18 years had hypertension. Our study aimed to investigate the association between medication adherence and blood pressure control and the factors associated with antihypertensive medication adherence.
METHODS: This cross-sectional study was conducted among adult patients with hypertension who had been under treatment at public primary health clinics in the Melaka Tengah District. A self-administered questionnaire was used, and blood pressure was measured. Descriptive and multivariate logistic regression analyses were conducted using the Statistical Package for the Social Sciences (version 28).
RESULTS: A total of 1531 patients were recruited in this study. Among them, 74.1% had good antihypertensive medication adherence, and 51.4% had their blood pressure controlled. Medication adherence was significantly associated with blood pressure control (P<0.005). The multivariate analysis showed that the determinants for antihypertensive medication non-adherence were Malay ethnicity, secondary education, farther distance from the clinic, experience of side effects of antihypertensive medications, concern about long-term side effects and usage of alternative medicine (P<0.05). Taking multiple antihypertensive medications was the only factor associated with uncontrolled blood pressure (P<0.05).
CONCLUSION: Addressing issues on medication adherence is important to ensure blood pressure control. The factors associated with non-adherence should be closely monitored to improve blood pressure control and prevent adverse health outcomes. Single-pill combination antihypertensive medications are encouraged to reduce pill burden and improve blood pressure control.