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  1. Carboxymethylcellulose film for bacterial wound infection control and healing
    Wong TW, Ramli NA
    Carbohydr Polym, 2014 Nov 4;112:367-75.
    PMID: 25129756 DOI: 10.1016/j.carbpol.2014.06.002
    Infection control and wound healing profiles of sodium carboxymethylcellulose (SCMC) films were investigated as a function of their anti-bacterial action, physical structures, polymer molecular weights and carboxymethyl substitution degrees. The films were prepared with in vitro polymer/film and in vivo microbe-colonized wound healing/systemic infection profiles examined. Adhesive high carboxymethyl substituted SCMC films aided healing via attaching to microbes and removing them from wound. Pseudomonas aeruginosa was removed via encapsulating in gelling low molecular weight SCMC film, whereas Staphylococcus aureus was trapped in tight folds of high molecular weight SCMC film. Incomplete microbe removal from wound did not necessary translate to inability to heal as microbe remnant at wound induced fibroblast migration and aided tissue reconstruction. Using no film nonetheless will cause systemic blood infection. SCMC films negate infection and promote wound healing via specific polymer-microbe adhesion, and removal of S. aureus and P. aeruginosa requires films of different polymer characteristics.
  2. Sodium carboxymethylcellulose scaffolds and their physicochemical effects on partial thickness wound healing
    Ramli NA, Wong TW
    Int J Pharm, 2011 Jan 17;403(1-2):73-82.
    PMID: 20974238 DOI: 10.1016/j.ijpharm.2010.10.023
    This study investigated critical physicochemical attributes of low (LV), medium (MV) and high molecular weight (HV) sodium carboxymethylcellulose (SCMC) scaffolds in partial thickness wound healing. SCMC scaffolds were prepared by solvent-evaporation technique. Their in vitro erosion, moisture affinity, morphology, tensile strength, polymer molecular weight and carboxymethyl substitution, and in vivo wound healing profiles were determined. Inferring from rat wound size, re-epithelialization and histological profiles, wound healing progressed with HV scaffold>LV-MV scaffold>control with no scaffold. The transepidermal water loss (TEWL) from wound of rats treated by control>HV scaffold>LV-MV scaffold. HV scaffold had the highest tensile strength of all matrices and was resistant to erosion in simulated wound fluid. In spite of constituting small nanopores, it afforded a substantial TEWL than MV and LV scaffolds from wound across an intact matrix through its low moisture affinity characteristics. The HV scaffold can protect moisture loss without its excessive accumulation at wound bed which hindered re-epithelialization process. Regulation of transepidermal water movement and wound healing by scaffolds was governed by SCMC molecular weight instead of its carboxymethyl substitution degree or matrix pore size distribution, with large molecular weight HV preferred over lower molecular weight samples.
  3. Phytomedicines are Efficient Complementary Therapies for the Treatment of Atopic Dermatitis: A Review of Mechanistic Insight and Recent Updates
    Tumpang MA, Ramli NA, Hussain Z
    Curr Drug Targets, 2018;19(6):674-700.
    PMID: 28914203 DOI: 10.2174/1389450118666170913162147
    BACKGROUND: Phytomedicines have been well-accepted alternative complementary therapies for the treatment of a wide range of acute and chronic skin inflammatory diseases including chronic herpes, prurigo, psoriasis, and atopic dermatitis (AD). A plethora of in vitro and in vivo studies have evidenced the therapeutic viability of phytomedicines, polyherbal formulations, plant-based materials and their decoctions for the treatment of mild-to-severe AD.

    OBJECTIVE: This review was aimed to summarize and critically discuss the convincing evidence for the therapeutic effectiveness of phytomedicines for the treatment of AD and explore their anti-AD efficacy.

    RESULTS: The critical analysis of a wide algorithm of herbal medicines revealed that their remarkable anti-AD efficacy is attributed to their potential of reducing erythema intensity, oedema, inflammation, transepidermal water loss (TEWL) and a remarkable suppression of mRNA expression of ADassociated inflammatory biomarkers including histamine, immunoglobulin (Ig)-E, prostaglandins, mast cells infiltration and production of cytokines and chemokines in the serum and skin biopsies.

    CONCLUSION: In conclusion, herbal medicines hold great promise as complementary and alternative therapies for the treatment of mild-to-moderate AD when used as monotherapy and for the treatment of moderate-to-severe AD when used in conjunction with other pharmacological agents.

  4. Fulltext Physicochemical characteristics of liposome encapsulation of stingless bees' propolis
    Ramli NA, Ali N, Hamzah S, Yatim NI
    Heliyon, 2021 Apr;7(4):e06649.
    PMID: 33898810 DOI: 10.1016/j.heliyon.2021.e06649
    Nutraceuticals from natural sources have shown potential new leads in functional food products. Despite a broad range of health-promoting effects, these compounds are easily oxidized and unstable, making their utilization as nutraceutical ingredients limited. In this study, the encapsulated stingless bees' propolis in liposome was prepared using soy phosphatidylcholine and cholesterol by thin-film hydration technique. Three different formulations of phosphatidylcholine composition and cholesterol prepared by weight ratio was conducted to extract high propolis encapsulation. Physicochemical changes in the result of the encapsulation process are briefly discussed using scanning electron microscopy and Fourier Transform Infrared Spectroscopy. A dynamic light-scattering instrument was used to measure the hydrodynamic diameter, polydispersity index, and zeta potential. The increment of the liposomal size was observed when the concentration of extract loaded increased. In comparing three formulations, F2 (8:1 w/w) presented the best formulation as it yielded small nanoparticles of 275.9 nm with high encapsulation efficiency (66.9%). F1 (6:1 w/w) formed large particles of liposomes with 422.8 nm, while F3 (10:1 w/w) showed low encapsulation efficiency with (by) 38.7%. The liposome encapsulation will provide an effective nanocarrier system to protect and deliver the flavonoids extracted from stingless bees' propolis.
  5. Fulltext Chemical, Biological and Morphological Properties of Fine Particles during Local Rice Straw Burning Activities
    Ramli NA, Md Yusof NFF, Zarkasi KZ, Suroto A
    Int J Environ Res Public Health, 2021 08 02;18(15).
    PMID: 34360485 DOI: 10.3390/ijerph18158192
    Rice straw is commonly burned openly after harvesting in Malaysia and many other Asian countries where rice is the main crop. This operation emits a significant amount of air pollution, which can have severe consequences for indoor air quality, public health, and climate change. Therefore, this study focuses on determining the compositions of trace elements and the morphological properties of fine particles. Furthermore, the species of bacteria found in bioaerosol from rice burning activities were discovered in this study. For morphological observation of fine particles, FESEM-EDX was used in this study. Two main categories of particles were found, which were natural particles and anthropogenic particles. The zinc element was found during the morphological observation and was assumed to come from the fertilizer used by the farmers. ICP-OES identifies the concentration of trace elements in the fine particle samples. A cultured method was used in this study by using nutrient agar. From this study, several bacteria were identified: Exiguobavterium indicum, Bacillus amyloliquefaciens, Desulfonema limicola str. Jadabusan, Exiguobacterium acetylicum, Lysinibacillus macrolides, and Bacillus proteolyticus. This study is important, especially for human health, and further research on the biological composition of aerosols should be conducted to understand the effect of microorganisms on human health.
  6. Fulltext Incidence of anemia and red blood cell (RBC) transfusion requirement in breast cancer
    Ramli NA, Iberahim S, Che Ismail AA, Hussin H
    Caspian J Intern Med, 2023;14(2):237-248.
    PMID: 37223288 DOI: 10.22088/cjim.14.2.237
    BACKGROUND: Cancer-related anaemia is one of the main burdens in oncology, although the available data on its prevalence and treatment options such as blood transfusion are often contradictory. This study aimed to evaluate the prevalence of anaemia and the requirement for packed red blood cell (PRBC) transfusion among women with breast cancer (BC) and to determine the associated factors for chemotherapy-induced anaemia (CIA).

    METHODS: This cross-sectional retrospective study conducted in Kelantan involved 104 newly diagnosed female BC patients from 2015 to 2016 who underwent chemotherapy. For statistical analysis, chi-square was used to compare between CIA and non-CIA groups. In addition, simple and multiple logistic regression were used to determine the association of the CIA.

    RESULTS: Our study revealed that 34.6% (n=36) of patients had mild anaemia, and 59.6% (n=62) had normal haemoglobin at pre-chemotherapy. The prevalence of anaemia increased from 40.4% to 77% at the end of our study. About 30.8% of patients received PRBC transfusion during chemotherapy with mean haemoglobin before the first transfusion of 7.9 g/dl. CIA was observed in 54.8% of cases. There was no significant association between CIA concerning the patient characteristic, cancer characteristic, or cancer treatment.

    CONCLUSION: We concluded that a significant proportion (40.4%) of BC patients was anaemic even before chemotherapy, with the red blood cell requirements up to 30.8% throughout chemotherapy. A larger prospective study is needed to determine the predictors for the CIA and subsequently improve patient management.

  7. Statistical analysis of PM₁₀ concentrations at different locations in Malaysia
    Sansuddin N, Ramli NA, Yahaya AS, Yusof NF, Ghazali NA, Madhoun WA
    Environ Monit Assess, 2011 Sep;180(1-4):573-88.
    PMID: 21136287 DOI: 10.1007/s10661-010-1806-8
    Malaysia has experienced several haze events since the 1980s as a consequence of the transboundary movement of air pollutants emitted from forest fires and open burning activities. Hazy episodes can result from local activities and be categorized as "localized haze". General probability distributions (i.e., gamma and log-normal) were chosen to analyze the PM(10) concentrations data at two different types of locations in Malaysia: industrial (Johor Bahru and Nilai) and residential (Kota Kinabalu and Kuantan). These areas were chosen based on their frequently high PM(10) concentration readings. The best models representing the areas were chosen based on their performance indicator values. The best distributions provided the probability of exceedances and the return period between the actual and predicted concentrations based on the threshold limit given by the Malaysian Ambient Air Quality Guidelines (24-h average of 150 μg/m(3)) for PM(10) concentrations. The short-term prediction for PM(10) exceedances in 14 days was obtained using the autoregressive model.
  8. Monsoonal differences and probability distribution of PM(10) concentration
    Md Yusof NF, Ramli NA, Yahaya AS, Sansuddin N, Ghazali NA, Al Madhoun W
    Environ Monit Assess, 2010 Apr;163(1-4):655-67.
    PMID: 19365611 DOI: 10.1007/s10661-009-0866-0
    There are many factors that influence PM(10) concentration in the atmosphere. This paper will look at the PM(10) concentration in relation with the wet season (north east monsoon) and dry season (south west monsoon) in Seberang Perai, Malaysia from the year 2000 to 2004. It is expected that PM(10) will reach the peak during south west monsoon as the weather during this season becomes dry and this study has proved that the highest PM(10) concentrations in 2000 to 2004 were recorded in this monsoon. Two probability distributions using Weibull and lognormal were used to model the PM(10) concentration. The best model used for prediction was selected based on performance indicators. Lognormal distribution represents the data better than Weibull distribution model for 2000, 2001, and 2002. However, for 2003 and 2004, Weibull distribution represents better than the lognormal distribution. The proposed distributions were successfully used for estimation of exceedences and predicting the return periods of the sequence year.
  9. Transformation of nitrogen dioxide into ozone and prediction of ozone concentrations using multiple linear regression techniques
    Ghazali NA, Ramli NA, Yahaya AS, Yusof NF, Sansuddin N, Al Madhoun WA
    Environ Monit Assess, 2010 Jun;165(1-4):475-89.
    PMID: 19440846 DOI: 10.1007/s10661-009-0960-3
    Analysis and forecasting of air quality parameters are important topics of atmospheric and environmental research today due to the health impact caused by air pollution. This study examines transformation of nitrogen dioxide (NO(2)) into ozone (O(3)) at urban environment using time series plot. Data on the concentration of environmental pollutants and meteorological variables were employed to predict the concentration of O(3) in the atmosphere. Possibility of employing multiple linear regression models as a tool for prediction of O(3) concentration was tested. Results indicated that the presence of NO(2) and sunshine influence the concentration of O(3) in Malaysia. The influence of the previous hour ozone on the next hour concentrations was also demonstrated.
  10. Solid waste collection and recycling in Nibong Tebal, Penang, Malaysia: a case study
    Isa MH, Asaari FA, Ramli NA, Ahmad S, Siew TS
    Waste Manag Res, 2005 Dec;23(6):565-70.
    PMID: 16379126
    The implementation of a suitable solid waste management programme with appropriate methods of recycling as an inherent element is vital to the alleviation of the problems associated with solid waste generation, handling and disposal, environmental conservation, public hygiene, etc. The present work is a case study on solid waste collection and recycling practices in Nibong Tebal town, Penang, Malaysia. The amount and types of domestic waste generated, household participation in recycling, identification of existing problems related to the implementation of the recycling programme, etc. formed the basis of this study. Surveys (interviews/questionnaires) and on-site observations were conducted to gather information on the solid waste collection and recycling practice of the residents. A focus group of 60 individuals was selected and their response to a questionnaire, prepared according to a Likert scale, was obtained and analysed. The majority of the respondents expressed concerns about recycling and wanted more to be done in this regard. Illegal collection, aesthetically displeasing sites and a lack of public awareness were problems of major concern. Issues related to inadequate funding and manpower as well as end market are also addressed and suggestions made.
  11. Fulltext A New Method of Rice Moisture Content Determination Using Voxel Weighting-Based from Radio Tomography Images
    Mohd Ramli NA, Fazalul Rahiman MH, Kamarudin LM, Mohamed L, Zakaria A, Ahmad A, et al.
    Sensors (Basel), 2021 May 26;21(11).
    PMID: 34073162 DOI: 10.3390/s21113686
    This manuscript presents a new method to monitor and localize the moisture distribution in a rice silo based on tomography images. Because the rice grain is naturally hygroscopic, the stored grains' quality depends on their level of moisture content. Higher moisture content leads to fibre degradation, making the grains too frail and possibly milled. If the moisture is too low, the grains become brittle and are susceptible to higher breakage. At present, the single-point measurement method is unreliable because the moisture build-up inside the silo might be distributed unevenly. In addition, this method mostly applies gravimetric analysis, which is destructive. Thus, we proposed a radio tomographic imaging (RTI) system to address these problems. Four simulated phantom profiles at different percentages of moisture content were reconstructed using Newton's One-Step Error Reconstruction and Tikhonov Regularization algorithms. This simulation study utilized the relationship between the maximum voxel weighting of the reconstructed RTI image and the percentage of moisture content. The outcomes demonstrated promising results, in which the weighting voxel linearly increased with the percentage of moisture content, with a correlation coefficient higher than 0.95 was obtained. Therefore, the results support the possibility of using the RTI approach for monitoring and localizing the moisture distribution inside the rice silo.
  12. Fulltext A Bibliometric Analysis of Opioid in Malaysia
    Zin CS, Abdullah NAD, Ramli NA, Khadir N, Zain NS, Rosley NF, et al.
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S667-S670.
    PMID: 33828358 DOI: 10.4103/jpbs.JPBS_283_19
    Opioid analgesics have been widely used for the treatment of pain. In USA, it was reported an increase in opioid prescribing is parallel with the increase of opioid use disorders such as misuse, abuse, and opioids overdose-related death. Little is known about the opioid situation and its related research in Malaysia. Therefore, this bibliometric study provided an overview on the productivity of opioid research in Malaysia. All published articles on opioid research in Malaysia from 2006 to 2018 were included, where they were retrieved from online databases. Then, the data were analysed, presented and discussed using standard bibliometric indicators, such as growth of publications, number of citation journals, geographical distribution, and issues addressed in the publications. Total of 78 research articles on opioids published between 2006 and 2018 were identified. The relative growth rate (RGR) of publications during the study period was 12.24%. The most common issue studied was the methadone maintenance therapy. Most articles were published in the indexed journals (98.72%) and the predominant journal was the Drug and Alcohol Dependence (11.54%). The article on buprenorphine and naltrexone reported the highest citations of 85. It can be concluded that research evaluating opioids in pain management particularly in patients with non-cancer pain in Malaysia is limited and requires further exploration.
  13. Severe cutaneous adverse reaction to drug excipient following brand-to-generic switch of levetiracetam
    Lim JA, Jamil A, Ramli NA, Johar FM, Nor M
    Am J Health Syst Pharm, 2024 Jan 24;81(3):e69-e72.
    PMID: 37864830 DOI: 10.1093/ajhp/zxad264
    PURPOSE: Levetiracetam is an antiepileptic drug known for its high tolerability, and severe adverse drug reactions are rare. We report the case of a severe cutaneous adverse drug reaction in a patient who was switched from brand-name to generic levetiracetam.

    SUMMARY: A 29-year-old woman undergoing contrast-enhanced computed tomography developed lesions over her trunk starting 6 hours after imaging. Although initially diagnosed as an allergy to the radiocontrast agent, the condition progressively worsened into toxic epidermal necrolysis-drug reaction with eosinophilia and systemic symptoms overlap syndrome, despite adequate hydration and treatment. Investigation of the patient's medications revealed that she had been switched from brand-name to generic levetiracetam a week before the onset of symptoms. Levetiracetam was immediately discontinued, with the patient recovering after 2 weeks of intensive care. Adverse drug reaction analysis identified excipients in generic levetiracetam as the likely cause of the severe reaction.

    CONCLUSION: This is the first reported case of severe cutaneous drug allergy after a brand-to-generic switch for levetiracetam. Brand-to-generic switches of medications can potentially cause severe allergic reactions due to differences in excipients.

  14. Hyaluronic acid, a promising skin rejuvenating biomedicine: A review of recent updates and pre-clinical and clinical investigations on cosmetic and nutricosmetic effects
    Bukhari SNA, Roswandi NL, Waqas M, Habib H, Hussain F, Khan S, et al.
    Int J Biol Macromol, 2018 Dec;120(Pt B):1682-1695.
    PMID: 30287361 DOI: 10.1016/j.ijbiomac.2018.09.188
    Hyaluronic acid (HA) plays multifaceted role in regulating the various biological processes such as skin repairmen, diagnosis of cancer, wound healing, tissue regeneration, anti-inflammatory, and immunomodulation. Owing to its remarkable biomedical and tissue regeneration potential, HA has been numerously employed as one of the imperative components of the cosmetic and nutricosmetic products. The present review aims to summarize and critically appraise recent developments and clinical investigations on cosmetic and nutricosmetic efficacy of HA for skin rejuvenation. A thorough analysis of the literature revealed that HA based formulations (i.e., gels, creams, intra-dermal filler injections, dermal fillers, facial fillers, autologous fat gels, lotion, serum, and implants, etc.) exhibit remarkable anti-wrinkle, anti-nasolabial fold, anti-aging, space-filling, and face rejuvenating properties. This has been achieved via soft tissue augmentation, improved skin hydration, collagen and elastin stimulation, and face volume restoration. HA, alone or in combination with lidocaine and other co-agents, showed promising efficacy in skin tightness and elasticity, face rejuvenation, improving aesthetic scores, reducing the wrinkle scars, longevity, and tear trough rejuvenation. Our critical analysis evidenced that application/administration of HA exhibits outstanding nutricosmetic efficacy and thus is warranted to be used as a prime component of cosmetic products.
  15. Fulltext Leveraging immunoliposomes as nanocarriers against SARS-CoV-2 and its emerging variants
    Mohammad Faizal NDF, Ramli NA, Mat Rani NNI, Shaibie NA, Aarti, Poonsawas P, et al.
    Asian J Pharm Sci, 2023 Nov;18(6):100855.
    PMID: 38125653 DOI: 10.1016/j.ajps.2023.100855
    The global COVID-19 pandemic arising from SARS-CoV-2 has impacted many lives, gaining interest worldwide ever since it was first identified in December 2019. Till 2023, 752 million cumulative cases and 6.8 million deaths were documented globally. COVID-19 has been rapidly evolving, affecting virus transmissibility and properties and contributing to increased disease severity. The Omicron is the most circulating variant of concern. Although success in its treatment has indicated progress in tackling the virus, limitations in delivering the current antiviral agents in battling emerging variants remain remarkable. With the latest advancements in nanotechnology for controlling infectious diseases, liposomes have the potential to counteract SARS-CoV-2 because of their ability to employ different targeting strategies, incorporating monoclonal antibodies for the active and passive targeting of infected patients. This review will present a concise summary of the possible strategies for utilizing immunoliposomes to improve current treatment against the occurrence of SARS-CoV-2 and its variants.
  16. Fulltext RF Remote Blood Glucose Sensor and a Microfluidic Vascular Phantom for Sensor Validation
    Yunos MFAM, Manczak R, Guines C, Mansor AFM, Mak WC, Khan S, et al.
    Biosensors (Basel), 2021 Dec 03;11(12).
    PMID: 34940251 DOI: 10.3390/bios11120494
    Diabetes has become a major health problem in society. Invasive glucometers, although precise, only provide discrete measurements at specific times and are unsuitable for long-term monitoring due to the injuries caused on skin and the prohibitive cost of disposables. Remote, continuous, self-monitoring of blood sugar levels allows for active and better management of diabetics. In this work, we present a radio frequency (RF) sensor based on a stepped impedance resonator for remote blood glucose monitoring. When placed on top of a human hand, this RF interdigital sensor allows detection of variation in blood sugar levels by monitoring the changes in the dielectric constant of the material underneath. The designed stepped impedance resonator operates at 3.528 GHz with a Q factor of 1455. A microfluidic device structure that imitates the blood veins in the human hand was fabricated in PDMS to validate that the sensor can measure changes in glucose concentrations. To test the RF sensor, glucose solutions with concentrations ranging from 0 to 240 mg/dL were injected into the fluidic channels and placed underneath the RF sensor. The shifts in the resonance frequencies of the RF sensor were measured using a network analyzer via its S11 parameters. Based on the change in resonance frequencies, the sensitivity of the biosensor was found to be 264.2 kHz/mg·dL-1 and its LOD was calculated to be 29.89 mg/dL.
  17. Cell membrane cloaked nanomedicines for bio-imaging and immunotherapy of cancer: Improved pharmacokinetics, cell internalization and anticancer efficacy
    Hussain Z, Rahim MA, Jan N, Shah H, Rawas-Qalaji M, Khan S, et al.
    J Control Release, 2021 07 10;335:130-157.
    PMID: 34015400 DOI: 10.1016/j.jconrel.2021.05.018
    Despite enormous advancements in the field of oncology, the innocuous and effectual treatment of various types of malignancies remained a colossal challenge. The conventional modalities such as chemotherapy, radiotherapy, and surgery have been remained the most viable options for cancer treatment, but lacking of target-specificity, optimum safety and efficacy, and pharmacokinetic disparities are their impliable shortcomings. Though, in recent decades, numerous encroachments in the field of onco-targeted drug delivery have been adapted but several limitations (i.e., short plasma half-life, early clearance by reticuloendothelial system, immunogenicity, inadequate internalization and localization into the onco-tissues, chemoresistance, and deficient therapeutic efficacy) associated with these onco-targeted delivery systems limits their clinical viability. To abolish the aforementioned inadequacies, a promising approach has been emerged in which stealthing of synthetic nanocarriers has been attained by cloaking them into the natural cell membranes. These biomimetic nanomedicines not only retain characteristics features of the synthetic nanocarriers but also inherit the cell-membrane intrinsic functionalities. In this review, we have summarized preparation methods, mechanism of cloaking, and pharmaceutical and therapeutic superiority of cell-membrane camouflaged nanomedicines in improving the bio-imaging and immunotherapy against various types of malignancies. These pliable adaptations have revolutionized the current drug delivery strategies by optimizing the plasma circulation time, improving the permeation into the cancerous microenvironment, escaping the immune evasion and rapid clearance from the systemic circulation, minimizing the immunogenicity, and enabling the cell-cell communication via cell membrane markers of biomimetic nanomedicines. Moreover, the preeminence of cell-membrane cloaked nanomedicines in improving the bio-imaging and theranostic applications, alone or in combination with phototherapy or radiotherapy, have also been pondered.
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