MyMedR

Displaying all 9 publications

Abstract:

Sort:

Fulltext Nasal NK/T cell lymphoma mimicking an latrogenic lateral nasal wall infection: a diagnostic dilemma

Saleh KA, Razif, Gendeh BS

Med J Malaysia, 2011 Jun;66(2):160-1.
PMID: 22106705

Extra nodal NK/T cell lymphoma, 'nasal type' is a rare clinicopathological entity. The prevalence of nasal lymphoma is estimated at 0.17-1.5% for all non -Hodgkin's lymphomas (NHL), of which 45% originate from the NK/T cell. It is more commonly encountered in Asian countries. The main clinical features are nasal congestion and epistaxis due to local aggressive destruction. It has a distinct immunophenotypic profile of CD2+, CD56+ and CD3-. The tumor often shows polymorphic lymphoreticular infiltrates and necrosis. We present a case of a 50-year-old male who presented with lateral nasal wall infection following endoscopic sinonasal surgery and later proven to be extranodal NK/T cell 'nasal type' lymphoma with immunophenotypic features.
Are essential medicines in Malaysia accessible, affordable and available?

Saleh K, Ibrahim MI

Pharm World Sci, 2005 Dec;27(6):442-6.
PMID: 16341951 DOI: 10.1007/s11096-005-1318-8

OBJECTIVE: To assess the pharmaceutical sector to know whether people have access to essential medicines.

SETTING: The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory).

METHOD: The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies.

MAIN OUTCOME MEASURE: Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines.

RESULTS: The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary.

CONCLUSIONS: The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain areas in Sabah availability was less than 80.0% and still a problem.
Fulltext EBT3 Films in Low Solar Ultraviolet and X-Ray Dose Measurement: A Comparative Analysis

Alsaee SK, Omar AF, Ahmed NM, Alsadig A, Sulieman A, Alzimami K

Dose Response, 2019;17(2):1559325819855532.
PMID: 31236089 DOI: 10.1177/1559325819855532

The purpose of this study is to investigate the potentiality of Gafchromic external beam therapy 3 (EBT3) film to measure low dosage of solar ultraviolet (SUV; 0-10 600 mJ/cm2) and x-ray (0-750 mGy) radiation. In this experiment, 2 groups of EBT3 films were prepared with size 2 cm × 1 cm. The first group of films was exposed by incremental SUV dose in the middle of the day. The other group was irradiated by x-ray at 100 kVp, 100 mA, and 2 S of tube voltage, tube current, and exposure time, respectively. The measured SUV consists of 90% ultraviolet A (UVA) and 10% ultraviolet B. The film discoloration was represented by visible absorbance spectroscopy technique using Jaz spectrometer from Ocean Optics Inc. Simple linear regression produced high accuracy with coefficients of determination, r 2 of 0.9804 and root mean square error (RMSE) of 434.88 mJ/cm2 for the measurement of SUV dose. On the other hand, r 2 of 0.98 and RMSE of 31 mGy was produced for the measurement of x-ray dose. The application of multiple linear regression enhanced the measurement accuracy with R 2 of 99% and 99.7% and RMSE of 327.06 mJ/cm2 and 15.045 mGy for SUV and x-ray dose, respectively. The spectral analysis shows a promising measurement at selected wavelengths for SUV and x-ray dose.
Fulltext Anti-angiogenic activity of Middle East medicinal plants of the Lamiaceae family

Abdallah Q, Al-Deeb I, Bader A, Hamam F, Saleh K, Abdulmajid A

Mol Med Rep, 2018 Aug;18(2):2441-2448.
PMID: 29901194 DOI: 10.3892/mmr.2018.9155

Angiogenesis plays a crucial role in malignant tumor progression and development. The present study aimed to identify lead plants with selective anti-angiogenic properties. A total of 26 methanolic extracts obtained from 18 plants growing in Saudi Arabia and Jordan that belong to the Lamiaceae family were screened for their cytotoxic and anti-angiogenic activities using MTT and rat aortic ring assays, respectively. Four novel extracts of Thymbra capitata (L.) Cav., Phlomis viscosa Poir, Salvia samuelssonii Rech.f., and Premna resinosa (Hochst.) Schauer were identified for their selective anti-angiogenic effects. These extracts did not exhibit cytotoxic effects on human endothelial cells (EA.hy926) indicating the involvement of indirect anti-angiogenic mechanisms. The active extracts are potential candidates for further phytochemical and mechanistic studies.
Fulltext Making Fair Choices on the Path to Universal Health Coverage: Applying Principles to Difficult Cases

Voorhoeve A, Tan-Torres Edejer T, Kapiriri L, Norheim OF, Snowden J, Basenya O, et al.

Health Syst Reform, 2017 Oct 02;3(4):301-312.
PMID: 30359178 DOI: 10.1080/23288604.2017.1324938

Abstract-Progress toward universal health coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the World Health Organization (WHO) Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases, and how should one adjudicate between them when their demands conflict? This article by some members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three key dimensions of progress toward UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to prepayment with pooling of funds. Our cases are simplified to highlight common trade-offs. Though we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC.
General Principles for the Education and Training of GCP Inspectors: The Outcome of Discussions by International Regulatory Experts in the Discussion Group on the ICH E6 Guideline

Uyama Y, Yamazaki E, Clark K, Wang CY, Woro E, Tong FY, et al.

Ther Innov Regul Sci, 2015 Mar;49(2):249-253.
PMID: 30222411 DOI: 10.1177/2168479014551646

In response to the globalization of drug development, regulatory inspection of Good Clinical Practice (GCP) has recently been conducted not only by International Conference on Harmonisation (ICH) regions but also non-ICH regions. To promote the international implementation of GCP, consistent understanding and interpretation of its concept among regions are important. This article summarizes the background and past activities of the E6 Discussion Group, established under the Regulators Forum.
Fulltext Is Serum Uric Acid Level Associated with Disease Activity in Rheumatoid Arthritis Patients

Alkhudir D, Al-Herz A, Saleh K, Alawadhi A, Al-Kandari W, Hasan E, et al.

Open Access Rheumatol, 2023;15:223-230.
PMID: 38026718 DOI: 10.2147/OARRR.S418814

BACKGROUND: An association between serum uric acid (UA) and disease activity in rheumatoid arthritis (RA) patients has not been well studied. We describe RA patients with high and normal UA and study its association with RA activity.
METHODS: Adult RA patients from the Kuwait Registry for Rheumatic Diseases (KRRD) were studied from February 2012 through March 2022. Patients with documented UA levels were included. UA of >357 µmol/L (6mg/dL) was considered high. Statistical comparison and correlation were made using multivariate logistic regression.
RESULTS: Overall, 1054 patients with documented UA. A total of 158 patients (15%) had high UA level with a mean of 409± 44.4µmol/L. The mean age for the high UA group and low UA group were 59.3 ± 10.7 years and 54.5 ± 12.4 years, respectively (p<0.001). 49.4% were female in high UA group, and 62.2% were female in low UA group, respectively (p<0.05). Logistic analysis showed an inverse relation between DAS28 and UA, as lower DAS28 score was associated with higher UA level (p=0.032) OR 1.39. There was a direct relation with HAQ, creatinine and UA. A higher HAQ is associated with a higher UA level (p=0.019) OR 0.78. High creatinine level is also associated with high UA level (p<0.001) OR 0.24. The use of antirheumatic drugs was similar among patients with high and normal UA.
CONCLUSION: RA patients with a higher UA had a lower disease activity despite using similar antirheumatic drugs. The reasons behind this association need to be further studied.
Adherence to the Mediterranean diet is associated with a reduced DAS28 index among patients with rheumatoid arthritis: Case study from KRRD

Alawadhi B, Alsaber A, Shatawan I, Al-Herz A, Setiya P, Saleh K, et al.

Int J Rheum Dis, 2023 Dec;26(12):2430-2440.
PMID: 37784239 DOI: 10.1111/1756-185X.14928

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, autoimmune disease that mostly affects the synovial joints. It has been hypothesized that dietary and other environmental and lifestyle factors contribute to the development of RA and its severity.
OBJECTIVE: The present study aims to measure the effect of the Mediterranean diet (MedDiet) on the disease activity scores (DAS28) among patients with RA.
METHODS: Adult patients who satisfied the American College of Rheumatology (ACR) classification criteria for RA from major hospitals in Kuwait were evaluated. A cross-sectional study conducted on 754 RA patients visits aged (21-79) years. Patients were evaluated using the DAS28. Patients' levels of adherence to the MedDiet are assessed using a validated 14-item Questionnaire (paper or web-based). The data was analyzed using both multivariate and univariate statistics. Multivariate logistic regression was used to analyze the statistical relationship between MedDiet and RA disease activity.
RESULTS: The finding suggests that a MedDiet can have a positive impact on DAS28 among patients with RA. In the DAS28 cohort (DAS28
Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage

Voorhoeve A, Edejer TTT, Kapiriri L, Norheim OF, Snowden J, Basenya O, et al.

Health Hum Rights, 2016 Dec;18(2):11-22.
PMID: 28559673

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting.