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Honey use in burn management: potentials and limitations

Boukraâ L, Sulaiman SA

Forsch Komplementmed, 2010 Apr;17(2):74-80.
PMID: 20484914 DOI: 10.1159/000297213

Management of the burn wound still remains a matter of debate, and an ideal dressing for burn wounds has not yet been discovered. Naturally occurring substances such as honey have been found to be useful as a wound cover for burns. Unlike most conventional local chemotherapeutics, honey does not lead to the development of antibiotic-resistant bacteria, and it may be used continuously. Among the challenging problems of using honey for medical purposes are dosage, safety, and formulation. Many approaches have been suggested to overcome such problems. With the increased availability of licensed medical products containing honey, clinical use is expected to increase and further evidence will become available. Honey seems to have the potential to clear infection as well as to be an effective prophylactic agent that may contribute to reducing the risks of cross-infection. A better understanding of the therapeutic and chemical properties of honey is needed to optimise the use of this product in the clinical management of burns. Its use in professional care centres should be limited to those with certified healing activities. The potentials and limitations of using honey as burn dressing are discussed in this review.
Rediscovering the antibiotics of the hive

Boukraâ L, Sulaiman SA

Recent Pat Antiinfect Drug Discov, 2009 Nov;4(3):206-13.
PMID: 19673699

Honey and other bee products were subjected to laboratory and clinical investigations during the past few decades and the most remarkable discovery was their antibacterial activity. Honey has been used since ancient times for the treatment of some diseases and for the healing of wounds but its use as an anti-infective agent was superseded by modern dressings and antibiotic therapy. However, the emergence of antibiotic resistant strains of bacteria has confounded the current use of antibiotic therapy leading to the re-examination of former remedies. Honey, propolis, royal jelly and bee venom have a strong antibacterial activity. Even antibiotic-resistant strains such as epidemic strains of methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycine resistant Enterococcus (VRE) have been found to be as sensitive to honey as the antibiotic-sensitive strains of the same species. Sensitivity of bacteria to bee products varies considerably within the product and the varieties of the same product. Botanical origin plays a major role in its antibacterial activity. Propolis has been found to have the strongest action against bacteria. This is probably due to its richness in flavonoids. The most challenging problems of using hive products for medical purposes are dosage and safety. Honey and royal jelly produced as a food often are not well filtered, and may contain various particles. Processed for use in wound care, they are passed through fine filters which remove most of the pollen and other impurities to prevent allergies. Also, although honey does not allow vegetative bacteria to survive, it does contain viable spores, including clostridia. With the increased availability of licensed medical stuffs containing bee products, clinical use is expected to increase and further evidence will become available. Their use in professional care centres should be limited to those which are safe and with certified antibacterial activities. The present article is a short review of recent patents on antibiotics of hives.
Fulltext Increasing the efficiency of detecting active tuberculosis cases in intermediate and high-burden tuberculosis countries: A way forward

Atif M, Sulaiman SA

J Basic Clin Pharm, 2012 Sep;3(4):330-1.
PMID: 24826045 DOI: 10.4103/0976-0105.105333
Slow release coating remedy for nitrogen loss from conventional urea: a review

Naz MY, Sulaiman SA

J Control Release, 2016 Mar 10;225:109-20.
PMID: 26809006 DOI: 10.1016/j.jconrel.2016.01.037

Developing countries are consuming major part of the global urea production with an anticipated nitrogen use efficiency of 20 to 35%. The release of excess nitrogen in the soil is not only detrimental to the environment but also lessens the efficiency of the conventional urea. The urea performance can be enhanced by encapsulating it with slow release coating materials and synchronizing the nutrients' release with the plant up-taking. However, the present cost of most of the coated fertilizers is considerably higher than the conventional fertilizers. The high cost factor prevents their widespread use in mainstream agriculture. This paper documents a review of literature related to the global urea market, issues pertaining to the conventional urea use, natural and synthetic materials for slow release urea and fluidized bed spray coating process. The aim of the current review is to develop technical understanding of the conventional and non-conventional coating materials and associated spray coating mechanism for slow release urea production. The study also investigated the potential of starch as the coating material in relation to the coatings tested previously for controlled release fertilizers.
The potential role of honey and its polyphenols in preventing heart diseases: a review

Khalil MI, Sulaiman SA

Afr J Tradit Complement Altern Med, 2010;7(4):315-21.
PMID: 21731163

Honey is rich in phenolic compounds, which act as natural antioxidants and are becoming increasingly popular because of their potential role in contributing to human health. A wide range of phenolic constituents is present in honey like quercetin, caffeic acid phenethyl ester (CAPE), acacetin, kaempferol, galangin which have promising effect in the treatment of cardiovascular diseases. Many epidemiological studies have shown that regular intake of phenolic compounds is associated with reduced risk of heart diseases. In coronary heart disease, the protective effects of phenolic compounds include mainly antithrombotic, anti-ischemic, anti-oxidant, and vasorelaxant. It is suggested that flavonoids decrease the risk of coronary heart disease by three major actions: improving coronary vasodilatation, decreasing the ability of platelets in the blood to clot, and preventing low-density lipoproteins (LDLs) from oxidizing. In this review paper, we discussed the preventive role of polyphenols of honey against cardiovascular diseases.
Evaluation of the management of sexually transmitted infections by private practitioners in pulau pinang, malaysia

Anwar M, Sulaiman SA

Malays J Med Sci, 2008 Oct;15(4):41-7.
PMID: 22589637 MyJurnal

To determine the current practices of private practitioners for the management of STIs in Pulau Pinang, Malaysia, evaluation of pharmacotherapy for STIs in private clinics and to ascertain the management of STIs compared to standard guidelines.
METHODS: Data was collected by self-administered questionnaire for private practitioners, which gathered information on their socio-demographic as well as practice characteristics. Descriptive statistical analysis was performed by using SPSS for Windows version 13.0.
RESULTS: Data was collected from 78 practitioners. Most of the treatment choices mentioned for the treatment of gonorrhea were inconsistent with the guidelines. About 51.2% of practitioners did not screen their patients for HIV/AIDS. Majority of private practitioners counseled their patients about HIV/AIDS on an irregular basis. A high percentage of 59% did not inform health authorities about STI cases and 32.1% mentioned that they did not use any guidelines.
CONCLUSIONS: Management of STIs by private practitioners with respect to selection of antibiotics, patient counseling and case notification leaves a lot to be desired. Current management practices can adversely impact on HIV/AIDS transmission in the country. Interventions are needed to improve the management practices of private practitioners.
Fulltext Resource Utilization Pattern And Cost Of Tuberculosis Treatment In Penang, Malaysia

Atif M, Sulaiman SA, Shafie AA, Asif M

Value Health, 2014 Nov;17(7):A725-6.
PMID: 27202579 DOI: 10.1016/j.jval.2014.08.051
A study exploring the association of attitude and treatment satisfaction with glycaemic level among gestational diabetes mellitus patients

Hussain Z, Yusoff ZM, Sulaiman SA

Prim Care Diabetes, 2015 Aug;9(4):275-82.
PMID: 25457621 DOI: 10.1016/j.pcd.2014.10.002

AIMS: The aim of this study was to evaluate attitude and treatment satisfaction of women suffering from GDM and their association with glycaemic level.
METHODS: A cross sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June to December 2013 on the sample of 175 patients. Data was collected through modified version of Diabetes Integration Scale (ATT-19) and Diabetes Treatment Satisfaction Questionnaires (DSTQs). Glycaemic level was evaluated in terms of Fasting Plasma Glucose (FPG). Three most recent values of FPG (mmol/l) were taken from patients medical profiles and their mean was calculated. Descriptive and inferential statistics were used for data analysis.
RESULTS: A total of 166 patients were included in final analysis. Only 35 (21.1%) patients had positive attitude and 122 (73.5%) of patients had adequate treatment satisfaction. There was no significant association of total mean ATT-19 score with age, ethnicity, educational level, occupational status, family history and type of therapy. For treatment satisfaction statistically significant association was present only between total mean treatment satisfaction score and educational level. Patients with negative attitude and inadequate treatment satisfaction had higher mean glycaemic level.
CONCLUSIONS: It is concluded that more than two folds of patients were satisfied with their ongoing treatment but majority of the patients were feeling difficulty in active coping measures for the management of GDM.
KEYWORDS: Attitude; GDM; Glycaemic level; Treatment satisfaction

Study site: antenatal clinic of Hospital Pulau Pinang
Effect of the borax mass and pre-spray medium temperature on droplet size and velocity vector distributions of intermittently sprayed starchy solutions

Naz MY, Sulaiman SA, Ariwahjoedi B

Phys Chem Chem Phys, 2015 Feb 7;17(5):3704-14.
PMID: 25557285 DOI: 10.1039/c4cp04378b

Spray coating technology has demonstrated great potential in the slow release fertilizers industry. The better understanding of the key spray parameters benefits both the environment and low cost coating processes. The use of starch based materials to coat the slow release fertilizers is a new development. However, the hydraulic spray jet breakup of the non-Newtonian starchy solutions is a complex phenomenon and very little known. The aim of this research was to study the axial and radial distributions of the Sauter Mean Diameter (SMD) and velocity vectors in pulsing spray patterns of native and modified tapioca starch solutions. To meet the objective, high speed imaging and Phase Doppler Anemometry (PDA) techniques were employed to characterize the four compositions of the starch-urea-borax complex namely S0, S1, S2 and S3. The unheated solutions exhibited very high viscosities ranging from 2035 to 3030 cP. No jet breakup was seen at any stage of the nozzle operation at an injection pressure of 1-5 bar. However, at 80 °C temperature and 5 bar pressure, the viscosity was reduced to 455 to 638 cP and dense spray patterns emerged from the nozzle obscuring the PDA signals. The axial size distribution revealed a significant decrease in SMD along the spray centreline. The smallest axial SMD (51 to 79 μm) was noticed in S0 spray followed by S1, S2 and S3. Unlikely, the radial SMD in S0 spray did not vary significantly at any stage of the spray injection. This trend was attributed to the continuous growth of the surface wave instabilities on the native starch sheet. However, SMD obtained with S1, S2 and S3 varied appreciably along the radial direction. The mean velocity vector profiles followed the non-Gaussian distribution. The constant vector distributions were seen in the near nozzle regions, where the spray was in the phase of development. In far regions, the velocity vectors were poly-dispersed and a series of ups and downs were seen in the respective radial distributions.
Evaluation of knowledge regarding gestational diabetes mellitus and its association with glycaemic level: A Malaysian study

Hussain Z, Yusoff ZM, Sulaiman SA

Prim Care Diabetes, 2015 Jun;9(3):184-90.
PMID: 25132140 DOI: 10.1016/j.pcd.2014.07.007

AIMS: The aim of this study was to evaluate the knowledge about GDM and its corresponding relation with glycaemic level in GDM patients.
METHOD: A cross-sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June 2013 to December 2013 using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) on the sample of 175 GDM patients. Three most recent fasting plasma glucose (FPG) values (mmol/l) were taken from patients profiles and mean was calculated.
RESULTS: A total of 166 patients were included in final analysis. A total mean knowledge score of 166 patients was 10.01±3.63 and total mean FPG value was 5.50±1.13. Knowledge had a significant negative association with FPG (r=- 0.306, P<0.01). Among different knowledge domains, highest mean score was seen for diet/food values domain and lowest for management of GDM. Educational level seems to be the most significant predictor of GDM knowledge and glycaemic control. Highest mean knowledge score and lowest mean glycaemic levels were recorded for patients aged 25-29 years, Malay ethnicity, working women and family history of DM.
CONCLUSION: Higher Knowledge about GDM is related to better glycaemic control. New educational strategies should be developed to improve the lower health literacy.
KEYWORDS: Educational level; GDM; Glycaemic level; Knowledge

Study site: antenatal clinic of Hospital Pulau Pinang, Malaysia
Fulltext Influence of fuel moisture content and reactor temperature on the calorific value of syngas resulted from gasification of oil palm fronds

Atnaw SM, Sulaiman SA, Yusup S

ScientificWorldJournal, 2014;2014:121908.
PMID: 24578617 DOI: 10.1155/2014/121908

Biomass wastes produced from oil palm mills and plantations include empty fruit bunches (EFBs), shells, fibers, trunks, and oil palm fronds (OPF). EFBs and shells are partially utilized as boiler fuel while the rest of the biomass materials like OPF have not been utilized for energy generation. No previous study has been reported on gasification of oil palm fronds (OPF) biomass for the production of fuel gas. In this paper, the effect of moisture content of fuel and reactor temperature on downdraft gasification of OPF was experimentally investigated using a lab scale gasifier of capacity 50 kW. In addition, results obtained from equilibrium model of gasification that was developed for facilitating the prediction of syngas composition are compared with experimental data. Comparison of simulation results for predicting calorific value of syngas with the experimental results showed a satisfactory agreement with a mean error of 0.1 MJ/Nm³. For a biomass moisture content of 29%, the resulting calorific value for the syngas was found to be only 2.63 MJ/Nm³, as compared to nearly double (4.95 MJ/Nm³) for biomass moisture content of 22%. A calorific value as high as 5.57 MJ/Nm³ was recorded for higher oxidation zone temperature values.
Fulltext Study on tar generated from downdraft gasification of oil palm fronds

Atnaw SM, Kueh SC, Sulaiman SA

ScientificWorldJournal, 2014;2014:497830.
PMID: 24526899 DOI: 10.1155/2014/497830

One of the most challenging issues concerning the gasification of oil palm fronds (OPF) is the presence of tar and particulates formed during the process considering its high volatile matter content. In this study, a tar sampling train custom built based on standard tar sampling protocols was used to quantify the gravimetric concentration of tar (g/Nm3) in syngas produced from downdraft gasification of OPF. The amount of char, ash, and solid tar produced from the gasification process was measured in order to account for the mass and carbon conversion efficiency. Elemental analysis of the char and solid tar samples was done using ultimate analysis machine, while the relative concentration of the different compounds in the liquid tar was determined making use of a liquid gas chromatography (GC) unit. Average tar concentration of 4.928 g/Nm3 and 1.923 g/Nm3 was obtained for raw gas and cleaned gas samples, respectively. Tar concentration in the raw gas sample was found to be higher compared to results for other biomass materials, which could be attributed to the higher volatile matter percentage of OPF. Average cleaning efficiency of 61% which is comparable to that of sand bed filter and venturi scrubber cleaning systems reported in the literature was obtained for the cleaning system proposed in the current study.
Gasifier selection, design and gasification of oil palm fronds with preheated and unheated gasifying air

Guangul FM, Sulaiman SA, Ramli A

Bioresour Technol, 2012 Dec;126:224-32.
PMID: 23073112 DOI: 10.1016/j.biortech.2012.09.018

Oil palm frond biomass is abundantly available in Malaysia, but underutilized. In this study, gasifiers were evaluated based on the available literature data and downdraft gasifiers were found to be the best option for the study of oil palm fronds gasification. A downdraft gasifier was constructed with a novel height adjustment mechanism for changing the position of gasifying air and steam inlet. The oil palm fronds gasification results showed that preheating the gasifying air improved the volumetric percentage of H(2) from 8.47% to 10.53%, CO from 22.87% to 24.94%, CH(4) from 2.02% to 2.03%, and higher heating value from 4.66 to 5.31 MJ/Nm(3) of the syngas. In general, the results of the current study demonstrated that oil palm fronds can be used as an alternative energy source in the energy diversification plan of Malaysia through gasification, along with, the resulting syngas quality can be improved by preheating the gasifying air.
Histological changes in male accessory reproductive organs in rats exposed to cigarette smoke and the protective effect of honey supplementation

Mohamed M, Sulaiman SA, Jaafar H

Afr J Tradit Complement Altern Med, 2012;9(3):329-35.
PMID: 23983363

The effect of cigarette smoke (CS) on histology of male accessory reproductive organs and the possible protective effect of honey supplementation in rats were investigated in this study. Rats received distilled water, honey, CS exposure or honey plus CS exposure. Honey (1.2 g/kg body weight/day) was administered by gavage and CS exposure (3 times per day) was done in a chamber for 13 weeks. CS exposure significantly increased relative weight of epididymis and ventral prostate. There were also significantly increased number of clear cells and epithelial height of cauda epididymis as well as severe interstitial oedema and decreased epithelial height of prostate gland. However, with the supplementation of honey, these histological changes were significantly reversed suggesting the protective effect of honey against the toxic effect of CS on male accessory reproductive organs in rats.
Protective effect of honey against cigarette smoke induced-impaired sexual behavior and fertility of male rats

Mohamed M, Sulaiman SA, Sirajudeen KN

Toxicol Ind Health, 2013 Apr;29(3):264-71.
PMID: 22275383 DOI: 10.1177/0748233711432568

Cigarette smoking is associated with sexual dysfunction and impaired fertility in males. The aim of this study was to determine the potential protective effect of honey against the toxic effect of cigarette smoke (CS) on sexual behavior and fertility of male rats. Thirty-two adult Sprague-Dawley rats were randomly divided into four groups (8 rats/group) as control, honey (H), CS and H plus CS (H + CS) groups. Rats in control and CS groups received oral administration of distilled water daily while rats in H and H + CS groups received honey (1.2 g/kg body weight/day) by oral gavage. Rats in CS and H + CS groups were also exposed to CS for 8 min 3 times/day. From 10 to 13 weeks of treatment, each male rat was cohabited with 3 untreated female rats for sexual behavioral and reproductive performance studies. Honey significantly increased the percentages of rats achieving intromission and ejaculation as well as increased mating and fertility indexes of male rats exposed to CS. Thus, honey has a protective effect against CS-induced impaired sexual behavior and fertility in male rats.
Reliability of the reported ingested dose of acetaminophen for predicting the risk of toxicity in acetaminophen overdose patients

Zyoud SH, Awang R, Sulaiman SA

Pharmacoepidemiol Drug Saf, 2012 Feb;21(2):207-13.
PMID: 21812068 DOI: 10.1002/pds.2218

The present study examines the relationship between the dose of acetaminophen reported to have been ingested by patients and the occurrence of serum acetaminophen levels above the 'possible toxicity' line in patients presenting at the hospital after acetaminophen overdose. The prognostic value of patient-reported dosage cut-offs of 8, 10 and 12 g was determined.
Effect of different doses of Malaysian honey on reproductive parameters in adult male rats

Mohamed M, Sulaiman SA, Jaafar H, Sirajudeen KN

Andrologia, 2012 May;44 Suppl 1:182-6.
PMID: 21592175 DOI: 10.1111/j.1439-0272.2010.01159.x

The aim of this study was to evaluate the effect of different doses of Malaysian honey on male reproductive parameters in adult rats. Thirty-two healthy adult male Sprague-Dawley rats were randomly divided into four groups (eight rats per group). Group 1 (control group) was given 0.5 ml of distilled water. Groups 2, 3 and 4 were given 0.2, 1.2 and 2.4 g kg(-1) body weight of honey respectively. The rats were treated orally by gavage once daily for 4 weeks. Honey did not significantly alter body and male reproductive organs weights. The rats in Group 3 which received honey at 1.2 g kg(-1) had significantly higher epididymal sperm count than those in Groups 1, 2 and 4. No significant differences were found for the percentage of abnormal sperm, elongated spermatid count, reproductive hormonal levels as well as the histology of the testis among the groups. In conclusion, Malaysian honey at a dose of 1.2 g kg(-1) daily significantly increased epididymal sperm count without affecting spermatid count and reproductive hormones. These findings might suggest that oral administration of honey at this dose for 4 weeks may enhance spermiogenesis in adult rats.
Fulltext A survey of knowledge of sexually transmitted infections among patients at a public hospital in Pulau Pinang, Malaysia

Anwar M, Sulaiman SA, Khan TM

Med Princ Pract, 2010;19(4):312-8.
PMID: 20516709 DOI: 10.1159/000312719

OBJECTIVE: The aim of this study was to assess the patients' knowledge and awareness of sexually transmitted infections (STIs).
SUBJECTS AND METHODS: A face-to-face interview was conducted among the patients visiting the Venereal Diseases Outpatient Department of the General Hospital of Pulau Pinang (Malaysia). A 19-item questionnaire was used. A total of 116 patients participated in the study and 107 patients had valid responses. The reliability and internal consistency of the questionnaire tool was estimated on the basis of Cronbach's alpha (= 0.81). The Statistical Package for Social Sciences (SPSS 13.0(R)) was used for data analysis. Student's t test and analysis of variance were used to analyse the knowledge differences among the groups.
RESULTS: Of the 107 patients, 82 (76.6%) were diagnosed with syphilis; AIDS was the most commonly known STI among the patients. Of the 107 patients, 35 were sexually active and of these 23 (65.7%) had more than 1 sexual partner. The most popular source of knowledge was newspapers (51 patients, 47.7%), with hospitals (3 patients, 2.8%) being the least popular one. Overall mean score on knowledge questions was 12.21 out of the maximum of 33 points. Knowledge about causative organisms, risk groups, transmission, symptoms, prevention and treatment of STIs was inadequate. The knowledge level was significantly related to gender (p = 0.03), religion (p = 0.005), educational level (p = 0.000), marital status (p = 0.000) and income level (p = 0.036).
CONCLUSION: This study demonstrated evidence of poor knowledge of STIs amongst the patients attending an STI service in the General Hospital of Pulau Pinang (Malaysia). Hence there is an immediate need for efforts towards improving patient knowledge of STIs.
Study site: Venereal Diseases Outpatient Department, General Hospital Pulau Pinang, Malaysia
High 5-hydroxymethylfurfural concentrations are found in Malaysian honey samples stored for more than one year

Khalil MI, Sulaiman SA, Gan SH

Food Chem Toxicol, 2010 Aug-Sep;48(8-9):2388-92.
PMID: 20595027 DOI: 10.1016/j.fct.2010.05.076

5-Hydroxymethylfurfural (HMF) content is an indicator of the purity of honey. High concentrations of HMF in honey indicate overheating, poor storage conditions and old honey. This study investigated the HMF content of nine Malaysian honey samples, as well as the correlation of HMF formation with physicochemical properties of honey. Based on the recommendation by the International Honey Commission, three methods for the determination of HMF were used: (1) high performance liquid chromatography (HPLC), (2) White spectrophotometry and (3) Winkler spectrophotometry methods. HPLC and White spectrophotometric results yielded almost similar values, whereas the Winkler method showed higher readings. The physicochemical properties of honey (pH, free acids, lactones and total acids) showed significant correlation with HMF content and may provide parameters that could be used to make quick assessments of honey quality. The HMF content of fresh Malaysian honey samples stored for 3-6 months (at 2.80-24.87 mg/kg) was within the internationally recommended value (80 mg/kg for tropical honeys), while honey samples stored for longer periods (12-24 months) contained much higher HMF concentrations (128.19-1131.76 mg/kg). Therefore, it is recommended that honey should generally be consumed within one year, regardless of the type.
Inhibitory effects of Malaysian tualang honey and Australian/New Zealand Manuka honey in modulating experimental breast cancers induced by n-methyl-n-nitrosourea (mnu): A comparative study

Othman NH, Ahmed S, Sulaiman SA

Pathology, 2016 Feb;48 Suppl 1:S148.
PMID: 27772925 DOI: 10.1016/j.pathol.2015.12.403

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