Displaying publications 41 - 60 of 88 in total

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  1. Abu Hassan Shaari NS, Abdul Manaf Z, Shahar S, Mohamad Ali N, Mohamed Ismail NA
    MyJurnal
    Peer-reviewed articles on the usage of mobile applications in the management of diabetes were reviewed. Studies using mobile device applications for diabetes interventions published between January 2007 and March 2013 were included in this review. Studies related to the developmental processes of the mobile applications were excluded. The characteristics of these studies and the outcomes of the methods used in the management of diabetes were gathered. We retrieved a total of 372 articles from ACM Digital library, PubMed and Proquest Medical Library. After applying the inclusion and exclusion criteria, 8 articles were eligible for further review. Most of the studies included in this review showed the effectiveness of mobile applications in diabetes management. Their major contribution comes from feedback functions of the systems that assist participants in the self-monitoring of their blood glucose and dietary intake. However, the majority of the studies showed the limited use of the mobile phone as a tool to input information into systems which would in turn convey a reminder message to the patient. In conclusion, with its features of portability and convenience, mobile application used in the management of diabetes has the potential to improve glycaemic control, resulting in significant clinical and financial benefits.
  2. Chaiyasarn K, Ali N, Phuphasuwan P, Poovarodom N, Joyklad P, Mohamad H, et al.
    Polymers (Basel), 2021 Oct 19;13(20).
    PMID: 34685363 DOI: 10.3390/polym13203604
    Experimental and finite element analysis results of reinforced concrete beams under monotonic loading were presented in this study. In the experimental program, one beam was tested in an as-built condition. The other two beams were strengthened using natural hybrid FRP layers in different configurations. The natural hybrid FRP composite was developed by using natural jute FRP and basalt FRP. One of the most appealing advantages of natural fiber is its beneficial impact on the environment, which is necessary for the sustainability recognition as an alternative to synthetic FRP. The hybrid FRP was applied to the bottom concrete surface in one beam, while a U-shaped strengthening pattern was adopted for the other beam. The flexural behavior of each beam was assessed through strain measurements. Each beam was incorporated with conventional strain gages, as well as the Brillouin Optical Time Domain Analysis (BOTDA) technique. BOTDA has its exclusive advantages due to its simple system architecture, easy implementation, measurement speed, and cross-sensitivity. The experimental results revealed that the beam strengthened with the U-shaped hybrid FRP composite pattern had a better flexural response than the other counterpart beams did both in terms of peak loads and maximum bottom longitudinal steel bar strains. Beams B-01 and B-02 exhibited 20.5% and 28.4% higher energy dissipation capacities than the control beam did, respectively. The ultimate failure of the control beam was mainly due to the flexural cracks at very low loads, whereas the ultimate failure mode of FRP composite-strengthened beams was due to the rupture of the hybrid FRP composite. Further, strain measurements using BOTDA exhibited similar patterns as conventional strain gage measurements did. However, it was concluded that BOTDA measurements were substantially influenced by the bottom flexural cracks, ultimately resulting in shorter strain records than those of conventional strain gages. Nonlinear structural analysis of the beams was performed using the computer program ATENA. The analytical results for the control beam specimen showed a close match with the corresponding experimental results mainly in terms of maximum deflection. However, the analytical peak load was slightly higher than the corresponding experimental value.
  3. Lee JY, Ang ASY, Mohd Ali N, Ang LM, Omar A
    J Pharm Policy Pract, 2021 Oct 25;14(1):84.
    PMID: 34696800 DOI: 10.1186/s40545-021-00370-3
    BACKGROUND: An urgent need for coronavirus infectious disease (COVID-19) treatment has resulted in off-label drug use. Although previous studies had investigated the adverse drug reaction (ADR) of the medications for COVID-19 in their respective local settings, the safety profile in a Malaysian setting remains unknown. Our study aims to establish the incidence of ADR for drugs used in COVID-19 management in a Malaysian tertiary hospital.

    METHODS: This retrospective observational study enrolled patients started on drugs for COVID-19 in Sungai Buloh Hospital from 1 March 2020 to 31 May 2020. The clinical staging of COVID-19 patients was decided by the treating physician in accordance with the Clinical Management of Confirmed COVID-19 Case in Adults (Annex 2E). Suspected ADRs were evaluated with a trigger tool of pre-defined laboratory values or the adverse events listed in the registered product insert. Causality assessment was conducted when an ADR was suspected using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system, and only cases classified as certain, probable and possible ADR were considered. Data analysis was completed with descriptive, univariate and multivariate analysis.

    RESULTS: The study (N = 1,080) identified 217 patients (20.1%) who experienced ADR, with 246 adverse events detected. Most events were related to the gastrointestinal (43.5%), hepatobiliary (36.2%) and cardiac (16.3%) systems. The most commonly suspected drugs were atazanavir (52.7%), chloroquine (36.8%) and lopinavir/ritonavir (34.6%). The independent risk factors of ADR were female (adjusted odds ratio (OR): 1.53; 95% CI 1.06-2.20; P = 0.024), diagnosis of COVID-19 stage 3 (adjusted OR: 2.58; 95% CI 1.20-5.55; P = 0.015) and stage 4 (adjusted OR: 4.17; 95% CI 1.79-9.73; P = 0.001), and the number of COVID-19 drugs (adjusted OR: 3.34; 95% CI 2.51-4.44; P 

  4. Ali N, Abbas S, Cao Y, Fazal H, Zhu J, Lai CW, et al.
    J Colloid Interface Sci, 2022 Feb 07;615:707-715.
    PMID: 35168019 DOI: 10.1016/j.jcis.2022.02.012
    Solar steam generation has great potential in alleviating freshwater crises, particularly in regions with accessible seawater and abundant insolation. Inexpensive, efficient, and eco-friendly photothermal materials are desired to fabricate sunlight-driven evaporation devices. Here, we have designed an economical strategy to fabricate a high-performance wood-based solar steam generation device. In current study, 3D-hierarchical Cu3SnS4 has been loaded on wood substrates of variable sizes via an in-situ solvothermal method. Considering the water transportation capacity and thermal insulation property of wood, an enhanced light absorption was achieved by a uniform coating of Cu3SnS4 on the inside and outside of the 3D porous structure of the wood. Thanks for the synergistic effect of Cu3SnS4 and wood substrate, the obtained composite endorsed high-performance solar steam generation with a steam generation efficiency of 90% and an evaporation rate as high as 1.35 kg m-2h-1 under one sun.
  5. Awang K, Ibrahim H, Rosmy Syamsir D, Mohtar M, Mat Ali R, Azah Mohamad Ali N
    Chem Biodivers, 2011 Apr;8(4):668-73.
    PMID: 21480512 DOI: 10.1002/cbdv.201000225
    The essential oils from the leaves and rhizomes of Alpinia pahangensis Ridl., collected from Pahang, Peninsular Malaysia, were obtained by hydrodistillation, and their chemical compositions were determined by GC and GC/MS analyses. The major components of the rhizome oil were γ-selinene (11.60%), β-pinene (10.87%), (E,E)-farnesyl acetate (8.65%), and α-terpineol (6.38%), while those of the leaf oil were β-pinene (39.61%), α-pinene (7.55%), and limonene (4.89%). The investigation of the antimicrobial activity of the essential oils using the broth microdilution technique revealed that the rhizome oil of A. pahangensis inhibited five Staphylococcus aureus strains with minimum inhibitory concentration (MIC) values between 0.08 and 0.31 μg/μl, and four selected fungi with MIC values between 1.25 and 2.50 μg/μl.
  6. Ali N, Aziz SA, Nordin S, Mi NC, Abdullah N, Paranthaman V, et al.
    Subst Use Misuse, 2018 01 28;53(2):239-248.
    PMID: 29116878 DOI: 10.1080/10826084.2017.1385630
    BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005.
    OBJECTIVE: To evaluate the effectiveness of MMT.
    METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20.
    RESULTS: There were 3254 respondents (93.6% response rate); of these 17.5% (n = 570) transferred to another treatment center, 8.6% (n = 280) died, 29.2% (n = 950) defaulted, and 7.6% (n = 247) were terminated for various reasons. Hence, 1233 (37%) respondents' baseline and follow-up data were further analyzed. Respondents had a mean age of 39.2 years old and were mainly male, Malay, Muslim, married (51.1%, n = 617), and currently employed. Few showed viral seroconversion after they started MMT (HIV: 0.5%, n = 6; Hepatitis B: 0.3%, n = 4; Hepatitis C: 2.7%, n = 29). There were significant reductions in opioid use, HIV risk-taking score (p < 0.01), social functioning (p < 0.01), crime (p < 0.01), and health (p < 0.01). However, there were significant improvements in quality of life in the physical, psychological, social, and environmental domains. Factors associated with change were being married, employed, consuming alcohol, and high criminality at baseline. Lower methadone dosage was significantly associated with improvements in the physical, psychological, and environmental domains.
    Conclusion/Importance: The MMT program was found to be successful; hence, it should be expanded.
  7. Ghani LA, Mahmood NZ, Ismail R, Sa'at SA, Ali N, Mohd Zakuan SA
    Heliyon, 2022 Dec;8(12):e12309.
    PMID: 36619421 DOI: 10.1016/j.heliyon.2022.e12309
    The research on food flow network is unpredictable as the approaches employed are more targeted at specific study points, often excluding spatial and temporal changes. The research questions must still address why and how food flow moves in the entire supply chain system. This study aims to investigate the movement of food flow using national statistics, comprising of four main subsystems: agriculture, nutrition, waste, wastewater management, and the environment by using the Material Flow Analysis (MFA) approach. Comprehensive research using primary and secondary data including literature reviews have successfully bridged the knowledge gap on food supply chain management in Malaysia. This article provides new contributions through the considerations of food safety and the opportunity to understand flow issues that are connected to hotspots, closed flow, and economic circulars. Additionally, this study acts as a simple guide for policymakers to manage the imbalances of food supply in certain areas. From the perspective of food waste management, several important strategies were successfully formulated to combat the leakage of food waste flow and financial burden while highlighting the need for local social actors' involvement to fulfil Malaysia's agenda of Sustainable Development Goals.
  8. Ghaben SJ, Mat Ludin AF, Mohamad Ali N, Beng Gan K, Singh DKA
    Digit Health, 2023;9:20552076231191014.
    PMID: 37599901 DOI: 10.1177/20552076231191014
    OBJECTIVE: This scoping review aimed to identify the design and usability testing of a telerehabilitation (TR) system, and its characteristics and functionalities that are best-suited for rehabilitating adults with chronic diseases.

    METHODS: Searches were conducted in PubMed, EBSCO, Web of Science, and Cochrane library for studies published between January 2017 and December 2022. We followed the Joanna Briggs Institute guidelines and the framework by Arksey and O'Malley. Screening was undertaken by two reviewers, and data extraction was undertaken by the first author. Then, the data were further reviewed and discussed thoroughly with the team members.

    RESULTS: A total of 31 results were identified, with the core criteria of developing and testing a telerehabilitation system, including a mobile app for cardiovascular diseases, cancer, diabetes, and chronic respiratory disorders. All developed systems resulted from multidisciplinary teams and employed mixed-methods research. We proposed the "input-process-output" framework that identified phases of both system design and usability testing. Through system design, we reported the use of user-centered design, iterative design, users' needs and characteristics, theory underpinning development, and the expert panel in 64%, 75%, 86%, 82%, and 71% of the studies, respectively. We recorded the application of moderated usability testing, unmoderated testing (1), and unmoderated testing (2) in 74%, 63%, and 15% of the studies, respectively. The identified design and testing activities produced a matured system, a high-fidelity prototype, and a released system in 81.5%, 15%, and 3.5%, respectively.

    CONCLUSION: This review provides a framework for TR system design and testing for a wide range of chronic diseases that require prolonged management through remote monitoring using a mobile app. The identified "input-process-output" framework highlights the inputs, design, development, and improvement as components of the system design. It also identifies the "moderated-unmoderated" model for conducting usability testing. This review illustrates characteristics and functionalities of the TR systems and healthcare professional roles.

  9. Chew BH, Cheong AT, Ismail M, Hamzah Z, A-Rashid MR, Md-Yasin M, et al.
    BMJ Open, 2014 Jun 11;4(6):e004645.
    PMID: 24919639 DOI: 10.1136/bmjopen-2013-004645
    OBJECTIVE: To examine the expectation of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.

    DESIGN: Cross-sectional study.

    SETTING: This study is part of a larger national study on the perception of the Malaysian public healthcare professionals on FMSs.

    PARTICIPANTS: PHCPs from three categories of health facilities, namely hospitals, health clinics and health offices.

    MAIN OUTCOME MEASURES: Qualitative analysis of written comments of respondents' expectation of FMSs.

    RESULTS: The participants' response rate was 58% (780/1345) with an almost equal proportion from each public healthcare facility. We identified 21 subthemes for the 623 expectation comments. The six emerging themes are (1) need for more FMSs, (2) clinical roles and functions of FMSs, (3) administrative roles of FMSs, (4) contribution to community and public health, (5) attributes improvement and (6) research and audits. FMSs were expected to give attention to clinical duty. Delivering this responsibility with competence included having the latest medical knowledge in their own and others' medical disciplines, practising evidence-based medicine in prehospital and posthospital care, better supervision of staff and doctors under their care, fostering effective teamwork, communicating more often with hospital specialists and making appropriate referral. Expectations ranged from definite and strong for more FMSs at the health clinics to low expectation for FMSs' involvement in research; to mal-expectation on FMSs' involvement in community and public health programmes.

    CONCLUSIONS: There were some remarkable differences in expectations on FMSs from the three different PHCPs. These ranged from being clinically competent and administratively available for patients and staff at the health clinics, to mal-expectations on FMSs to engage in public health affairs. Relevant parties, including FMSs themselves, could take appropriate self-improvement initiatives to enhance public practice of family medicine and patient care.

    TRIAL REGISTRATION NUMBER NMRR ID: 08-12-1167.

  10. Samreen A, Ali MS, Huzaifa M, Ali N, Hassan B, Ullah F, et al.
    Chem Rec, 2024 Jan;24(1):e202300247.
    PMID: 37933973 DOI: 10.1002/tcr.202300247
    The high-temperature solid oxide fuel cells (SOFCs) are the most efficient and green conversion technology for electricity generation from hydrogen-based fuel as compared to conventional thermal power plants. Many efforts have been made to reduce the high operating temperature (>800 °C) to intermediate/low operating temperature (400 °C
  11. Sabry AH, I Dallal Bashi O, Nik Ali NH, Mahmood Al Kubaisi Y
    Heliyon, 2024 Feb 29;10(4):e26218.
    PMID: 38420389 DOI: 10.1016/j.heliyon.2024.e26218
    The use of computer-based automated approaches and improvements in lung sound recording techniques have made lung sound-based diagnostics even better and devoid of subjectivity errors. Using a computer to evaluate lung sound features more thoroughly with the use of analyzing changes in lung sound behavior, recording measurements, suppressing the presence of noise contaminations, and graphical representations are all made possible by computer-based lung sound analysis. This paper starts with a discussion of the need for this research area, providing an overview of the field and the motivations behind it. Following that, it details the survey methodology used in this work. It presents a discussion on the elements of sound-based lung disease classification using machine learning algorithms. This includes commonly prior considered datasets, feature extraction techniques, pre-processing methods, artifact removal methods, lung-heart sound separation, deep learning algorithms, and wavelet transform of lung audio signals. The study introduces studies that review lung screening including a summary table of these references and discusses the literature gaps in the existing studies. It is concluded that the use of sound-based machine learning in the classification of respiratory diseases has promising results. While we believe this material will prove valuable to physicians and researchers exploring sound-signal-based machine learning, large-scale investigations remain essential to solidify the findings and foster wider adoption within the medical community.
  12. Iqbal SZ, Usman S, Razis AFA, Basheir Ali N, Saif T, Asi MR
    Int J Environ Res Public Health, 2020 Aug 03;17(15).
    PMID: 32756472 DOI: 10.3390/ijerph17155602
    The main goal of the present research was to explore the seasonal variation of deoxynivalenol (DON) in wheat, corn, and their products, collected during 2018-2019. Samples of 449 of wheat and products and 270 samples of corn and their products were examined using reverse-phase liquid chromatography with a UV detector. The findings of the present work showed that 104 (44.8%) samples of wheat and products from the summer season, and 91 (41.9%) samples from winter season were contaminated with DON (concentration limit of detections (LOD) to 2145 µg/kg and LOD to 2050 µg/kg), from summer and winter seasons, respectively. In corn and products, 87 (61.2%) samples from summer and 57 (44.5%) samples from winter season were polluted with DON with levels ranging from LOD to 2967 µg/kg and LOD to 2490 µg/kg, from the summer and winter season, respectively. The highest dietary intake of DON was determined in wheat flour 8.84 µg/kg body weight/day from the summer season, and 7.21 µg/kg body weight/day from the winter season. The findings of the work argued the need to implement stringent guidelines and create awareness among farmers, stakeholders, and traders of the harmful effect of DON. It is mostly observed that cereal crops are transported and stockpiled in jute bags, which may absorb moisture from the environment and produce favorable conditions for fungal growth. Therefore, these crops must store in polyethylene bags during transportation and storage, and moisture should be controlled. It is highly desirable to use those varieties that are more resistant to fungi attack. Humidity and moisture levels need to be controlled during storage and transportation.
  13. Mohd Ali N, Yeap SK, Ho WY, Beh BK, Tan SW, Tan SG
    J Biomed Biotechnol, 2012;2012:171956.
    PMID: 23251075 DOI: 10.1155/2012/171956
    With increasing public health awareness worldwide, demand for functional food with multiple health benefits has also increased. The use of medicinal food from folk medicine to prevent diseases such as diabetes, obesity, and cardiovascular problems is now gaining momentum among the public. Seed from Salvia hispanica L. or more commonly known as chia is a traditional food in central and southern America. Currently, it is widely consumed for various health benefits especially in maintaining healthy serum lipid level. This effect is contributed by the presence of phenolic acid and omega 3/6 oil in the chia seed. Although the presence of active ingredients in chia seed warrants its health benefits, however, the safety and efficacy of this medicinal food or natural product need to be validated by scientific research. In vivo and clinical studies on the safety and efficacy of chia seed are still limited. This paper covers the up-to-date research on the identified active ingredients, methods for oil extraction, and in vivo and human trials on the health benefit of chia seed, and its current market potential.
  14. Abdul Wahab SA, Yakob Y, Mohd Khalid MKN, Ali N, Leong HY, Ngu LH
    Genet Res (Camb), 2022;2022:5870092.
    PMID: 36160031 DOI: 10.1155/2022/5870092
    BACKGROUND: Glycogen storage disease type 1a (GSD1a) is a rare autosomal recessive metabolic disorder characterized by hypoglycaemia, growth retardation, lactic acidosis, hepatomegaly, hyperlipidemia, and nephromegaly. GSD1a is caused by a mutation in the G6PC gene encoding glucose-6-phosphatase (G6Pase); an enzyme that catalyses the hydrolysis of glucose-6-phosphate (G6P) to phosphate and glucose.

    OBJECTIVE: To elaborate on the clinical findings, biochemical data, molecular genetic analysis, and short-term prognosis of 13 GSD1a patients in Malaysia.

    METHODS: The information about 13 clinically classified GSD1a patients was retrospectively studied. The G6PC mutation analysis was performed by PCR-DNA sequencing.

    RESULTS: Patients were presented with hepatomegaly (92%), hypoglycaemia (38%), poor weight gain (23%), and short stature (15%). Mutation analysis revealed nine heterozygous mutations; eight previously reported mutations (c.155 A > T, c.209 G > A, c.226 A > T, c.248 G > A, c.648 G > T, c.706 T > A, c.1022 T > A, c.262delG) and a novel mutation (c.325 T > C). The most common mutation found in Malaysian patients was c.648 G > T in ten patients (77%) of mostly Malay ethnicity, followed by c.248 G > A in 4 patients of Chinese ethnicity (30%). A novel missense mutation (c.325 T > C) was predicted to be disease-causing by various in silico software.

    CONCLUSIONS: The establishment of G6PC molecular genetic testing will enable the detection of presymptomatic patients, assisting in genetic counselling while avoiding the invasive methods of liver biopsy.

  15. Selvaraj FJ, Mohamed M, Omar K, Nanthan S, Kusiar Z, Subramaniam SY, et al.
    BMC Fam Pract, 2012;13:97.
    PMID: 23046818 DOI: 10.1186/1471-2296-13-97
    BACKGROUND: To evaluate the efficacy of Counselling and Advisory Care for Health (COACH) programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm) and primary care physicians assisted by nurse educators (PCP-NE arm).
    METHODS: This was a multi-centre, open label, randomised trial of a disease management programme (COACH) among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE) and 148 to care provided by primary care physicians (PCP) alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio), Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36.
    RESULTS: Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS) mean change from baseline LDL-C were -30.09% and -27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288), with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had ended).
    CONCLUSION: Patients who received coaching and advice from primary care physicians (with or without the assistance by nurse educators) showed improvement in LDL-cholesterol. Disease management services delivered by PCP-NE demonstrated a trend towards add-on improvements in cholesterol control compared to care delivered by physicians alone; however, the improvements were not maintained when the services were withdrawn.
    TRIAL REGISTRATION:
    National Medical Research Registration (NMRR) Number: NMRR-08-287-1442Trial Registration Number (ClinicalTrials.gov Identifier): NCT00708370.
  16. Mohd Ali N, Mohd Yusof H, Long K, Yeap SK, Ho WY, Beh BK, et al.
    Biomed Res Int, 2013;2013:693613.
    PMID: 23484140 DOI: 10.1155/2013/693613
    Mung bean is a hepatoprotective agent in dietary supplements. Fermentation and germination processes are well recognized to enhance the nutritional values especially the concentration of active compounds such as amino acids and GABA of various foods. In this study, antioxidant and hepatoprotective effects of freeze-dried mung bean and amino-acid- and GABA-enriched germinated and fermented mung bean aqueous extracts were compared. Liver superoxide dismutase (SOD), malondialdehyde (MDA), ferric reducing antioxidant power (FRAP), nitric oxide (NO) levels, and serum biochemical profile such as aspartate transaminase (AST), alanine transaminase (ALT), triglycerides (TG), and cholesterol and histopathological changes were examined for the antioxidant and hepatoprotective effects of these treatments. Germinated and fermented mung bean have recorded an increase of 27.9 and 7.3 times of GABA and 8.7 and 13.2 times of amino acid improvement, respectively, as compared to normal mung bean. Besides, improvement of antioxidant levels, serum markers, and NO level associated with better histopathological evaluation indicated that these extracts could promote effective recovery from hepatocyte damage. These results suggested that freeze-dried, germinated, and fermented mung bean aqueous extracts enriched with amino acids and GABA possessed better hepatoprotective effect as compared to normal mung bean.
  17. Mohd Ali N, Boo L, Yeap SK, Ky H, Satharasinghe DA, Liew WC, et al.
    PeerJ, 2016;4:e1536.
    PMID: 26788424 DOI: 10.7717/peerj.1536
    Decline in the therapeutic potential of bone marrow-derived mesenchymal stem cells (MSC) is often seen with older donors as compared to young. Although hypoxia is known as an approach to improve the therapeutic potential of MSC in term of cell proliferation and differentiation capacity, its effects on MSC from aged donors have not been well studied. To evaluate the influence of hypoxia on different age groups, MSC from young (<30 years) and aged (>60 years) donors were expanded under hypoxic (5% O2) and normal (20% O2) culture conditions. MSC from old donors exhibited a reduction in proliferation rate and differentiation potential together with the accumulation of senescence features compared to that of young donors. However, MSC cultured under hypoxic condition showed enhanced self-renewing and proliferation capacity in both age groups as compared to normal condition. Bioinformatic analysis of the gene ontology (GO) and KEGG pathway under hypoxic culture condition identified hypoxia-inducible miRNAs that were found to target transcriptional activity leading to enhanced cell proliferation, migration as well as decrease in growth arrest and apoptosis through the activation of multiple signaling pathways. Overall, differentially expressed miRNA provided additional information to describe the biological changes of young and aged MSCs expansion under hypoxic culture condition at the molecular level. Based on our findings, the therapeutic potential hierarchy of MSC according to donor's age group and culture conditions can be categorized in the following order: young (hypoxia) > young (normoxia) > old aged (hypoxia) > old aged (normoxia).
  18. Chew BH, Yasin MM, Cheong AT, Rashid MR, Hamzah Z, Ismail M, et al.
    Springerplus, 2015;4:213.
    PMID: 25992310 DOI: 10.1186/s40064-015-1004-9
    Perception of healthcare providers who worked with family medicine specialists (FMSs) could translate into the effectiveness of primary healthcare delivery in daily practices. This study examined perceptions of public healthcare providers/professionals (PHCPs) on FMSs at public health clinics throughout Malaysia. This was a cross-sectional study in 2012-2013 using postal method targeting PHCPs from three categories of health facilities, namely health clinics, health offices and hospitals. A structured questionnaire was developed to assess PHCP's perception of FMS's clinical competency, safety practice, ethical and professional values, and research involvement. It consists of 37 items with Likert scale of strongly disagree (a score of 1) to strongly agree (a score of 5). Interaction and independent effect of the independent variables were tested and adjusted means score were reported. The participants' response rate was 58.0% (780/1345) with almost equal proportion from each of the three public healthcare facilities. There were more positive perceptions than negative among the PHCPs. FMSs were perceived to provide effective and safe treatment to their patients equally disregards of patient's social background. However, there were some concerns of FMSs not doing home visits, not seeing walk-in patients, had long appointment time, not active in scientific research, writing and publication. There were significant differences in perception based on a respondent's health care facility (p 
  19. Idris I, Tohid H, Muhammad NA, A Rashid MR, Mohd Ahad A, Ali N, et al.
    BMJ Open, 2018 12 22;8(12):e025125.
    PMID: 30580276 DOI: 10.1136/bmjopen-2018-025125
    OBJECTIVES: This study aimed to determine the prevalence of anaemia among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at primary care settings and its associated factors.
    DESIGN, SETTING AND PARTICIPANTS: This cross-sectional study involved 808 adult patients with T2DM and CKD who were recruited via systematic sampling from 20 public primary care clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical profiles were collected through interviews, examination of medical records and blood testing.
    RESULTS: The prevalence of anaemia was 31.7% (256/808). The anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% of the patients with anaemia were not known to have anaemia prior to the study. Among 36 patients with documented history of anaemia, 80.6% were still anaemic, and only a half received iron therapy. Multivariate regression analysis showed that women (adjusted odd ratio (AOR): 1.57, 95% CI: 1.12 to 2.21, p=0.009) and those with older age (AOR: 1.04, 95% CI: 1.01 to 1.06, p<0.001), CKD stage 3a (AOR: 2.47; 95% CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95% CI: 2.14 to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95% CI: 4.36 to 23.47, p<0.001), CKD stage 5 (AOR: 10.80; 95% CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 3.12, 95% CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having higher body mass index (AOR 0.95, 95% CI: 0.92 to 0.99, p=0.012) and higher diastolic blood pressure (AOR 0.97, 95% CI: 0.95 to 0.99, p<0.001) were associated with lower odds to have anaemia.
    CONCLUSION: Anaemia among patients with T2DM and CKD in primary care was common, and the majority was unrecognised. Inadequate treatment of anaemia was also prevalent. Therefore, screening of anaemia should be incorporated into the routine assessment of diabetic complications particularly for those with significant associated factors. It is hoped that such strategy could lead to early treatment and hence improve their overall care.

    TRIAL REGISTRATION NUMBER: NMRR-15-660-24324.
  20. Chong CW, Alkatheeri AHS, Ali N, Tay ZH, Lee YL, Paramasivam SJ, et al.
    Gut Pathog, 2020;12:14.
    PMID: 32175011 DOI: 10.1186/s13099-020-00352-x
    Background: The rise of nature-based ecotourism in the past decade has introduced unprecedented challenges in managing the increasing interaction between humans and animals. The potential transmission of antibiotic resistant microbes between humans and non-human primate populations is a concern due to their genetic similarity. Malaysia is well known for hotspots of wildlife diversity where non-human primates like monkeys and orangutans have become popular tourist attractions. In this study, we assessed the prevalence of antimicrobial resistant Staphylococcus aureus, Enterococcus species, and other Enterobacteriaceae in the faeces of human (HS) and two non-human primates (NHP) in Malaysia, the Long-tailed macaque (Macaca fascicularis, MF) and Silvered leaf monkey (Trachypithecus cristatus, TC). In addition, the faecal bacterial composition was profiled to evaluate the potential association between antibiotic resistant profiles and composition of gut microbiota.

    Results: We tested the isolated bacteria using a selection of antibiotics. The results showed that both the number of antibiotic resistant strains and resistance level were higher in humans than NHPs. Overall, the composition of gut microbiome and pattern of antibiotic resistance showed that there was higher similarity between MF and TC, the two NHPs, than with HS. In addition, samples with higher levels of antibiotic resistance showed lower bacterial richness. Homo sapiens had the lowest bacterial diversity and yet it had higher abundance of Bacteroides. In contrast, NHPs displayed higher bacterial richness and greater prevalence of Firmicutes such as Ruminococceae and Oscillospira.

    Conclusion: Higher antibiotic susceptibility in NHPs is likely related to low direct exposure to antibiotics. The lack of resistance may also suggest limited antimicrobial resistance transmission between humans and NHP. Nonetheless, continued monitoring over a long period will help mitigate the risk of anthropozoonosis and zooanthroponosis.

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