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Fulltext Mechanism of cholesterol gallstone formation

Abu Bakar MA

Med J Malaysia, 1987 Dec;42(4):290-3.
PMID: 3331409
Fulltext Spatial accessibility to health care services among children with cerebral palsy in Johor, Peninsular Malaysia

Abu Bakar MA, Samat N, Yaacob NS

Geospat Health, 2021 10 19;16(2).
PMID: 34672180 DOI: 10.4081/gh.2021.987

Cerebral palsy (CP) is one of the most common causes of disability in childhood, leading to functional limitations and poor nutritional status. Families with CP children face challenges in providing proper care. Thus, accessibility of CP patients to health facilities is important to ensure that they can maintain regular visits to health facilities for proper treatment and care. The current study aimed to map the spatial distribution of CP in Johor, Malaysia and measure the accessibility of CP patients to nearby hospitals, health clinics and community-based rehabilitation centres. The study is based on CP cases in 2017 obtained from the Department of Social Welfare, Malaysia and analysed using the average nearest neighbour, buffer analysis and Kernel Density Estimation. Results indicate that there is generally good access to health care services for many of the CP children in Johor, but for 25% of those living more than 10 km away from the health clinics or community-based rehabilitation centres, regular visits can be a problem. This information should be used for targeted intervention and planning for health care strategies. Furthermore, information on hospital accessibility of CP children would allow for planning of proper and regular treatment for these patients. The study has shown that it is possible to improve the understanding of the distribution of CP cases by integrating spatial analysis using geographical information systems without relying on official information about the density of populations.
Fulltext The use of electronic sensor in hormone analysis

Muda NE, Abu Bakar MA, Majlis BY

Malays J Med Sci, 1999 Jul;6(2):12-6.
PMID: 22589683 MyJurnal

The development of antibody-based biosensor has grown steadily during recent years, and their use as a routine instrument in clinical application is not far from reality. This study has demonstrated the capability of conductometric sensor to quantitate human Follicle Stimulating Hormone (hFSH) from urine samples. The principles are adopted from Enzyme Linked Immunosorbent Assay (ELISA) technique. Self fabricated gold coated electrode was dipped in the microtiter well containing antibody-antigen complex. Substrate was added to the system to initiate a secondary reaction, which produced electroactive species and change the conductivity of the solution. The changes were proportional with the concentration of the hormone present. The results obtained correlate well with the conventional ELISA technique. Inter and intra assay variation (%CV) were under 6% and the lowest detection limit is 0.75 mIU/ml which was well under the physiological range of the hormone. This system offered advantages such as simplicity, reliability, minimal addition of reagents, freedom from turbidity and color problem, probability of miniaturizing the electrode thus minimizing the sample volume and the ability of on line data analysis. This study proved that Antigen-Antibody reaction via EIA could be detected electronically and it has a potential to be used as one of the measuring mode in clinical analysis.
Treatment of Terasil Red R and Cibacron Red R wastewater using extracted aluminum from red earth: factorial design

Alkarkhi AF, Lim HK, Yusup Y, Teng TT, Abu Bakar MA, Cheah KS

J Environ Manage, 2013 Jun 15;122:121-9.
PMID: 23570974 DOI: 10.1016/j.jenvman.2013.03.010

The ability of aluminum coagulant extracted from red earth to treat Terasil Red R (disperse) and Cibacron Red R (reactive) synthetic dye wastewater was studied. The effects of extractant concentration, soil-to-volume of extractant ratio, and the types of extracting agents (NaOH vs. KCl) on the concentration of aluminum extracted were also investigated. In addition, the efficiency of extracted aluminum was compared with aluminum sulfate, in terms of its capability to reduce the chemical oxygen demand (COD) and to remove synthetic color. Factorial design was applied to determine the effect of selected factors on the amount of aluminum extracted from red earth (i.e., pH, dose of coagulant, type of coagulant on COD reduction, and color removal). It was found that only selected factors exhibited a significant effect on the amount of aluminum extracted from red earth. It was also determined that all factors and their interactions exhibited a significant effect on COD reduction and color removal when applying the extracted aluminum in a standard coagulation process. The results were also compared to aluminum sulfate. Furthermore, NaOH was found to be a better extractant of aluminum in red earth than KCl. Therefore, the best extracting conditions for both extractants were as follows: 2 M NaOH and in a 1:5 (soil/volume of extractant) ratio; 1 M KCl and 1:5 ratio. In treating synthetic dye wastewater, the extracted coagulant showed comparable treatment efficiency to the commercial coagulant. The extracted coagulant was able to reduce the COD of the dispersed dye by 85% and to remove 99% of the color of the dispersed dye, whereas the commercial coagulant reduced 90% of the COD and removed 99% of the color of the dispersed dye. Additionally, the extracted coagulant was able to reduce the COD of the reactive dye by 73% and to remove 99% of the color of the reactive dye. However, the commercial coagulant managed to reduce the COD of the reactive dye by 94% and to remove 96% of the color for the reactive dye.
Man With Abdominal Pain

Mustafa MA, Fauzi MH, Abu Bakar MA, Mohd Noor N, Mohamed Hussain M

Ann Emerg Med, 2020 Sep;76(3):362-378.
PMID: 32828330 DOI: 10.1016/j.annemergmed.2020.03.024
Study on the incidence of adverse events during intra-hospital transfer of critical care patients from emergency department

Mohd Ismail MR, Baharuddin KA, Zainal Abidin ZE, Abu Bakar MA, Sjahid AS

Med J Malaysia, 2020 07;75(4):325-330.
PMID: 32723989

INTRODUCTION: Emergency department (ED) plays a main role in the initial management of patients who are critically ill. These patients require intra-hospital transfer for continuation of care. Adverse events can occur during this short duration and the distance of intra -hospital transfer. The aims of this study were to determine the incidence of adverse events during intrahospital transfer from ED and to determine the factors associated.
METHODOLOGY: This was a cross-sectional observational study done from November 2017 until December 2017 at ED Hospital Sultan Abdul Halim (HSAH), a 650-bedded tertiary hospital in the state of Kedah. All patients that were triaged to red zone, age 18 years and above, and involved in intra-hospital transfer to critical coronary unit, intensive care unit and wards were included. All cases were documented in proforma by the accompanying staff.
RESULTS: Among the 170 critically ill patients, only 29 patients (17.1%) experienced adverse events during intra-hospital transfer. The adverse events seen were hypotension (12.4%), desaturation (3.5%) and dislodged peripheral line (2.4%). Cardiorespiratory related diagnosis was the commonest presentation. Intra-hospital transfer during morning shift and evening shift has 79.5% (b=-1.59, OR=0.21, 95% CI: 0.06, 0.69, p=0.011) and 75.6% ((b=-1.41, OR=0.24, 95% CI: 0.08, 0.73, p=0.012) lesser odds of experiencing adverse events compare to night shift. Patients with vasopressor/inotropes had 9 times higher odds of experiencing adverse events during transportation, compared to patients with no vasopressor/inotropes (b=2.27, OR=9.70, 95% CI: 3.39, 27.72, p<0.001).
CONCLUSIONS: Critical care patients who are involved in intrahospital transfer were at risk of adverse events such as hypotension, desaturation and dislodge peripheral line. Risk identification and maintaining level of care is important to minimize the adverse events during transfer. Patients had higher rates of adverse events if they were transferred during night shifts and on inotropic/vasopressor support.
Efficacy of ketorolac in the treatment of acute migraine attack: a systematic review and meta-analysis

Mohd Noor N, Yazid MB, Mohd Noor N, Baharuddin KA, Abu Bakar MA

Acad Emerg Med, 2022 Feb 09.
PMID: 35138658 DOI: 10.1111/acem.14457

OBJECTIVES: This review was designated to evaluate the efficacy of parenteral ketorolac in treating acute migraine headache.
METHODS: We searched databases Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Google Scholar up to January 2021 and identified randomised controlled trials comparing ketorolac to any other medications in treating patients presenting with migraine headache.
RESULTS: Thirteen trials were included in our review, comprising of 944 participants. We derived seven comparisons; ketorolac versus phenothiazines, metoclopramide, sumatriptan, dexamethasone, sodium valproate, caffeine, and diclofenac. There were no significant differences in the reduction of pain intensity at 1-hour under the comparisons between ketorolac and phenothiazines (standard mean difference (SMD) 0.09, P 0.74), or metoclopramide (SMD 0.02, P 0.95). We also found no difference in the outcome recurrence of headache [ketorolac vs phenothiazines (risk ratio (RR) 0.98, P 0.97)], ability to return to work or usual activity [ketorolac vs metoclopramide (RR 0.64, P 0.13)], need for rescue medication [ketorolac vs phenothiazines (RR 1.72, P 0.27), ketorolac vs metoclopramide (RR 2.20, P 0.18)], and frequency of adverse effects [ketorolac vs metoclopramide (RR 1.07, P 0.82)]. Limited trials suggested that ketorolac offered better pain relief at 1-hour compared to sumatriptan and dexamethasone, had lesser frequency of adverse effects than phenothiazines, and was superior to sodium valproate in terms of reduction of pain intensity at 1-hour, need for rescue medication and sustained headache freedom within 24-hour.
CONCLUSIONS: Ketorolac may have similar efficacy to phenothiazines and metoclopramide in treating acute migraine headache. Ketorolac may also offer better pain control than sumatriptan, dexamethasone and sodium valproate. However, given the lack of evidence due to inadequate number of trials available, future studies are warranted.
Fulltext In vitro effects of plantago major extract on urolithiasis

Aziz SA, See TL, Khuay LY, Osman K, Abu Bakar MA

Malays J Med Sci, 2005 Jul;12(2):22-6.
PMID: 22605954

The study was carried out to determine the in vitro effect of Plantago major extract on calcium oxalate crystals and to compare the effects of Plantago major extract with clinically used drugs like allopurinol and potassium citrate (positive controls). Modified Schneider slide gel method was used for the in vitro study and the crystals formed were measured by Image Analyser system KS 300, 3.0 Carl Zeiss. The concentrations of Plantago major extract used were from 100ppm to 350ppm. Plantago major extract at concentrations in the range of (100ppm-350ppm) significantly inhibited the size of calcium oxate crystals (dihydrate variety) against negative control (p<0.05) and against positive controls (p<0.05). However the inhibition concentration 50 (IC(50)) values on the size of calcium oxalate crystal for the extract, potassium citrate and allopurinol were 300ppm, 350ppm and 450ppm respectively. Extract of Plantago major also has inhibition effect on the number of crystals but it was not significant. In conclusion extract of Plantago major was better than allopurinol and potassium citrate in inhibiting the size of the calcium oxalate crystal in-vitro.
Rational design of carbonitrile-carboxaldehyde cation receptor models: probing the nature of the heteroatom-metal interaction

Rosli AN, Abu Bakar MA, Lee VS, Zain SM, Ahmad MR, Abdul Manan NS, et al.

J Mol Model, 2014 Sep;20(9):2428.
PMID: 25149440 DOI: 10.1007/s00894-014-2428-9

In this work, hybrid functional and G4 methods were employed in the rational design of carbonitrile-carboxaldehyde receptor models for cation recognition. Electron-sharing and ionic interactions between the models and the cations were analyzed utilizing the concepts of overlap population, atomic valence, electrostatic potential, and CHELPG charge in order to elucidate the nature of the heteroatom-metal interaction, the N versus O disparity, and the effect of pH. Receptor fragment models from ionomycin were employed to rationalize the selection of receptor models for discriminating group I cations and enhancing the selectivity for Mg(II) rather than Ca(II), and to examine the effects of keto-enol forms and negatively charged sites. The changes in geometries, overlap population, metal valence, and CHELPG charge upon solvation in heptane medium as compared to the gas phase were negligible. The optimized geometries reveal that the interaction between group II cations and the keto, enol, and enolate forms of 2-cyanoethanal causes 12 % bending of the C-C-N angle from linearity. Overlap populations show that the electron-sharing interaction favors group II cations but that the same mechanism allows Li(I) to compete. The total spin of Li(I) is 17 % greater than that of Ca(II), but the G4 binding energies of the two are separated by more than 50 kcal/mol, favoring group II cations, which may eliminate interference from Li(I). 1,2-Dicyanoethylene, which has only one form, shows similar characteristics. CHELPG analysis shows that Mg(II) transfers 25 and 18 % of its positive charge to 2-cyanoethanal enolate and 1,2-dicyanoethylene, respectively. Hydrogen atoms receive most of the positive charge in both receptors, but the N-termini exhibit strikingly different characteristics. Electrostatic potential contour profiles were found to be in good agreement with the atomic charge distributions. The application of uncharged 1,3-dicarbonyl and 2-cyanocarbonyl receptors and a judicious choice of polymeric membrane that suppresses the Hofmeister effect should lead to high selectivity for magnesium, whereas the utilization of multiple negatively charged ionophores should result in selectivity for calcium.