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Fulltext Correlation of iatrogenic mild hyperkalaemia and bradyarrhythmia: a problem of polypharmacy in elderly

Ahmad, N. H., Tan, T. L.

Medicine & Health, 2017;12(2):329-334.
MyJurnal

Mild hyperkalaemia does not typically cause cardiac symptoms. However, for an elderly patient on atrio-ventricular (AV) nodal blocker, even mild hyperkalaemia may result in disastrous outcome. We report a case of persistent bradyarrythmia caused by iatrogenic hyperkalaemia in a patient who had concomitant use of AV nodal medication. An 81-year-old lady with multiple comorbidities and a long list of medications presented with symptomatic bradyarrhythmia. She, in fact, had two AV nodal blockers in her prescription, a beta-blocker and amiodarone. Her potassium level was found to be mildly elevated due to acute renal failure. She remained bradycardic despite initial treatment and was subsequently dependant on intravenous isoproterenol until her renal function improved. This case highlights the different threshold for manifestation of hyperkalaemic symptoms in a growing group of patients: elderly patients with multiple comorbidities and polypharmacy.
Keywords: bradyarrythmia, bradycardia, elderly, hyperkalaemia, polypharmacy
Characterization of un-plasticized and propylene carbonate plasticized carboxymethyl cellulose doped ammonium chloride solid biopolymer electrolytes

Ahmad NH, Isa MIN

Carbohydr Polym, 2016 Feb 10;137:426-432.
PMID: 26686147 DOI: 10.1016/j.carbpol.2015.10.092

Two solid biopolymer electrolytes (SBEs) systems of carboxymethyl cellulose doped ammonium chloride (CMC-AC) and propylene carbonate plasticized (CMC-AC-PC) were prepared via solution casting technique. The ionic conductivity of SBEs were analyzed using electrical impedance spectroscopy (EIS) in the frequency range of 50 Hz-1 MHz at ambient temperature (303K). The highest ionic conductivity of CMC-AC SBE is 1.43 × 10(-3)S/cm for 16 wt.% of AC while the highest conductivity of plasticized SBE system is 1.01 × 10(-2)S/cm when added with 8 wt.% of PC. TGA/DSC showed that the addition of PC had increased the decomposition temperature compared of CMC-AC SBE. Fourier transform infrared (FTIR) spectra showed the occurrence of complexation between the SBE components and it is proved successfully executed by Gaussian software. X-ray diffraction (XRD) indicated that amorphous nature of SBEs. It is believed that the PC is one of the most promising plasticizer to enhance the ionic conductivity and performance for SBE system.
COVID-19 - How prepared are emergency departments in embracing the new norm?

Iqhbal KM, Ahmad NH

Med J Malaysia, 2020 09;75(5):585-586.
PMID: 32918431

No abstract provided.
Fulltext Evaluation on physico-chemical properties of pink guava puree residue as bioresource

Mhd Abd Kader, K. A., Ab. Aziz, N., Aziz, A., Talib, A. T., Ahmad, N. H., Tan, C. P., et al.

International Food Research Journal, 2016;23(101):125-131.
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Pink Guava Puree (PGP) factory produces tons of residues from its unit operation [refiner (R),
siever (S), and decanter (D)]. These residues represent a waste of nutrients and can contribute
to environmental problem. However, it can benefit related industries if the properties of the
residues are known. Thus, this research aims to determine the compositions of the residues
from PGP processing factory in order to evaluate possible value-added by-product and energy
sources. The residues from each unit operation were being tested for proximate composition,
dietary fibre components, pH value, emulsifying activity (EA) and emulsifying stability (ES),
carbon-to-nitrogen (C/N) ratio, and sugar analysis. The sugar content was analysed using High
Performance Liquid Chromatography (HPLC-RI detector). Results showed that the residues
have good composition of carbohydrate (11.82–12.18%), and thus potential as carbon source
and can be a good substrate for fermentation. These residues may also benefit the food industry
as a good source of dietary fibre (18.63–29.86%). The pH value for these PGP residues is 4;
thus they were considered as acidic food by-product. The low pH value also contributed to the
low EA and ES value other than the low content of protein in the sample. C/N ratio for PGP
residue from R (46:1) is the lowest compared to the C/N ratio from S (84:1) and D (115:1). The
amount of sugars detected in the PGP residues in descending order were fructose > glucose >
sucrose.
Fulltext Knowledge and perception on blood safety issues among blood donors at the National Blood Centre: a pilot study [Abstract]

Tan PP, Mohamed Fauzi, H., Chang CT, Ahmad NH, Bahar B, Mangantig E, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):54-54.
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ABSTRACTS FOR INTERNATIONAL HEALTH AND MEDICAL SCIENCES CONFERENCE 2019 (IHMSC 2019)
Held at Taylor’s University Lakeside Campus, Subang Jaya, Selangor, Malaysia, 8-9th March, 2019
Introduction: Unsafe blood products cause transfusion-transmissible infections among blood receivers. The knowledge and perception of blood donors is important as it is associated with their donation behaviour and hence the safety of blood products. There was no previous study that assessed the knowledge and perception on blood safety issues among blood donors to date. The objective of this study was to assess the knowledge and perception of blood
donors on blood safety issues.
Methods: This was a pilot study conducted to pilot test the self-developed questionnaire by the researchers. The questionnaire was available in the Malay language. One-hundred-thirty donors at the National Blood Centre were recruited to complete the self-administered questionnaire. Health sciences professionals, medical students and non-Malaysians were excluded in this study.
Results: A total of 130 donors comprising of 70 males (53.8%) and 60 females (46.2%) responded. The mean age of the respondents is 32.48±8.86 years. Most of the respondents were Malay (55.4%), single (49.2%), working in private sector (46.9%) and regular donor (68.5%). More than half of the respondents did not know that dengue, Zika and mad-cow disease can be contracted through blood transfusion. Ten percent of the respondents answered that bisexual people are eligible to donate blood. 40.7% of the donors agreed to check their HIV status through blood donation. Majority of the donors (60.7%) agreed that the donors’ blood is safe if the screening test is negative. Whereas, 33.9% of the donors disagreed that they shall be responsible if their blood causes infection.
Conclusion: Several knowledge gaps and inappropriate perception among the respondents were identified and these might affect the safety of the blood products. Targeted measures should be taken to rectify donors’ knowledge and perception in order to minimise inappropriate blood donor behaviours and reduce unsafe blood products.
The rate of blood culture contamination and common organisms isolated in Malaysian public hospitals

Mokhtar NA, Ting SY, Zainol Abidin NZ, Abdul Hameed A, Mohamed Z, Mustapa NI, et al.

Malays J Pathol, 2024 Aug;46(2):307-314.
PMID: 39207008

INTRODUCTION: Blood culture contamination remains a dilemma issue in the diagnosis of bloodstream infection. However, to date, there is no national data on blood culture contamination and the common organism isolated in Malaysia. This is a pioneer multi-centre study involving public hospitals with medical microbiologists in Malaysia to determine the blood culture contamination rate and the common organism isolated.
MATERIALS AND METHODS: This retrospective cross-sectional study involved record review of all blood culture results over 9 months period from 1st January 2018 until 30th September 2018 in 27 government hospitals in Malaysia. For each positive culture result, the type of isolated organism was classified to represent true bacteraemia or contamination.
RESULTS: We analysed 448,109 blood culture records from the participating hospitals. The blood culture positivity rate was 12.5% (57395 of 448109) and 25.0% (14367 of 57395) of the positive blood culture represents contamination. The national blood culture contamination rate in Malaysia was 3.2%. The contamination rate in the adult population was significantly higher than the paediatric population (3.6% vs. 2.6%; p<0.001). The blood contamination rate by institution ranged from 1.5% to 6.8%. The most frequently isolated microorganisms in the contaminated cultures were coagulase-negative staphylococci (71.0%).
CONCLUSION: Blood culture contamination is a major issue that warrants priority in recognition, and interventions should be implemented to reduce the blood contamination rate in Malaysia.