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Fulltext Anticoagulation Control in Different Ethnic Groups Receiving Vitamin K Antagonist for Stroke Prevention in Atrial Fibrillation

Zawawi NA, Abdul Halim Zaki I, Ming LC, Goh HP, Zulkifly HH

Front Cardiovasc Med, 2021;8:736143.
PMID: 34869639 DOI: 10.3389/fcvm.2021.736143

Vitamin K antagonist such as warfarin reduces the risk of stroke in atrial fibrillation (AF) patients. Since warfarin has a narrow therapeutic index, its administration needs to be regularly monitored to avoid any adverse clinical outcomes such as stroke and bleeding. The quality of anticoagulation control with warfarin therapy can be measured by using time in therapeutic range (TTR). This review focuses on the prevalence of AF, quality of anticoagulation control (TTR) and adverse clinical outcome in AF patients within different ethnic groups receiving warfarin therapy for stroke prevention. A literature search was conducted in Embase and PubMed using keywords of "prevalence," "atrial fibrillation," "stroke prevention," "oral anticoagulants," "warfarin," "ethnicities," "race" "time in therapeutic range," "adverse clinical outcome," "stroke, bleeding." Articles published by 1st February 2020 were included. Forty-one studies were included in the final review consisting of AF prevalence (n = 14 studies), time in therapeutic range (n = 18 studies), adverse clinical outcome (n = 9 studies) within different ethnic groups. Findings indicate that higher prevalence of AF but better anticoagulation control among the Whites as compared to other ethnicities. Of note, non-whites had higher risk of strokes and bleeding outcomes while on warfarin therapy. Addressing disparities in prevention and healthcare resource allocation could potentially improve AF-related outcomes in minorities.
Comparative analysis of an anthraquinone and chalcone derivatives-based virtual combinatorial library. A cheminformatics "proof-of-concept" study

Moshawih S, Hadikhani P, Fatima A, Goh HP, Kifli N, Kotra V, et al.

J Mol Graph Model, 2022 Dec;117:108307.
PMID: 36096064 DOI: 10.1016/j.jmgm.2022.108307

A Laplacian scoring algorithm for gene selection and the Gini coefficient to identify the genes whose expression varied least across a large set of samples were the state-of-the-art methods used here. These methods have not been trialed for their feasibility in cheminformatics. This was a maiden attempt to investigate a complete comparative analysis of an anthraquinone and chalcone derivatives-based virtual combinatorial library. This computational "proof-of-concept" study illustrated the combinatorial approach used to explain how the structure of the selected natural products (NPs) undergoes molecular diversity analysis. A virtual combinatorial library (1.6 M) based on 20 anthraquinones and 24 chalcones was enumerated. The resulting compounds were optimized to the near drug-likeness properties, and the physicochemical descriptors were calculated for all datasets including FDA, Non-FDA, and NPs from ZINC 15. UMAP and PCA were applied to compare and represent the chemical space coverage of each dataset. Subsequently, the Laplacian score and Gini coefficient were applied to delineate feature selection and selectivity among properties, respectively. Finally, we demonstrated the diversity between the datasets by employing Murcko's and the central scaffolds systems, calculating three fingerprint descriptors and analyzing their diversity by PCA and SOM. The optimized enumeration resulted in 1,610,268 compounds with NP-Likeness, and synthetic feasibility mean scores close to FDA, Non-FDA, and NPs datasets. The overlap between the chemical space of the 1.6 M database was more prominent than with the NPs dataset. A Laplacian score prioritized NP-likeness and hydrogen bond acceptor properties (1.0 and 0.923), respectively, while the Gini coefficient showed that all properties have selective effects on datasets (0.81-0.93). Scaffold and fingerprint diversity indicated that the descending order for the tested datasets was FDA, Non-FDA, NPs and 1.6 M. Virtual combinatorial libraries based on NPs can be considered as a source of the combinatorial compound with NP-likeness properties. Furthermore, measuring molecular diversity is supposed to be performed by different methods to allow for comparison and better judgment.
Fulltext Comparative analysis of potential drug-drug interactions in a public and private hospital among chronic kidney disease patients in Khyber Pakhtunkhwa: A retrospective cross-sectional study

Zafar R, Rehman IU, Shah Y, Ming LC, Goh HP, Goh KW

PLoS One, 2023;18(9):e0291417.
PMID: 37773947 DOI: 10.1371/journal.pone.0291417

INTRODUCTION: Chronic kidney disease (CKD) is a significant public health challenge due to its rising incidence, mortality, and morbidity. Patients with kidney diseases often suffer from various comorbid conditions, making them susceptible to potential drug-drug interactions (pDDIs) due to polypharmacy and multiple prescribers. Inappropriate prescriptions for CKD patients and their consequences in the form of pDDIs are a major challenge in Pakistan.
AIM: This study aimed to compare the incidence and associated risk factors of pDDIs among a public and private sector hospital in Khyber Pakhtunkhwa, Pakistan.
METHOD: A retrospective cross-sectional study design was conducted to compare pDDIs among public and private sector hospitals from January 2023 to February 2023. Patients profile data for the full year starting from January 1 2022 to December 302022, was accessed All adult patients aged 18 years and above, of both genders, who currently have or have previously been diagnosed with end-stage renal disease (ESRD) were included. For assessing pDDIs, patient data was retrieved and checked using Lexicomp UpToDate® for severity and documentation of potential drug-drug interactions.
RESULTS: A total of 358 patients' data was retrieved (with n = 179 in each hospital); however, due to incomplete data, n = 4 patients were excluded from the final analysis. The prevalence of pDDIs was found to be significantly higher in private hospitals (84.7%) than in public hospitals (26.6%), with a p-value <0.001. Patients in the age category of 41-60 years (AOR = 6.2; p = 0.008) and those prescribed a higher number of drugs (AOR = 1.2; p = 0.027) were independently associated with pDDIs in private hospitals, while the higher number of prescribed drugs (AOR = 2.9; p = <0.001) was an independent risk factor for pDDIs in public hospitals. The majority of pDDIs (79.0%) were of moderate severity, and a significant number of patients (15.1%) also experienced major pDDIs, with a p-value <0.001. The majority of pDDIs had fair documentation for reliability rating in both public and private hospitals.
CONCLUSION: The prevalence of pDDIs was higher among CKD patients at private hospitals, and most of the pDDIs were of moderate severity. A considerable number of patients also experienced major pDDIs. The risk of experiencing pDDIs was found to be higher in older patients and among those prescribed a higher number of drugs.
Evaluating healthcare professionals' perceptions of dispensing separation and sale of pharmacy medicine in Brunei Darussalam

Juperi RNAA, Goh HP, Rehman IU, Lee KS, Ming LC, Hermansyah A

J Pharm Policy Pract, 2023 Aug 24;16(1):101.
PMID: 37620839 DOI: 10.1186/s40545-023-00594-5

BACKGROUND: Pharmacy medicine (P) is obtained exclusively from a pharmacy under the supervision of a pharmacist. This study aims to understand the perception of healthcare professionals towards the dispensing separation, as well as the dispensing of pharmacy medicine by community pharmacies to enhance patient health outcomes in Brunei Darussalam.
METHODS: A cross-sectional study was conducted between 1st March 2023 and 20th April 2023 among healthcare professionals. A newly designed and validated questionnaire was used. Its face and content validity, along with internal consistency, was adequately established. Convenient sampling was employed to recruit participants for the study. Statistical analysis using one-way ANOVA was performed, considering a p-value
Identification and optimization of TDP1 inhibitors from anthraquinone and chalcone derivatives: consensus scoring virtual screening and molecular simulations

Moshawih S, Goh HP, Kifli N, Darwesh MAE, Ardianto C, Goh KW, et al.

J Biomol Struct Dyn, 2023 Sep 11.
PMID: 37697727 DOI: 10.1080/07391102.2023.2256870

Virtual screening aims to identify and rank compounds with drug/lead-like properties based on their affinity for the protein target. We developed a methodology that integrates structure- and ligand-based screening approaches to enhance hit rates against the TDP1 protein within a database of anthraquinone and chalcone derivatives, followed by evaluation of prioritized compounds through molecular simulations. This technique is particularly useful for training set imbalances. Four screening methods were used: QSAR, pharmacophore, shape similarity, and docking. Each method was individually trained to score compounds, and the scores were fused to create parallel Z-score fusion. The QSAR models exhibited satisfactory R2 values (0.84 to 0.75), whereas the pharmacophoric and shape similarity models demonstrated excellent performance (ROC:0.82-0.88). Docking enrichment analysis identified 6N0D as the optimal TDP1 crystal structure (ROC = 0.73). Remarkably, the consensus scoring method surpassed other screening methods, achieving the highest ROC value of 0.98. Docking screening prioritized compounds with binding modes resembling the co-crystallized ligands, whereas MMGBSA, consensus, and docking produced dynamic simulations that were as stable as the co-crystallized ligands. Additionally, the QSAR-selected compounds exhibited binding modes similar to those of commercially available TDP1 inhibitors. In this study, a strong correlation was found between the inhibitory concentrations and binding energy values of commercialized TDP1 inhibitors, indicating that the top-ranked compounds are expected to have potent inhibitory effects in the nano-/micromolar range. The results of this study establish that consensus scoring can be used as an adaptable mainstay virtual screening methodology, pending subsequent experimental validation for affirmation.Communicated by Ramaswamy H. Sarma.
Fulltext Insights into the computer-aided drug design and discovery based on anthraquinone scaffold for cancer treatment: A protocol for systematic review

Chua HM, Moshawih S, Goh HP, Ming LC, Kifli N

PLoS One, 2023;18(9):e0290948.
PMID: 37656730 DOI: 10.1371/journal.pone.0290948

There is still unmet medical need in cancer treatment mainly due to drug resistance and adverse drug events. Therefore, the search for better drugs is essential. Computer-aided drug design (CADD) and discovery tools are useful to streamline the lengthy and costly drug development process. Anthraquinones are a group of naturally occurring compounds with unique scaffold that exert various biological properties including anticancer activities. This protocol describes a systematic review that provide insights into the computer-aided drug design and discovery based on anthraquinone scaffold for cancer treatment. It was prepared in accordance with the "Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 guidelines, and published in the "International prospective register of systematic reviews" database (PROSPERO: CRD42023432904). Search strategies will be developed based on the combination of relevant keywords and executed in PubMed, Scopus, Web of Science and MedRxiv. Only original studies that employed CADD as primary tool in virtual screening for the purpose of designing or discovering anti-cancer drugs involving anthraquinone scaffold published in English language will be included. Two independent reviewers will be involved to screen and select the papers, extract the data and assess the risk of bias. Apart from exploring the trends and types of CADD methods used, the target proteins of these compounds in cancer treatment will also be revealed in this review. It is believed that the outcome of this study could be utilized to support the ongoing research in similar area with better quality and greater probability of success, consequently optimizing the resources in subsequent in vitro, in vivo, non-clinical and clinical development. It will also serve as an evidence based scientific guide for new research to design novel anthraquinone-derived drug with improved efficacy and safety profile for cancer treatment.
Fulltext The effect of colchicine on mortality outcome and duration of hospital stay in patients with COVID-19: A meta-analysis of randomized trials

Kow CS, Lee LH, Ramachandram DS, Hasan SS, Ming LC, Goh HP

Immun Inflamm Dis, 2022 Feb;10(2):255-264.
PMID: 34970856 DOI: 10.1002/iid3.562

BACKGROUND: Overactivation of the NLR family pyrin domain containing 3 (NLRP3) inflammasome can lead to severe illness in patients with coronavirus disease-2019 (COVID-19). The NLRP3 inhibitor, colchicine, therefore, appears to be promising for the treatment of COVID-19.
AIMS: We aimed to perform a meta-analysis of randomized trials investigating the effect of colchicine in patients with COVID-19.
MATERIALS & METHODS: We systematically searched electronic databases and clinical trial registries (up to October 17, 2021) for eligible studies. The outcomes of interest were all-cause mortality and duration of hospital stay. Meta-analysis with the random-effects model was used to estimate the pooled odds ratio (OR) of mortality and 95% confidence interval (CI). The pooled standardized mean difference of duration of hospital stay with 95% CI between colchicine users and non-colchicine users was estimated using Cohen's d index.
RESULTS: The meta-analyses revealed no significant difference in the odds of mortality (pooled OR = 0.76; 95% CI: 0.53-1.07), but a significant reduction in the duration of hospital stay with the use of colchicine (pooled standardized mean difference = -0.59; 95% CI: -1.06 to -0.13).
DISCUSSION AND CONCLUSION: The ability of colchicine to reduce the length of stay in hospitalized patients with COVID-19 is consistent with its potential to prevent clinical deterioration via inhibition of NLRP3 inflammasome. Nevertheless, such beneficial effects of colchicine did not translate into mortality benefits in patients with COVID-19.
Assessing consumers' perception and demand on the community pharmacists' dispensing

Xuan YW, Goh HP, Rehman IU, Shafqat N, Al-Worafi YM, Ming LC, et al.

J Pharm Policy Pract, 2023 Nov 29;16(1):162.
PMID: 38031133 DOI: 10.1186/s40545-023-00609-1

BACKGROUND: This study aimed to assess the general public's perception of services provided by community pharmacies, their willingness to utilize these services, their satisfaction with and understanding of community pharmacists, and their views on dispensing separation and pharmacy medicines (P medicines).
METHODS: An online cross-sectional study was conducted, in which questionnaires were distributed among the general public. A novel questionnaire was designed and validated specifically for this study. It was composed of six sections: demographics, pharmacy usage and service preferences, understanding and satisfaction with pharmacists, views on dispensing separation, private community pharmacies, and knowledge of P medicines. Statistical analyses such as one-way ANOVA, independent t test, and binary logistic regression were employed, with a p value of
Fulltext Extracellular Vesicle-Mediated Chemoresistance in Oral Squamous Cell Carcinoma

Law ZJ, Khoo XH, Lim PT, Goh BH, Ming LC, Lee WL, et al.

Front Mol Biosci, 2021;8:629888.
PMID: 33768115 DOI: 10.3389/fmolb.2021.629888

Oral Squamous Cell Carcinoma (OSCC) remains a cancer with poor prognosis and high recurrence rate. Even with multimodal treatment options available for OSCC, tumor drug resistance is still a persistent problem, leading to increased tumor invasiveness among OSCC patients. An emerging trend of thought proposes that extracellular vesicles (EVs) play a role in facilitating tumor progression and chemoresistance via signaling between tumor cells. In particular, exosomes and microvesicles are heavily implicated in this process by various studies. Where primary studies into a particular EV-mediated chemoresistance mechanism in OSCC are limited, similar studies on other cancer cell types will be used in the discussion below to provide ideas for a new line of investigation into OSCC chemoresistance. By understanding how EVs are or may be involved in OSCC chemoresistance, novel targeted therapies such as EV inhibition may be an effective alternative to current treatment options in the near future. In this review, the current understandings on OSCC drug mechanisms under the novel context of exosomes and microvesicles were reviewed, including shuttling of miRNA content, drug efflux, alteration of vesicular pH, anti-apoptotic signaling, modulation of DNA damage repair, immunomodulation, epithelial-to-mesenchymal transition and maintenance of tumor by cancer stem cells.
Fulltext Evaluating NSAIDs in SARS-CoV-2: Immunomodulatory mechanisms and future therapeutic strategies

Moshawih S, Jarrar Q, Bahrin AA, Lim AF, Ming L, Goh HP

Heliyon, 2024 Feb 15;10(3):e25734.
PMID: 38356603 DOI: 10.1016/j.heliyon.2024.e25734

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely recognized for their analgesic and anti-inflammatory properties. Amidst the SARS-CoV-2 pandemic, the role of NSAIDs in modulating viral and bacterial infections has become a critical area of research, sparking debates and necessitating a thorough review. This review examines the multifaceted interactions between NSAIDs, immune responses, and infections. Focusing on the immunomodulatory mechanisms of NSAIDs in SARS-CoV-2 and their implications for other viral and bacterial infections, we aim to provide clarity and direction for future therapeutic strategies. NSAIDs demonstrate a dual role in infectious diseases. They reduce inflammation by decreasing neutrophil recruitment and cytokine release, yet potentially compromise antiviral defense mechanisms. They also modulate cytokine storms in SARS-CoV-2 and exhibit the potential to enhance anti-tumor immunity by inhibiting tumor-induced COX-2/PGE2 signaling. Specific NSAIDs have shown efficacy in inhibiting viral replication. The review highlights NSAIDs' synergy with other medications, like COX inhibitors and immunotherapy agents, in augmenting therapeutic effects. Notably, the World Health Organization's analysis found no substantial link between NSAIDs and the worsening of viral respiratory infections. The findings underscore NSAIDs' complex role in infection management. Understanding these interactions is crucial for optimizing therapeutic approaches in current and future pandemics. However, their dual nature warrants cautious application, particularly in vulnerable populations. NSAIDs present a paradoxical impact on immune responses in viral and bacterial infections. While offering potential benefits, their usage in infectious diseases, especially SARS-CoV-2, demands a nuanced understanding to balance therapeutic advantages against possible adverse effects.
Fulltext Cancer protective effects of plums: A systematic review

Bahrin AA, Moshawih S, Dhaliwal JS, Kanakal MM, Khan A, Lee KS, et al.

Biomed Pharmacother, 2022 Feb;146:112568.
PMID: 34963086 DOI: 10.1016/j.biopha.2021.112568

Plums is one of the most cultivated stone fruits due to its fast growing popularity. It has various traditionally recognized health benefits. There are two main commercial types of plums: the European plum (Prunus domestica) and the Japanese plum (Prunus salicina), each having many varieties. Researchers are gathering further evidence of pharmacological effects for plums by scientifically studying its anti-inflammatory, antioxidant properties. A systematic review analysing the literature related to the effects of plums on prevention and treatment of cancer is warranted. This is the first review examining the cancer-related effects of plums. Antioxidation properties of the active constituents of plum were also compared. Scopus, Google Scholar, PubMed, Medxriv and Cochrane Library databases, from their date of inception until July 2021 were utilized. The risk of bias was assessed using CONSORT checklist. A total of 6639 studies were screened and eventually only 54 studies were included. Full-text review of included studies revealed that plum extracts were rich in antioxidants. Overall, most of the studies that fulfilled the eligibility criteria were in vitro and a few clinical studies involving in vivo work. Therefore, it would be beneficial to perform more studies on animals or humans, to confirm that the result obtained from these in vitro studies are able to be extrapolated in a wider range of applications. Further clinical and in vivo studies are warranted to validate plums as a functional food for treatment and prevention of cancer.
Fulltext Economic Analysis of Patient's Own Medication, Unit-Use and Ward Stock Utilization: Results of the First Pilot Study

Abdul Nasir HH, Goh HP, Wee DVT, Goh KW, Lee KS, Hermansyah A, et al.

Int J Environ Res Public Health, 2022 Sep 09;19(18).
PMID: 36141623 DOI: 10.3390/ijerph191811350

BACKGROUND: Medication wastage is causing a cost burden to the healthcare system that is worth millions of dollars. An economic and ecological friendly intervention such as using a patient's own medications (POM) has proven to reduce wastage and save the cost spent by the hospital. The potential benefits of using POM in inpatient settings have yet to be explored in a country with universal health coverage. This study aimed to pilot test the POM intervention in an adult ward setting and to perform the economic analysis of using POM and ward stock during hospitalization.
METHODS: A prospective cross-sectional observational study was conducted among the patients admitted to the medical and surgical wards in a public hospital located in Brunei Darussalam between February 2022 and April 2022. Hospitalized adults above 18 years old with regular medications with a minimum length of stay of 48 h and a maximum length of stay of 21 days were included in the study. These eligible patients were divided into a POM group and a non-POM group. The economic analysis of using POM was performed by calculating the direct cost per unit of medication used during admission (from unit-use, ward stock and POM) and comparing the cost spent for both groups. Expired ward stock deemed as medication wastage was determined. Medical research ethics were approved, and all participating patients had given their written informed consent before enrolling in this study.
RESULTS: A total of 112 patients aged 63.2 ± 15.8 years participated in this study. The average cost of medication supplied by the inpatient pharmacy for the non-POM group was USD 21.60 ± 34.20 per patient, whereas, for the POM group, it was approximately USD 13.00 ± 18.30 per patient, with a mean difference of USD 8.60 ± 5.17 per patient (95% CI: -3.95, 27.47, p ≥ 0.05). The use of POM minimized 54.03% (USD 625.04) of the total cost spent by the hospital for the POM group within the period of the study.
CONCLUSION: The pilot study showed that the supplied medication cost per patient was not significantly different between the POM and non-POM groups. Nevertheless, the utilization of POM during hospitalization is capable of reducing at least 50% of the total cost spent on inpatient medications by the hospital. The use of POM during hospitalization also helped in reducing the total time spent on the medication process per patient.
Fulltext Licorice: A Potential Herb in Overcoming SARS-CoV-2 Infections

Ng SL, Khaw KY, Ong YS, Goh HP, Kifli N, Teh SP, et al.

J Evid Based Integr Med, 2021;26:2515690X21996662.
PMID: 33787349 DOI: 10.1177/2515690X21996662

The management of the global pandemic outbreak due to the coronavirus disease (COVID-19) has been challenging with no exact dedicated treatment nor established vaccines at the beginning of the pandemic. Nonetheless, the situation seems to be better controlled with the recent COVID-19 vaccines roll-out globally as active immunisation to prevent COVID-19. The extensive usage and trials done in recent outbreak in China has shown the effectiveness of traditional Chinese Medicines (TCM) in improving the wellbeing of COVID-19 patients. Therefore, COVID-19 Prevention and Treatment guidelines has listed a number of recommended concoctions meant for COVID-19 patients. Licorice, more commonly known as Gancao in Chinese Pinyin, is known as one of the most frequently used ingredients in TCM prescriptions for treatment of epidemic diseases. Interestingly, it is deemed as food ingredient as well, where it is normally used in Western cuisines' desserts and sweets. The surprising fact that licorice appeared in the top 10 main ingredients used in TCM prescriptions in COVID-19 has drawn great attention from researchers in revealing its biological potential in overcoming this disease. To date, there are no comprehensive review on licorice and its benefits when used in COVID-19. Thus, in this current review, the possible benefits, mechanism of actions, safety and limitations of licorice were explored in hope to provide a quick reference guide for its preclinical and clinical experimental set-up in this very critical moment of pandemic.
Fulltext Cosmetics: What Do Bruneian Female Adults Believe?

Ming LC, Azmi NHR, Goh HP, Chaw LL, Goh KW, Elkudssiah Ismail N, et al.

Int J Environ Res Public Health, 2022 Aug 25;19(17).
PMID: 36078298 DOI: 10.3390/ijerph191710584

OBJECTIVES: The study aimed to measure the level of attitudes and the current practices of the female community in Brunei Darussalam regarding the usage of cosmetics.
METHODS: An online survey was conducted using a non-probabilistic snowball sampling approach via the social media channels WhatsApp and Instagram. The inclusion criteria were female Bruneian citizens or permanent residents, aged between 18 and 65 years old, who can understand English or Malay, and use cosmetic products at least once a day.
RESULTS: A total of 445 participants responded to the online survey. Most of the participants agreed that the use of cosmetic products improves one's physical appearance to the public (391, 87.8%) and also improves self-confidence (405, 91.1%). There were significant differences in monthly cosmetic product expenses and participants' attitudes about safe cosmetic use (p = 0.001). No significant changes in the individuals' attitudes based on their age or educational level were observed. Overall, the participants had a good level of cosmetic safety practice. Almost half of the participants use social media to obtain information regarding what cosmetics to use or purchase.
CONCLUSION: There is a medium to high level of attitude and a high level of practice regarding the safe use of cosmetics among Bruneian female adults. Social media was the main source of information for the respondents, followed by friend circle and family members.
Fulltext Mobile Health Apps on COVID-19 Launched in the Early Days of the Pandemic: Content Analysis and Review

Ming LC, Untong N, Aliudin NA, Osili N, Kifli N, Tan CS, et al.

JMIR Mhealth Uhealth, 2020 09 16;8(9):e19796.
PMID: 32609622 DOI: 10.2196/19796

BACKGROUND: Mobile health (mHealth) app use is a major concern because of the possible dissemination of misinformation that could harm the users. Particularly, it can be difficult for health care professionals to recommend a suitable app for coronavirus disease (COVID-19) education and self-monitoring purposes.
OBJECTIVE: This study aims to analyze and evaluate the contents as well as features of COVID-19 mobile apps. The findings are instrumental in helping health care professionals to identify suitable mobile apps for COVID-19 self-monitoring and education. The results of the mobile apps' assessment could potentially help mobile app developers improve or modify their existing mobile app designs to achieve optimal outcomes.
METHODS: The search for the mHealth apps available in the android-based Play Store and the iOS-based App Store was conducted between April 18 and May 5, 2020. The region of the App Store where we performed the search was the United States, and a virtual private network app was used to locate and access COVID-19 mobile apps from all countries on the Google Play Store. The inclusion criteria were apps that are related to COVID-19 with no restriction in language type. The basic features assessment criteria used for comparison were the requirement for free subscription, internet connection, education or advisory content, size of the app, ability to export data, and automated data entry. The functionality of the apps was assessed according to knowledge (information on COVID-19), tracing or mapping of COVID-19 cases, home monitoring surveillance, online consultation with a health authority, and official apps run by health authorities.
RESULTS: Of the 223 COVID-19-related mobile apps, only 30 (19.9%) found in the App Store and 28 (44.4%) in the Play Store matched the inclusion criteria. In the basic features assessment, most App Store (10/30, 33.3%) and Play Store (10/28, 35.7%) apps scored 4 out of 7 points. Meanwhile, the outcome of the functionality assessment for most App Store apps (13/30, 43.3%) was a score of 3 compared to android-based apps (10/28, 35.7%), which scored 2 (out of the maximum 5 points). Evaluation of the basic functions showed that 75.0% (n=36) of the 48 included mobile apps do not require a subscription, 56.3% (n=27) provide symptom advice, and 41.7% (n=20) have educational content. In terms of the specific functions, more than half of the included mobile apps are official mobile apps maintained by a health authority for COVID-19 information provision. Around 37.5% (n=18) and 31.3% (n=15) of the mobile apps have tracing or mapping and home monitoring surveillance functions, respectively, with only 17% (n=8) of the mobile apps equipped with an online consultation function.
CONCLUSIONS: Most iOS-based apps incorporate infographic mapping of COVID-19 cases, while most android-based apps incorporate home monitoring surveillance features instead of providing focused educational content on COVID-19. It is important to evaluate the contents and features of COVID-19 mobile apps to guide users in choosing a suitable mobile app based on their requirements.
Fulltext Coriandrum sativum L.: A Review on Ethnopharmacology, Phytochemistry, and Cardiovascular Benefits

Mahleyuddin NN, Moshawih S, Ming LC, Zulkifly HH, Kifli N, Loy MJ, et al.

Molecules, 2021 Dec 30;27(1).
PMID: 35011441 DOI: 10.3390/molecules27010209

Coriandrum sativum (C. sativum), belonging to the Apiaceae (Umbelliferae) family, is widely recognized for its uses in culinary and traditional medicine. C. sativum contains various phytochemicals such as polyphenols, vitamins, and many phytosterols, which account for its properties including anticancer, anti-inflammatory, antidiabetic, and analgesic effects. The cardiovascular benefits of C. sativum have not been summarized before, hence this review aims to further evaluate and discuss its effectiveness in cardiovascular diseases, according to the recent literature. An electronic search for literature was carried out using the following databases: PubMed, Scopus, Google Scholar, preprint platforms, and the Cochrane Database of Systematic Reviews. Articles were gathered from the inception of the database until August 2021. Moreover, the traditional uses and phytochemistry of coriander were surveyed in the original resources and summarized. As a result, most of the studies that cover cardiovascular benefits and fulfilled the eligibility criteria were in vivo, while only a few were in vitro and clinical studies. In conclusion, C. sativum can be deemed a functional food due to its wide range of cardiovascular benefits such as antihypertensive, anti-atherogenic, antiarrhythmic, hypolipidemic as well as cardioprotective effects.
Fulltext Natural products as novel anti-obesity agents: insights into mechanisms of action and potential for therapeutic management

Shaik Mohamed Sayed UF, Moshawih S, Goh HP, Kifli N, Gupta G, Singh SK, et al.

Front Pharmacol, 2023;14:1182937.
PMID: 37408757 DOI: 10.3389/fphar.2023.1182937

Obesity affects more than 10% of the adult population globally. Despite the introduction of diverse medications aimed at combating fat accumulation and obesity, a significant number of these pharmaceutical interventions are linked to substantial occurrences of severe adverse events, occasionally leading to their withdrawal from the market. Natural products serve as attractive sources for anti-obesity agents as many of them can alter the host metabolic processes and maintain glucose homeostasis via metabolic and thermogenic stimulation, appetite regulation, pancreatic lipase and amylase inhibition, insulin sensitivity enhancing, adipogenesis inhibition and adipocyte apoptosis induction. In this review, we shed light on the biological processes that control energy balance and thermogenesis as well as metabolic pathways in white adipose tissue browning, we also highlight the anti-obesity potential of natural products with their mechanism of action. Based on previous findings, the crucial proteins and molecular pathways involved in adipose tissue browning and lipolysis induction are uncoupling protein-1, PR domain containing 16, and peroxisome proliferator-activated receptor-γ in addition to Sirtuin-1 and AMP-activated protein kinase pathway. Given that some phytochemicals can also lower proinflammatory substances like TNF-α, IL-6, and IL-1 secreted from adipose tissue and change the production of adipokines like leptin and adiponectin, which are important regulators of body weight, natural products represent a treasure trove for anti-obesity agents. In conclusion, conducting comprehensive research on natural products holds the potential to accelerate the development of an improved obesity management strategy characterized by heightened efficacy and reduced incidence of side effects.
Fulltext Knowledge and Perception of Facial Candling for Allergic Rhinitis among University Staff and Students

Hamdan NKA, Lean QY, Neoh CF, Abdullah AH, Lim SM, Ramasamy K, et al.

Evid Based Complement Alternat Med, 2020;2020:5713134.
PMID: 32831870 DOI: 10.1155/2020/5713134

Introduction: Facial candling is a traditional method used for relieving symptoms of allergic rhinitis (AR). This study aims to investigate the knowledge and perception of facial candling in a sample of staff and students in a public university in Malaysia.
Methods: An online questionnaire survey method was used. Based on sample size calculation, a total of 1,508 UiTM staff and students from ten selected campuses of Universiti Teknologi MARA (UiTM) were invited to participate in this survey. An up-to-date e-mail list of staff in the selected campuses was used as the sampling frame for the study, whereas the students were recruited from the official university student Facebook portal.
Results: A total of 788 respondents participated in this survey, 72.2% of them knew about facial candling, though only 35.4% had tried the treatment. Approximately one-fifth of respondents agreed that facial candling might treat AR. It was found that a higher number of users than nonusers agreed that facial candling was a traditional medicine (78.9% vs 55.0%); could be used on the face and ears (83.5% vs 45.4%); and could be self-administered at home (83.5 vs 45.4%). Interestingly, more than half of them were uncertain about its long-term effects and adverse reactions.
Conclusion: This study confirms the facial candling use among patients with AR although the percentage is low. The patients and general public need to be better informed about the use of facial candling in AR and its associated risks.
Fulltext Pharmacotherapeutics Applications and Chemistry of Chalcone Derivatives

Dhaliwal JS, Moshawih S, Goh KW, Loy MJ, Hossain MS, Hermansyah A, et al.

Molecules, 2022 Oct 19;27(20).
PMID: 36296655 DOI: 10.3390/molecules27207062

Chalcones have been well examined in the extant literature and demonstrated antibacterial, antifungal, anti-inflammatory, and anticancer properties. A detailed evaluation of the purported health benefits of chalcone and its derivatives, including molecular mechanisms of pharmacological activities, can be further explored. Therefore, this review aimed to describe the main characteristics of chalcone and its derivatives, including their method synthesis and pharmacotherapeutics applications with molecular mechanisms. The presence of the reactive α,β-unsaturated system in the chalcone's rings showed different potential pharmacological properties, including inhibitory activity on enzymes, anticancer, anti-inflammatory, antibacterial, antifungal, antimalarial, antiprotozoal, and anti-filarial activity. Changing the structure by adding substituent groups to the aromatic ring can increase potency, reduce toxicity, and broaden pharmacological action. This report also summarized the potential health benefits of chalcone derivatives, particularly antimicrobial activity. We found that several chalcone compounds can inhibit diverse targets of antibiotic-resistance development pathways; therefore, they overcome resistance, and bacteria become susceptible to antibacterial compounds. A few chalcone compounds were more active than conventional antibiotics, like vancomycin and tetracycline. On another note, a series of pyran-fused chalcones and trichalcones can block the NF-B signaling complement system implicated in inflammation, and several compounds demonstrated more potent lipoxygenase inhibition than NSAIDs, such as indomethacin. This report integrated discussion from the domains of medicinal chemistry, organic synthesis, and diverse pharmacological applications, particularly for the development of new anti-infective agents that could be a useful reference for pharmaceutical scientists.

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