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What do healthcare providers know about nutrition support? A survey of the knowledge, attitudes, and practice of pharmacists and doctors toward nutrition support in Malaysia

Karim SA, Ibrahim B, Tangiisuran B, Davies JG

JPEN J Parenter Enteral Nutr, 2015 May;39(4):482-8.
PMID: 24590009 DOI: 10.1177/0148607114525209

Malnutrition is one of the health problems that can be prevented by appropriate nutrition care provided by healthcare providers. However, this practice is still lacking possibly because of the providers' inadequate knowledge. The aim of this study was to evaluate the self-reported knowledge, attitudes, and practices of pharmacists and doctors toward nutrition support in a tertiary care hospital setting.
Contributing factors to outpatient pharmacy near miss errors: a Malaysian prospective multi-center study

Rajah R, Hanif AA, Tan SSA, Lim PP, Karim SA, Othman E, et al.

Int J Clin Pharm, 2019 Feb;41(1):237-243.
PMID: 30506127 DOI: 10.1007/s11096-018-0762-1

Background Detecting errors before medication dispensed or 'near misses' is a crucial step to combat the incidence of dispensing error. Despite this, no published evidence available in Malaysia relating to these issues. Objective To determine the incidence of medication labeling and filling errors, frequency of each type of the errors and frequency of the contributing factors at the final stage before dispensing. Setting Six Penang public funded hospitals outpatient pharmacies. Methods A prospective multicentre study, over 8 week's period. Pharmacists identified and recorded the details of either medication labeling and/or filling error at the final stage of counter-checking before dispensing. Besides, the contributing factors for each error were determined and recorded in data collection form. Descriptive analysis was used to explain the study data. Main outcome measure The incidence of near misses. Results A total of 187 errors (near misses) detected, with 59.4% (n = 111) were medication filling errors and 40.6% (n = 76) were labeling errors. Wrong drug (n = 44, 39.6%) was identified as the highest type of filling errors while incorrect dose (n = 34, 44.7%) was identified as the highest type of labeling errors. Distracted and interrupted work environment was reported to lead the highest labeling and filling errors, followed by lack of knowledge and skills for filling errors and high workload for labeling errors. Conclusion The occurrence of near misses related to medication filling and labelling errors is substantial at outpatient pharmacy in Penang public funded hospitals. Further research is warranted to evaluate the intervention strategies needed to reduce the near misses.
Fulltext Fractional Multi-Step Differential Transformed Method for Approximating a Fractional Stochastic SIS Epidemic Model with Imperfect Vaccination

Abuasad S, Yildirim A, Hashim I, Abdul Karim SA, Gómez-Aguilar JF

Int J Environ Res Public Health, 2019 03 18;16(6).
PMID: 30889889 DOI: 10.3390/ijerph16060973

In this paper, we applied a fractional multi-step differential transformed method, which is a generalization of the multi-step differential transformed method, to find approximate solutions to one of the most important epidemiology and mathematical ecology, fractional stochastic SIS epidemic model with imperfect vaccination, subject to appropriate initial conditions. The fractional derivatives are described in the Caputo sense. Numerical results coupled with graphical representations indicate that the proposed method is robust and precise which can give new interpretations for various types of dynamical systems.
Fulltext Systematic Review and Meta-Analysis of Diabetes Knowledge among Type 2 Diabetes Patients in Southeast Asia

Lim PC, Rajah R, Lee CY, Wong TY, Tan SSA, Karim SA

Rev Diabet Stud, 2021 Nov 01;17(2):82-89.
PMID: 34852899 DOI: 10.1900/RDS.2021.17.82

OBJECTIVE: Recognition of patient baseline knowledge is important in educating patients with type 2 diabetes mellitus (T2D) to manage their disease effectively. The purpose of this study is to review current evidence on the level of diabetes knowledge among T2D patients and determine factors affecting their knowledge. METHODS: A systematic search of English language articles published between 1990 and June 2019 was conducted using six electronic databases. Only quantitative studies that assessed knowledge of T2D patients in Southeast Asian countries were included. Data were extracted and a meta-analysis was conducted. RESULTS: A total of 6210 articles were retrieved; seven articles met the inclusion criteria, comprising 1,749 T2D patients. The calculated mean knowledge score was 55.6% (95% CI: 7.6 to 103.6). Five types of assessment tools were identified ranging from five to 41 questions that focused on disease specifics, treatment, and nutrition. Age, education level, and glycemic control were the most common factors impacting knowledge. CONCLUSIONS: The level of knowledge among T2D patients in Southeast Asia was unsatisfactory, especially in older patients with low education levels and poor glycemic control. Hence, an appropriate educational plan should be prioritized to these groups.
Ethyl acetate extract of fungus comb from Malayan termite (Macrotermes gilvus Hagen) mound modulates splenic inflammatory responses in mice

Susanto H, Sudiana K, Nandika D, Karlinasari L, Arinana A, Karim SA, et al.

Open Vet J, 2024 Sep;14(9):2269-2279.
PMID: 39553755 DOI: 10.5455/OVJ.2024.v14.i9.15

BACKGROUND: The fungus comb is a unique structure inside termites' nests that facilitates the growth of Termitomyces sp. as a nutrient source for the termites. It is known to possess immunomodulatory properties that boost the immune system.
AIM: The objective of this study was to assess the impact of ethyl acetate extract of fungus comb (EAEFC) on the inflammatory reaction in the spleen of mice induced by intraperitoneal injection of lipopolysaccharide (LPS).
METHODS: An experimental study was conducted using a post-test-only control group design with male BALB/C mice (n = 24). The mice were divided randomly into four groups, each comprising six mice, and administered substances via gavage. Groups I and III were administered a solution of 5% dimethyl sulfoxide (DMSO) in distilled water, while Groups II and IV were given 500 mg/kg BW EAEFC dissolved in 5% DMSO. On the fifteenth day, Groups I and II received intraperitoneal injections of 5 ml/kg BW saline, while Groups III and IV were injected with 10 mg/kg BW LPS dissolved in saline. After three hours, the mice were euthanized and splenic immunohistology was examined under a light microscope. The results were expressed as mean ± standard deviation, while the group differences were assessed statistically.
RESULTS: The expression of interleukin (IL)-1, furin, and activated NK cell was significantly higher in the inflamed model after EAEFC supplementation, while the extract suppressed IL-10.
CONCLUSION: EAEFC was found to alter cytokine expression in the spleen in response to inflammation.
Fulltext Neural correlates of eye contact in face-to-face verbal interaction: An EEG-based study of the extraversion personality trait

Roslan NS, Izhar LI, Faye I, Amin HU, Mohamad Saad MN, Sivapalan S, et al.

PLoS One, 2019;14(7):e0219839.
PMID: 31344061 DOI: 10.1371/journal.pone.0219839

The extraversion personality trait has a positive correlation with social interaction. In neuroimaging studies, investigations on extraversion in face-to-face verbal interactions are still scarce. This study presents an electroencephalography (EEG)-based investigation of the extraversion personality trait in relation to eye contact during face-to-face interactions, as this is a vital signal in social interactions. A sample of healthy male participants were selected (consisting of sixteen more extraverted and sixteen less extraverted individuals) and evaluated with the Eysenck's Personality Inventory (EPI) and Big Five Inventory (BFI) tools. EEG alpha oscillations in the occipital region were measured to investigate extraversion personality trait correlates of eye contact during a face-to-face interaction task and an eyes-open condition. The results revealed that the extraversion personality trait has a significant positive correlation with EEG alpha coherence in the occipital region, presumably due to its relationship with eye contact during the interaction task. Furthermore, the decrease in EEG alpha power during the interaction task compared to the eyes-open condition was found to be greater in the less extraverted participants; however, no significant difference was observed between the less and more extraverted participants. Overall, these findings encourage further research towards the understanding of neural mechanism correlates of the extraversion personality trait-particularly in social interaction.
Fulltext Variation of current protocols for managing out-of-hospital cardiac arrest in prehospital settings among Asian countries

Lin CH, Ng YY, Chiang WC, Karim SA, Shin SD, Tanaka H, et al.

J Formos Med Assoc, 2016 Aug;115(8):628-38.
PMID: 26596689 DOI: 10.1016/j.jfma.2015.10.003

Protocols for managing patients with out-of-hospital cardiac arrest (OHCA) may vary due to legal, cultural, or socioeconomic concerns. We sought to assess international variation in policies and protocols related to OHCA.
Characteristics and Outcomes of Traumatic Cardiac Arrests in the Pan-Asian Resuscitation Outcomes Study

Lee MHM, Chia MYC, Fook-Chong S, Shahidah N, Tagami T, Ryu HH, et al.

Prehosp Emerg Care, 2023;27(8):978-986.
PMID: 35994382 DOI: 10.1080/10903127.2022.2113941

OBJECTIVE: Little is known about survival outcomes after traumatic cardiac arrest in Asia, or the association of Utstein factors with survival after traumatic cardiac arrests. This study aimed to describe the epidemiology and outcomes of traumatic cardiac arrests in Asia, and analyze Utstein factors associated with survival.
METHODS: Traumatic cardiac arrest patients from 13 countries in the Pan-Asian Resuscitation Outcomes Study registry from 2009 to 2018 were analyzed. Multilevel logistic regression was performed to identify factors associated with the primary outcomes of survival to hospital discharge and favorable neurological outcome (Cerebral Performance Category (CPC) 1-2), and the secondary outcome of return of spontaneous circulation (ROSC).
RESULTS: There were 207,455 out-of-hospital cardiac arrest cases, of which 13,631 (6.6%) were trauma patients aged 18 years and above with resuscitation attempted and who had survival outcomes reported. The median age was 57 years (interquartile range 39-73), 23.0% received bystander cardiopulmonary resuscitation (CPR), 1750 (12.8%) had ROSC, 461 (3.4%) survived to discharge, and 131 (1.0%) had CPC 1-2. Factors associated with higher rates of survival to discharge and favorable neurological outcome were arrests witnessed by emergency medical services or private ambulances (survival to discharge adjusted odds ratio (aOR) = 2.95, 95% confidence interval (CI) = 1.99-4.38; CPC 1-2 aOR = 2.57, 95% CI = 1.25-5.27), bystander CPR (survival to discharge aOR = 2.16; 95% CI 1.71-2.72; CPC 1-2 aOR = 4.98, 95% CI = 3.27-7.57), and initial shockable rhythm (survival to discharge aOR = 12.00; 95% CI = 6.80-21.17; CPC 1-2 aOR = 33.28, 95% CI = 11.39-97.23) or initial pulseless electrical activity (survival to discharge aOR = 3.98; 95% CI = 2.99-5.30; CPC 1-2 aOR = 5.67, 95% CI = 3.05-10.53) relative to asystole.
CONCLUSIONS: In traumatic cardiac arrest, early aggressive resuscitation may not be futile and bystander CPR may improve outcomes.
Fulltext A multinational Delphi consensus to end the COVID-19 public health threat

Lazarus JV, Romero D, Kopka CJ, Karim SA, Abu-Raddad LJ, Almeida G, et al.

Nature, 2022 Nov;611(7935):332-345.
PMID: 36329272 DOI: 10.1038/s41586-022-05398-2

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.