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The role of chemical mediators in the pathogenesis of inflammation with emphasis on the kinin system

Sharma JN, Mohsin SS

Exp Pathol, 1990;38(2):73-96.
PMID: 1971600

In recent years, numerous agents have been recognized as inflammatory mediators. In this review, however, we discuss only those having direct relevance to human inflammatory diseases These mediators are clinically important due to their proinflammatory properties such as vasodilatation, increased vascular permeability, pain and chemotaxis. They may lead to the fifth cardinal sign, loss of function in inflammatory diseases. Agonists and non-specific antagonists are used as pharmacological tools to investigate the inflammatory role of PGs, LTs, PAF, IL-1, histamine, complement, SP, PMN-leukocytes, and kallikrein-kininogen-kinin systems. Unfortunately, no compound is known which concurrently abolishes all actions and interactions of inflammatory mediators. Therefore it would be highly useful to promote efforts in developing selective and competitive antagonists against proinflammatory actions of these chemical mediators. This may help to a better understanding of the pathogenesis of inflammatory reactions, and it may also be useful for the therapy of inflammatory diseases.
Influence of a kinin antagonist on acute hypotensive responses induced by bradykinin and captopril in spontaneously hypertensive rats

Sharma JN, Stewart JM, Mohsin SS, Katori M, Vavrek R

Agents Actions Suppl., 1992;38 ( Pt 3):258-69.
PMID: 1334354

We have evaluated the effects of a B2 receptor antagonist (B5630) of kinins on BK and captopril-induced acute hypotensive responses in anaesthetized SHR. Intravenous treatment of BK (1.0 microgram) and captopril (0.3 mg/kg) caused significant (p < 0.05) fall in the SBP and DBP. Whereas BK caused greater fall in the SBP (p < 0.05), DBP (p < 0.01) and duration of hypotension (p < 0.05) when administered after captopril (Fig 1 and 2). All the hypotensive effects of BK and captopril were significantly antagonised (p < 0.05) in the presence of B5630 (2.0 mg/kg). Further, the duration of hypotensive responses of BK and captopril were blocked (p < 0.05) by B5630. The agonists and BK-antagonist did not cause significant (p > 0.05) alterations in HR during the entire investigation. These findings provide evidence to support the suggestion that B2 receptor might be involved in the regulation of the hypotensive actions of BK and captopril. Kinins should also have valuable functions in the antihypertensive property of captopril-like drugs.
Ambulance response time and emergency medical dispatcher program: a study in Kelantan, Malaysia

Shah CH, Ismail IM, Mohsin SS

Southeast Asian J Trop Med Public Health, 2008 Nov;39(6):1150-4.
PMID: 19062707

This study provided data by a simple method of acquiring information related to ambulance response time (ART) and determined whether it met the international standards of ART. Additionally, this paper also compared the duration of ART at this hospital before and after the implementation of an Emergency Medical Dispatcher (EMD) program. The ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint were received and ended when the emergency team arrived at the scene of the incident. The parameters recorded include call processing time, time taken to prepare the team and time taken to travel to the scene. The results of the study revealed that the ART for the university hospital (HUSM) was at 913.2 +/- 276.5 seconds (mean +/- SD) and it was far below the international standard of ART as a benchmark of a good ambulance service. However, the study suggested that the EMD program that was recently implemented at the HUSM gave a significantly improvement to the ART score.
Development of a Sexually Transmitted Disease Client-friendly Unit at a Primary Care Clinic in Malaysia: Lessons Learnt

Pannir Selvam SB, Khoo EM, Chow SY, Wong PF, Mohsin SS, Abdullah A, et al.

Sex Transm Dis, 2019 02;46(2):143-145.
PMID: 30278029 DOI: 10.1097/OLQ.0000000000000918

Management of sexually transmitted diseases and human immunodeficiency virus is challenging due to the social stigma attached. We describe the development of a client-friendly sexually transmitted disease service in a primary care clinic in Malaysia with a special focus on key populations. Challenges and key lessons learnt from its development and implementation are discussed.
Fulltext Impact of community lifestyle intervention on anthropometric parameters and body composition among overweight and obese women: findings from the MyBFF@home study

Mohd Zaki NA, Appannah G, Mohamad Nor NS, Omar A, Fazliana M, Ambak R, et al.

BMC Womens Health, 2018 07 19;18(Suppl 1):110.
PMID: 30066638 DOI: 10.1186/s12905-018-0595-z

BACKGROUND: The prevalence of overweight and obesity among Malaysian women remained high over the past three decades. Collaboration with existing community at-risk may be feasible for wide-scale prevention of overweight and obesity in the country. The aims of this study were to examine the impact of community-based lifestyle intervention among overweight and obese women on their anthropometric and body composition changes as compared to the usual care group.
METHODS: This was a quasi-experimental study conducted in low-cost flats in Kuala Lumpur, Malaysia. A total of 255 overweight and obesity individuals aged between 18 to 59 years old were assigned to either the lifestyle intervention group (n = 169) or the usual care group (n = 146) over a period of 6 months. Individuals in the intervention group received 6 individual lifestyle counselling comprised of physical activity, diet counselling and self-monitoring components aimed to achieve at least 5% weight loss while individuals in the usual care group obtained six sessions of health care seminars from health care providers. These individuals were then followed-up for another 6 months without any intervention as part of maintenance period.
RESULTS: An intention-to-treat analysis of between-groups at 6-month of intervention (β, 95% CI) revealed greater changes in weight among intervention individuals' (- 1.09 kg vs. -0.99; p 0.05). Individuals in the intervention group showed a significant increase for skeletal muscle mass (0.13 kg) than those individuals in the control group (- 0.37 kg), p = 0.033, throughout the study period.
CONCLUSION: This study provides evidence that an overweight and obesity prevention program can be implemented in a community setting, with some reduction of several anthropometric and body composition parameters.
Management of Atopic Eczema in primary care

Azizan NZ, Ambrose D, Sabeera B, Mohsin SS, Pf W, Mohd Affandi A, et al.

Malays Fam Physician, 2020;15(1):39-43.
PMID: 32284803

Introduction : Atopic eczema (AE) is a common inflammatory skin dermatosis that is increasing in prevalence. However, it can present in various clinical presentations, which leads to challenges in the diagnosis and treatment of the condition, especially in a primary care setting. The Clinical Practice Guidelines on the Management of Atopic Eczema was developed by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2018. It covers the aspects of diagnosis, severity assessment, treatment, and referral.