MyMedR

Displaying all 4 publications

Abstract:

Sort:

Impact of the circular economy on ecological footprint: evidence from Germany

Musa K, Tufail S, Erum N, Said J, Mustaffa AH

Environ Sci Pollut Res Int, 2024 Sep 10.
PMID: 39254808 DOI: 10.1007/s11356-024-34857-8

The circular economy practices contribute to sustainable development by maximising efficiency, utilising renewable resources, extending product lifespans, and implementing waste reduction strategies. This study investigates the individual impacts of four sources of the circular economy on the ecological footprint in Germany, a country that is among the pioneers in establishing a comprehensive roadmap for the circular economy. The four sources examined are renewable energy consumption (REC), recycling, reuse, and repair of materials. Using time series data from 1990 to 2021, the study employed the dynamic autoregressive distributed lag (ARDL) simulation technique and also applied kernel-based linear regression (KRLS) to test the robustness of the results. The findings revealed that reuse practices significantly reduce the ecological footprint in both the short and long run. REC and repair also substantially decrease the ecological footprint, as shown by the simulation analysis. Conversely, while recycling is generally considered crucial for minimising environmental impact, in this study, it was found to contribute to environmental degradation. This paradox may be attributed to the nascent state of the recycling industry and data limitations. The results from KRLS confirm the findings of the dynamic ARDL. It is recommended that policymakers develop measures that are appropriate, efficient, and targeted to enhance the role of each source of the circular economy in reducing the ecological footprint in Germany. The major limitation of the study is its reliance on the indirect measures of circular economy attributed to the non-availability of data on direct measures.
Fulltext Prospective surveillance of nosocomial device-associated bacteremia in three adult intensive units in Malaysia

Gopal Katherason S, Naing L, Jaalam K, Kamarul Iman Musa K, Nik Abdullah NM, Aiyar S, et al.

Trop Biomed, 2010 Aug;27(2):308-16.
PMID: 20962730 MyJurnal

Nosocomial blood stream infection (or nosocomial bacteremia) is a common problem in hospitals worldwide, including Malaysia. A three-year prospective cohort study (October 2003-March 2007) of the incidences, risk factors, and patterns of the microorganisms causing bacteremia was conducted using a validated surveillance form in three intensive care units (ICUs) in Malaysia. Center for Disease Control criteria were used to diagnose bacteremia. Patients were monitored from admission until the end point of study, which was the first detection of bacteremia in the blood in each patient. The frequency of occurrence of bacteremia with clinical symptoms was 10.7% (n=23). Bacteremia was observed to occur within a mean length of stay of 10 days in ICU. The rate of device-related infection was 10.4% per device utilization days with a device utilization rate of 95.9%/1000 patient days. The total number of patient days was 2309 and the period of device utilization was 2211 days. The common bacteria detected were extended-spectrum beta-lactamases (ESBLs) Klebsiella pneumoniae (n=6); Pseudomonas aeruginosa (n=6); Acinetobacter species (n=5); Methicillin-resistant Staphylococcus aureus (MRSA)(n=3); and (non- ESBL) Klebsiella pneumoniae (n=2). Multivariable analysis using Cox Proportional Hazard Model showed that the predictors for developing bacteremia were cancer, MRSA carriage, duration of central venous catheter (CVC) infusion, frequency change of CVC, and the administration of hydrocortisone drugs. These results indicate that a combination of nursing and medical interventions as well as patients' severity of illness could lead to bacteremia in ICU. Strategic implementation of quality assurance measures in ICUs could help to control this problem.
Fulltext Modelling the prognostic effect of glucose and lipid profiles on stroke recurrence in Malaysia: an event-history analysis

Chen XW, Nazri Shafei M, Abdul Aziz Z, Nazifah Sidek N, Imran Musa K

PeerJ, 2020;8:e8378.
PMID: 32095319 DOI: 10.7717/peerj.8378

Background: Diabetes and dyslipidemia are significantly associated with stroke recurrence, yet the evidence for this relationship is conflicting. Consequently, the parameters in the glucose and lipid profiles may inform us regarding their relationship with stroke recurrence, thus enhancing the physicians' clinical decision-making.
Aim: This study sought to investigate whether glucose and lipid profiles could prognosticate stroke recurrence in Malaysia.
Methods: We conducted a retrospective hospital-based study where we analyzed the first-ever stroke cases regarding about which the Malaysia National Stroke Registry was informed between 2009 and 2017, that fulfilled this study's criteria, and that were followed for stroke recurrence. Using the Cox proportional hazard regression analysis, we estimated the adjusted hazard ratios (HRs), which reflected the prognostic effect of the primary variables (i.e., glucose and lipid profiles on the first-stroke admission) on stroke recurrence.
Results: Among the 8,576 first-ever stroke patients, 394 (4.6%) experienced a subsequent first stroke recurrence event. The prognostic effect measured by univariable Cox regression showed that, when unadjusted, ten variables have prognostic value with regards to stroke recurrence. A multivariable regression analysis revealed that glucose was not a significant prognostic factor (adjusted HR 1.28; 95% CI [1.00-1.65]), while triglyceride level was the only parameter in the lipid profile found to have an independent prognostication concerning stroke recurrence (adjusted HR: 1.28 to 1.36).
Conclusions: Triglyceride could independently prognosticate stroke recurrence, which suggests the role of physicians in intervening hypertriglyceridemia. In line with previous recommendations, we call for further investigations in first-ever stroke patients with impaired glucose and lipid profiles and suggest a need for interventions in these patients.
Ventilator-associated nosocomial pneumonia in intensive care units in Malaysia

Gopal Katherason S, Naing L, Jaalam K, Imran Musa K, Nik Mohamad NA, Aiyar S, et al.

J Infect Dev Ctries, 2009 Oct 22;3(9):704-10.
PMID: 19858572

BACKGROUND: The outcome indicator of nosocomial infection (NI) in the intensive care unit (ICU) is used to benchmark the quality of patient care in Malaysia. We conducted a three-year prospective study on the incidences of ventilator-associated pneumonia (VAP), risk factors, and patterns of the microorganisms isolated in three ICUs.
METHODOLOGY: A follow-up in prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a university hospital and two governmental hospitals in Malaysia from October 2003 to December 2006. VAP was detected using CDC criteria which included clinical manifestation and confirmed endotracheal secretion culture results.
RESULTS: In total, 215 patients (2,306 patient-days) were enrolled into the study. The incidence of ICU-acquired device-related NI was 29.3 % (n = 63). The device-related VAP infection rate was 27.0 % (n = 58), with a mechanical ventilator utilization rate of 88.7%. The death rate due to all ICU-acquired NI including sepsis was 6.5%. The most common causative pathogen was Klebsiella pneumoniae (n = 27). Multivariate analysis using Cox regression showed that the risk factors identified were aspiration pneumonia (HR = 4.09; 95% CI = 1.24, 13.51; P = 0.021), cancer (HR = 2.51; 95% CI = 1.27, 4.97; P = 0.008), leucocytosis (HR=3.43; 95% CI= 1.60, 7.37; P=0.002) and duration of mechanical ventilation (HR=1.04; 95% CI = 1.00, 1.08; P = 0.030). Age, gender and race were not identified as risk factors in the multivariable analysis performed.
CONCLUSION: The incidence of VAP was comparable to that found in the National Nosocomial Infection Surveillance (NNIS) System report of June 1998. The incidence of VAP was considered high for the three hospitals studied.