Acute Ischemic Stroke and Acute on Chronic Kidney Disease

Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled). He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis), acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating conditio

Rapid screening method for isolation of glycerol-consuming bacteria for ethanol production

Large numbers of glycerol-consuming bacteria are present in nature; hence bioconversion of glycerol into biofuel which is bioethanol is one of the interests. The effective screening procedure is needed to screen and isolate broad ranges of bacteria from environment. The screening method was modified based on enzymatic oxidation of ethanol, which is correlated to reduction of 2,6-dichlorophenol-indophenol dye that resulted in the formation of yellow zone. Approximately 300 colonies were able to grow on minimal media using glycerol as sole carbon. Only about 70 isolates showed positive result when using the modified ethanol production assay after pre-screening stage. The formation of decolourized zone was apparent using modified assay containing 5 mL/L of 0.05M 2,6-dichlorophenol-indophenol, 10 mL of reaction mixture and 500 μl/L of enzyme, respectively. The ethanol production capability of the isolates was further proven by anaerobic fermentation as a quantitative method. This modified method is applicable in screening for ethanol producer from glycerol as carbon source allows rapid and more bacteria can be screened

Attributable causes of chronic kidney disease in adults: a five-year retrospective study in a tertiary-care hospital in the northeast of the Malaysian Peninsula

CONTEXT AND OBJECTIVE: Chronic kidney disease (CKD) is an escalating medical and socioeconomic problem worldwide. Information concerning the causes of CKD, which is a prerequisite for reducing the disease burden, is sparse in Malaysia. Therefore, this study aimed to evaluate the attributable causes of CKD in an adult population at a tertiary referral hospital. DESIGN AND SETTING: Retrospective study at Hospital Universiti Sains Malaysia (HUSM). METHODS: This was an analysis based on medical records of adult patients at HUSM. Data regarding demographics, laboratory investigations, attributable causes and CKD stage were gathered. RESULTS: A total of 851 eligible cases were included. The patients’ mean age was 61.18 ± 13.37 years. CKD stage V was found in 333 cases (39.1%) whereas stages IV, IIIb, IIIa, and II were seen in 240 (28.2%), 186 (21.9%), 74 (8.7%) and 18 (2.1%), respectively. The percentage of CKD stage V patients receiving renal replacement therapy was 15.6%. The foremost attributable causes of CKD were diabetic nephropathy (DN) (44.9%), hypertension (HPT) (24.2%) and obstructive uropathy (9.2%). The difference in the prevalence of CKD due to DN, HPT and glomerulonephritis between patients ≤ 50 and > 50 years old was statistically significant. CONCLUSION: Our results suggest that DN and HPT are the major attributable causes of CKD among patients at a Malaysian tertiary-care hospital. Furthermore, the results draw attention to the possibility that greater emphasis on primary prevention of diabetes and hypertension will have a great impact on reduction of hospital admissions due to CKD in Malaysia

Governance for disaster risk reduction: development of standard operating procedure during flood disaster in hemodialysis patients

The recent flood had affected many healthcare facilities, including the hemodialysis centers. End Stage Renal Failure (ESRF) patients are hemodialysis dependent depriving them from treatment may lead to increased morbidity and mortality. A specific Standard Operating Procedure (SOP) is required during disaster for hemodialysis services to ensure treatments are not disrupted. During our recent flood in Kelantan. we have identified several issues on human resources poor coordination, missing patients' clinical records, logistic issues for patient and medical supply transfer and unsupervised dialysis quality control as the major problems. This research is meant to develop a SOP for the hemodialysis staffs and patients during disaster. to ensure mitigation, preparedness, response and recovery process successful. The SOP will be developed in 4 phases. namely: Phase 1: identification of stakeholders and the experts and establishing working groups for specific areas (i.e.: human resources management development of web based medical data records. logistics coordination and dialysis quality control). Phase 2: Workshops and Guideline Reviews by the assigned working groups and development of web based medical record system for hemodialysis patients. Phase 3 SOP development and consensus by the stakeholders. Phase 4: SOP Review and Approval (application of the SOP in a drill) The SOP developed from this study will be applied during flood disaster and the web based medical records will be referred in the clinical management of the patients. The outputs of this study will reduce mortality and prevent morbidities in patients on regular hemodialysis and will ensure the continuity of care with acceptable quality of service during disaster. Complications related to dialysis treatments can also be prevented and reduced with effective coordination of human resources and logistics A specific Standard Operating Procedure (SOP) is required during disaster for hemodialysis services to ensure treatments are not disrupted

Acute Ischemic Stroke and Acute on Chronic Kidney Disease

Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled). He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis), acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating conditio

Effect of Fruit/Vegetable-Drug Interactions on CYP450, OATP and p-Glycoprotein: A Systematic Review

Purpose: To review the concomitant use of certain drugs with fruit/vegetable juices that may lead to drug-juice interactions resulting in medication-related problems.Method: In this systematic review, online databases (PubMed, Google Scholar and Science Direct) were searched for information on juices derived from fruits and vegetables that are reported to have inhibitory effects on cytochrome P450, p-glycoprotein and organic anion transporting polypeptides (OATPs).Results: Fruits can inhibit CYP1A1, CYP1A2, CYP1A4, CYP3A1, CYP3A4, CYP2C6, CYP2C9,CYP2E1 and drug transporters (P-glycoprotein, OATP). On the other hand CYP1A1, CYP1A2, CYP2A2, CYP3A1, CYP1B1, CYP2B1, CYP2B2, CYP2C1, CYP2C6, CYP2E1 can be inhibited by some vegetables. Antihypertensives, antidiabetics, statins, analgesics and antipsychotics were the most common drugs interacting with fruits and vegetables. The inhibition of their metabolism by fruits and vegetables can cause serious toxic effects, e.g., hypertension, poor glycemic control, rhabdomyolosis and drug overdose-related toxic effects. Overall, active components of fruits and vegetables can interact with many drugs leading to adverse effects.Conclusion: Screening of fruits/vegetables for possible risk of interaction, and patient counseling are some effective strategies for preventing such interactions for optimal patient care.Keywords: Fruits and vegetables, Cytochrome P450, Drug interactions, p-Glycoprotein, Organic anion transporting polypeptide

Syaralise Empire / Nabilah Farhah Adnan ... [et al.]

All Batu Pahat, Johor residents and social media platforms have recognized Syaralise Empire. This is due to a lack of individuals offering a nice pillow that is distinct from a typical pillow and has a choice of pillow designs and pattern to choose from. Syaralise Empire's sell a product that included a diverse variety of adorable pillows designs, patterns, and colours. The main issue that the Syaralise Empire faced was a lack of space to store stock, which caused the operations of checking to slow down.Lack of expertise and insufficient understanding in organizing the products neatly and nicely or information. The syaralise empire also must deal with customer demands from suppliers. This demand exceeded Syaralise Empire's expectations, as it required customized design and the customer was not interested in existing designs. Other than that, the main problem that the Syaralise Empire faced was the pandemic of the Covid-19 attack, which resulted in a decrease in the number of customers using the cash on delivery service as a result of the movement control order action. Last but not least, we will discuss the history of the Syaralise Empire in this case study. Then, we provide our swot analysis and findings regarding the Syaralise empire's problem and how they plan to solve it

Magic Gift 4U / Nabilah Farhah Adnan ... [et al.]

Magic Gift 4u is a company that provide a service surprise gift which a valuable gift box that includes gifts for someone that we love such as family, friends or even lover to express affection, and is an extension of the social needs of a packaging function. We will buy or produce presents by hand for special days or anniversaries. All of this requires the use of lovely packing boxes to convey romance or solemnity. In particularly, put a lovely ribbon on the box, no matter what the gift is, and it will instantly make the gift more beautiful. The handmade, huge, and round bow becomes part of the packaging, giving tension and vitality to the packaging while conveying the gift's quality and value. Besides, appearance of the box and the gift also plays an important role. We not only using the box, but we also offer a bouquet of flower when there is a demand from customer. We also offer a few combos’ that customer can give a variety of gift to their loves one such as cloths, necklace, chocolate, Spotify plague, perfume and many more. Other than that, the price is affordable to all people. Our product is suits both gender whether a man or a woman. Our targeting market is for someone that wanted to give a present to someone they love but in surprise way. Magic Gift 4u is suit and open to all race, ethnic, region. Our surprise gift box suitable in any important event such as Mother’s Day, Father’s Day, Birthday, Anniversary and so on. Then, it has already been observed by our group that in Malaysia we do not handle so much about surprise service where the demand for surprise is very high in the market now. We also provide an agent for different state, due to that customer can easily reach the agent based on their location. We are also available in online and offline. We can be found in a social media platform by searching our company name. In addition, people are now lazy to go out looking for gift and that is the reason Magic Gift 4u is established. At the same time, our company provide a services surprise gift box different from the others and we emphasize the quality of the service more than the price of surprise gift which our goals are customer satisfy and happy. It is because it helps company to growth more and can help company to increase our sales. Due to that we will achieve our company goals. Lastly, on this assignment our team which is Magic Gift 4u company or our groupmates wanted to present our business proposal which focus on key points or findings about how we want to start and manage of this business by using business model canvas before being operated. The business model canvas that we will focus on is customer segment, values propositions, channels, customer relationship, revenue streams, key resources, key partnerships, and cost structure

Glycerol as alternative substrate for bioethanol production using free and immobilized Escherichia coli SS1

Increase in the crude oil price and the concern about climatic change has resulted in the rapid increase of biodiesel production. In the production of this biofuel, glycerol will essentially generate as by-product. As a result, the production of glycerol has also increased. Biofuel from glycerol can be categorized as second generation of biofuels where it can be used to replace the first generation of biofuel including glucose and vegetable oils as feedstock to reduce the competition between biofuel and food production. Thus the aim of this study is to carry out bioethanol production using glycerol in batch and continuous fermentation by free and immobilized Escherichia coli SS1. Bioethanol production was carried out using both free and immobilized cells in 2 liter bioreactor with 800 mL working volume. Glycerol concentration of 20 g/L, 35 g/L and 45 g/L were used as initial substrate concentration in batch free cells fermentations. Dilution rate of 0.1/h and 0.2/h were used and was selected based on the maximum specific growth rate from batch fermentation. Immobilization of E.coli SS1 was done by using sodium alginate and calcium chloride as crossed link agent. Optimization study was done to determine the stability and rigidity of alginate beads. Parameters involved in this optimization study were sodium alginate concentration, calcium chloride concentration, beads diameter and initial pH of medium. The optimum conditions for cell immobilization were 0.2 M calcium chloride, at pH 7 with 3% concentration of sodium alginate and beads diameter of 3 mm. Results showed that high glycerol concentration did not affect the yield of ethanol with the yield was closed to theoretical yield; 1 mol ethanol per 1 mol glycerol. Dilution rate of 0.1/h was the optimum dilution rate to be used in this fermentation where glycerol consumption and ethanol production was similar to batch fermentation by yielding 1 mol ethanol per mol glycerol. Continuous fermentation of immobilized E. coli SS1 was done by using the optimized beads with the dilution rate of 0.2/h and 20 g/L. The results showed that immobilized cells can last up to 3rd cycle of continuous fermentation. Ethanol production obtained was 6.17 g/L by utilizing approximately 19 g/L glycerol. The yield achieved was 0.65 mol ethanol per mol glycerol. Compare with other studies, the result in this experiment was slightly lower where other managed to obtain about 0.6 to 0.8 mol ethanol per mol glycerol, respectively