An outcome study of extended versus standard infusion of meropenem in septic critically ill patients / Fahmi Hassan

Sepsis incidence in critical care settings is a major problem in health care. Good choice of antibiotic treatment may improve the outcome of patients with sepsis. Meropenem is one of the most widely used antibiotics for treatment of serious bacterial infection in hospitalized patients. Since meropenem is a beta-lactam antibiotic, it exhibits the bactericidal effect with time-dependent activity. Currently ICUs in Malaysia do not have a standard guideline on how to infuse meropenem; whether to use 30-minute or three-hour infusion due to the lack of clinical evidence supporting either methods. The objective of this study is to compare the clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case control study was conducted among patients over 18 years old who were diagnosed with sepsis and treated with meropenem infusion in Intensive Care Unit of three hospitals in Malaysia. Patients included in the study received either 30-minute infusion of meropenem or three-hour infusion of meropenem as per practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and also patients file from the record departments of individual settings. During the study period, a total of 1975 patients received meropenem infusion during their admission in the ICUs of the three selected hospitals. 11.4% of the selected samples met the inclusion criteria of the study and were included in the analysis. From the 225 subjects, 108 patients received three-hour infusion of meropenem while the remaining 117 patients received 30-minute infusion of meropenem. Patients receiving the extended infusion of meropenem were found to have significantly lower mortality rate, shorter length of hospital stay, and higher rate of fever and white blood cell reduction. This study would be able to strengthen the evidence in using prolonged infusion of meropenem as a standard practice in critical care settings in Malaysia. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, a randomized clinical trial with large sample size should be carried out in local settings in order to improve the result of the study and minimizes other confounders that may influence with the result of the study

Does Islamic insurance development promote economic growth? a panel data analysis

This paper examines the impact of Islamic insurance development on economic growth. The Islamic insurance market has been experiencing tremendous growth in its activities since inception, particularly in the ASEAN and GCC markets. Using the difference GMM estimation technique for dynamic panel data model for a set of 22 countries for the period 2004 to 2012, we find a strong evidence of a positive and significant effect from the Islamic insurance activities on economic growth. We further find a robust positive and significant link between trade and economic growth, a positive but insignificant relationship between CPI and economic growth while government consumption show a negative relation. Our result provides further support for the supply-leading hypothesis in the finance growth literature

Anti-diabetes mechanism of action by synacinn TM in adipocytes

Type 2 diabetes mellitus is described as a defective action of insulin to properly regulate glucose transport within cells and clinically known as insulin resistance. Several factors such as elevated free fatty acid, glucocorticoids as well as abnormal levels of cytokines have been reported to cause insulin resistance. Potentially, phytochemical agents with insulin resistance reverting effect could serve as an alternative treatment for type 2 diabetes mellitus. Synacinn™ is a polyherbal supplement formulated from Andrographis paniculata, Curcuma xanthorrhiza, Cinnamomum zeylanicum, Eugenia polyantha and Orthosiphon stamineous. It is claimed as a hypoglycemic agent for diabetes mellitus treatment. Even though the anti-diabetes potential of each singular herbs has been well examined, scientific evidence has never been reported for polyherbal combination. In this study, the potential anti-diabetes mechanism of standardized Syancinn™ was investigated using two types of in vitro models; normal and insulin-resistant 3T3-L1 adipocytes. It was found that Synacinn™ improved the insulin-mediated glucose utilization in both models. For normal adipocytes, the increase of glucose utilization resulted in overexpression of glucose transporter 4, insulin receptor 1 and protein kinase B. Meanwhile in insulin resistant adipocytes, Synacinn™ increased the glucose transporter 4 expression without affecting the insulin receptor 1 and protein kinase B expression, indicating that Synacinn™ mechanism of action is dominant on the glucose transport rather than repairing the insulin signal transduction. This study also shows that Synacinn™ is a mild peroxisome proliferator-activated receptor gamma ligand and pro-adipogenic agent. During adipogenesis, Synacinn™ stimulated the peroxisome proliferator-activated receptor gamma nuclear transcriptional activity, as well as expression of (cytosine-cytosine-adenosine-adenosine-thymidine)-enhancer-binding protein alpha, adiponectin, glucose transporter 4 and protein kinase B. In terms of safety, standardized Syancinn™ was free from heavy metals and microbial contaminations and the concentrations used in the experiment do not affect the normal embryogenesis of zebrafish. Collectively, results suggest that Synacinn™ is a peroxisome proliferator-activated receptor gamma ligand agent which acted through two mechanisms: 1) restores the insulin-mediated glucose utilization by activating the glucose transporter 4 expression in insulin resistant adipocytes and 2) enhances the adipogenesis into insulin-sensitive adipocytes containing abundance of glucose transporter 4 resulted from activation of (cytosine-cytosine-adenosine-adenosine-thymidine)-enhancer-binding protein alpha and proliferator-activated receptor gamma

Staff recruitment using expert system / Mohd Hassan Fahmi Nordin

Companies nowadays had to face the challenges of hiring the right talent. The main strategy for recruiting new talent that most organizations rely on now is interview. Staff Recruitment Using Expert System is designed to choose the eligible applicant for the lecturer’s position at UiTM Terengganu. Expert system is one of the artificial intelligent (Al) techniques that can implement in many areas. This research is to develop a protoype of staff recruitment using expert system which inference technique had been choosen is forward chaining technique. The system will identify by using the criteria that has been set up by the admin such qualification, age, citizen, the grade of bahasa Melayu in Sijil Peperiksaan Malaysia (SPM) and compare with the criteria that has been input by the applicant. This research methodology consists of five stages which are preliminary study, knowledge acquisition and comprehension, system and rule design, system development and finally testing. The data was gathered from the Management Department in UiTM Terengganu. The system is a web-based system and developed using PHP as programming language and MySql as database tool. In future, it is recommended that the prototype can learn from experience

Stakeholder interests and sharia compliance assurance: a discourse on the role of sharia boards of Islamic banks

This study argues that the relevant theoretical framework underlying the operations of Islamic banks is the stakeholder theory with the stakeholders are expected to be ultimately concerned with the provision of Islamic banking products and services that are Sharia compliant. Based on our semi-structured interviews undertaken with 46 key players operating in the Sharia governance framework of the Malaysian Islamic banking industry, our study reveals only a weak emphasis for the stakeholder theoretical framework. We derive this conclusion based on our finding that Sharia boards are overwhelmingly inclined to limit themselves to aspects related to the development and approval of Islamic banking products. This study also reports that the Sharia compliance review is primarily undertaken by Islamic banks’ internal Sharia compliance officers, and then merely presented to the Sharia board for approval. Interestingly, the study further reports that the appointment of Sharia board members was predominantly motivated by a desire to image build and to serve the commercial interests of Islamic banks, thus raising concern that boards are being used as a tool for satisfying managerial opportunistic behaviour. Finally, the pursuit of stakeholder interest assumed by Islamic banks was reported to be influenced by conventional banking practice

Debt and economic growth in an oil rich economy: evidence from Saudi Arabia

The objective of this paper is to examine the impact of debt on economic growth in Saudi Arabia based on autoregressive distributed lags approach for the period of 1969-2013. The result indicates that variables are cointegrated and null hypothesis was rejected at the 5% significance level. The coefficients of long-run result reveal that public debt affects economic growth in a positive and statistically significant manner. Furthermore, inflation was found to also enhance economic growth in the oil rich kingdom. Despite the overwhelming evidence in the literature suggesting debt stifles growth, our study recommend that policymakers maintain the current level of debt-to- gross domestic product in the country

TIPOLOGI GEOMETRI BANGUNAN MEUNASAH DI KECAMATAN INDRAJAYA KABUPATEN PIDIE, ACEH

Abstract: The function of the meunasah in the social system of the Acehnese people is a place of worship, a center for religious and cultural education and is also a place to discuss social problems that occur in community life in the village. The search for characters is important to find typology of meuansah, so that the relationship between geometric typology and shape has a broad interpretation. The search for shape characters to find typology of meunasah in Indrajaya District, Pidie Regency, Aceh was carried out in 5 stages, (1) determine the location of the meunasah building sample points in 52 villages in Indrajaya District, (2) literature review, (3) collecting data on the object of research by measuring the meunasah building, (4) redrawing the meunasah measurements that have been carried out at the data collection stage using digital applications to produce data, namely the meunasah floor plans and facades in each village and the last stage is (5) analysis of determining the type with a geometric approach with architectural elements of the meunasah building facades, namely doors, columns, windows, walls, roofs, floors and terrace fences. The findings consist of 16 types of meunasah typology with similarity criteria of typology variable forms.Abstrak: Keberadaan bangunan meunasah dalam sistem sosial masyarakat Aceh berfungsi sebagai tempat ibadah, pusat Pendidikan kegamaan dan kebudayaan dan juga merupakan tempat untuk mendiskusikan berbagai permasalahan sosial yang terjadi dalam kehidupan masyarakat di gampong tersebut. Pencarian terhadap karakter menjadi penting untuk menemukan tipologi dari meunasah, sehingga katerkaitan tipologi geometri dengan bentuk memiliki intepretasi yang luas. Pencarian karakter bentuk untuk mememukan tipologi dari meunasah di Kecamatan Indrajaya Kabupaten Pidie, Aceh dilakukan melalui 5 tahap yaitu (1) menentukan lokasi titik sampel bangunan meunasah di 52 gampong di Kecamatan Indrajaya, (2) penguatan referensi, (3) pengumpulan data objek penelitian dengan cara pengukuran bangunan meunasah, (4) menggambar ulang pengukuran meunasah yang telah dilakukan pada tahap pengumpulan data menggunakan aplikasi digital untuk menghasilkan data yaitu gambar denah dan tampak meunasah di setiap gampong dan tahap yang terakhir adalah (5) analisis menentukan tipe dengan pendekatan geometri dengan variabel elemen arsitektural dari fasad bangunan meunasah antara lain pintu, kolom, jendela, dinding, atap, lantai dan pagar teras. Penemuan berupa 16 tipe dari tipologi meunasah dengan kriteria kesamaan dan kemiripan dari bentuk variabel tipologi.