Association between elevated carotid intima-media thickness and serum uric acid levels among patients with essential hypertension in primary care setting in Sungai Buloh, Malaysia.

AIMS: Our study aimed to investigate the association between elevated carotid-intima media thickness (CIMT) and serum uric acid (SUA) levels in hypertensive patients attending primary care clinics in Sungai Buloh, Malaysia. METHODS: We conducted a cross-sectional study on 140 hypertensive patients attending outpatient follow-up in two primary care clinics in Sungai Buloh, Malaysia, using a convenient sampling method. SUA levels were measured and divided into four quartiles. Two radiologist specialists performed B mode ultrasonography to assess the thickness of the right and left carotid intima media in all participants. RESULTS: Participants' mean SUA level was 355.75 ± 0.13. Their mean age was 53.44 (± 9.90), with a blood pressure control of 137.09 ± 13.22/81.89 ± 8.95. Elevated CIMT taken at ≥75th percentile was 0.666 for the left and 0.633 for the right common carotid arteries. By using a hierarchical method of multiple logistic regression, compared with the first quartile of the SUA level as reference group, the odd of elevated CIMT in quartile 4 in the common carotid artery was (OR = 2.00; 95% CI = 0.64-6.27, P = .576) for the right and (OR = 0.62; 95% CI = 0.20-2.00, P = .594) for the left. Waist circumference (P = .001), body mass index (P = .013), triglycerides (P < .001), and high-density lipoprotein cholesterol (P = .001) were significantly associated with the SUA quartiles. CONCLUSION: Although there was an increasing trend in the odd of elevated right CIMT across the SUA quartiles, this association, however, was not significant. Preventive effort to tackle the clustering effect of metabolic markers within this study population is needed to reduce the future risk of developing cardiovascular disease.

The impact of a disease management program (COACH) on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study): a randomised controlled trial.

BACKGROUND: To evaluate the efficacy of Counselling and Advisory Care for Health (COACH) programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm) and primary care physicians assisted by nurse educators (PCP-NE arm). METHODS: This was a multi-centre, open label, randomised trial of a disease management programme (COACH) among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE) and 148 to care provided by primary care physicians (PCP) alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio), Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36. RESULTS: Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS) mean change from baseline LDL-C were -30.09% and -27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288), with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had ended). CONCLUSION: Patients who received coaching and advice from primary care physicians (with or without the assistance by nurse educators) showed improvement in LDL-cholesterol. Disease management services delivered by PCP-NE demonstrated a trend towards add-on improvements in cholesterol control compared to care delivered by physicians alone; however, the improvements were not maintained when the services were withdrawn. TRIAL REGISTRATION: National Medical Research Registration (NMRR) Number: NMRR-08-287-1442Trial Registration Number (ClinicalTrials.gov Identifier): NCT00708370.

Effect of Solvent on Superhydrophobicity Behavior of Tiles Coated with Epoxy/PDMS/SS.

Superhydrophobic coatings are widely applied in various applications due to their water-repelling characteristics. However, producing a durable superhydrophobic coating with less harmful low surface materials and solvents remains a challenge. Therefore, the aim of this work is to study the effects of three different solvents in preparing a durable and less toxic superhydrophobic coating containing polydimethylsiloxane (PDMS), silica solution (SS), and epoxy resin (DGEBA). A simple sol-gel method was used to prepare a superhydrophobic coating, and a spray-coating technique was employed to apply the superhydrophobic coating on tile substrates. The coated tile substrates were characterized for water contact angle (WCA) and tilting angle (TA) measurements, Field-Emission Scanning Electron Microscopy (FESEM), Atomic Force Microscopy (AFM), and Fourier Transform Infrared Spectroscopy (FTIR). Among 3 types of solvent (acetone, hexane, and isopropanol), a tile sample coated with isopropanol-added solution acquires the highest water contact angle of 152 ± 2° with a tilting angle of 7 ± 2° and a surface roughness of 21.80 nm after UV curing for 24 h. The peel off test showed very good adherence of the isopropanol-added solution coating on tiles. A mechanism for reactions that occur in the best optimized solvent is proposed.

Shear bond strength of two chemically different denture base polymers to reline materials.

PURPOSE: This study evaluated the shear bond strengths of light-polymerized urethane dimethacrylate (Eclipse) and heat-polymerized polymethylmethacrylate (Meliodent) denture base polymers to intraoral and laboratory-processed reline materials. MATERIALS AND METHODS: Thirty disks measuring 15 mm diameter and 2 mm thick were prepared for each denture base material following the manufacturers' recommendation. They were relined with Meliodent RR, Kooliner, and Secure reline materials after 1 month of water immersion. Ten additional Eclipse specimens were relined using the same Eclipse resin. A shear bond test was carried out on an Instron machine at a crosshead speed of 1.0 mm/min 24 hours after relining. Data were analyzed using two-way and one-way ANOVAs and post hoc Dunnett's T3 test (p= 0.05). The nature of failure was analyzed under a stereomicroscope. The effect of dichloromethane adhesive on the two denture polymer surfaces and the failed interfaces of mixed and adhesive failures were analyzed under a SEM (scanning electron microscope). RESULTS: Two-way ANOVA showed significant differences in the shear bond strength values as a function of the denture base polymers, reline materials, and their interaction (p < 0.05). One-way ANOVA showed significant differences in shear bond strength values among denture base-reline combinations (p < 0.05) except for Meliodent-Kooliner and Eclipse-Meliodent RR relines. Meliodent showed the highest shear bond strength value when relined with Meliodent RR (14.5 +/- 0.5 MPa), and Eclipse showed the highest value with Eclipse relining (11.4 +/- 0.6 MPa). Meliodent denture base showed adhesive, cohesive, and mixed failure, while all Eclipse showed adhesive failure with various reline materials. CONCLUSION: The two chemically different denture base polymers showed different shear bond strength values to corresponding reline materials.

Improvement of efficient in vitro regeneration potential of mature callus induced from Malaysian upland rice seed (Oryza sativa cv. Panderas).

A new and rapid protocol for optimum callus production and complete plant regeneration has been assessed in Malaysian upland rice (Oryza sativa) cv. Panderas. The effect of plant growth regulator (PGR) on the regeneration frequency of Malaysian upland rice (cv. Panderas) was investigated. Mature seeds were used as a starting material for callus induction experiment using various concentrations of 2,4-D and NAA. Optimal callus induction frequency at 90% was obtained on MS media containing 2,4-D (3 mg L(-1)) and NAA (2 mg L(-1)) after 6 weeks while no significant difference was seen on tryptophan and glutamine parameters. Embryogenic callus was recorded as compact, globular and light yellowish in color. The embryogenic callus morphology was further confirmed with scanning electron microscopy (SEM) analysis. For regeneration, induced calli were treated with various concentrations of Kin (0.5-1.5 mg L(-1)), BAP, NAA and 0.5 mg L(-1) of TDZ. The result showed that the maximum regeneration frequency (100%) was achieved on MS medium containing BAP (0.5 mg L(-1)), Kin (1.5 mg L(-1)), NAA (0.5 mg L(-1)) and TDZ (0.5 mg L(-1)) within four weeks. Developed shoots were successfully rooted on half strength MS free hormone medium and later transferred into a pot containing soil for acclimatization. This cutting-edge finding is unique over the other existing publishable data due to the good regeneration response by producing a large number of shoots.