MyMedR (Malaysian Medical Repository) is an open access collection of Malaysian health and biomedical research. The materials are imported from PubMed and MyJurnal. We gratefully acknowledge the permission to reuse the materials from the National Library of Medicine of the United States and the Malaysian Citation Centre. This project is funded by Academy of Family Physicians of Malaysia. The project team members are: CL Teng, CJ Ng, EM Khoo, Mastura Ismail, Abrizah Abdullah, TK Chiew, Thanaletchumi Dharmalingam.

Please note that some citations are non-Malaysian publications. Common reasons are: (1) One or more authors had a Malaysian affiliation; (2) The article abstract mentioned Malaysia; (3) The study subjects included Malay ethnic group.

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  1. Sarwari, Abdul Qahar, Mohammad Nubli Wahab
    Literature has established the effectiveness of self-regulatory techniques using Heart Rate Variability (HRV)-Biofeedback Technology in improving individual’s heart coherence. The current study aims to evaluate the effectiveness of Quick Coherence Technique, a self-regulatory technique, through the application of HRV-biofeedback technology on the level of heart coherence among university students. A total of 20 students of a technical public university participated in the study. The Quick Coherence Technique (QCT) and the emWave device and software of the HeartMath Institute were used to collect the data. According to the HRV power spectrum, the HRV data is divided under very low frequency (VLF), low frequency (LF), and high frequency (HF) frequency ranges. Based on the results, the use of HRV-biofeedback technology and the QCT had helped to increase the levels of HRV scores and heart coherence of the participants.
  2. Konsue, N., Amron, N.A.
    Cruciferous vegetables belong to the mustard family of plants such as Brussels sprouts, kale, broccoli, cabbage and cauliflower. They are well known for their cancer prevention properties which are due to high content of bioactive compounds, isothiocyanates (ITCs). This study was aimed to investigate nitrosation inhibition ability of the cruciferous vegetables commonly consumed with meat products namely, broccoli, cauliflower and cabbage. Aqueous extracts of fresh and steamed (2 and 4 min) vegetables were subjected to determination of antioxidant capacity (DPPH and FRAP assay) and chemical composition i.e. total phenolic and isothiocyanate (ITC) content. It was found that TPC, DPPH and FRAP values of raw vegetables were different in each vegetable and ranged from 17.12-38.91 mg GAE/100 ml, 44.09-63.31% and 1.36-6.81 mg TE/100 ml, respectively. Among three types of cruciferous vegetable, broccoli had the highest PEITC content being 0.21 mmol/100 g compared to cauliflower (0.15 mmol/100 g) and cabbage (0.06 mmol/100 g). Moreover, it was found that steaming process significantly enhanced antioxidant activity, TPC as well as PEITC content in a timedependent manner up to 4 min (p
  3. Ziad F, Katchy KC, Al Ramadan S, Alexander S, Kumar S
    Ann Saudi Med, 2006 7 25;26(3):200-4.
    PMID: 16861859
    BACKGROUND: Hirschsprung disease [HD] is a predominantly childhood disorder of intestinal motility with a multifactorial and polygenic etiology. The objective of this study was to document the clinical and pathological features of HD in Kuwait, which has an estimated consanguinity rate of 54%.

    METHODS: We analyzed all rectal and colonic biopsies (n=268) for suspected HD identified from the records in the Pathology Department of Al-Sabah Hospital for the period between 1994 and 2004.

    RESULTS: One hundred and two patients (87 males and 15 females) had histologically confirmed HD. Fifty-eight (57%) were neonates (<1 month of age), while 21% were more than 4 months old. The diagnosis was based on open biopsy in 11 cases and rectal biopsies in 91 cases. Nine patients with open biopsies presented as intestinal obstruction, necrotizing enterocolitis, or perforation. The extent of the disease was unknown in 13 patients. There were 67 males and 3 females with short segment HD. Nine had long segment, two ultra-short segment and eight total colonic aganglionosis (TCA). Five TCA cases involved the small intestine. A skip area was observed in two cases. Six patients had other anomalies. A positive family history for HD was established in three patients. Two of these were male siblings from a consanguineous marriage and had Waardenburg syndrome.

    CONCLUSION: This study has highlighted an exceptionally strong male predominance of short segment and a relatively high frequency (5.6%) of small intestinal involvement in HD in Kuwait. These data call for a more detailed epidemiological study with special emphasis on genetics.

    MeSH terms: Adolescent; Child; Child, Preschool; Consanguinity; Female; Hirschsprung Disease/pathology*; Humans; Infant; Infant, Newborn; Kuwait; Male; Rectum/pathology*; Retrospective Studies
  4. Yaakob ZH, Undok AW, Abidin IZ, Wan Ahmad WA
    Ann Saudi Med, 2012 6 19;32(4):433-6.
    PMID: 22705620
    Massive pulmonary embolism (PE) is not an uncommon condition, and it usually carries a high risk of mortality. It is one of the fatal conditions that commonly affect young patients. A definitive treatment for patients with massive PE is still lacking, and surgical intervention carries a substantial mortality risk. Thus, percutaneous intervention (clot fragmentation and/or aspiration) remains an option in some patients, specifically in those with a risk of bleeding, contraindicating the use of thrombolysis. There have been no randomized trials to validate percutaneous intervention in massive PE. A sufficient level of evidence is still lacking, and its use depends upon the expert committee's opinion and study of previous case reports. We present a 23-year-old man with first onset massive PE secondary to protein C deficiency, who was treated successfully with the combination of systemic thrombolysis and percutaneous interventions.
    MeSH terms: Angiography; Catheterization/methods; Combined Modality Therapy; Humans; Male; Pulmonary Embolism/etiology; Pulmonary Embolism/physiopathology; Pulmonary Embolism/therapy*; Thrombolytic Therapy/methods*; Protein C Deficiency/complications*; Young Adult
  5. Alfadhel M, AlShehhi W, Alshaalan H, Al Balwi M, Eyaid W, Eyaida W
    Ann Saudi Med, 2013 9 26;33(4):382-6.
    PMID: 24060719 DOI: 10.5144/0256-4947.2013.382
    BACKGROUND AND OBJECTIVES: Mucolipidosis II (MLII) is characterized by severe global developmental delay, coarse facial features, skeletal deformities, and other systemic involvement. It is caused by a deficiency in N-acetylglucosamine-1 phosphotransferase.

    DESIGN AND SETTINGS: This is a case series study conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2008-2012.

    PATIENTS AND METHODS: We described three unrelated Saudi children who presented with neonatal hyperparathyroidism, microcephaly, craniosynostosis, coarse facial features, cardiac involvement, and skeletal deformities.

    RESULTS: The MLII diagnosis was confirmed by assaying enzyme activities in fibroblasts, which showed a severe reduction in hydrolyzed substrates compared to controls, and by identifying a pathogenic homozygous GNPTAB gene mutation. One of the children died at 2 months of age due to severe pulmonary hypertension, and the other two children were still alive at 12 months and 18 months of age, respectively. Both surviving children had severe global developmental delay at 2 months of age.

    CONCLUSION: Clinicians should investigate any child presenting with neonatal hyperparathyroidism, craniosynostosis, skeletal deformities, and coarse facial features for MLII.

    MeSH terms: Developmental Disabilities/etiology*; Cyclic N-Oxides; Female; Humans; Hypertension, Pulmonary/etiology; Hypertension, Pulmonary/physiopathology; Infant; Male; Mercaptoethanol/analogs & derivatives; Mucolipidoses/diagnosis; Mucolipidoses/genetics; Mucolipidoses/physiopathology*; Mutation; Saudi Arabia; Severity of Illness Index; Transferases (Other Substituted Phosphate Groups)/genetics*
  6. Asha'ari ZA, Ahmad MZ, Jihan WS, Che CM, Leman I
    Ann Saudi Med, 2013 11 6;33(5):469-75.
    PMID: 24188941 DOI: 10.5144/0256-4947.2013.469
    BACKGROUND AND OBJECTIVES: The role of honey in the treatment of allergic rhinitis (AR) is controversial. We studied the complementary effect of ingestion of a high dose of honey, in addition to standard medications, on AR.

    DESIGN AND SETTINGS: Prospective randomized placebo-controlled study. Subjects were recruited from an otolaryngology clinic in 2 tertiary referral centers in the East coast of Peninsular Malaysia. The study period ranged from April 2010-April 2011.

    METHODS: Forty AR patients were divided equally into a case group and a control group. All the subjects received a daily dose of 10 mg of loratadine for 4 weeks. The case group ingested 1 g/kg body weight of honey daily in separate doses for the 4-week period. The control group ingested the same dose of honey-flavored corn syrup as placebo. AR symptoms were scored at the start, week 4, and week 8 of the study.

    RESULTS: There were no significant differences between the mean total symptom score of the case and the control groups at the start of the study. At week 4, both groups showed progressive improvement in the symptoms; at week 8, only the case group showed a continuous improvement in the symptom score. Only the group that ingested honey showed a significant improvement in individual AR symptoms. The improvement persisted for a month after the cessation of the treatment.

    CONCLUSION: Honey ingestion at a high dose improves the overall and individual symptoms of AR, and it could serve as a complementary therapy for AR.

    MeSH terms: Adult; Double-Blind Method; Female; Honey*; Humans; Malaysia; Male; Middle Aged; Prospective Studies; Rhinitis, Allergic, Perennial/therapy*; Time Factors; Treatment Outcome; Loratadine/administration & dosage; Loratadine/therapeutic use*; Anti-Allergic Agents/administration & dosage; Anti-Allergic Agents/therapeutic use*; Young Adult; Rhinitis, Allergic
  7. Zuhdi AS, Mariapun J, Mohd Hairi NN, Wan Ahmad WA, Abidin IZ, Undok AW, et al.
    Ann Saudi Med, 2014 1 15;33(6):572-8.
    PMID: 24413861 DOI: 10.5144/0256-4947.2013.572
    BACKGROUND AND OBJECTIVES: Understanding the nature and pattern of young coronary artery disease (CAD) is important due to the tremendous impact on these patients' socio-economic and physical aspect. Data on young CAD in the southeast Asian region is rather patchy and limited. Hence we utilized our National Cardiovascular Disease Database (NCVD)-Percutaneous Coronary Intervention (PCI) Registry to analyze young patients who underwent PCI in the year 2007 to 2009.

    DESIGN AND SETTINGS: This is a retrospective study of all patients who had undergone coronary angioplasty from 2007 to 2009 in 11 hospitals across Malaysia.

    METHODS: Data were obtained from the NCVD-PCI Registry, 2007 to 2009. Patients were categorized into 2 groups-young and old, where young was defined as less than 45 years for men and less than 55 years for women and old was defined as more than or equals to 45 years for men and more than or equals to 55 years for women. Patients' baseline characteristics, risk factor profile, extent of coronary disease and outcome on dis.charge, and 30-day and 1-year follow-up were compared between the 2 groups.

    RESULTS: We analyzed 10268 patients, and the prevalence of young CAD was 16% (1595 patients). There was a significantly low prevalence of Chinese patients compared to other major ethnic groups. Active smoking (30.2% vs 17.7%) and obesity (20.9% vs 17.3%) were the 2 risk factors more associated with young CAD. There is a preponderance toward single vessel disease in the young CAD group, and they had a favorable clinical outcome in terms of all-cause mortality at discharge (RR 0.49 [CI 0.26-0.94]) and 1-year follow-up (RR 0.47 [CI 0.19-1.15]).

    CONCLUSION: We observed distinctive features of young CAD that would serve as a framework in the primary and secondary prevention of the early onset CAD.

    MeSH terms: Adult; Age Factors; Aged; Coronary Artery Disease/etiology; Coronary Artery Disease/physiopathology; Coronary Artery Disease/therapy*; Female; Follow-Up Studies; Humans; Malaysia; Male; Middle Aged; Obesity/complications; Obesity/epidemiology; Registries; Retrospective Studies; Risk Factors; Sex Factors; Smoking/adverse effects; Angioplasty, Balloon, Coronary/methods*; Databases, Factual; Percutaneous Coronary Intervention/methods*
  8. Hudu SA, Malik YA, Niazlin MT, Harmal NS, Alshrari AS, Sekawi Z
    Ann Saudi Med, 2014 1 15;33(6):591-4.
    PMID: 24413864 DOI: 10.5144/0256-4947.2013.591
    BACKGROUND AND OBJECTIVES: Hepatitis B core antibodies (anti-HBc) are detected in almost every patient with previous exposure to hepatitis B virus (HBV). However, with this marker alone, one cannot understand the activity of the disease; therefore, this study aimed to identify the implication of isolated hepatitis B core antibody and evaluate the effect of hepatitis B vaccine booster in isolated anti-HBc among adults who received the HBV vaccine as infants.

    DESIGN AND SETTINGS: A prospective cohort study of vaccinated undergraduate students of University Putra Malaysia.

    PATIENTS AND METHODS: A total of 408 undergraduate students who received infant hepatitis B vaccination volunteered for this study; 5 mL of venous blood was taken from the volunteers. Hepatitis B surface antigen (HBsAg) and core antibodies were tested using a commercially available enzyme-linked immunosorbent assay kit according to the manufacturer's instructions (DRG international Inc., USA). Molecular detection of hepatitis B viral DNA was performed using nested polymerase chain reaction.

    RESULTS: The prevalence of isolated anti-HBc among the vaccinated cohort was found to be 5.0%, out of which 80% had a hepatitis B surface antibodies (anti-HBs) titer higher than 10 IU/L, while 20% had less than 10 IU/L anti-HBs titer. All the anti-HBc positivesubjects had detectable hepatitis B viral DNA in their serum. Anamnestic response was found to be 100% among isolated anti-HBc with negative antibody.

    CONCLUSION: Isolated anti-HBc developed protective levels of anti-HBs after a single dose of recombinant hepatitis B vaccination. HBV DNA was detected in all isolated anti-HBc indicating occult chronic HBV infection with undetectable HBsAg.

    MeSH terms: DNA, Viral/blood*; Enzyme-Linked Immunosorbent Assay; Female; Hepatitis B Antibodies/blood*; Hepatitis B Surface Antigens/immunology*; Humans; Immunization, Secondary; Malaysia; Male; Prospective Studies; Students; Universities; Cohort Studies; Polymerase Chain Reaction; Hepatitis B Vaccines/administration & dosage*; Hepatitis B Vaccines/immunology; Hepatitis B, Chronic/diagnosis; Hepatitis B, Chronic/immunology
  9. Moghaddam HM, Esfehani RJ, Panah NY, Esfehani AJ
    Ann Saudi Med, 2014 6 5;34(2):147-52.
    PMID: 24894784 DOI: 10.5144/0256-4947.2014.147
    BACKGROUND AND OBJECTIVES: The rate of consanguineous marriage is high in Middle Eastern countries such as Iran. The relationship between consanguineous marriage and congenital heart disease is discussed in some studies, but there is not much data for relationship between atrial septal defect (ASD) and consanguineous marriage. The aim of this study was to evaluate the relationship between consanguineous marriage and ASD echocardiographic characteristics.

    DESIGN AND SETTINGS: This was a cross-sectional study approved by Mashhad University of Medical Sciences ethics committee and took place in Mashhad, Iran, for a period of 3 years from August 2008 till September 2011.

    METHODS: In this cross-sectional study, 113 ASD patients participated and they were categorized into 3 groups on the basis of family relationship between their parents: first group-"no relationship," second group- "third degree relationship," and third group- "far relationship."

    RESULTS: Among the 54 male and 59 female ASD patients, the most prevalent type of ASD was ASD secundum (85.0%) followed by sinus venosus (8.8%). A total of 56% patients were present in the first group and 15% and 29% in the second group and the third group, respectively." The relationship between consanguinity and type of ASD (P < .001) and gender (P < .001 each) was observed. The relationship between the age of onset of disease and consanguinity (P=.003) was also observed.

    CONCLUSION: Considering the fact that there is a high prevalence of ASD and consanguineous marriage in Iran and bearing in mind the results of the present study, we recommend educating couples about the outcomes of consanguineous marriage in pre-marriage counseling.

    MeSH terms: Child; Child, Preschool; Consanguinity*; Cross-Sectional Studies; Echocardiography; Family; Female; Heart Septal Defects, Atrial/classification; Heart Septal Defects, Atrial/epidemiology*; Humans; Iran/epidemiology; Male; Marriage; Pedigree; Prevalence; Age of Onset
  10. Azman M, Sani A, Kamaruddin NA
    Ann Saudi Med, 2015 5 15;34(6):476-81.
    PMID: 25971819 DOI: 10.5144/0256-4947.2014.476
    BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is a common disease affecting middle-aged patients and is associated with significant cardiovascular, cerebrovascular, and metabolic complications. Current evidences show inconclusive association between OSA and insulin resistance (IR). This study aims to examine the possible correlation between OSA parameters and IR.

    DESIGN AND SETTINGS: This was a cross-sectional study to examine the association between OSA parameters and IR using homeostasis model assessment (HOMA) on patients who underwent polysomnogram (PSG) in a tertiary center between March 2011 and March 2012 (1 year).

    PATIENTS AND METHODS: A total of 62 patients underwent PSG within the study period, of which 16 patients were excluded due to abnormal fasting blood sugar. Information on patients' medical illnesses, medications, and Epworth sleepiness scale (ESS) was obtained. Patients' body mass index (BMI), neck circumference, and waist circumference (WC) were measured. Blood samples were collected after 8 hours of fasting to measure HOMA-IR value. Overnight PSG was performed for all patients. Data was recorded and analyzed using SPSS, version 12.0 (SPSS Inc, Chicago, USA).

    RESULTS: The prevalence of IR in OSA patients was 64.3%. There was significant correlation between OSA parameters (apnea-hypopnea index, ESS, BMI, and WC) and HOMA-IR with correlation coefficient of 0.529, 0.224, 0.261, and 0.354, respectively.

    CONCLUSION: A linear correlation exists between OSA parameters and IR concluding a definite causal link between OSA and IR. IR screening is recommended in severe OSA patients.

    MeSH terms: Adult; Blood Glucose/metabolism*; Cross-Sectional Studies; Female; Humans; Insulin/metabolism*; Insulin Resistance*; Male; Middle Aged; Obesity/complications; Obesity/metabolism*; Severity of Illness Index; Body Mass Index; Linear Models; Polysomnography; Sleep Apnea, Obstructive/complications; Sleep Apnea, Obstructive/metabolism*; Sleep Apnea, Obstructive/physiopathology; Waist Circumference
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