Displaying publications 1 - 20 of 47 in total

  1. Abdullah A, Abdul Rahman R, Aziz S, Abu Bakar S, AbAziz AA
    Med J Malaysia, 2013;68(1):76-8.
    PMID: 23466775 MyJurnal
    Nasal obstruction in neonates is a potentially fatal condition because neonates are obligatory nasal breathers. Bilateral choanal atresia is therefore a neonatal emergency. Several approaches for corrections of choanal atresia are available including the helium laser: YAG. A 5-year-old Chinese girl born with bilateral choanal atresia, had birth asphyxia that required intubation. She underwent multiple surgeries for correction of choanal atresia at other hospitals but failed to improve. She was referred to Universiti Kebangsaan Malaysia Medical Center (UKMMC) after presenting with intermittent respiratory distress and cyanosis following an upper respiratory tract infection. A repeat computed tomography (CT) scan done preoperatively showed complete bony stenosis over the left choana and finding was confirmed by examination under general anesthesia. She underwent endoscopic transnasal removal of left bony atretic plate. There was no intra or postoperative complications. During follow up 10 years later, the airway on both sides remains patent.
  2. Khor BH, Tiong HC, Tan SC, Abdul Rahman R, Abdul Gafor AH
    Nutrients, 2020 Sep 13;12(9).
    PMID: 32933198 DOI: 10.3390/nu12092809
    Nutritional assessment is essential to identify patients with acute kidney injury (AKI) who are protein-energy wasting (PEW) and at risk of poor clinical outcomes. This systematic review aimed to investigate the relationship of nutritional assessments for PEW with clinical outcomes in patients with AKI. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases using search terms related to PEW, nutrition assessment, and AKI to identify prospective cohort studies that involved AKI adult patients with at least one nutritional assessment performed and reported relevant clinical outcomes, such as mortality, length of stay, and renal outcomes associated with the nutritional parameters. Seventeen studies reporting eight nutritional parameters for PEW assessment were identified and mortality was the main clinical outcome reported. A meta-analysis showed that PEW assessed using subjective global assessment (SGA) was associated with greater mortality risk (RR: 1.99, 95% CI: 1.36-2.91). Individual nutrition parameters, such as serum chemistry, body mass, muscle mass, and dietary intakes, were not consistently associated with mortality. In conclusion, SGA is a valid tool for PEW assessment in patients with AKI, while other nutrition parameters in isolation had limited validity for PEW assessment.
  3. Abdul Rahman N, Ramli R, Abdul Rahman R, Hussaini HM, Abdul Hamid AL
    Geriatr Gerontol Int, 2010 Jan;10(1):64-9.
    PMID: 20102384 DOI: 10.1111/j.1447-0594.2009.00561.x
    Road traffic accidents are the main cause of trauma in Malaysia. It has been shown that there was an increase in admissions for trauma patients older than 60 years in the last decade. The purpose of this study was to determine the pattern of maxillofacial injuries in the geriatric patients referred to Seremban Hospital, Malaysia.
  4. Cheong JY, Makmor-Bakry M, Lau CL, Abdul Rahman R
    S. Afr. Med. J., 2012 Jul;102(7):616-9.
    PMID: 22748440
    The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in intensive care units in Malaysia is significant. Invasive MRSA infections are commonly treated with vancomycin. In clinical practice, the serum vancomycin trough concentration is used as a surrogate marker of vancomycin efficacy. A low concentration of vancomycin may result in less effective therapy and increase the risk of bacterial resistance. We evaluated the relationship between the resolution of MRSA infections and trough concentrations of vancomycin.
  5. Rajamani L, Cabanban AS, Abdul Rahman R
    Ambio, 2006 Aug;35(5):266-8.
    PMID: 16989512
  6. Ramli R, Abdul Rahman R
    Singapore Dent J, 2005 Dec;27(1):13-6.
    PMID: 16438263
    Minor oral surgery in warfarinized patients can be performed without stopping or altering the dose of the drug. Thirty patients underwent various types of oral surgical procedures without interruption of their anticoagulant therapy and their therapeutic international normalized ratio maintained. Local measures such as pressure, packing the sockets with oxidized regenerated cellulose, and suturing were applied. In some patients, tranexamic acid mouthwashes were prescribed to further enhance haemostasis. Four patients had minimal postoperative bleeding in the form of bloodstained saliva, which lasted for 24 hours. This study highlights the importance of local measures in controlling postoperative bleeding in warfarinized patients undergoing minor oral surgical procedures.
  7. Shaharir SS, Mohamed Said MS, Mohd R, Abdul Cader R, Mustafar R, Abdul Rahman R
    PLoS One, 2019;14(9):e0222343.
    PMID: 31539383 DOI: 10.1371/journal.pone.0222343
    Flare of Systemic Lupus Erythematosus (SLE) may occur during pregnancy and puerperium. We studied the prevalence and factors associated with SLE relapse during pregnancy and post-partum period in a multi-ethnic SLE cohort. Consecutive SLE patients who attended the outpatient clinic were reviewed for previous history of pregnancies in our institution. Patients who had a complete antenatal, delivery, and post-partum follow up were included. Their medical records were retrospectively analysed to assess the disease activity at pre-pregnancy/conception, during antenatal, and post-partum period. Presence of flare episodes during pregnancy and puerperium were recorded. The pregnancy outcomes recorded include live birth, foetal loss, prematurity and intra-uterine growth restrictions (IUGR). Univariate and multivariable logistic regression with generalized estimating equations (GEE) analyses were performed to determine the factors associated with disease relapse and the pregnancy outcomes. A total of 120 patients with 196 pregnancies were included, with a live birth rate of 78.6%. Four (2.0%) were diagnosed to have SLE during pregnancy. The flare rate in pregnancy was 40.1% while post-partum 17.4%. Majority of the relapse in pregnancy occurred in haematological system (62.3%) followed by renal (53.2%), musculoskeletal (22.1%), and mucocutaneous (14.3%). In GEE analyses, active disease at conception was the independent predictor of SLE relapse during and after pregnancy, whereas older maternal age and Malay ethnicity were associated with higher flare during post-partum. HCQ use was significantly associated with reduced risk of flare in univariate analysis but it was no longer significant in the GEE analyses. Presence of disease flare in pregnancy was significantly associated with prematurity. In conclusion, pregnancy in SLE need to be planned during quiescent state as pre-pregnant active disease was associated with disease relapse in both during and after pregnancy. Malay patients had an increased risk of post-partum flare but further larger prospective studies are needed to confirm the association between pregnancies in the different ancestral background.
  8. Lim JL, Yusof NS, Md Tarekh NA, Abdul Rahman R
    Cureus, 2020 Nov 19;12(11):e11580.
    PMID: 33364104 DOI: 10.7759/cureus.11580
    Dermatomyositis is often presented as paraneoplastic syndrome. The diagnosis of dermatomyositis can prompt clinicians to further investigate the underlying cause, in particular malignancy. This case report illustrates the association of lung adenocarcinoma and dermatomyositis with antecedent presentation of cutaneous and musculoskeletal manifestations, one year prior to the diagnosis of carcinoma.
  9. Jameran AS, Cheah SK, Tzar MN, Musthafa QA, Low HJ, Maaya M, et al.
    J Crit Care, 2021 10;65:216-220.
    PMID: 34252648 DOI: 10.1016/j.jcrc.2021.06.018
    PURPOSE: Early detection of candidemia in critically ill patients is important for preemptive antifungal treatment. Our study aimed to identify the independent risk factors for the development of a new candidemia prediction score.

    METHODS: This single-centre retrospective observational study evaluated 2479 intensive care unit (ICU) cases from January 2016 to December 2018. A total of 76 identified candidemia cases and 76 matched control cases were analyzed. The patients' demographic characteristics and illness severity were analyzed, and possible risk factors for candidemia were investigated.

    RESULTS: Multivariate logistic regression analysis identified renal replacement therapy (RRT) (odds ratio [OR]: 52.83; 95% confidence interval [CI]: 7.82-356.92; P < 0.0001), multifocal Candida colonization (OR: 23.55; 95% CI: 4.23-131.05; P < 0.0001), parenteral nutrition (PN) (OR: 63.67; 95% CI: 4.56-889.77; P = 0.002), and acute kidney injury (AKI) (OR: 7.67; 95% CI: 1.24-47.30; P = 0.028) as independent risk factors. A new prediction score with a cut-off value of 5.0 (80.3% sensitivity and 77.3% specificity) was formulated from the logit model equation.

    CONCLUSIONS: Renal replacement therapy, AKI, PN, and multifocal Candida colonization were the independent risk factors for the new candidemia prediction score with high discriminatory performance and predictive accuracy.

  10. Yeoh AH, Tang SS, Abdul Manap N, Wan Mat WR, Said S, Che Hassan MR, et al.
    Turk J Med Sci, 2016 Apr 19;46(3):620-5.
    PMID: 27513234 DOI: 10.3906/sag-1502-56
    BACKGROUND/AIM: The effects of pericardium 6 (P6) electrical stimulation in patients at risk of postoperative nausea and vomiting (PONV) following laparoscopic surgery were evaluated.

    MATERIALS AND METHODS: Eighty patients for laparoscopic surgery with at least one of the determined risks (nonsmoker, female, previous PONV/motion sickness, or postoperative opioid use) were randomized into either an active or sham group. At the end of surgery, Reletex electrical acustimulation was placed at the P6 acupoint. The active group had grade 3 strength and the sham group had inactivated electrodes covered by silicone. It was worn for 24 h following surgery. PONV scores were recorded.

    RESULTS: The active group had significantly shorter durations of surgery and lower PONV incidence over 24 h (35.1% versus 64.9%, P = 0.024) and this was attributed to the lower incidence of nausea (31.4% versus 68.6%, P = 0.006). The overall incidence of vomiting was not significantly different between the groups, but it was higher in the sham group of patients with PONV risk score 3 (23.9%, P = 0.049).

    CONCLUSION: In patients at high risk for PONV, P6 acupoint electrical stimulation lowers the PONV incidence by reducing the nausea component. However, this reduction in nausea is not related to increasing PONV risk scores.

  11. Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R
    PLoS One, 2021;16(9):e0257843.
    PMID: 34559859 DOI: 10.1371/journal.pone.0257843
    OBJECTIVE: To determine the effect of Ashwagandha extract on sleep.

    METHODS: A comprehensive search was conducted in CENTRAL, MEDLINE, SCOPUS, Google Scholars, World Health Organization Trials Portal, ClinicalTrials.gov, Clinical Trial Registry of India, and AYUSH Research Portal for all appropriate trials. Randomized controlled trials that examined the effect of Ashwagandha extract versus placebo on sleep in human participants 18 years old and above were considered. Two authors independently read all trials and independently extracted all relevant data. The primary outcomes were sleep quantity and sleep quality. The secondary outcomes were mental alertness on rising, anxiety level, and quality of life.

    RESULTS: A total of five randomized controlled trials containing 400 participants were analyzed. Ashwagandha extract exhibited a small but significant effect on overall sleep (Standardized Mean Difference -0.59; 95% Confidence Interval -0.75 to -0.42; I2 =  62%). The effects on sleep were more prominent in the subgroup of adults diagnosed with insomnia, treatment dosage ≥600 mg/day, and treatment duration ≥8 weeks. Ashwagandha extract was also found to improve mental alertness on rising and anxiety level, but no significant effect on quality of life. No serious side effects were reported.

    CONCLUSION: Ashwagandha extract appears to has a beneficial effect in improving sleep in adults. However, data on the serious adverse effects of Ashwagandha extract are limited, and more safety data would be needed to assess whether it would be safe for long-term use.

  12. Jamaleddin Surani SA, Budiman M, Azman M, Abdul Rahman R
    Int J Clin Pract, 2022;2022:4090444.
    PMID: 36458263 DOI: 10.1155/2022/4090444
    INTRODUCTION: Although uncommon, local anaesthetic systemic toxicity (LAST) may impose fatal risk to the patients. We investigated the awareness of LAST and knowledge on local anaesthetics among our postgraduate trainees.

    MATERIALS AND METHODS: A total of 134 postgraduate trainees from the departments of general surgery (Surgical), orthopaedic surgery (Ortho), otorhinolaryngology (ENT), obstetrics and gynaecology (OBGYN), as well as anaesthesiology and intensive care (Anaesth) were recruited. A validated questionnaire was used to assess awareness and knowledge. All participants attended a medical-education session and completed the questionnaire as preassessment and postassessment. Data were analysed, and comparisons between disciplines were conducted.

    RESULTS: The trainees' awareness of LAST was overall poor at preassessment which improved almost 6-folds at postassessment. Surprisingly, only 20 (45.5%) participants from the anaesthesiology group had awareness of LAST at preassessment, and none of the participants were from surgical, orthopaedic, and obstetrics and gynaecology departments. Preassessment scores were significantly higher in the anaesth group as compared to all other groups; with a difference in the average score for Anaesth vs Surgical of 3.46 (95%, CI:2.17, 4.74), Anaesth vs Ortho of 3.64 (95%, CI:2.64, 4.64), Anaesth vs ENT of 3.43 (95%, CI:2.20, 4.67), and Anaesth vs OBGYN of 6.93 (95%, CI:5.64, 8.21). However, there was no significant difference of awareness scores between all participants at postassessment scores.

    CONCLUSION: The overall level of awareness was poor. However, the implementation of an education session significantly improved the knowledge and awareness across all disciplines.

  13. Mokhtar MN, Azaharuddin I, Abdullah FH, Izaham A, Abdul Rahman R
    Front Med (Lausanne), 2022;9:1058121.
    PMID: 36569164 DOI: 10.3389/fmed.2022.1058121
    Pseudomonas putida is a rare pathogen leading to nosocomial and central nervous system infections. Despite having a low virulence and being a rare organism to cause bacteremia, it can evolve into a multidrug-resistant organism and lead to mortality and morbidity in the intensive care setting. A 64-year-old male gardener was presented with extensive acute subarachnoid hemorrhage with intraventricular extension causing hydrocephalus requiring embolization and coiling following a cerebral angiogram, which showed bilateral posterior circulation aneurysm and left anterior circulation aneurysm. External ventricular drain (EVD) was inserted given the worsening hydrocephalus. During his stay in the intensive care unit (ICU), he was becoming more septic and a full septic workup including a cerebral spinal fluid culture taken from the indwelling catheter of the EVD and was found to be positive for a ceftazidime-sensitive strain of P. putida. Following the treatment with intravenous ceftazidime for 1 week and a revision of the EVD on day 32 of admission, he continued to recover well and showed an improvement in his Glasgow Coma Scale (GCS) and septic parameters. Eventually, he was able to wean off mechanical ventilation. He was discharged from ICU care to the neurosurgical ward with supplemental oxygen on day 42 of admission. It is necessary to be aware of the possibility of nosocomial P. putida infection, especially in patients with indwelling catheters, and to consider the early initiation of appropriate antibiotic regimens once detected as well as strict precautions in hygiene during the management of these patients to avoid further development of multi-drug resistant (MDR) strains.
  14. Lim TO, Ngah BA, Suppiah A, Ismail F, Abdul Rahman R
    Singapore Med J, 1991 Aug;32(4):245-8.
    PMID: 1776003
    Consecutive hypertensives admitted with cardiovascular complications were studied. One hundred and eight complicated hypertensives (10%) out of 1,066 medical admissions were seen in the three month study. Thirty three per cent had cerebrovascular disease, 30% ischaemic heart disease, 2% had malignant hypertension and 85% had hypertensive heart disease. All patients had uncontrolled hypertension at admission (mean blood pressure 184/115 mmHg). Twenty-four patients (22%) were newly diagnosed; of the rest of previously diagnosed hypertensives (78%), 3% had never been on treatment and 56% had dropped out of treatment, which explained their ineffective blood pressure control. However, 18% of patients had apparently been on regular follow up and treatment, and yet their blood pressure control was poor. Many patients had evidence of renal disease. The prevalence of cardiovascular risk factors was also high; 56% had hypercholesterolaemia; 46% had hypertriglyceridaemia; 44% smoked, 38% were overweight or obese, and 18% were diabetic. This indicates that hypertension is best regarded as an ingredient of a cardiovascular risk profile and its management requires multifactorial correction of all risk factors identified.
  15. Zainal Abidin, M., Shamsudin, R., Othman, Z., Abdul Rahman, R.
    Cantaloupes continue to ripen after harvesting which is caused by ethylene production due to climacteric behaviour during postharvest storage. In this study, the cantaloupe fruits harvested at commercial maturity were evaluated for quality attributes during three weeks of storage at 10°C and a relative humidity (RH) of 90±5%. In addition, fresh-cut samples were stored for a further 19 days at 2°C and 87% RH. The fresh-cut samples were prepared on a weekly basis by dipping into deionised water (control) at 2°C for 1 minute. The effect of postharvest storage of cantaloupe on the physico-chemical properties and microbial activity was observed prior to fresh-cut processing. It was found that firmness, luminosity (L*), and titratable acidity (TA) decreased, while total soluble solids (TSS), pH, TSS:TA ratio, microbial activity (total plate count (TPC) and yeast and mould (YM)) of the fresh-cut increased over the postharvest storage period of the fruit. Meanwhile, the orange colour and the intensity (hue angle, hab, and chromaticity) of the flesh did not differ significantly during storage. The cantaloupe stored for three weeks at a low temperature indicated a successful potential for fresh-cut processing due to good maintenance of the product quality.
  16. Jafarizadeh Malmiri, H., Osman, A., Tan, C.P., Abdul Rahman, R.
    Response surface methodology (RSM) was used to optimize the concentrations of chitosan and glycerol for coating Berangan banana (Musa sapientum cv. Berangan). The effects of main edible coating components, chitosan (0.5-2.5%, w/w) and glycerol (0-2%, w/w) on weight loss, firmness, total colour difference, total soluble solids content (TSS) and titratable acidity (TA) of coated banana were studied during 10 days of storage at 26±2°C and 40-50% relative humidity. Results showed that the experimental data could be adequately fitted into a second-order polynomial model with coefficient of determination (R 2 ) ranging from 0.745 to 0.930 for all the variables studied. In general, the chitosan concentration appeared to be the most significant (P< 0.1) factor influencing all variables except for TSS. The optimum concentration of chitosan and glycerol were predicted to be 2.02% and 0.18%, respectively. Statistical assessment showed insignificant difference between experimental and predicted values.
  17. Cheok CY, Mohd Adzahan N, Abdul Rahman R, Zainal Abedin NH, Hussain N, Sulaiman R, et al.
    Crit Rev Food Sci Nutr, 2018 Feb 11;58(3):335-361.
    PMID: 27246698 DOI: 10.1080/10408398.2016.1176009
    Recent rapid growth of the world's population has increased food demands. This phenomenon poses a great challenge for food manufacturers in maximizing the existing food or plant resources. Nowadays, the recovery of health benefit bioactive compounds from fruit wastes is a research trend not only to help minimize the waste burden, but also to meet the intensive demand from the public for phenolic compounds which are believed to have protective effects against chronic diseases. This review is focused on polyphenolic compounds recovery from tropical fruit wastes and its current trend of utilization. The tropical fruit wastes include in discussion are durian (Durio zibethinus), mangosteen (Garcinia mangostana L.), rambutan (Nephelium lappaceum), mango (Mangifera indica L.), jackfruit (Artocarpus heterophyllus), papaya (Carica papaya), passion fruit (Passiflora edulis), dragon fruit (Hylocereus spp), and pineapple (Ananas comosus). Highlights of bioactive compounds in different parts of a tropical fruit are targeted primarily for food industries as pragmatic references to create novel innovative health enhancement food products. This information is intended to inspire further research ideas in areas that are still under-explored and for food processing manufacturers who would like to minimize wastes as the norm of present day industry (design) objective.
  18. Fikry M, Yusof YA, M Al-Awaadh A, Abdul Rahman R, Chin NL, Ghazali HM
    Antioxidants (Basel), 2019 Jul 18;8(7).
    PMID: 31323854 DOI: 10.3390/antiox8070226
    Full-fat roasted date seeds are considered an excellent source of antioxidants which can treat many diseases. The specific objectives were to investigate the effect of roasting temperature and time on the hardness of whole seeds, moisture content of the roasted date seeds powder, DPPH radical scavenging activity, total phenolic contents, extraction yield, pH, browning index and sensory properties of the brew prepared from the full-fat roasted date seeds and to construct descriptive models that could describe this effect. Date seeds were roasted at three temperatures (160, 180 and 200 °C) for different period of times (10, 20 and 30 min) using a natural conventional oven; then grinded and next brewed. Hardness of whole seeds, moisture content of the seeds powder, DPPH radical scavenging activity and total phenolic contents, extraction yield, pH and browning index and sensory properties of the brew were significantly affected by the roasting conditions. The statistical results indicated that the proposed model could adequately describe the measured properties. Strong correlations have been found among the properties of the brew as well. The producers of the date seeds brew can utilize these results for controlling the roasting process.
  19. Cheok CY, Sobhi B, Mohd Adzahan N, Bakar J, Abdul Rahman R, Ab Karim MS, et al.
    Food Chem, 2017 Feb 1;216:10-8.
    PMID: 27596386 DOI: 10.1016/j.foodchem.2016.08.011
    Chili shrimp paste (CSP) is an exotic traditional Southeast Asian condiment prepared using mainly fresh chilies and fermented shrimp paste (belacan) which attributed to strong pungent fishy odor. This study aims to evaluate the effectiveness of electron beam irradiation (EBI) exposure on CSP for microorganisms decontamination, and its physicochemical qualities changes. Changes in capsaicinoid contents and volatile compounds were analyzed using HPLC and GC-MS. Mesophilic bacteria, yeast, mold and pathogenic Enterobacteriaceae decreased as irradiation dose increasing from 0 to 10kGy. EBI at 10kGy effectively decontaminated the samples with no significant effects on phenolic and capsaicinoids contents compared to the fresh samples. From 24 compounds, irradiated CSP retained 23 volatile compounds, while thermally treated CSP has only 19 compounds. EBI at 10kGy is effective for decontamination in CSP with lesser destructive effect on volatile compounds and texture compared to thermal treatment.
  20. Sobhi, B., Noranizan, M., Ab Karim, S., Abdul Rahman, R., Bakar, J., Ghazali, Z.
    Chili shrimp paste (CSP) is a favorite condiment in Southeast Asia. Microbial spoilage makes CSP unsuitable for consumption within several days. Thermal treatment was applied to produce microbiologically safe CSP. The effect of heating process on physicochemical and sensorial properties of CSP was studied. Heating at the optimum condition (21.6 min, 80 ˚C) has been shown effective and reliable in controlling microorganisms in CSP. Complete inactivation of peroxidase activities could not be accomplished at the optimal point, and significant reduction of the total phenolic and capsaicinoids contents was observed. Sensorial evaluation indicated that thermally processed CSP was less preferred by panelists when compared to freshly prepared samples of dry weight respectively.
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