Displaying publications 1 - 20 of 140 in total

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  1. Thye KL, Wan Abdullah WMAN, Balia Yusof ZN, Wee CY, Ong-Abdullah J, Loh JY, et al.
    Sci Rep, 2022 Nov 16;12(1):19639.
    PMID: 36385165 DOI: 10.1038/s41598-022-21909-7
    Banana (Musa acuminata) is an important fruit crop and source of income for various countries, including Malaysia. To date, current agrochemical practice has become a disputable issue due to its detrimental effect on the environment. λ-carrageenan, a natural polysaccharide extracted from edible red seaweed, has been claimed to be a potential plant growth stimulator. Hence, the present study investigates the effects of λ-carrageenan on plant growth using Musa acuminata cv. Berangan (AAA). Vegetative growth such as plant height, root length, pseudostem diameter, and fresh weight was improved significantly in λ-carrageenan-treated banana plants at an optimum concentration of 750 ppm. Enhancement of root structure was also observed in optimum λ-carrageenan treatment, facilitating nutrients uptake in banana plants. Further biochemical assays and gene expression analysis revealed that the increment in growth performance was consistent with the increase of chlorophyll content, protein content, and phenolic content, suggesting that λ-carrageenan increases photosynthesis rate, protein biosynthesis, and secondary metabolites biosynthesis which eventually stimulate growth. Besides, λ-carrageenan at optimum concentration also increased catalase and peroxidase activities, which led to a significant reduction in hydrogen peroxide and malondialdehyde, maintaining cellular homeostasis in banana plants. Altogether, λ-carrageenan at optimum concentration improves the growth of banana plants via inducing metabolic processes, enhancing nutrient uptake, and regulation of cell homeostasis. Further investigations are needed to evaluate the effectiveness of λ-carrageenan on banana plants under field conditions.
  2. Daniyal WMEMM, Fen YW, Saleviter S, Chanlek N, Nakajima H, Abdullah J, et al.
    Polymers (Basel), 2021 Feb 02;13(3).
    PMID: 33540931 DOI: 10.3390/polym13030478
    In this study, X-ray photoelectron spectroscopy (XPS) was used to study chitosan-graphene oxide (chitosan-GO) incorporated with 4-(2-pyridylazo)resorcinol (PAR) and cadmium sulfide quantum dot (CdS QD) composite thin films for the potential optical sensing of cobalt ions (Co2+). From the XPS results, it was confirmed that carbon, oxygen, and nitrogen elements existed on the PAR-chitosan-GO thin film, while for CdS QD-chitosan-GO, the existence of carbon, oxygen, cadmium, nitrogen, and sulfur were confirmed. Further deconvolution of each element using the Gaussian-Lorentzian curve fitting program revealed the sub-peak component of each element and hence the corresponding functional group was identified. Next, investigation using surface plasmon resonance (SPR) optical sensor proved that both chitosan-GO-based thin films were able to detect Co2+ as low as 0.01 ppm for both composite thin films, while the PAR had the higher binding affinity. The interaction of the Co2+ with the thin films was characterized again using XPS to confirm the functional group involved during the reaction. The XPS results proved that primary amino in the PAR-chitosan-GO thin film contributed more important role for the reaction with Co2+, as in agreement with the SPR results.
  3. Chan HC, Adnan WA, Jaalam K, Abdullah MR, Abdullah J
    PMID: 16295557
    Mild head injury (MHI) is a common presentation to many hospitals in both rural and urban settings in Southeast Asia, but it is not well studied. We studied 330 patients that presented to Hospital Universiti Sains Malaysia Emergency Department with possible MHI, with the intentions to identify prognostic factors that may improve the diagnosis of MHI in the emergency setting as well as to determine which patients would need follow-up. Patients' one-year outcomes were classified as discharged well (DW) for patients without post-traumatic signs and symptoms and discharged with long term follow-up (DFU) for patients with such signs and symptoms. Four patients died and 82 were DFU. An abnormal skull X ray was associated with mode of accident and type of transportation, older age, presence of vomiting, confusion, bleeding from ear, nose or throat, abnormal pupil size on the right side associated with orbital trauma, unequal pupillary reflexes, absence of loss of consciousness (LOC), a lower Glasgow Coma Scale (GCS) score, multiple clinical presentations, and DFU. An abnormal CT scan was associated with older age, multiple clinical presentation, skull X-ray findings, and DFU. A similar analysis on outcomes revealed that mode of accident, older age, vomiting, confusion, headache, bleeding from ear, nose and throat, neurological deficits, absence of LOC, pupil size, multiple presentation, abnormal skull X ray, CT scan of the brain, and a GCS of 13 was associated with DFU. In conclusion, all patients involved in motor vehicle accidents (MVAs), especially motorcycles, aged over 30 years of age, with multiple clinical presentations, including a lower GCS, and with abnormal radiological findings should have a longer follow-up due to persistent post-traumatic symptomatology.
  4. Ching CB, Abdullah J, Yusof NA
    J Food Sci Technol, 2022 Mar;59(3):1053-1062.
    PMID: 35153325 DOI: 10.1007/s13197-021-05109-1
    Palm oil is one of the most produced and traded vegetable oils in the world recently. The quality of palm oil is very important to be examined and one of the quality indices is free fatty acid (FFA) content. Thus, in this study, an electrochemical technique for the determination of FFA as alternative to conventional method (titration method) has been explored. The electrochemical method was developed based on electrochemically reduced graphene oxide (rGO) deposited onto screen printed carbon electrode (SPCE) via drop-casting technique. The modified electrode was characterized by physico-chemical and electrochemical methods, respectively. The voltammetric behaviour of 2-methyl-1,4-naphthaquinone (VK3) in the presence of palmitic acid at the modified electrode was investigated in an acetonitrile/water (3:1) mixture containing 2.5 M lithium perchlorate (LiClO4). The electrochemical detection of palmitic acid was based on the voltammetric reduction of VK3 to form corresponding hydroquinone which is proportional to the concentration of palmitic acid. Under optimum condition, the developed method showed a good linear relationship in the concentration ranging from 0.192 mM to 0.833 mM with the detection limit of 0.079 mM. The developed sensor illustrates high sensitivity and rapid detection towards determination of FFA content in palm oil.
  5. Jamilan MA, Abdullah J, Alang Ahmad SA, Md Noh MF
    J Food Sci Technol, 2019 Aug;56(8):3846-3853.
    PMID: 31413410 DOI: 10.1007/s13197-019-03855-x
    In this work, voltammetric study based on cetyltrimethylammonium bromide (CTAB) as an ion-pairing agent for the determination of iodine level in iodized table salt has been explored. CTAB was used as an intermediate compound between iodide (I-) and the electrode due to its ability to dissociate to produce cetyltrimethylammonium ions ([CTA]+). The [CTA]+ with a long hydrophobic alkyl chain can be directly adsorbed onto the surface of the working electrode, and this in turns coated the electrode with cationic charge and enhance the electrode ability to bind to iodide (I-) and other molecular iodine ions. A mixture of iodide and CTAB ([CTA]+I-) was prepared and potential of 1.0 V for 60.0 s was applied to pre-concentrate the solution on the working electrode causing the [CTA]+I- to oxidize to iodine (I2). The produced I2 immediately react with chloride ion (Cl-) from the electrolyte of hydrochloric acid (HCl) to produce I2Cl- and form ion-pair with CTA+ as [CTA]+I2Cl-. The linear calibration curve of the developed method towards iodide was in the concentration range of 0.5-4.0 mg/L with sensitivity of - 1.383 µA mg/L-1 cm-2 (R2 = 0.9950), limit of detection (LOD) of 0.3 mg/L and limit of quantification (LOQ) of 1.0 mg/L, respectively. The proposed method indicates good agreement with the standard method for iodine determination with recovery range from 95.0 to 104.3%. The developed method provided potential application as a portable on-site iodine detector.
  6. Mohammed Modawe Alshik Edris N, Abdullah J, Kamaruzaman S, Sulaiman Y
    Mikrochim Acta, 2019 03 29;186(4):261.
    PMID: 30927085 DOI: 10.1007/s00604-019-3376-y
    A nanocomposite consisting of electrochemically reduced graphene oxide, poly(Eriochrome black T) and gold nanoparticles (ERGO-pEBT/AuNPs) was prepared for the simultaneous detection of resorcinol (RC), catechol (CC), and hydroquinone (HQ). The electrochemical oxidation of HQ, CC, and RC was analysed by using cyclic voltammetry and differential pulse voltammetry. Three well-separated potentials were found at 166, 277, and 660 mV (vs. Ag/AgCl) for HQ, CC, and RC, respectively The linear ranges were 0.52-31.4, 1.44-31.2, and 3.8-72.2 μM for HQ, CC, and RC, respectively. The limits of detections (LODs) for both individual and simultaneous detections are negligibly different are (15, 8, and 39 nM, respectively). Graphical abstract Voltammetric determination of hydroquinone, catechol, and resorcinol at ERGO-pEBT/AuNPs resulted in high peak currents and outstanding oxidation potential separation of the analytes.
  7. Wan Abdullah WMAN, Saidi NB, Yusof MT, Wee CY, Loh HS, Ong-Abdullah J, et al.
    Front Plant Sci, 2021;12:769855.
    PMID: 35095950 DOI: 10.3389/fpls.2021.769855
    Fusarium oxysporum f. sp. cubense tropical race 4 (FocTR4) is a destructive necrotrophic fungal pathogen afflicting global banana production. Infection process involves the activation of programmed cell death (PCD). In this study, seven Musa acuminata vacuolar processing enzyme (MaVPE1-MaVPE7) genes associated with PCD were successfully identified. Phylogenetic analysis and tissue-specific expression categorized these MaVPEs into the seed and vegetative types. FocTR4 infection induced the majority of MaVPE expressions in the susceptible cultivar "Berangan" as compared to the resistant cultivar "Jari Buaya." Consistently, upon FocTR4 infection, high caspase-1 activity was detected in the susceptible cultivar, while low level of caspase-1 activity was recorded in the resistant cultivar. Furthermore, inhibition of MaVPE activities via caspase-1 inhibitor in the susceptible cultivar reduced tonoplast rupture, decreased lesion formation, and enhanced stress tolerance against FocTR4 infection. Additionally, the Arabidopsis VPE-null mutant exhibited higher tolerance to FocTR4 infection, indicated by reduced sporulation rate, low levels of H2O2 content, and high levels of cell viability. Comparative proteomic profiling analysis revealed increase in the abundance of cysteine proteinase in the inoculated susceptible cultivar, as opposed to cysteine proteinase inhibitors in the resistant cultivar. In conclusion, the increase in vacuolar processing enzyme (VPE)-mediated PCD played a crucial role in modulating susceptibility response during compatible interaction, which facilitated FocTR4 colonization in the host.
  8. Abdullah J, Rushdan A, Hamzah M, Ariff AR, Rani A
    Ann. Transplant., 1999;4(3-4):28-31.
    PMID: 10853777
    Four patients underwent reconstruction of anterior cranial fossa of skull defects between November 1997 and January 1998. All of them had traumatic anterior cranial fossa defect and were reconstructed with lyophilised bovine cortical bone graft. There was no cerebrospinal fluid leakage, meningitis, extradural abscess or other infections. This study demonstrates that the use of bovine bone graft in the reconstruction of anterior base defects is safe.
  9. Ashraf M, Abdullah J, Ariff A, Biswal BM, Mokhtar I, Othman N
    Malays J Med Sci, 2003 Jan;10(1):95-9.
    PMID: 23365508
    Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.
  10. Fatihhi SJ, Harun MN, Abdul Kadir MR, Abdullah J, Kamarul T, Öchsner A, et al.
    Ann Biomed Eng, 2015 Oct;43(10):2487-502.
    PMID: 25828397 DOI: 10.1007/s10439-015-1305-8
    Fatigue assessment of the trabecular bone has been developed to give a better understanding of bone properties. While most fatigue studies are relying on uniaxial compressive load as the method of assessment, in various cases details are missing, or the uniaxial results are not very realistic. In this paper, the effect of three different load histories from physiological loading applied on the trabecular bone were studied in order to predict the first failure surface and the fatigue lifetime. The fatigue behaviour of the trabecular bone under uniaxial load was compared to that of multiaxial load using a finite element simulation. The plastic strain was found localized at the trabecular structure under multiaxial load. On average, applying multiaxial loads reduced more than five times the fatigue life of the trabecular bone. The results provide evidence that multiaxial loading is dominated in the low cycle fatigue in contrast to the uniaxial one. Both bone volume fraction and structural model index were best predictors of failure (p 
  11. Mardzuki AI, Abdullah J, Ghazaime G, Ariff AR, Ghazali M
    Med J Malaysia, 2003 Mar;58(1):115-9.
    PMID: 14556336 MyJurnal
    We report three cases of large occipito-encephaloceles that were managed in the Neurosciences Unit, Hospital Universiti Sains Malaysia over the last 5 years. All patients had pre-operative MRI (magnetic resonance imaging) evolution and mapping of the sagittal sinus tract. The cerebrospinal fluid (CSF) of all three patients were initially diverted by means of ventricular shunt two weeks prior to shunt removal. The slow drainage of CSF prevented electrolyte and volume disturbances due to sudden decompression during their definitive occipital encephalocele operations. After 3 years follow-up, all these patients are progressing well.
  12. Mat Nayan SA, Mohd Haspani MS, Abd Latiff AZ, Abdullah JM, Abdullah S
    J Clin Neurosci, 2009 Dec;16(12):1567-71.
    PMID: 19793660 DOI: 10.1016/j.jocn.2009.01.036
    We studied the efficacy of two surgical methods used for the treatment of intracranial subdural empyema (ISDE) at our centre. A cross-sectional study (1999-2005) of 90 patients with non-traumatic supratentorial ISDE revealed that the two surgical methods used for empyema removal were burr hole/s and drainage (50 patients, 55.6%) and a cranial bone opening procedure (CBOP) (40 patients, 44.4%). Patients in the CBOP group had a better result in terms of clinical improvement (chi-squared analysis, p=0.006) and clearance of empyema on brain CT scan (chi-squared analysis, p<0.001). Reoperation was more frequent among patients who had undergone burr hole surgery (multiple logistic regression, p<0.001). The outcome and morbidity of ISDE survivors were not related to the surgical method used (p>0.05). The only factor that significantly affected the morbidity of ISDE was level of consciousness at the time of surgery (multiple logistic regression, p<0.001). We conclude that CBOP and evacuation of the empyema is a better surgical method for ISDE than burr hole/s and drainage. Wide cranial opening and empyema evacuation improves neurological status, gives better clearance of the empyema and reduces the need for reoperation. Level of consciousness at the time of presentation is a predictor of the morbidity of ISDE. Thus, aggressive surgical treatment should occur as early as possible, before the patient deteriorates.
  13. Lee WK, Namasivayam P, Ong Abdullah J, Ho CL
    Sci Rep, 2017 04 24;7:46563.
    PMID: 28436444 DOI: 10.1038/srep46563
    Seaweeds survive in marine waters with high sulfate concentration compared to those living at freshwater habitats. The cell wall polymer of Gracilaria spp. which supplies more than 50% of the world agar is heavily sulfated. Since sulfation reduces the agar quality, it is interesting to investigate the effects of sulfate deprivation on the sulfate contents of seaweed and agar, as well as the metabolic pathways of these seaweeds. In this study, two agarophytes G. changii and G. salicornia were treated under sulfate deprivation for 5 days. The sulfate contents in the seaweed/agar were generally lower in sulfate-deprivated samples compared to those in the controls, but the differences were only statistically significant for seaweed sample of G. changii and agar sample of G. salicornia. RNA sequencing (RNA-Seq) of sulfate-deprivated and untreated seaweed samples revealed 1,292 and 3,439 differentially expressed genes (DEGs; ≥1.5-fold) in sulfate-deprivated G. changii and G. salicornia, respectively, compared to their respective controls. Among the annotated DEGs were genes involved in putative agar biosynthesis, sulfur metabolism, metabolism of sulfur-containing amino acids, carbon metabolism and oxidative stress. These findings shed light on the sulfate deprivation responses in agarophytes and help to identify candidate genes involved in agar biosynthesis.
  14. Perera J, Perera J, Abdullah J, Lee N
    BMC Med Educ, 2009;9:37.
    PMID: 19563621 DOI: 10.1186/1472-6920-9-37
    BACKGROUND: Most medical schools use simulated patients (SPs) for teaching. In this context the authenticity of role play and quality of feedback provided by SPs is of paramount importance. The available literature on SP training mostly addresses instructor led training where the SPs are given direction on their roles. This study focuses on the use of peer and self evaluation as a tool to train SPs.
    METHODS: SPs at the medical school participated in a staff development and training programme which included a) self-assessment of their performance while observing video-tapes of their role play using a structured guide and b) peer group assessment of their performance under tutor guidance. The pre and post training performance in relation to authenticity of role play and quality of feedback was blindly assessed by students and tutors using a validated instrument and the scores were compared. A focus group discussion and a questionnaire assessed acceptability of the training programme by the SPs.
    RESULTS: The post-training performance assessment scores were significantly higher (p < 0.05) than the pre-training scores. The degree of improvement in the quality of feedback provided to students was more when compared to the improvement of role play. The acceptability of the training by the SPs was very satisfactory scoring an average of 7.6 out of 10. The majority of the SPs requested the new method of training to be included in their current training programme as a regular feature.
    CONCLUSION: Use of structured self-reflective and peer-interactive, practice based methods of SP training is recommended to improve SP performance. More studies on these methods of training may further refine SP training and lead to improvement of SP performance which in turn may positively impact medical education.
  15. Yap Abdullah J, Manaf Abdullah A, Zaim S, Hadi H, Husein A, Ahmad Rajion Z, et al.
    Proc Inst Mech Eng H, 2024 Jan;238(1):55-62.
    PMID: 37990963 DOI: 10.1177/09544119231212034
    This study aimed to compare the 3D skull models reconstructed from computed tomography (CT) images using three different open-source software with a commercial software as a reference. The commercial Mimics v17.0 software was used to reconstruct the 3D skull models from 58 subjects. Next, two open-source software, MITK Workbench 2016.11, 3D Slicer 4.8.1 and InVesalius 3.1 were used to reconstruct the 3D skull models from the same subjects. All four software went through similar steps in 3D reconstruction process. The 3D skull models from the commercial and open-source software were exported in standard tessellation language (STL) format into CloudCompare v2.8 software and superimposed for geometric analyses. Hausdorff distance (HD) analysis demonstrated the average points distance of Mimics versus MITK was 0.25 mm. Meanwhile, for Mimics versus 3D Slicer and Mimics versus InVesalius, there was almost no differences between the two superimposed 3D skull models with average points distance of 0.01 mm. Based on Dice similarity coefficient (DSC) analysis, the similarity between Mimics versus MITK, Mimics versus 3D Slicer and Mimics versus InVesalius were 94.1, 98.8 and 98.3%, respectively. In conclusion, this study confirmed that the alternative open-source software, MITK, 3D Slicer and InVesalius gave comparable results in 3D reconstruction of skull models compared to the commercial gold standard Mimics software. This open-source software could possibly be used for pre-operative planning in cranio-maxillofacial cases and for patient management in the hospitals or institutions with limited budget.
  16. Zakaria MA, Abdullah JM, George JP, Mutum SS, Lee NN
    Med J Malaysia, 2006 Jun;61(2):229-32.
    PMID: 16898318 MyJurnal
    Third ventricular cavernous angiomas are rare vascular malformations of the brain. We report an eight-year old boy with a rare third ventricular cavernous angioma that hemorrhaged presenting with symptoms of acute hydrocephalus. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed a heterogenous ill-defined, solid and cystic intraventricular mass in the third ventricle which was mildly enhanced with contrast and there was associated hydrocephalus. The mass was removed with success and follow up after two years revealed no neurological abnormalities.
  17. Abd Rahman S, Ariffin N, Yusof NA, Abdullah J, Mohammad F, Ahmad Zubir Z, et al.
    Sensors (Basel), 2017 Jul 01;17(7).
    PMID: 28671559 DOI: 10.3390/s17071537
    A semiconducting water-soluble core-shell quantum dots (QDs) system capped with thiolated ligand was used in this study for the sensitive detection of glucose in aqueous samples. The QDs selected are of CdSe-coated ZnS and were prepared in house based on a hot injection technique. The formation of ZnS shell at the outer surface of CdSe core was made via a specific process namely, SILAR (successive ionic layer adsorption and reaction). The distribution, morphology, and optical characteristics of the prepared core-shell QDs were assessed by transmission electron microscopy (TEM) and spectrofluorescence, respectively. From the analysis, the results show that the mean particle size of prepared QDs is in the range of 10-12 nm and that the optimum emission condition was displayed at 620 nm. Further, the prepared CdSe/ZnS core shell QDs were modified by means of a room temperature ligand-exchange method that involves six organic ligands, L-cysteine, L-histidine, thio-glycolic acid (TGA or mercapto-acetic acid, MAA), mercapto-propionic acid (MPA), mercapto-succinic acid (MSA), and mercapto-undecanoic acid (MUA). This process was chosen in order to maintain a very dense water solubilizing environment around the QDs surface. From the analysis, the results show that the CdSe/ZnS capped with TGA (CdSe/ZnS-TGA) exhibited the strongest fluorescence emission as compared to others; hence, it was tested further for the glucose detection after their treatment with glucose oxidase (GOx) and horseradish peroxidase (HRP) enzymes. Here in this study, the glucose detection is based on the fluorescence quenching effect of the QDs, which is correlated to the oxidative reactions occurred between the conjugated enzymes and glucose. From the analysis of results, it can be inferred that the resultant GOx:HRP/CdSe/ZnS-TGA QDs system can be a suitable platform for the fluorescence-based determination of glucose in the real samples.
  18. Rashid JI, Yusof NA, Abdullah J, Hashim U, Hajian R
    PMID: 25491829 DOI: 10.1016/j.msec.2014.09.010
    This work describes the incorporation of SiNWs/AuNPs composite as a sensing material for DNA detection on indium tin-oxide (ITO) coated glass slide. The morphology of SiNWs/AuNPs composite as the modifier layer on ITO was studied by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). The morphological studies clearly showed that SiNWs were successfully decorated with 20 nm-AuNPs using self-assembly monolayer (SAM) technique. The effective surface area for SiNWs/AuNPs-modified ITO enhanced about 10 times compared with bare ITO electrode. SiNWs/AuNPs nanocomposite was further explored as a matrix for DNA probe immobilization in detection of dengue virus as a bio-sensing model to evaluate its performance in electrochemical sensors. The hybridization of complementary DNA was monitored by differential pulse voltammetry (DPV) using methylene blue (MB) as the redox indicator. The fabricated biosensor was able to discriminate significantly complementary, non-complementary and single-base mismatch oligonucleotides. The electrochemical biosensor was sensitive to target DNA related to dengue virus in the range of 9.0-178.0 ng/ml with detection limit of 3.5 ng/ml. In addition, SiNWs/AuNPs-modified ITO, regenerated up to 8 times and its stability was up to 10 weeks at 4°C in silica gel.
  19. Goh CH, Hamzah MR, Kandasamy R, Ghani ARI, Wong SH, Idris Z, et al.
    Med J Malaysia, 2020 11;75(6):666-671.
    PMID: 33219175
    INTRODUCTION: Chiari malformation (CM) is a disorder of mesodermal origin and is commonly associated with syringomyelia. Foramen magnum decompression is the first-line of standard treatment in symptomatic patients with a confirmed radiographic diagnosis. Magnetic resonance (MR) cine allows accurate evaluation of cerebrospinal fluid (CSF) physiology at the craniovertebral junction but often this is under-utilised in Malaysia.

    METHODS: In this series, we looked into nine cases of CM with syringomyelia from clinical and radiological perspective before and after surgery. The radiological parameters were herniated tonsillar length, syrinx: cord ratio, syrinx length and diameter. Flow velocity and morphologic changes in Chiari were illustrated.

    RESULTS: Seven patients showed either reduction in syrinx length, syrinx: cord ratio or both postoperatively. Clinical recovery somewhat varied in motor and sensory symptoms. Four patients gained better functional grade in modified Rankin scale (MRS) while the rest remained similar. The study highlighted the advantage of CSF flow dynamics information over MR anatomical radiographic improvement in addressing the neurologic and functional recovery. We also discussed the practicality of cine sequence in preoperative patient selection, syrinx analysis and postoperative flow evaluation in anticipation of clinical outcome.

    CONCLUSION: Phase-contrast cine MRI is a useful tool dictated by resource availability. We recommend its routine use in preoperative analysis and subsequent observational follow-up after surgery.

  20. Maheswaran M, Adnan WA, Ahmad R, Ab Rahman NH, Naing NN, Abdullah J
    PMID: 18613557
    Non-traumatic Altered States of Consciousness (ASC) are a non-specific consequence of various etiologies, and are normally monitored by Glasgow Coma Scale (GCS). The GCS gives varriable results among untrained emergency medicine personel in developing countries where English is not the first language. An In House Scoring System (IHSS) scale was made by the first author for the purpose of triaging so as to quickly asses patients when seen by medical personel. This IHSS scale was compared to the GCS to determine it's specificity and sensitivity in the accident and emergency department (ED) of Hospital University Sains Malaysia (HUSM). All patients with non-traumatic ASC were selected by purposive sampling according to pre-determined criteria. Patients were evaluated by the two systems, IHSS and GCS, by emergency physicians who were on call. Patient demographics, clinical features, investigations, treatment given and outcomes were collected and followed for a period of 14 days. A total of 221 patients with non-traumatic ASC were studied, 54.3% were males. The mean age of the patients was 56 years old. The mean overall GCS score on presentation to the ED was 10.3. The mean duration of ASC was 11.6 hours. One hundred thirty patients (58.8%) experienced ASC secondary to general or focal cerebral disorders. The mortality rate was 40.3% 2 weeks after the ED visit. Fifty-four point three percent of the patients were awake and considered to have good outcomes while 45.7% of the patients had poor outcomes (comatose or dead) 2 weeks after the ED visit. The mean overall GCS score, verbal and motor subscores as well as the IHSS had significantly decreased (worsened) after treatment in the ED. A poor IHSS scale, hypertension, current smoking, abnormal pupillary reflexes and acidosis were associated with a worse 2-week outcome. The mean age and WBC count was lower and the mean overall GCS score and eye, verbal and motor subscores were higher as well as those having a lower IHSS scale for the good outcome category. Multivariate analysis revealed that smokers and hypertensives were at higher risk for a poor outcome. Higher eye scores on the GCS were associated fewer poor outcomes. There was significant agreement between the IHSS scale and GCS scores in the assessment of non-traumatic ASC. The sensitivity and specificity of the IHSS score versus GCS were 71.9% and 100.0%, respectively.
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