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Fulltext Preparing Malaysia for Population Aging through the Advanced Memory and Cognitive Service in Hospital Universiti Sains Malaysia

Ab Razak A, Rahman NA, Zulkifly MFM, Sapiai NA, Phoa PKA, Mohamed Mustafar MF, et al.

Malays J Med Sci, 2023 Oct;30(5):1-6.
PMID: 37928788 DOI: 10.21315/mjms2023.30.5.1

Improving healthcare and living conditions has led to an increase in life expectancies and challenges of population aging in Malaysia. The Advanced Memory and Cognitive Service builds on integrated healthcare among multidisciplinary specialists to provide holistic and patient-centred healthcare. The service treats older adults experiencing neurocognitive impairment as well as young individuals with complex neurocognitive disorders and thoroughly screens asymptomatic individuals at high risk of developing neurocognitive disorders. This early intervention strategy is a preventive effort in the hope of reducing disease burden and improving quality of life to prepare Malaysia for the forthcoming population aging.
Fulltext Updates on knowledge, attitude and preventive practices on tuberculosis among healthcare workers

Abd Wahab F, Abdullah S, Abdullah JM, Jaafar H, Md Noor SS, Wan Mohammad WMZ, et al.

Malays J Med Sci, 2016 Nov;23(6):25-34.
PMID: 28090176 MyJurnal DOI: 10.21315/mjms2016.23.6.3

Ranking as the most communicable disease killer worldwide, tuberculosis, has accounted with a total of 9.6 million new tuberculosis cases with 1.5 million tuberculosis-related deaths reported globally in 2014. Tuberculosis has remain as an occupational hazard for healthcare workers since 1920s and due to several tuberculosis outbreaks in healthcare settings in the early 1990s, the concern about the transmission to both patients and healthcare workers has been raised. Healthcare workers have two to three folds greater the risk of active tuberculosis than the general population. Several studies on knowledge, attitude and practices on tuberculosis among healthcare workers worldwide have revealed that majority of the participated healthcare workers had good knowledge on tuberculosis. Most of the healthcare workers from South India and South Africa also reported to have positive attitude whereas a study in Thailand reported that most of the healthcare providers have negative attitude towards tuberculosis patients. Nevertheless, majority of the healthcare workers have low level of practice on tuberculosis prevention. An improved communication between healthcare workers and the patients as well as their families is the key to better therapeutic outcomes with good knowledge, attitude and preventive practice towards tuberculosis.
Fulltext Parcellation of the Hippocampus According to Its Connection Probability with Prefrontal Cortex Subdivisions in a Malaysian Malay Population: Preliminary Findings

Abdullah AN, Ahmad AH, Zakaria R, Tamam S, Abdullah JM

Malays J Med Sci, 2021 Jun;28(3):65-76.
PMID: 34285645 DOI: 10.21315/mjms2021.28.3.6

Background: Lesion studies have shown distinct roles for the hippocampus, with the dorsal subregion being involved in processing of spatial information and memory, and the ventral aspect coding for emotion and motivational behaviour. However, its structural connectivity with the subdivisions of the prefrontal cortex (PFC), the executive area of the brain that also has various distinct functions, has not been fully explored, especially in the Malaysian population.
Methods: We performed diffusion magnetic resonance imaging with probabilistic tractography on four Malay males to parcellate the hippocampus according to its relative connection probability to the six subdivisions of the PFC.
Results: Our findings revealed that each hippocampus showed putative connectivity to all the subdivisions of PFC, with the highest connectivity to the orbitofrontal cortex (OFC). Parcellation of the hippocampus according to its connection probability to the six PFC subdivisions showed variability in the pattern of the connection distribution and no clear distinction between the hippocampal subregions.
Conclusion: Hippocampus displayed highest connectivity to the OFC as compared to other PFC subdivisions. We did not find a unifying pattern of distribution based on the connectivity-based parcellation of the hippocampus.
Fulltext History of Neurosurgery in Malaysia: The Past, Present and Future

Abdullah FC, Zakaria Z, Thambinayagam HC, Kandasamy R, Alias A, Abu Bakar A, et al.

Malays J Med Sci, 2021 Dec;28(6):129-185.
PMID: 35002497 DOI: 10.21315/mjms2021.28.6.13

The history of neurosurgery in Malaysia traces back to 1962 and is filled with stories of vibrant and humble neurosurgeons who have dedicated their life to patients and professions. The early development of neurological and neurosurgical services begins from the establishment of the neurosurgery unit at Hospital Kuala Lumpur (HKL), followed by the foundation of the Tunku Abdul Rahman Neuroscience Institute (IKTAR). Due to the exponentially increased demand for the care of neurosurgical patients, many universities and government hospitals have opened their neurosurgical units. In 2001, the formal residency training programme (USM Masters in Neurosurgery) started and since then has produced qualified neurosurgeons that empowered and shaped the present generation. The formation of the Neurosurgical Association of Malaysia (NAM) is another turning point towards bidirectional collaboration with the World Federation of Neurosurgical Societies (WFNS). Many opportunities were created for educational activities and the expansion of subspecialties in neurosurgery. This article describes the impact of the past neurosurgeons and the endeavors that they had gone through; the present neurosurgeons who pioneered the current neurosurgical services in Malaysia, and the future neurosurgeons that will continue the legacy and bring neurosurgery further ahead in this country.
Fulltext Newcastle disease virus interaction in targeted therapy against proliferation and invasion pathways of glioblastoma multiforme

Abdullah JM, Mustafa Z, Ideris A

Biomed Res Int, 2014;2014:386470.
PMID: 25243137 DOI: 10.1155/2014/386470

Glioblastoma multiforme (GBM), or grade IV glioma, is one of the most lethal forms of human brain cancer. Current bioscience has begun to depict more clearly the signalling pathways that are responsible for high-grade glioma initiation, migration, and invasion, opening the door for molecular-based targeted therapy. As such, the application of viruses such as Newcastle disease virus (NDV) as a novel biological bullet to specifically target aberrant signalling in GBM has brought new hope. The abnormal proliferation and aggressive invasion behaviour of GBM is reported to be associated with aberrant Rac1 protein signalling. NDV interacts with Rac1 upon viral entry, syncytium induction, and actin reorganization of the infected cell as part of the replication process. Ultimately, intracellular stress leads the infected glioma cell to undergo cell death. In this review, we describe the characteristics of malignant glioma and the aberrant genetics that drive its aggressive phenotype, and we focus on the use of oncolytic NDV in GBM-targeted therapy and the interaction of NDV in GBM signalling that leads to inhibition of GBM proliferation and invasion, and subsequently, cell death.
Fulltext Improving the management of brain injuries in Malaysian hospitals

Abdullah JM

Med J Malaysia, 2011 Jun;66(2):83.
PMID: 22106681
Intravascular hypothermia for acute hemorrhagic stroke: a pilot study

Abdullah JM, Husin A

Acta Neurochir. Suppl., 2011;111:421-4.
PMID: 21725794 DOI: 10.1007/978-3-7091-0693-8_72

The use of intravascular hypothermia in the treatment of hemorrhagic stroke is currently still being researched. The exact therapeutic properties and effect of hypothermia on the natural progression of the disease are not known, and a only small number of papers has been published with results from these studies. Mild hypothermia at 34°C was induced in six patients with hemorrhagic stroke in the first 48 h after presentation, using an intravascular catheter placed in the inferior vena cava. The hypothermia was induced and maintained for 24 h followed by gradual rewarming. Another 18 patients with hemorrhagic stroke but not receiving hypothermia were then taken as the control group, and all patients were treated with standard stroke management. The patients were then followed up using the modified Rankin Scale (mRS) for 6 months and 1 year. There was a statistically significant improvement at 6 months and 1 year follow-up using the mRS score in the hypothermia group, indicating a possible beneficial effect of early therapeutic hypothermia in the management of acute hemorrhagic stroke. However, a larger study is needed in order to confirm our finding.
Molecular genetic analysis of BAX and cyclin D1 genes in patients with malignant glioma

Abdullah JM, Ahmad F, Ahmad KA, Ghazali MM, Jaafar H, Ideris A, et al.

Neurol Res, 2007 Apr;29(3):239-42.
PMID: 17509221

Brain tumorigenesis is a complex process involving multiple genetic alterations. Cyclin D1 and BAX genes are two of the most important regulators in controlling the normal proliferation and apoptosis of cells, respectively. In this study, we analysed the possibilities of involvement of cyclin D1 and BAX genes in the gliomagenesis.
National response to neurological diseases in Malaysia: planning for the future

Abdullah JM, Hussin AM, Tharakan J, Abdullah MR, Saad R, Kamari Z, et al.

Southeast Asian J. Trop. Med. Public Health, 2006 Jul;37(4):798-805.
PMID: 17121309

The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.
Association of loss of heterozygosity and PTEN gene abnormalities with paraclinical, clinical modalities and survival time of glioma patients in Malaysia

Abdullah JM, Farizan A, Asmarina K, Zainuddin N, Ghazali MM, Jaafar H, et al.

Asian J Surg, 2006 Oct;29(4):274-82.
PMID: 17098662

The pattern of allelic loss of heterozygosity (LOH) and PTEN mutations appear to be associated with the progression of gliomas leading to a decrement in the survival rate of patients. This present study was carried out to determine the LOH and PTEN mutational status in glioma patients and its association with patients' survival.
Molecular genetic analysis of phosphatase and tensin homolog and p16 tumor suppressor genes in patients with malignant glioma

Abdullah JM, Zainuddin N, Sulong S, Jaafar H, Isa MN

Neurosurg Focus, 2003 Apr 15;14(4):e6.
PMID: 15679305

Several genes have been shown to carry mutations in human malignant gliomas, including the phosphatase and tensin homolog (PTEN) deleted on chromosome 10 and p16 tumor suppressor genes. Alterations of this gene located on chromosome 10 q23 and 9p21, respectively, may contribute to gliomagenesis. In this study, the authors analyzed 20 cases of malignant gliomas obtained in patients living on the east coast of Malaysia to investigate the possibilities of involvement of the PTEN and p16 genes.
The GABA A receptor subunits heterologously expressed in Xenopus oocytes

Abdullah JM, Zhang J

Mini Rev Med Chem, 2013 Apr 01;13(5):744-8.
PMID: 23373649

The γ-aminobutyric acid (GABA) A receptor is composed of a variety of subunits and combinations and shows a characteristic distribution in the CNS. To date, 20 subunits of the GABA A receptor have been cloned: α1-6, β1-4, γ1-3, δ, π, ε , Θ, and ρ1-3. Oocyte of Xenopus laevis is one of the most frequently used heterologous expression systems, which are used to design and analyze specific combinations of GABA A receptor subunits. In oocytes, a certain GABA A receptor function is studied only by comparing the amplitude of the response to GABA and other drugs by physiological and pharmacological methods. According to the studies on Xenopus laevis oocytes, the α1β2γ2S receptor combination is mostly used. The α1-containing receptors mediate sedative and anticonvulsant acts. The results of studies on oocytes show that PKA, NKCC1, P2X3 receptors, and GABA A receptor-associated protein, etc., are existing systems that show different reactivity to the GABA A receptors. The GABA A receptor subunits contain distinct binding sites for BZDs, neurosteroids, general anesthetics, etc., which are responsible for the numerous functions of the GABA A receptor. A variety of other drugs, such as topiramate, TG41, (+)- and (-)-borneol, apigenin, and 6-methylflavone could also have modulatory effects on the GABA A receptors. Some of the different models and hypotheses on GABA A receptor structure and function have been achieved by using the two-electrode voltage clamp method in oocytes.
Persistence of cognitive deficits following paediatric head injury without professional rehabilitation in rural East Coast Malaysia

Abdullah JM, Kumaraswamy N, Awang N, Ghazali MM, Abdullah MR

Asian J Surg, 2005 Jul;28(3):163-7.
PMID: 16024307

To use data from a prospective, longitudinal study to determine whether psychomotor functions improve spontaneously during the first year following paediatric traumatic brain injury without modern rehabilitation facilities in a rural area of Malaysia.
Intramedullary spindle cell hemangioendothelioma of the thoracic spinal cord--case report

Abdullah JM, Mutum SS, Nasuha NA, Biswal BM, Ariff AR

Neurol. Med. Chir. (Tokyo), 2002 Jun;42(6):259-63.
PMID: 12116532

A 28-year-old Malay man presented with progressive paraparesis over a period of 6 months. Magnetic resonance imaging of the spine revealed a thoracic intramedullary spinal cord tumor at the T-7 level with homogeneous enhancement following intravenous gadolinium administration. Laminectomy and partial decompression of the tumor was performed. Histological examination of the tumor revealed features of spindle cell hemangioendothelioma. The patient was managed with limited field radiotherapy followed by systemic interferon therapy. Good neurological improvement was seen subsequently. The patient has survived 48 months with growth restraint at the primary site, although residual neurological deficit persists. Immunotherapy should be considered as a treatment modality for intramedullary hemangioendothelioma of the spinal cord after surgery and radiotherapy.
Fulltext Malignant rhabdoid tumour of the brain

Abdullah JM, Rahman ZA, Ariff AR, Jaafar H, Phang KS

Singapore Med J, 2004 Jun;45(6):286-8.
PMID: 15181525

Rhabdoid tumour is a rare childhood tumour with poor prognosis. We report a 13-month-old Malay girl suffering from this tumour that was located at the left fronto-temporo-parietal region of the brain. Computed tomography showed a large irregular enhancing mass that caused obstructive hydrocephalus. The tumour did not reduce in size after three operations and finally the patient succumbed to the disease four months after diagnosis.
Prediction of outcomes in traumatic brain injury: The IMPACT and CRASH prognostic models in a single neurosurgical center, Malaysia

Abdullah JM, Idris Z, Ghani AR, Lim MS

J Neurosurg Sci, 2023 Jun;67(3):367-373.
PMID: 33709663 DOI: 10.23736/S0390-5616.21.05249-8

BACKGROUND: Traumatic brain injury (TBI) has recently become a major concern for public health care and a socioeconomic burden internationally. Prognostic models are mathematical models developed from specific populations which are used to predict the mortality and unfavorable outcomes especially in trauma centers. Hence, we formulate a study to perform an external validation of the IMPACT and CRASH prognostic models; the CRASH model to predict 14-day mortality and 6-month unfavorable outcome and the IMPACT model to estimate 6-month mortality and unfavorable outcome in a single center cohort of TBI patients in Malaysia.
METHODS: All patients with traumatic brain injury (mild, moderate, and severe) who were admitted to Queen Elizabeth Hospital from November 1, 2017, to January 31, 2019, were prospectively analyzed through a data collection sheet. The discriminatory power of the models was assessed as area under the receiver operating characteristic curve and calibration was assessed using the Hosmer-Lemeshow (H-L) goodness-of-fit test and Cox calibration regression analysis.
RESULTS: We analyzed 281 patients with significant TBI treated in a single neurosurgical center in Malaysia over a 2-year period. The overall observed 14-day mortality was 9.6%, a 6-month unfavorable outcome of 23.5%, and a 6-month mortality of 13.2%. Overall, both the CRASH and IMPACT models showed good discrimination with AUCs ranging from 0.88 to 0.94 and both models calibrating satisfactorily H-L GoF P>0.05 and calibration slopes >1.0 although IMPACT seemed to be slightly more superior compared to the CRASH model.
CONCLUSIONS: The CRASH and IMPACT prognostic models displayed satisfactory overall performance in our cohort of TBI patients, but further investigations on factors contributing to TBI outcomes and continuous updating on both models remain crucial.
A Critical Appraisal of COVID-19 in Malaysia and Beyond

Abdullah JM, Wan Ismail WFN, Mohamad I, Ab Razak A, Harun A, Musa KI, et al.

Malays J Med Sci, 2020 Mar;27(2):1-9.
PMID: 32308536 DOI: 10.21315/mjms2020.27.2.1

When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.
Progress in Clinical Neurosciences, Cognitive Neurosciences, Clinical Psychology, Neurotechnology and Brain Mapping in Malaysia

Abdullah JM

Malays J Med Sci, 2021 Apr;28(2):1-14.
PMID: 33958956 DOI: 10.21315/mjms2021.28.2.1

Last year, there was an increase in the amount of manpower in Malaysia, especially in terms of the numbers of neurosurgeons, cognitive neuroscientists and clinical psychologists. One way to increase the number of cognitive neurotechnologists in the country in 2021 is to allow neuroscientists to register as neurotechnologists with the Malaysian Board of Technologists (MBOT). The Malaysian Brain Mapping project has risen from its humble beginnings as an initiative of the Universiti Sains Malaysia Brain Mapping Group in 2017. There is currently a proposal for its entry into the national arena via the Precision Medicine Initiative with the Academy Science Malaysia, the Ministry of Science, Technology and Innovation, Ministry of Higher Education and Ministry of Health. The current Malaysian Government's Science, Technology, Innovation and Economy (STIE) plan was launched in 2020, leading to the establishment of neurotechnology as one of 10 STIE drivers.
Fulltext Hominem Sine Opus Spatium: Where Do the Ideas Come from to Move the Brain, Mind, Behaviour and Neurosciences in Malaysia?

Abdullah JM

Malays J Med Sci, 2018 Mar;25(2):1-14.
PMID: 30918450 DOI: 10.21315/mjms2018.25.2.1

People can work wonders without a room. Rooms make people think within a box, and people who are not confined within a room can wonder while thinking and solve problems as they see them in the environment. The dearth in the growth of professionals trained in the neurosciences who will use neurotechnology in the future is a dire situation facing Malaysia, according to the Academy of Sciences Malaysia's 2017 Emerging Science, Engineering and Technology (ESET) study. Further, this human resource needs to be fundamentally cultivated at schools from a very young age. The author describes the activities that have taken place in the country via a bottom-up approach over the last two years and hopes that eventually these endeavours will end with the creation of an ASEAN Brain, Mind, Behaviour and Neuroscience Institute for Creativity and Innovation being established with the full support of the Government of Malaysia or other local and international financial donors.
Fulltext Neurosciences at Universiti Sains Malaysia Represent Malaysia to Support Global Precision Brain Health

Abdullah JM

Malays J Med Sci, 2019 May;26(3):1-23.
PMID: 31303847 DOI: 10.21315/mjms2019.26.3.1

The combined effort of the neuroscience and psychology cluster at the Universiti Sains Malaysia (USM)-fundamental, applied and clinical-has moved the institution to the number two position in the country, behind Universiti Malaya. The strategy to join the Global Brain Consortium (GBC) and put Malaysia on the map to address the GBC mission, vision, focus areas and outcomes began recently, in May 2019.

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