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Fulltext α-Thalassemia with Haemoglobin Adana mutation: prenatal diagnosis

Zainal NZ, Alauddin H, Ahmad S, Hussin NH

Malays J Pathol, 2014 Dec;36(3):207-11.
PMID: 25500521

Thalassaemia carriers are common in the Asian region including Malaysia. Asymptomatic patients can be undiagnosed until they present for their antenatal visits. Devastating obstetric outcome may further complicate the pregnancy if both parents are thalassaemia carriers leading to hydrophic fetus due to haemoglobin Bart's disease. However in certain cases where unexplained hydrops fetalis occur in parents with heterozygous thalassaemia carrier,mutated α genes should be suspected. We report a twenty-nine year old woman in her third pregnancy with two previous pregnancies complicated by early neonatal death at 21 and 28 weeks of gestation due to hydrops fetalis. DNA analysis revealed the patient to have heterozygous (--SEA) α-gene deletion, while her husband has a compound heterozygosity for α(3.7) deletion and codon 59 (GGC → GAC) mutation of the α-gene. This mutation, also known as hemoglobin Adana, can explain hydrops fetalis resulting from two alpha gene deletions from the patient (mother) and a single alpha gene deletion with mutation from the father. The third pregnancy resulted in a grossly normal baby boy with 3 α-gene deletions (HbH disease). We postulate that, in view of heterogenisity of the α-thalassaemia in this patient with severely unstable haemoglobin Adana chains from her husband, there will be a 25% possibility of fetal hydrops in every pregnancy.
Whole genome sequencing analysis demonstrates therapy-induced echinocandin resistance in Candida auris isolates

Spruijtenburg B, Ahmad S, Asadzadeh M, Alfouzan W, Al-Obaid I, Mokaddas E, et al.

Mycoses, 2023 Dec;66(12):1079-1086.
PMID: 37712885 DOI: 10.1111/myc.13655

Candida auris is an emerging, multidrug-resistant yeast, causing outbreaks in healthcare facilities. Echinocandins are the antifungal drugs of choice to treat candidiasis, as they cause few side effects and resistance is rarely found. Previously, immunocompromised patients from Kuwait with C. auris colonisation or infection were treated with echinocandins, and within days to months, resistance was reported in urine isolates. To determine whether the development of echinocandin resistance was due to independent introductions of resistant strains or resulted from intra-patient resistance development, whole genome sequencing (WGS) single-nucleotide polymorphism (SNP) analysis was performed on susceptible (n = 26) and echinocandin-resistant (n = 6) isolates from seven patients. WGS SNP analysis identified three distinct clusters differing 17-127 SNPs from two patients, and the remaining isolates from five patients, respectively. Sequential isolates within patients had a maximum of 11 SNP differences over a time period of 1-10 months. The majority of isolates with reduced susceptibility displayed unique FKS1 substitutions including a novel FKS1M690V substitution, and nearly all were genetically related, ranging from only three to six SNP differences compared to susceptible isolates from the same patient. Resistant isolates from three patients shared the common FKS1S639F substitution; however, WGS analysis did not suggest a common source. These findings strongly indicate that echinocandin resistance is induced during antifungal treatment. Future studies should determine whether such echinocandin-resistant strains are capable of long-term colonisation, cause subsequent breakthrough candidiasis, have a propensity to cross-infect other patients, or remain viable for longer time periods in the hospital environment.
Fulltext Weight perception among non-pregnant urban Malaysian women: is it reliable?

Fadzil F, Shamsuddin K, Wan Puteh SE, Ahmad S, Abdul Hayi NS, Abdul Samad A, et al.

Int J Public Health Res, 2015;5(2):637-642.
MyJurnal

Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.
Voltammetric determination of iodide in iodized table salt using cetyltrimethylammonium bromide as ion-pairing

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.
Fulltext Ventricular pro-arrhythmic phenotype, arrhythmic substrate, ageing and mitochondrial dysfunction in peroxisome proliferator activated receptor-γ coactivator-1β deficient (Pgc-1β-/-) murine hearts

Ahmad S, Valli H, Chadda KR, Cranley J, Jeevaratnam K, Huang CL

Mech Ageing Dev, 2018 Jul;173:92-103.
PMID: 29763629 DOI: 10.1016/j.mad.2018.05.004

INTRODUCTION: Ageing and age-related bioenergetic conditions including obesity, diabetes mellitus and heart failure constitute clinical ventricular arrhythmic risk factors.
MATERIALS AND METHODS: Pro-arrhythmic properties in electrocardiographic and intracellular recordings were compared in young and aged, peroxisome proliferator-activated receptor-γ coactivator-1β knockout (Pgc-1β-/-) and wild type (WT), Langendorff-perfused murine hearts, during regular and programmed stimulation (PES), comparing results by two-way ANOVA.
RESULTS AND DISCUSSION: Young and aged Pgc-1β-/- showed higher frequencies and durations of arrhythmic episodes through wider PES coupling-interval ranges than WT. Both young and old, regularly-paced, Pgc-1β-/- hearts showed slowed maximum action potential (AP) upstrokes, (dV/dt)max (∼157 vs. 120-130 V s-1), prolonged AP latencies (by ∼20%) and shortened refractory periods (∼58 vs. 51 ms) but similar AP durations (∼50 ms at 90% recovery) compared to WT. However, Pgc-1β-/- genotype and age each influenced extrasystolic AP latencies during PES. Young and aged WT ventricles displayed distinct, but Pgc-1β-/- ventricles displayed similar dependences of AP latency upon (dV/dt)max resembling aged WT. They also independently increased myocardial fibrosis. AP wavelengths combining activation and recovery terms paralleled contrasting arrhythmic incidences in Pgc-1β-/- and WT hearts. Mitochondrial dysfunction thus causes pro-arrhythmic Pgc-1β-/- phenotypes by altering AP conduction through reducing (dV/dt)max and causing age-dependent fibrotic change.
Fulltext Validation of the knowledge, attitude and perceived practice of asthma instrument among community pharmacists using Rasch analysis

Akram W, Hussein MS, Ahmad S, Mamat MN, Ismail NE

Saudi Pharm J, 2015 Oct;23(5):499-503.
PMID: 26594115 DOI: 10.1016/j.jsps.2015.01.011

There is no instrument which collectively assesses the knowledge, attitude and perceived practice of asthma among community pharmacists. Therefore, this study aimed to validate the instrument which measured the knowledge, attitude and perceived practice of asthma among community pharmacists by producing empirical evidence of validity and reliability of the items using Rasch model (Bond & Fox software®) for dichotomous and polytomous data. This baseline study recruited 33 community pharmacists from Penang, Malaysia. The results showed that all PTMEA Corr were in positive values, where an item was able to distinguish between the ability of respondents. Based on the MNSQ infit and outfit range (0.60-1.40), out of 55 items, 2 items from the instrument were suggested to be removed. The findings indicated that the instrument fitted with Rasch measurement model and showed the acceptable reliability values of 0.88 and 0.83 and 0.79 for knowledge, attitude and perceived practice respectively.
Fulltext Validation of Malaysian Versions of Perceived Diabetes Self-Management Scale (PDSMS), Medication Understanding and Use Self-Efficacy Scale (MUSE) and 8-Morisky Medication Adherence Scale (MMAS-8) Using Partial Credit Rasch Model

Al Abboud SA, Ahmad S, Bidin MB, Ismail NE

J Clin Diagn Res, 2016 Nov;10(11):LC01-LC05.
PMID: 28050405 DOI: 10.7860/JCDR/2016/15079.8845

INTRODUCTION: The Diabetes Mellitus (DM) is a common silent epidemic disease with frequent morbidity and mortality. The psychological and psychosocial health factors are negatively influencing the glycaemic control in diabetic patients. Therefore, various questionnaires were developed to address the psychological and psychosocial well-being of the diabetic patients. Most of these questionnaires were first developed in English and then translated into different languages to make them useful for the local communities.
AIM: The main aim of this study was to translate and validate the Malaysian versions of Perceived Diabetes Self-Management Scale (PDSMS), Medication Understanding and Use Self-Efficacy Scale (MUSE), and to revalidate 8-Morisky Medication Adherence Scale (MMAS-8) by Partial Credit Rasch Model (Modern Test Theory).
MATERIALS AND METHODS: Permission was obtained from respective authors to translate the English versions of PDSMS, MUSE and MMAS-8 into Malay language according to established standard international translation guidelines. In this cross-sectional study, 62 adult DM patients were recruited from Hospital Kuala Lumpur by purposive sampling method. The data were extracted from the self-administered questionnaires and entered manually in the Ministeps (Winsteps) software for Partial Credit Rasch Model. The item and person reliability, infit/outfit Z-Standard (ZSTD), infit/outfit Mean Square (MNSQ) and point measure correlation (PTMEA Corr) values were analysed for the reliability analyses and construct validation.
RESULTS: The Malay version of PDSMS, MUSE and MMAS-8 found to be valid and reliable instrument for the Malaysian diabetic adults. The instrument showed good overall reliability value of 0.76 and 0.93 for item and person reliability, respectively. The values of infit/outfit ZSTD, infit/outfit MNSQ, and PTMEA Corr were also within the stipulated range of the Rasch Model proving the valid item constructs of the questionnaire.
CONCLUSION: The translated Malay version of PDSMS, MUSE and MMAS-8 was found to be a highly reliable and valid questionnaire by Partial Credit Model. The Malay version was conceptually equivalent to original version, easy to understand and can be used for the Malaysian adult diabetic patients for future studies.
Fulltext Validation and Reliability of Healthcare Workers' Knowledge, Attitude, and Practice Instrument for Uncomplicated Malaria by Rasch Measurement Model

Ismail NE, Jimam NS, Dapar MLP, Ahmad S

Front Pharmacol, 2019;10:1521.
PMID: 31998125 DOI: 10.3389/fphar.2019.01521

Background: This study assessed the validity and reliability of healthcare workers' knowledge, attitudes, and practices instrument for uncomplicated malaria (HKAPIUM) for evaluation of healthcare workers' knowledge, attitudes, and practices (KAP) on uncomplicated malaria management in primary healthcare (PHC) facilities in Plateau state, Nigeria. Methods: Relevant variables from literature, malaria treatment guidelines for Nigeria, and World Health Organization (WHO) were used to generate and present the items for the draft HKAPIUM scale, which was first screened by six experts before administered to 121 respondents who filled and returned immediately. The data were sorted and analyzed using Rasch measurement model (Bond & Fox software®). Results: The outcome of the initial screening showed high items content validity indices (I-CVI) (0.83-1.00) and high scale-CVI (S-CVI) {universal agreement (UA) within the experts (S-CVI/UA) (0.67-0.89) and the average CVI [S-CVI/Ave (0.94-0.98)]} for relevance, clarity, simplicity, and comprehensiveness. The Rasch analysis outputs showed good items' reliability for the three factors (KAP) > 0.9 with high separation index values of > 2.0; however person reliability were poor (< 0.6) which were confirmed by their low separation values. Goodness of fit statistics indicated nine items not fitting the model based on the suggested fit index values of 0.6 to 1.5, and ± 2 for mean square (MNSQ) and standardized Z-score (Zstds) respectively, and 0.3 to 0.7 for "point-measure correlation coefficients" (PTMEA Corr). Deletion of misfit items resulted in the items and persons' reliabilities falling above the minimum accepted limit of 0.6, with their separation values were all in the range of 1 and 2 which were acceptable. Similarly, fit index values for MNSQ infit and outfit, and Zstd parameters items in the new scale were all within the acceptable range of 0.6 to 1.5, and ±2 respectively, in addition to the positive PTMEA Corr as further confirmation of the items' fitness to the model. Conclusion: The reduction of 27-items draft HKAPIUM scale to 18 items was successful with good reliability and fitness to the model.
Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia

Kalok A, Loh SYE, Chew KT, Abdul Aziz NH, Shah SA, Ahmad S, et al.

Vaccine, 2020 02 24;38(9):2183-2189.
PMID: 32001070 DOI: 10.1016/j.vaccine.2020.01.043

BACKGROUND: Vaccine hesitancy is a complex behaviour which involves various degrees of indecision about specific vaccines or vaccination uptake. Access to antenatal care had been associated with positive vaccine behavior.
OBJECTIVE: To determine the prevalence of vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers and the associated socio-demographic factors.
METHODS: A cross-sectional study was conducted among 1081 women who received antenatal care at a teaching hospital in Kuala Lumpur. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines (PACV) Survey in both English and validated Malay versions. The sociodemographic data of the mothers and their partners, source of vaccine information and reasons for hesitancy were analysed.
RESULTS: Eighty-six (8.0%) pregnant mothers were vaccine hesitant. Ethnicity, religion, number of children, educational level and employment status were significantly associated with vaccine hesitancy. Multivariable analysis showed that a low level of education was the most significant risk factor (p
Fulltext Vaccine hesitancy in East Malaysia (Sabah): A survey of the national COVID-19 immunisation programme

Jafar A, Mapa MT, Sakke N, Dollah R, Joko EP, Atang C, et al.

Geospat Health, 2022 01 14;17(s1).
PMID: 35147010 DOI: 10.4081/gh.2022.1037

The Malaysian government has introduced the National COVID-19 Immunisation Programme (PICK) as a new mechanism to address the transmission of coronavirus disease 2019 (COVID-19). Unfortunately, the number of PICK registrations is still unsatisfactory and is now even lower. The low level of participation of the Sabah (East Malaysia) population significantly impacts the PICK registrations. Therefore, this study aims to identify the factors that cause vaccine hesitancy among the people of Sabah. This study seeks to identify these trends based on zone and district boundaries. A total of 1024 respondents were sampled in this study. Raw data collected through the survey method were analysed using K-means clustering, principal component analysis (PCA), and spatial analysis. The study discovered that factors including confidence, authority, mainstream media, complacency, social media, and convenience are the top causes of vaccine hesitancy among respondents. This study also revealed that the Sabah population's key variables causing vaccine hesitancy to vary by region (zones and districts). The conclusion is significant as a source of supporting data for stakeholders seeking to identify the Sabah population's constraints in each region and therefore, it would help improve PICK management's performance in Sabah.
Utero-cutaneous fistula after caesarean section secondary to red degeneration of intramural fibroid

Lim PS, Shafiee MN, Ahmad S, Hashim Omar M

Sex Reprod Healthc, 2012 Jun;3(2):95-6.
PMID: 22578758 DOI: 10.1016/j.srhc.2012.03.002

A 33 year-old woman had an emergency caesarean section for retained second twin which was complicated by utero-cutaneous fistula due to red degeneration of intramural fibroid. The utero-cutaneous communication was demonstrated by an examination under anaesthesia using dye test. She then underwent excision of the fistula tract and myomectomy. She recovered well following the surgery. This is the first case of utero-cutaneous fistula where the communication is between the endometrial cavity and skin lesion via a necrotic intramural fibroid following caesarean section. Fistulogram might fail to demonstrate the communication. In highly suspected case, other modalities of investigations could be utilised.
Fulltext Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia

Rahman RA, Atan IK, Ali A, Kalok AM, Ismail NAM, Mahdy ZA, et al.

BMC Pregnancy Childbirth, 2021 May 10;21(1):368.
PMID: 33971828 DOI: 10.1186/s12884-021-03838-x

BACKGROUND: Spontaneous preterm birth is a global issue that contributed to perinatal morbidities and mortalities worldwide. The study aimed to describe the experience at UKM Medical Center in managing women at high risk for spontaneous preterm birth using the Arabin pessary.
METHODS: This is a retrospective observational study involving 58 pregnancies from 1st January 2013 to 31st December 2019. Inclusion criteria were previous mid-trimester miscarriage and/or preterm birth, previous cervical surgery or short cervical length on routine sonogram. The demographic data, characteristics of each pregnancy and details of outcomes and management were described.
RESULTS: The majority of women were Malay with mean age and body mass index of 32.9 ± 4.2 years and 27.1 ± 6.3 kg/m2 respectively. The most frequent indications for Arabin pessary insertion were previous mid-trimester miscarriage (46.4%) and early preterm birth (17.2%). A total of 73.4% of these women had the pessary inserted electively at a mean cervical length of 31.6 ± 9.1 mm at median gestation of 15.0 weeks. They were managed as outpatient (56.9%), inpatient (24.1%) or mixed (19.0%) with combination of progestogen (81.0%) and 53.4% received antenatal corticosteroids. Spontaneous preterm birth at or more than 34 weeks gestation occurred in 74.1% with birthweight at or more than 2000 g (82.4%). Despite cervical funneling in 12 women (20.7%), 66.7% delivered at or later than 34 weeks gestation and 2 (16.7%) resulted in miscarriage.
CONCLUSIONS: Insertion of the Arabin pessary is beneficial to prevent spontaneous preterm birth in pregnant women who are at high risk. In particular, early insertion and close monitoring allows the best possible outcomes.
TRIAL REGISTRATION: This study was retrospectively registered with ClinicalTrials.gov ( NCT04638023 ) on 20/11/2020.
Fulltext Unsteady magnetohydrodynamic free convection flow of a second grade fluid in a porous medium with ramped wall temperature

Samiulhaq, Ahmad S, Vieru D, Khan I, Shafie S

PLoS One, 2014;9(5):e88766.
PMID: 24785147 DOI: 10.1371/journal.pone.0088766

Magnetic field influence on unsteady free convection flow of a second grade fluid near an infinite vertical flat plate with ramped wall temperature embedded in a porous medium is studied. It has been observed that magnitude of velocity as well as skin friction in case of ramped temperature is quite less than the isothermal temperature. Some special cases namely: (i) second grade fluid in the absence of magnetic field and porous medium and (ii) Newtonian fluid in the presence of magnetic field and porous medium, performing the same motion are obtained. Finally, the influence of various parameters is graphically shown.
Fulltext Unpacking the asymmetric impact of exchange rate volatility on trade flows: A study of selected developed and developing Asian economies

Kayani UN, Aysan AF, Gul A, Haider SA, Ahmad S

PLoS One, 2023;18(10):e0291261.
PMID: 37819995 DOI: 10.1371/journal.pone.0291261

Maintaining a stable exchange rate is a challenging task for the world, especially for developing economies. This study examines the impact of asymmetric exchange rates on trade flows in selected Asian countries and finds that the effects of increased exchange rate volatility on exports and imports differ among Pakistan, Malaysia, Japan, and Korea. The quarterly data from the period 1980 to 2018 is collected from the International Financial Statistics (IFS) database maintained by the International Monetary Fund (IMF). We employ both linear and non-linear Autoregressive Distributed Lag (ARDL) models for estimation. The non-linear models yielded more significant findings, while the linear models did not indicate any significant effects of exchange rate volatility on trade flows. The results of the study suggest that in the case of Pakistan, both the linear and non-linear models indicate that increased exchange rate volatility adversely affects exports and imports, while decreased volatility enhances both. This implies that stabilizing the exchange rate would be beneficial for Pakistan's trade. In contrast, the linear model applied to Malaysia shows no long-run effects of exchange rate volatility on exports. However, the result suggests that decreased volatility stimulates Malaysia's exports. Therefore, in the case of Malaysia, stabilizing the exchange rate could contribute to boosting exports. We also found that increased exchange rate volatility boosts exports of Japan. On the other hand, decreased volatility hurts exports of Japan. As for the long-run effects of exchange rate volatility on imports, we found that increased volatility boosts imports of Korea. The study provides various policy implications regarding the impact of exchange rate volatility on trade flows in developing economies. The study highlights the importance of country-specific considerations in understanding the impact of exchange rate volatility on trade flows, and has important policy implications for promoting trade and economic growth in these nations. It emphasizes the need to model exchange rate volatility separately for developed and developing countries and to continue research and analysis to identify ways to mitigate its negative effects on the economy.
Fulltext Unmet Healthcare Needs Among Elderly Malaysians

Shah SA, Safian N, Ahmad S, Nurumal SR, Mohammad Z, Mansor J, et al.

J Multidiscip Healthc, 2021;14:2931-2940.
PMID: 34703245 DOI: 10.2147/JMDH.S326209

Purpose: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia.
Patients and Methods: This cross-sectional study used data collected during 2018-2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs.
Results: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life.
Conclusion: The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people's knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs.
Unequal distribution of COVID-19 vaccine: A looming crisis

Sawal I, Ahmad S, Tariq W, Tahir MJ, Essar MY, Ahmed A

J Med Virol, 2021 09;93(9):5228-5230.
PMID: 33942326 DOI: 10.1002/jmv.27031
Fulltext Understanding the challenges to COVID-19 vaccines and treatment options, herd immunity and probability of reinfection

Al-Hatamleh MAI, Abusalah MA, Hatmal MM, Alshaer W, Ahmad S, Mohd-Zahid MH, et al.

J Taibah Univ Med Sci, 2023 Jun;18(3):600-638.
PMID: 36570799 DOI: 10.1016/j.jtumed.2022.11.007

Unlike pandemics in the past, the outbreak of coronavirus disease 2019 (COVID-19), which rapidly spread worldwide, was met with a different approach to control and measures implemented across affected countries. The lack of understanding of the fundamental nature of the outbreak continues to make COVID-19 challenging to manage for both healthcare practitioners and the scientific community. Challenges to vaccine development and evaluation, current therapeutic options, convalescent plasma therapy, herd immunity, and the emergence of reinfection and new variants remain the major obstacles to combating COVID-19. This review discusses these challenges in the management of COVID-19 at length and highlights the mechanisms needed to provide better understanding of this pandemic.
Fulltext UV/O3 treatment as a surface modification of rice husk towards preparation of novel biocomposites

Rajendran Royan NR, Sulong AB, Yuhana NY, Chen RS, Ab Ghani MH, Ahmad S

PLoS One, 2018;13(5):e0197345.
PMID: 29847568 DOI: 10.1371/journal.pone.0197345

The use of rice husks (RH) to reinforce polymers in biocomposites are increasing tremendously. However, the incompatibility between the hydrophilic RH fibers and the hydrophobic thermoplastic matrices leads to unsatisfactory biocomposites. Surface modification of the fiber surface was carried out to improve the adhesion between fiber and matrix. In this study, the effect of surface modification of RH via alkali, acid and ultraviolet-ozonolysis (UV/O3) treatments on the properties of composites recycled high density polyethylene (rHDPE) composites was investigated. The untreated and treated RH were characterized by Fourier Transform Infrared (FTIR) and Scanning Electron Microscope (SEM). The composites containing 30 wt% of RH (treated and untreated) were then prepared via extrusion and followed by compression molding. As compared to untreated RH, all surface treated RH exhibited rougher surface and showed improved adhesion with rHDPE matrix. Tensile strength of UV/O3-treated RH composites showed an optimum result at 18.37 MPa which improved about 5% in comparison to the composites filled with untreated RH. UV/O3 treatment promotes shorter processing time and lesser raw material waste during treatment process where this is beneficial for commercialization in the future developments of wood plastic composites (WPCs). Therefore, UV/O3 treatment can be served as an alternative new method to modify RH surface in order to improve the adhesion between hydrophilic RH fibre and hydrophobic rHDPE polymer matrix.
Fulltext Trends in evidence-based treatment and mortality for ST elevation myocardial infarction in Malaysia from 2006 to 2013: time for real change

Venkatason P, Zubairi YZ, Hafidz I, Wan WA, Zuhdi AS

Ann Saudi Med, 2016 5 30;36(3):184-9.
PMID: 27236389 DOI: 10.5144/0256-4947.2016.184

BACKGROUND: The administration of evidence-based pharmacotherapy and timely primary percutaneous coronary intervention have been shown to improve outcome in ST elevation myocardial infarction (STEMI). However, implementation remains a challenge due to the limitations in facilities, expertise and funding.
OBJECTIVES: To investigate adherence to guideline-based management and mortality of STEMI patients in Malaysia.
DESIGN: Retrospective analysis.
SETTINGS: STEMI patients from 18 participating hospital across Malaysia included in the National Cardiovascular Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006 to 2013.
PATIENTS AND METHODS: Patients were categorized into four subgroups based on the year of admission (2006 to 2007, 2008 to 2009, 2010 to 2011 and 2012 to 2013). Baseline characteristics and clinical presentation, in-hospital pharmacotherapy, invasive revascularization and in-hospital/30-day mortality were analysed and compared between the subgroups.
MAIN OUTCOME MEASURE(S): Rate of in-hospital catheterization/percutaneous coronary intervention.
RESULTS: The registry contained data on 19483 patients. Intravenous thrombolysis was the main reperfusion therapy. Although the overall rate of in-hospital catheterisation/PCI more than doubled over the study period, while the use of primary PCI only slowly increased from 7.6% in 2006/2007 to 13.6% in 2012/2013. The use of evidence-based oral therapies increased steadily over the years except for ACe-inhibitors and angiotensin-receptor blockers. The adjusted risk ratios (RR) for in-hospital mortality for the four sub-groups have not shown any significant improvement. The 30-day adjusted risk ratios however showed a significant albeit gradual risk reduction (RR 0.773 95% CI 0.679-0.881, P < .001).
CONCLUSION: Adherence to evidence-based treatment in STEMI in Malaysia is still poor especially in terms of the rate of primary PCI. Although there is a general trend toward reduced 30-day mortality, the reduction was only slight over the study period. Drastic effort is needed to improve adherence and clinical outcomes.
LIMITATION: Retrospective registry data with inter-hospital variation.
Fulltext Traumatic Anterior Dislocation of Hip in a Child - Case Report

Ahmad S, Devkota P, Mamman KG

Malays Orthop J, 2015 Mar;9(1):30-31.
PMID: 28435593 DOI: 10.5704/MOJ.1503.003

Traumatic hip dislocation in children is relatively rare accounting for about 5% of all hip dislocations. Most of the hip dislocations seen in children are of the posterior type but the much rarer anterior and anterior-inferior (obturator) types have also been described. We present the case of an eight years old girl with an obturator type of hip dislocation following trivial trauma. She was treated with closed reduction and immobilisation in skin traction for three weeks. She was followed up closely for one year and did not develop any complications during that period.

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