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  1. Fulltext Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
    Awang S, Alias N, DeWitt D, Jamaludin KA, Abdul Rahman MN
    Front Public Health, 2021;9:726647.
    PMID: 34869147 DOI: 10.3389/fpubh.2021.726647
    Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.
  2. Fulltext Anemia among Men in Malaysia: A Population-Based Survey in 2019
    Awaluddin SM, Shahein NA, Che Abdul Rahim N, Mohd Zaki NA, Nasaruddin NH, Saminathan TA, et al.
    Int J Environ Res Public Health, 2021 Oct 17;18(20).
    PMID: 34682667 DOI: 10.3390/ijerph182010922
    This study aimed to determine the prevalence of anemia and factors associated with anemia among men in Malaysia. The researchers used data from the 2019 National Health and Morbidity Survey (NHMS). The hemoglobin levels of men aged 15 years and above who gave their consent was measured using the HemoCue® Hb 201+ System©. The majority of them (87.2%) were men aged 15-59 years, referred to as the younger age group in this study. The prevalence of anemia among men was 12.6% (95% confidence interval (CI): 10.9, 14.5). The prevalence was higher among older men (30.7%; 95% CI: 26.6, 35.1) than younger men (10.0%; 95% CI: 8.2, 12.2). Anemia among men was associated with older age (adjusted odds ratios (aOR) = 3.1; 95% CI: 2.1, 4.4) and those with diabetes (aOR = 1.5; 95% CI: 1.2, 2.1) via a logistic regression analysis. In conclusion, older men were more affected by anemia than younger men in this study. Anemia among older men in Malaysia is at the level of moderate to severe public health significance. The likelihood of developing anemia is increased among older men with diabetes compared to older men without diabetes. These often-overlooked issues among men need to be detected and treated early in order to prevent complications and improve their quality of life.
  3. Reshaping the Curriculum for Academy in Factory in Malaysia
    Jamaludin KA, Ealangov S, Saleh SNHM, Zabidi NA, Alias N, Yasin MHM, et al.
    Front Psychol, 2023;14:1120611.
    PMID: 37082577 DOI: 10.3389/fpsyg.2023.1120611
    Academy in Factory (AiF) was recently introduced in Malaysia to cater to the talent development and education attainment for a future-ready workforce. Though ideally expected to be an effective initiative, a lack of a strong curriculum framework hinders its implementation. To date the literature on AiF is very limited. It was found that its vague definition and characteristics, non-harmonised interaction between industry and academia, and non-existing curriculum framework are among contributing factors to its ineffective implementation. Thus, this study is aimed at reshaping a curriculum framework that is responsive to its aims and objectives. Building upon an extensive review of literature on AiF, industry-based curriculum, employability and human capital development, and best practices in the international context, the proposed framework is hoped to serve as a reference to improve its current practice.
  4. Fulltext Muslim young adults' financial strain and financial stress during the COVID-19 pandemic: The moderating role of religiosity
    Jaffar N, Mohd Faizal S, Selamat Z, Alias N
    Heliyon, 2023 Oct;9(10):e21047.
    PMID: 37876443 DOI: 10.1016/j.heliyon.2023.e21047
    The COVID-19 pandemic affected everyone's lives and general well-being worldwide, including young adults. Young adulthood is marked by a shift in various social areas including acquiring financial independence. As the pandemic was an exceptional scenario in all nations, there is a research gap in analysing how it would affect financial experiences of young adults, particularly the Muslim young adults. These individuals may face financial stress as a result of the COVID-19 pandemic due to their high level of financial strain. Furthermore, little is still known about the role that religiosity may play in the relationship between the financial strain and financial stress, notably during the pandemic. The objectives of this study were to examine the level of financial strain and financial stress of Muslim young adults, assess the effect of financial strain on financial stress of Muslim young adults and investigate the moderating effect of religiosity on the relationship between Muslim young adults' financial strain and financial stress during the COVID-19 pandemic. A survey of 230 Muslim young adults was conducted in Malaysia. Results showed that thirty percent of Muslim young adults fell under high level of financial strain while majority of them fell under high level of financial stress. Additionally, financial strain had a significant positive effect on the financial stress of Muslim young adults. This means that the more financially strained, the more Muslim young adults experienced financial stress during the COVID-19 pandemic. Religiosity, however, did not moderate the relationship between financial strain and financial stress. These results highlighted the significance of comprehending the level of financial strain and financial stress experienced by Muslim young adults during the COVID-19 pandemic. The results provided relevant parties insights in developing strategies for Muslim young adults to manage financial strain and financial stress to reduce the negative effect of the COVID-19 pandemic.
  5. Radiation effects on the intima-media thickness of the common carotid artery in post-radiotherapy patients with head and neck malignancy
    Shariat M, Alias NA, Biswal BM
    Postgrad Med J, 2008 Nov;84(997):609-12.
    PMID: 19103820 DOI: 10.1136/pgmj.2008.068569
    Post-radiation large vessel injury has not received as much attention as microvascular irradiation injury. A few studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy to the head and neck. However, in most of these studies, the irradiated subjects also had other major risk factors for atherosclerosis. In this study, irradiated subjects with major risk factors such as hypertension, diabetes, history of previous cerebrovascular accident and connective tissue disorder were excluded.
  6. A new implicit high-order iterative scheme for the numerical simulation of the two-dimensional time fractional Cable equation
    Khan MA, Alias N, Khan I, Salama FM, Eldin SM
    Sci Rep, 2023 Jan 27;13(1):1549.
    PMID: 36707653 DOI: 10.1038/s41598-023-28741-7
    In this article, we developed a new higher-order implicit finite difference iterative scheme (FDIS) for the solution of the two dimension (2-D) time fractional Cable equation (FCE). In the new proposed FDIS, the time fractional and space derivatives are discretized using the Caputo fractional derivative and fourth-order implicit scheme, respectively. Moreover, the proposed scheme theoretical analysis (convergence and stability) is also discussed using the Fourier analysis method. Finally, some numerical test problems are presented to show the effectiveness of the proposed method.
  7. Malaysian burden of disease: years of life lost due to premature deaths
    Khaw WF, Chan YM, Nasaruddin NH, Alias N, Tan L, Ganapathy SS
    BMC Public Health, 2023 Jul 18;23(1):1383.
    PMID: 37464344 DOI: 10.1186/s12889-023-16309-z
    BACKGROUND: In Malaysia, the previous mortality burden has been a significant concern, particularly due to the high prevalence of noncommunicable diseases (NCDs) as the leading cause of death. Estimates of mortality are key indicators for monitoring population health and determining priorities in health policies and health planning. The aim of this study was to estimate the disease burden attributed to 113 major diseases and injuries in Malaysia in 2018 using years of life lost (YLL) method.

    METHODS: This study included all deaths that occurred in Malaysia in 2018. The YLL was derived by adding the number of deaths from 113 specific diseases and multiplying it by the remaining life expectancy for that age and sex group. Data on life expectancy and mortality were collected from the Department of Statistics Malaysia.

    RESULTS: In 2018, there were 3.5 million YLL in Malaysia. Group II (NCDs) caused 72.2% of total YLL. Ischaemic heart disease was the leading cause of premature mortality among Malaysians (17.7%), followed by lower respiratory infections (9.7%), road traffic injuries (8.7%), cerebrovascular disease (stroke) (8.0%), and diabetes mellitus (3.9%).

    CONCLUSIONS: NCDs are a significant health concern in Malaysia and are the primary contributor to the overall burden of disease. These results are important in guiding the national health systems on how to design and implement effective interventions for NCDs, as well as how to prioritise and allocate healthcare resources. Key strategies to consider include implementing health promotion campaigns, adopting integrated care models, and implementing policy and regulatory measures. These approaches aim to enhance health outcomes and the managements of NCDs in Malaysia.

  8. Fulltext Chronology of DIC technique based on the fundamental mathematical modeling and dehydration impact
    Alias N, Saipol HF, Ghani AC
    J Food Sci Technol, 2014 Dec;51(12):3647-57.
    PMID: 25477631 DOI: 10.1007/s13197-012-0913-7
    A chronology of mathematical models for heat and mass transfer equation is proposed for the prediction of moisture and temperature behavior during drying using DIC (Détente Instantanée Contrôlée) or instant controlled pressure drop technique. DIC technique has the potential as most commonly used dehydration method for high impact food value including the nutrition maintenance and the best possible quality for food storage. The model is governed by the regression model, followed by 2D Fick's and Fourier's parabolic equation and 2D elliptic-parabolic equation in a rectangular slice. The models neglect the effect of shrinkage and radiation effects. The simulations of heat and mass transfer equations with parabolic and elliptic-parabolic types through some numerical methods based on finite difference method (FDM) have been illustrated. Intel®Core™2Duo processors with Linux operating system and C programming language have been considered as a computational platform for the simulation. Qualitative and quantitative differences between DIC technique and the conventional drying methods have been shown as a comparative.
  9. Sectional analysis of the pollutant wash-off process based on runoff hydrograph
    Alias N, Liu A, Egodawatta P, Goonetilleke A
    J Environ Manage, 2014 Feb 15;134:63-9.
    PMID: 24463850 DOI: 10.1016/j.jenvman.2013.12.034
    The validity of using rainfall characteristics as lumped parameters for investigating the pollutant wash-off process such as first flush occurrence is questionable. This research study introduces an innovative concept of using sector parameters to investigate the relationship between the pollutant wash-off process and different sectors of the runoff hydrograph and rainfall hyetograph. The research outcomes indicated that rainfall depth and rainfall intensity are two key rainfall characteristics which influence the wash-off process compared to the antecedent dry period. Additionally, the rainfall pattern also plays a critical role in the wash-off process and is independent of the catchment characteristics. The knowledge created through this research study provides the ability to select appropriate rainfall events for stormwater quality treatment design based on the required treatment outcomes such as the need to target different sectors of the runoff hydrograph or pollutant species. The study outcomes can also contribute to enhancing stormwater quality modelling and prediction in view of the fact that conventional approaches to stormwater quality estimation is primarily based on rainfall intensity rather than considering other rainfall parameters or solely based on stochastic approaches irrespective of the characteristics of the rainfall event.
  10. Fulltext Projection of meteorological droughts in Nigeria during growing seasons under climate change scenarios
    Shiru MS, Shahid S, Dewan A, Chung ES, Alias N, Ahmed K, et al.
    Sci Rep, 2020 06 22;10(1):10107.
    PMID: 32572138 DOI: 10.1038/s41598-020-67146-8
    Like many other African countries, incidence of drought is increasing in Nigeria. In this work, spatiotemporal changes in droughts under different representative concentration pathway (RCP) scenarios were assessed; considering their greatest impacts on life and livelihoods in Nigeria, especially when droughts coincide with the growing seasons. Three entropy-based methods, namely symmetrical uncertainty, gain ratio, and entropy gain were used in a multi-criteria decision-making framework to select the best performing General Circulation Models (GCMs) for the projection of rainfall and temperature. Performance of four widely used bias correction methods was compared to identify a suitable method for correcting bias in GCM projections for the period 2010-2099. A machine learning technique was then used to generate a multi-model ensemble (MME) of the bias-corrected GCM projection for different RCP scenarios. The standardized precipitation evapotranspiration index (SPEI) was subsequently computed to estimate droughts from the MME mean of GCM projected rainfall and temperature to predict possible spatiotemporal changes in meteorological droughts. Finally, trends in the SPEI, temperature and rainfall, and return period of droughts for different growing seasons were estimated using a 50-year moving window, with a 10-year interval, to understand driving factors accountable for future changes in droughts. The analysis revealed that MRI-CGCM3, HadGEM2-ES, CSIRO-Mk3-6-0, and CESM1-CAM5 are the most appropriate GCMs for projecting rainfall and temperature, and the linear scaling (SCL) is the best method for correcting bias. The MME mean of bias-corrected GCM projections revealed an increase in rainfall in the south-south, southwest, and parts of the northwest whilst a decrease in the southeast, northeast, and parts of central Nigeria. In contrast, rise in temperature for entire country during most of the cropping seasons was projected. The results further indicated that increase in temperature would decrease the SPEI across Nigeria, which will make droughts more frequent in most of the country under all the RCPs. However, increase in drought frequency would be less for higher RCPs due to increase in rainfall.
  11. ISSR marker-assisted genetic diversity analysis of Dioscorea hispida and selection of the best variety for sustainable production
    Nudin NFH, Ali AM, Ngah N, Mazlan NZ, Mat N, Ghani MNA, et al.
    C. R. Biol., 2017 Aug;340(8):359-366.
    PMID: 28888550 DOI: 10.1016/j.crvi.2017.08.003
    Plant breeding is a way of selection of a particular individual for the production of the progeny by separating or combining desired characteristics. The objective of this study was to justify different characteristics of Dioscorea hispida (Ubi gadong) varieties using molecular techniques to select the best variety for sustainable production at the farmer's level. A total of 160 germplasms of Ubi gadong were collected from different locations at the Terengganu and Kelantan states of Malaysia. Forty eight (48) out of 160 germplasms were selected as "primary" selection based on yield and other qualitative characters. Selected collections were then grown and maintained for ISSR marker-assisted genetic diversity analysis. Overall plant growth and yield of tubers were also determined. A total of 12 ISSR markers were tested to justify the characteristics of Ubi gadong varieties among which three markers showed polymorphic bands and on average 57.3% polymorphism were observed representing the highest variation among germplasms. The ISSR marker based on UPGMA cluster analysis grouped all 48 D. hispida into 10 vital groups that proved a vast genetic variation among germplasm collections. Therefore, hybridization should be made between two distant populations. The D. hispida is already proved as the highest starch content tuber crops and very rich in vitamins with both micro and macro minerals. Considering all these criteria and results from marker-assisted diversity analysis, accessions that are far apart based on their genetic coefficient (like DH27 and DH71; DH30 and DH70; DH43 and DH62; DH45 and DH61; DH77 and DH61; DH78 and DH57) could be selected as parents for further breeding programs. This will bring about greater diversity, which will lead to high productive index in terms of increase in yield and overall quality and for the ultimate target of sustainable Ubi gadong production.
  12. On the missing links in quantum dot solar cells: a DFT study on fluorophore oxidation and reduction processes in sensitized solar cells
    Muzakir SK, Alias N, Yusoff MM, Jose R
    Phys Chem Chem Phys, 2013 Oct 14;15(38):16275-85.
    PMID: 24000052 DOI: 10.1039/c3cp52858h
    The possibility of achieving many electrons per absorbed photon of sufficient energy by quantum dots (QDs) drives the motivation to build high performance quantum dot solar cells (QDSCs). Although performance of dye-sensitized solar cells (DSCs), with similar device configuration as that of QDSCs, has significantly improved in the last two decades QDSCs are yet to demonstrate impressive device performances despite the remarkable features of QDs as light harvesters. We investigated the fundamental differences in the optical properties of QDs and dyes using DFT calculations to get insights on the inferior performance of QDSCs. The CdSe QDs and the ruthenium bipyridyl dicarboxylic acid dye (N3) were used as typical examples in this study. Based on a generalized equation of state correlating material properties and photoconversion efficiency, we calculated ground and excited state properties of these absorbers at the B3LYP/lanl2dz level of DFT and analyzed them on the basis of the device performance. Five missing links have been identified in the study which provides numerous insights into building high efficiency QDSCs. They are (i) fundamental differences in the emitting states of the QDs in the strong and weak confinement regimes were observed, which explained successfully the performance differences; (ii) the crucial role of bifunctional ligands that bind the QDs and the photo-electrode was identified; in most cases use of bifunctional ligands does not lead to a QD enabled widening of the absorption of the photo-electrode; (iii) wide QDs size distribution further hinders efficient electron injections; (iv) wide absorption cross-section of QDs favours photon harvesting; and (v) the role of redox potential of the electrolyte in the QD reduction process.
  13. Formation of grassy TiO2 nanotube thin film by anodisation in peroxide electrolyte for Cr(VI) removal under ultraviolet radiation
    Taib MAA, Alias N, Jaafar M, Razak KA, Tan WK, Shahbudin IP, et al.
    Nanotechnology, 2020 Oct 23;31(43):435605.
    PMID: 32640434 DOI: 10.1088/1361-6528/aba3d8
    Arrays of TiO2 nanotubes (TiO2 NTs) with grassy surfaces were observed on titanium foil anodised at 60 V in fluorinated ethylene glycol (EG) with added hydrogen peroxide (H2O2). The grassy surface was generated by the chemical etching and dissolution of the surface of the TiO2 NTs walls, which was accelerated by the temperature increase on the addition of H2O2 . Upon annealing at 600 °C, the grassy part of the TiO2 NTs was found to consist of mostly anatase TiO2 whereas the bottom part of the anodic oxide comprised a mixture of anatase and rutile TiO2. The TiO2 NTs were then used to reduce hexavalent chromium (Cr(VI)) under ultraviolet radiation. They exhibited a rather efficient photocatalytic effect, with 100% removal of Cr(VI) after 30 min of irradiation. The fast removal of Cr(VI) was due to the anatase dominance at the grassy part of the TiO2 NTs as well as the higher surface area the structure may have. This work provides a novel insight into the photocatalytic reduction of Cr(VI) on grassy anatase TiO2 NTs.
  14. Nanoporous anodic Nb2O5 with pore-in-pore structure formation and its application for the photoreduction of Cr(VI)
    Alias N, Hussain Z, Tan WK, Kawamura G, Muto H, Matsuda A, et al.
    Chemosphere, 2021 Nov;283:131231.
    PMID: 34144283 DOI: 10.1016/j.chemosphere.2021.131231
    An anodic film with a nanoporous structure was formed by anodizing niobium at 60 V in fluorinated ethylene glycol (fluoride-EG). After 30 min of anodization, the anodic film exhibited a "pore-in-pore" structure; that is, there were smaller pores growing inside larger pores. The as-anodized film was weakly crystalline and became orthorhombic Nb2O5 after heat treatment. The energy band gap of the annealed nanoporous Nb2O5 film was 2.9 eV. A photocatalytic reduction experiment was performed on Cr(VI) under ultraviolet (UV) radiation by immersing the nanoporous Nb2O5 photocatalyst in a Cr(VI) solution at pH 2. The reduction process was observed to be very slow; hence, ethylenediaminetetraacetic acid (EDTA) was added as an organic hole scavenger, which resulted in 100% reduction after 45 min of irradiation. The photocatalytic reduction experiment was also performed under visible light, and findings showed that complete reduction achieved after 120 min of visible light exposure.
  15. Photoreduction of Cr(VI) in wastewater by anodic nanoporous Nb2O5 formed at high anodizing voltage and electrolyte temperature
    Alias N, Hussain Z, Tan WK, Kawamura G, Muto H, Matsuda A, et al.
    Environ Sci Pollut Res Int, 2022 Aug;29(40):60600-60615.
    PMID: 35426025 DOI: 10.1007/s11356-022-20005-7
    In this study, nanoporous anodic film was produced by anodization of niobium, Nb in a fluoride ethylene glycol electrolyte. The effect of anodization voltage and electrolyte temperature was studied to find an optimum condition for circular, ordered, and uniform pore formation. The diameter of the pores was found to be larger when the applied voltage was increased from 20 to 80 V. The as-anodized porous film was also observed to comprise of nanocrystallites which formed due to high field-induced crystallization. The nanocrystallites grew into orthorhombic Nb2O5 after post-annealing treatment. The Cr(VI) photoreduction property of both the as-anodized and annealed Nb2O5 samples obtained using an optimized condition (anodization voltage: 60 V, electrolyte temperature: 70 °C) was compared. Interestingly, the as-anodized Nb2O5 film was found to display better photoreduction of Cr(VI) than annealed Nb2O5. However, in terms of stability, the annealed Nb2O5 presented high photocatalytic efficiency for each cycle whereas the as-anodized Nb2O5 showed degradation in photocatalytic performance when used continually.
  16. Multifocal mucus secreting papillary adenocarcinoma of the bile duct causing obstructive jaundice
    Khan TF, Sherazi ZA, Alias NA, Mahmood Z
    Ann Acad Med Singap, 1993 Mar;22(2):251-3.
    PMID: 8363342
    We present a 64-year-old Malay lady who had undergone a choledochoduodenostomy (CDD) two years ago for obstructive jaundice. She was admitted with jaundice and underwent ultrasonography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangio pancreatography (ERCP) and computed tomographic (CT) scanning of the liver and biliary tree. All the investigations confirmed a type IVa choledochal cyst. At operation, the grossly dilated biliary system was packed with a thick mucoid material and the mucosa of the bile ducts was visibly abnormal with scattered nodules. This mucoid material had caused occlusion of the entire biliary tree resulting in obstructive jaundice. To the best of our knowledge, this is probably the first report of obstructive jaundice caused by thick mucus. The peculiar management problems of this case and the risk of malignant change in choledochal cysts are discussed.
  17. Relationship between urinary incontinence and quality of life of older persons in Malaysia
    Taufik Ramli MH, Lodz NA, Abdul Aziz FA, Maw Pin T, Alias N, Abdul Mutalip MH, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:38-42.
    PMID: 33370861 DOI: 10.1111/ggi.14028
    AIMS: As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia.

    METHODS: This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities.

    RESULTS: Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities.

    CONCLUSION: UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

  18. Referral of epileptic patients in North East Coast of West Malaysia an area with poor MRI coverage: an analysis
    Mohamed Y, Alias NN, Shuaib IL, Tharakan J, Abdullah J, Munawir AH, et al.
    Southeast Asian J. Trop. Med. Public Health, 2006 Nov;37(6):1199-208.
    PMID: 17333778
    Advances in neuroimaging techniques, particularly Magnetic Resonance Imaging (MRI), have proved invaluable in detecting structural brain lesions in patients with epilepsy in developed countries. In Malaysia, a few electroencephalography facilities available in rural district hospitals run by trained physician assistants have Internet connections to a government neurological center in Kuala Lumpur. These facilities are more commonly available than MRI machines, which require radiological expertise and helium replacement, which may problematic in Southeast Asian countries where radiologists are found in mainly big cities or towns. We conducted a cross-sectional study over a two year period begining January 2001 on rural patients, correlating EEG reports and MRI images with a clinical diagnosis of epilepsy to set guidelines for which rural patients need to be referred to a hospital with MRI facilities. The patients referred by different hospitals without neurological services were classified as having generalized, partial or unclassified seizures based on the International Classification of Epileptic Seizures proposed by the International League Against Epilepsy (ILAE). The clinical parameters studied were seizure type, seizure frequency, status epilepticus and duration of seizure. EEG reports were reviewed for localized and generalized abnormalities and epileptiform changes. Statistical analysis was performed using logistic regression and area under the curve. The association between clinical and radiological abnormalities was evaluated for sensitivity and specificity. Twenty-six males and 18 females were evaluated. The mean age was 20.7 +/- 13.3 years. Nineteen (43.2%) had generalized seizures, 22 (50.0%) had partial seizures and 3 (6.8%) presented with unclassified seizures. The EEG was abnormal in 30 patients (20 with generalized abnormalities and 10 localized abnormalities). The MRI was abnormal in 17 patients (38.6%); the abnormalities observed were cerebral atrophy (5), hippocampal sclerosis (4), infarct/gliosis (3), cortical dysgenesis (2) and tumors (2). One patient had an arachnoid cyst in the right occipital region. Of the 17 patients with an abnormal MRI, 14 had an abnormal EEG, this difference was not statistically significant. There was no significant associaton between epileptographic changes and MRI findings (p = 0.078). EEG findings were associated with MRI findings (p = 0.004). The association between an abnormal EEG and an abnormal MRI had a specificity of 82.4%, while epileptogenic changes had a specificity of 64.7% in relation to abnormal MRI findings. This meants that those patients in rural hospitals with abnormal EEGs should be referred to a neurology center for further workup and an MRI to detect causes with an epileptic focus.
  19. Fulltext The prognostic value of early follow-up computerized tomography of the brain in adult traumatic brain injury
    Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN
    Med J Malaysia, 2006 Oct;61(4):466-73.
    PMID: 17243525 MyJurnal
    A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.
  20. A study of the factors related to intima-media thickness of the common carotid artery amongst rural middle age individuals in Hospital Universiti Sains Malaysia
    Yunus R, Ariff AR, Shuaib IL, Jelani AM, Alias NA, Abdullah J, et al.
    Southeast Asian J. Trop. Med. Public Health, 2006 Jul;37(4):806-11.
    PMID: 17121310
    There is very little data regarding the factors related to intima-media thickness (IMT) of the common carotid artery in normal individuals in those with non-insulin diabetes mellitus and perimenopausal women in Southeast Asian countries. Ultrasound imaging evaluating the carotid artery IMT in those with diabetes and those on hormone replacement therapy (HRT) was performed beginning in August 2000 for a period of nearly two years at the Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. A total of 153 participants were included. Significant differences between the women on HRT and not on HRT were IMT and systolic blood pressure. When comparing those with non-insulin dependent diabetes mellitus (NIDDM) and normal individuals, the significant differences were IMT, total cholesterol level, systolic blood pressure and diastolic blood pressure. IMT was high in those with NIDDM but not in those on HRT. Both those with NIDDM and those on HRT had associated dyslipidemia and systolic hypertension.
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