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Fulltext Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L, et al.

World J Emerg Surg, 2016;11:33.
PMID: 27429642 DOI: 10.1186/s13017-016-0089-y

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
Southeast Asian Pharmacogenomics Research Network (SEAPharm): Current Status and Perspectives

Chumnumwat S, Lu ZH, Sukasem C, Winther MD, Capule FR, Abdul Hamid AAAT, et al.

Public Health Genomics, 2019;22(3-4):132-139.
PMID: 31587001 DOI: 10.1159/000502916

Pharmacogenomics (PGx) is increasingly being recognized as a potential tool for improving the efficacy and safety of drug therapy. Therefore, several efforts have been undertaken globally to facilitate the implementation process of PGx into routine clinical practice. Part of these efforts include the formation of PGx working groups working on PGx research, synthesis, and dissemination of PGx data and creation of PGx implementation strategies. In Asia, the Southeast Asian Pharmacogenomics Research Network (SEAPharm) is established to enable and strengthen PGx research among the various PGx communities within but not limited to countries in SEA; with the ultimate goal to support PGx implementation in the region. From the perspective of SEAPharm member countries, there are several key elements essential for PGx implementation at the national level. They include pharmacovigilance database, PGx research, health economics research, dedicated laboratory to support PGx testing for both research and clinical use, structured PGx education, and supportive national health policy. The status of these essential elements is presented here to provide a broad picture of the readiness for PGx implementation among the SEAPharm member countries, and to strengthen the PGx research network and practice in this region.
Fulltext Benefit and pitfalls of newborn hearing screening

Asma A, Wan Fazlina WH, Almyzan A, Han YS, Jamilah AG, Roslin S, et al.

Med J Malaysia, 2008 Oct;63(4):293-7.
PMID: 19385487 MyJurnal

The importance of universal newborn hearing screening (UNHS) in identifying hearing-impaired infants as early as possible is already well recognized. Transient evoked otoacoustic emissions (TEOAE) have been established as a reliable method for UNHS in full term infants. This is a cross sectional study between April 2003--December 2005. Thirteen thousand five hundred and ninety eight (13,598) newborns were screened for hearing loss with portable otoacoustic emission (OAE) before discharge. The initial coverage rate during the 3 years study period was 85.9% (13,598) with 89.2% (3762), 79.0% (4480) and 90.3% (5356) for 2003, 2004 and 2005 respectively. The mean age when hearing loss was diagnosed using ABR were 3.56 months old, 3.08 months old, and 2.25 months old and 3.01 months old for 2003, 2004, 2005 respectively and it was statistically significant. The defaulter rate at the third stage during the 3 years study period was 35% (21), 15.2% (7) and 18.2% (2) for 2003, 2004 and 2005 respectively. This study showed significant improvement in initial referral rate, coverage rate and age of diagnosis. However, we need to improve on high defaulter rates.
Pediatric auricular chondrocytes gene expression analysis in monolayer culture and engineered elastic cartilage

Ruszymah BH, Lokman BS, Asma A, Munirah S, Chua K, Mazlyzam AL, et al.

Int J Pediatr Otorhinolaryngol, 2007 Aug;71(8):1225-34.
PMID: 17531328

This study was aimed at regenerating autologous elastic cartilage for future use in pediatric ear reconstruction surgery. Specific attentions were to characterize pediatric auricular chondrocyte growth in a combination culture medium and to assess the possibility of elastic cartilage regeneration using human fibrin.
Fulltext The association between GJB2 mutation and GJB6 gene in non syndromic hearing loss school children

Asma A, Ashwaq A, Norzana AG, Atmadini AM, Ruszymah BH, Saim L, et al.

Med J Malaysia, 2011 Jun;66(2):124-8.
PMID: 22106692 MyJurnal

Recently, molecular testing for GJB2 mutations has become the standard of care for the diagnosis of patients with non syndromic hearing impairment of unknown cause. The aims of this study are to determine the association between GJB2 mutation and GJB6 and to report the variation of mutations in deaf students who have heterozygous GJB2. This retrospective study was conducted at Universiti Kebangsaan Malaysia Medical Center (UKMMC). Data was collected from previous files and records from Tissue Engineering and Human Genetic Research Group Laboratory. Approval from Ethical Committee was obtained prior to the study. A total of 138 students have been screened in previous studies in UKMMC for the presence of GJB2 mutations as a cause for hearing loss. Thirty four of the 138 subjects have GJB2 mutations; 2 showed homozygous mutations whereas another 32 were heterozygous for GJB2 gene mutation. Only 31 DNA samples of students presented with sensorineural hearing loss with heterozygous mutation in GJB2 gene were included in this study. The sequencing results obtained were analyzed. The degree of hearing loss of those students with association between GJB2 mutation and GJB6 mutation will be discussed. Five out of 31 subjects (16.2%) have mutations in their GJB6 gene, suggesting a digenic inheritance of GJB2/GJB6 mutation. In total, four novel mutations were identified; E137D (n=1), R32Q (n=1), E101K (n=1) and Y156H (n=1) and one mutation deletion; 366delT (n=1). All students with association GJB2 mutation and GJB6 showed severe to profound hearing loss in both ears. Interestingly this study not detected the large deletion of 342 kb in GJB6 gene suggesting that the mutation is very rare in this region compared to certain parts of the world.
Fulltext Effects of uvulopalatopharyngoplasty: a seven year review

Aneeza WH, Marina MB, Razif MY, Azimatun NA, Asma A, Sani A

Med J Malaysia, 2011 Jun;66(2):129-32.
PMID: 22106693 MyJurnal

To review the long term outcome of Uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnoea syndrome in a tertiary referral centre. 38 records were traced where UPPP was done from July 2000 to December 2007. 14 patients were followed up for one to seven years where the Epworth sleepiness scale was scored, long term side effects documented and post operative muller's manoeuvre done. Success of UPPP is defined as a reduction in apnoea hypopnea index (AHI) more than 50%. Sixty percent (60%) were successfully treated with UPPP in the long term. Mean ESS was significantly reduced from 12 +/- 6 to 7 +/- 4. 11 out of 14 patients (78.5%) were reported to develop long term side effects of UPPP, the highest being velopharyngeal insufficiency (42.8%). In conclusion, UPPP is effective in improving symptoms of OSA in the long term. However, in view of its side effects, uvula preserving surgery should be considered as a surgical option.
Stem cell genes are poorly expressed in chondrocytes from microtic cartilage

Ishak MF, Chua KH, Asma A, Saim L, Aminuddin BS, Ruszymah BH, et al.

Int J Pediatr Otorhinolaryngol, 2011 Jun;75(6):835-40.
PMID: 21543123 DOI: 10.1016/j.ijporl.2011.03.021

This study was aimed to see the difference between chondrocytes from normal cartilage compared to chondrocytes from microtic cartilage. Specific attentions were to characterize the growth of chondrocytes in terms of cell morphology, growth profile and RT-PCR analysis.
Synovial sarcoma: a rare presentation of parapharyngeal mass

Shaariyah MM, Mazita A, Masaany M, Razif MY, Isa MR, Asma A

Chin J Cancer, 2010 Jun;29(6):631-3.
PMID: 20507738

Synovial sarcoma is a rare soft tissue sarcoma of the head and neck region involving the parapharyngeal space. The diagnosis of synovial sarcoma can be very challenging to the pathologists. We present a rare case of parapharyngeal synovial sarcoma in a young female patient who had a two-month history of left cervical intumescent mass at level II. The fine needle aspiration cytology of the mass was proved inconclusive. Transcervical excision of the mass was performed and the first case of parapharyngeal sarcoma was identified in our center by fluorescence in situ hybridization (FISH) technique. Repeat imaging revealed residual tumor. The patient successfully underwent a second excision of the residual tumor and received adjuvant radiotherapy.
Growth kinetic study on normal and microtic chondrocytes of human auricular cartilage

Ishak MF, Aminuddin BS, Asma A, Lokman BS, Ruszymah BH, Goh BS

Med J Malaysia, 2008 Jul;63 Suppl A:117-8.
PMID: 19025013

Chondrocytes were isolated from normal and microtic human auricular cartilage after ear surgery carried out at Universiti Kebangsaan Malaysia Medical Centre. Chondrocytes were cultured and expanded until passage 4. After reached confluence, cultured chondrocytes at each passage (P1, P2, P3 and P4) were harvested and assigned for growth profile analysis. There was no significant difference in cell viability between both normal and microtic samples (p = 0.84). Both samples showed no significant differences for growth profile parameters in terms of growth rate, population doubling time and total number of cell doubling, except in passage 1, where there is significant difference in cell growth rate (p = 0.004). This preliminary data has indicated that chondrocytes from microtic cartilage has the potential to be used in the reconstruction of human pinna in the future.
Tinnitus Evaluation in Type 1 Diabetes Mellitus at Tertiary Hospital Malaysia

Ameen SA, Norasyikin AW, Dina HN, Zara MNF, Tyler R, Asma A

Int Tinnitus J, 2022 Dec 01;26(2):89-94.
PMID: 36724354 DOI: 10.5935/0946-5448.20220013

OBJECTIVES: To determine the prevalence of tinnitus in Type 1 Diabetes Mellitus (T1DM) patients, to evaluate its severity and to correlate it with estimated Glomerular Filtration Rate (eGFR) as well as glycaemia control (HbA1c).
MATERIAL AND METHODS: We performed a questionnaire-based cross-sectional study at Hospital Canselor Tuanku Muhriz (HCTM) from a period of 15 months. A total of 133 T1DM patients who fulfilled our study's criteria were subjected to otoscopy examination, tuning fork test and free field voice test. The mini-Tinnitus Questionnaire (TQ) was used to assess the severity of tinnitus. We were careful to categorize the perceived duration of tinnitus.
RESULTS: The prevalence of tinnitus among T1DM patients was 24.1% (32/133 patients). Out of 32 patients, approximately 78.1% (25 patients) had a compensated level of tinnitus distress and the remaining 21.9% (7/32) had moderate tinnitus. The duration of tinnitus ranged from 2 seconds to 2 minutes, whıch was ringing and intermittent in nature. The HbA1c and estimated Glomerular Filtration Rate (eGFR) were higher in tinnitus compared to the non-tinnitus group. There was no significant correlation between the severity of tinnitus and HbA1c level or eGFR.
CONCLUSIONS: Our study concluded that tinnitus amongst T1DM patients was likely to be non-pathological in view of its short duration with minimal to no distress to the sufferers. An elevated HbA1c may increase the risk of developıng tinnitus.
Fulltext Cat Scratch Disease-A Benign Disease with Thymic Hyperplasia Mimicking Lymphoma

Leong MH, Nabillah MJ, Rizuana IH, Asma A, Kew TY, Tan GC

Diagnostics (Basel), 2023 Jul 24;13(14).
PMID: 37510201 DOI: 10.3390/diagnostics13142457

Cat scratch disease (CSD) is a benign condition caused by the inoculation of Bartonella henselae. The imaging findings are non-specific, and it is difficult to diagnose the disease via imaging. However, imaging studies help exclude other differential diagnoses in diagnostic dilemmas. We encountered a case of a 17-year-old adolescent who presented with painful neck swelling. CT showed multiple bilateral cervical lymphadenopathies with triangular soft tissue mass at the anterior mediastinum likely to be thymic hyperplasia, which is unusual in CSD and was mistaken for a lymphoproliferative disorder. Tissue diagnosis with a thorough clinical history yielded the diagnosis of cat scratch disease, and follow-up imaging showed resolution of the cervical lymphadenopathy and thymic hyperplasia.
Fulltext Surgical outcome of bone anchored hearing aid (baha) implant surgery: a 10 years experience

Asma A, Ubaidah MA, Hasan SS, Wan Fazlina WH, Lim BY, Saim L, et al.

Indian J Otolaryngol Head Neck Surg, 2013 Jul;65(3):251-4.
PMID: 24427576 DOI: 10.1007/s12070-013-0621-2

Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.
Fulltext Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE

Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, Owais AA, et al.

Nutrients, 2019 Aug 17;11(8).
PMID: 31426498 DOI: 10.3390/nu11081939

Premenstrual syndrome (PMS) is a cyclical late luteal phase disorder of the menstrual cycle whereby the daily functioning of women is affected by emotional and physical symptoms substantially interfering with their quality of life. Little is known about PMS in the United Arab Emirates (UAE). This study aimed to determine the prevalence and severity of PMS among university students in Sharjah, UAE, and clarify its associations with dietary habits, lifestyle behaviors, and anthropometric factors. A cross-sectional study was conducted on female college students at the University of Sharjah, UAE. Data were collected using self-administered questionnaires and anthropometric assessments. Descriptive statistics and multiple logistic regression analyses were performed. Participants were 300 adult university students aged 18-24 years (mean age 20.07 ± 1.53 years). In total, 95% of participants reported at least one PMS symptom during their menstrual period. The prevalence of PMS was 35.3%, with mild symptoms being the most commonly reported. Multiple regression analysis showed that smoking was associated with increased risk of reporting psychological (OR 2.5, 95% CI 1.1-5.8; p < 0.05) and behavioral symptoms (OR 2.2, 95% CI 1.0-4.9; p < 0.05), while high calorie/fat/sugar/salt foods intake was associated with increased risk of reporting physical symptoms (OR 3.2, 95% CI 1.4-7.3; p < 0.05). However, fruit consumption (OR 0.34, 95% CI 0.125-0.92; p < 0.05) was associated with a decreased risk of reporting behavioral symptoms. A high prevalence of PMS was reported among university students, with smoking and high calorie/fat/sugar/salt food consumption identified as strong risk factors for PMS.
Graphene loaded TiO2 submicron spheres scattering layer for efficient dye-sensitized solar cell

Shahid MU, Mohamed NM, Muhsan AS, Azella Zaine SN, Khatani M, Yar A, et al.

Chemosphere, 2023 Apr;321:138009.
PMID: 36731659 DOI: 10.1016/j.chemosphere.2023.138009

Dye-Sensitized Solar Cells (DSSCs) have attracted great attention due to environmentally friendly low-cost processing, excellent working ability in diffuse light, and potential to meet the power demands of future buildings due the true class of building integrated photovoltaics (BIPV). Nevertheless, DSSCs have relatively low photoconversion efficiency (PCE) due to multiple issues. Several strategies have been employed to enhance its PCE. For instance, bi-layered structure of photoelectrode i.e., mesoporous TiO2 transparent layer with top scattering layer was introduced which scatter light inside on large angles improves the harvesting ability of photoelectrode thus enhanced PCE. However, scattering layer is composed of aggregated small particles which offer sluggish electron transport due to multiple grain boundaries, consequently, unwanted recombination reaction which leads to poor PCE. This issue has been addressed for transparent layer immensely but ignored for scattering layer. Mostly for scattering layer in previous studies novel structures have been proposed to enhance scattering properties and dye adsorption only. Therefore, in this study for the first time presenting dual functional graphene/TiO2 scattering layer in which solvent exfoliated graphene is incorporated in TiO2 submicron spheres which enhanced electron transport properties, while submicron spheres scatter light effectively. Scattering and electron transport characteristics of DSSCs are thoroughly investigated with the function of graphene loading. Electrochemical impedance spectroscopy (EIS) has revealed that diffusion coefficient length and coefficient and conductivity attained maximum value at 0.01 wt%. while other important parameters such as electron lifetime and electron density in conduction band have been improved till 0.020 wt% graphene loading. However, results indicated that with 0.01 w% graphene 33% higher PCE was achieved than without scattering layer and 13% higher than scattering layer without graphene. The depraving in PCE at >0.01 wt% graphene despite of excellent electron transport improvement is attributed to the loss of diffuse reflectance and higher optical absorption by graphene.
Comparative study of ZIF-8-materials for removal of hazardous compounds using physio-chemical remediation techniques

Sarwar B, Khan AU, Aslam M, Bokhari A, Mubashir M, Alothman AA, et al.

Environ Res, 2023 Mar 01;220:115168.
PMID: 36584838 DOI: 10.1016/j.envres.2022.115168

The inherent toxicity, mutagenicity and carcinogenicity of dyes that are discharged into aquatic ecosystems, harming the health of humans and animals. ZIF-8 based composites are regarded as good adsorbents for the breakdown of dyes in order to remove or degrade them. In the course of this research, metal-organic framework materials known as ZIF-8 and its two stable composites, ZIF-8/BiCoO3 (MZBC) and ZIF-8/BiYO3 (MZBY), were produced via a hydrothermal process and solvothermal process, respectively, for the dangerous Congo red (CR) dye removal from the solution in water using adsorption method. According to the findings, the most significant amount of CR dye that could be adsorbed is onto MZBC, followed by MZBY and ZIF-8. The pseudo-second-order kinetic model was used effectively to match the data for adsorption behavior and was confirmed using the Langmuir isotherm equation. There is a possibility that the pH and amount of adsorbent might influence the adsorption behavior of the adsorbents. According to the experiment results, the technique featured an endothermic adsorption reaction that spontaneously occurred. The higher adsorption capability of MZBC is because of the large surface area. This results in strong interactions between the functional groups on the surface of MZBC and CR dye molecules. In addition to the electrostatic connection between functional group Zn-O-H on the surface of ZIF-8 in MZBC and the -NH2 or SO3 functional group areas in CR molecules, it also includes the strong π-π interaction of biphenyl rings.
Rare embryonal rhabdomyosarcoma of external acoustic canal: a case report and literature review

Eksan MS, Noorizan Y, Chew YK, Noorafidah MD, Asma A

Am J Otolaryngol, 2014 Nov-Dec;35(6):814-5.
PMID: 25128187 DOI: 10.1016/j.amjoto.2014.07.009

Embryonal rhabdomyosarcoma of external ear canal is very rare, even in the pediatric population. We report an embryonal rhabdomyosarcoma of external acoustic canal, occurring in a 12-year-old Chinese girl who presented with left ear canal mass. Wide local excision of the mass was done under local anesthesia. Histopathological examination revealed the diagnosis. She then underwent 20 cycles of radiotherapy. CECT scan post treatment showed clearance of tumor cell. Now, patient is disease free for 5 years. We believe that early diagnosis followed by complete resection of the tumor with clear margin and radiotherapy improves the prognosis of the disease.
Keratoacanthoma: an unusual nasal mass

Sazafi MS, Salina H, Asma A, Masir N, Primuharsa Putra SH

Acta Otorhinolaryngol Ital, 2013 Dec;33(6):428-30.
PMID: 24376301

We report a case of keratoacanthoma in a non-sun-exposed nasal vestibule of an 84-year-old man. He presented with a progressively growing left nasal mass that had been present for 8 months. Examination showed a non-tender protruding mass arising from medial vestibular wall of the left nostril. Histopathology indicated it was a keratoacanthoma. In an elderly patient with a history of a progressively growing mass in the nose, a differential diagnosis of malignancy should be ruled out, and histological conformation is essential. To our knowledge, only a very small number of cases of nasal vestibular keratoacanthoma have been reported.
Fulltext Congenital cholesteatoma: delayed diagnosis and its consequences

Goh BS, Faizah AR, Salina H, Asma A, Saim L

Med J Malaysia, 2010 Sep;65(3):196-8.
PMID: 21939167

This is a retrospective review of congenital cholesteatoma cases that were managed surgically. There were 5 cases. The age of presentation ranged from 5 to 18 year old. Three patients presented with complication of the disease. Three patients had intact tympanic membrane, two had perforation at the anterior superior quadrant. All patients had cholesteatoma medial to tympanic membrane. Four cases had extensive ossicular erosion with preoperative hearing worse than 40 dB. Four cases underwent canal wall down mastoid surgery and one underwent canal wall up surgery. One patient had recurrence which required revision surgery. In conclusion, congenital cholesteatoma presented late due to the silent nature of disease in its early stage. Extensive disease, ossicular destruction with risk of complication at presentation were marked in our study. Hence, more aggressive surgical intervention is recommended in the management of congenital cholesteatoma.
Therapeutic approach in managing patients with large vestibular aqueduct syndrome (LVAS)

Asma A, Anouk H, Luc VH, Brokx JP, Cila U, Van De Heyning P

Int J Pediatr Otorhinolaryngol, 2010 May;74(5):474-81.
PMID: 20189254 DOI: 10.1016/j.ijporl.2010.01.023

To discuss the clinical approach in managing patients with large vestibular aqueduct syndrome.
Fulltext Comparison of Food Choice Motives between Malay Husbands and Wives in an Urban Community

Asma A, Nawalyah AG, Rokiah MY, Mohd Nasir MT

Malays J Nutr, 2010 Apr;16(1):69-81.
PMID: 22691854 MyJurnal

The main objective of this study was to determine the motives underlying the selection of foods between husbands and wives in an urban community. Thiscross-sectional study was carried out in Bandar Baru Bangi, Selangor, Malaysia among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not on any special diet. Data were collected using the Food Choice Questionnaire (FCQ) which measured the health-related and non health related factor that influence people's food choices. It consisted of 36 items designed to assess the reported importance of nine factors: health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern. In this study, the FCQ was adapted and a new factor, religion (religious guidelines), was included. Demographic characteristics including age, occupation, education, household income and household size were also collected. Data were analysed using SPSS version 16. Results showed that 40.7% of husbands (mean age= 43.33 + 11.16 years) and 55.3% of wives (mean age= 41.28 + 10.93 years) perceived themselves as the main food shopper while 12.0% of the husbands and 85.3% of the wives perceived themselves as the main meal planner. Husbands rated religion as the most prominent factor in food choice motives with a mean average rating of 4.56 + 0.59 on a 5-point rating scale, followed by health and convenience factor. Meanwhile, the wives rated health as the most essential factor with mean average rating of 4.49 + 0.58, followed by religion and convenience factor. Sensory appeal, ethical concerns and familiarity were rated as the bottom three factors of food choice motives among these two groups. Price of foods was not considered as an important factor in making food choices for the subjects in this study. In conclusion, the husbands and wives of this urban community rated religion, health and convenience as the three most important food choice motives in food selection.

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