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Fulltext The Brain-Gut Clinic in Hospital Universiti Sains Malaysia: Pioneering New Service to Advance Neuro-Gastroenterology and Motility in Malaysia

Lee YY, Izham N, Mohd Zulkifly MF, Mohamed Mustafar MF, Ismail AK, Mohamed Shah NFFN, et al.

Malays J Med Sci, 2023 Jun;30(3):1-7.
PMID: 37425382 DOI: 10.21315/mjms2023.30.3.1

Neurogastroenterology and motility is a new but advanced subspecialty within gasteroenterology that cater to difficult, persistent and refractory gut-brain symptoms. Hospital USM has the country's first and new state-of-the art motility lab that was recently launched on the 25 May 2023, and is covered in nationwide media. Another first is the Brain-Gut Clinic, established on the 16 November 2022. The clinic is a new concept that builds on unique multiple disciplines in relation to the gut-brain axis. It is hoped that there will be more awareness on the existence of neurogastroenterology and motility among doctors and community, and that more research can be forthcoming to reduce the disease burden.
Fulltext Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia

Nozmi N, Samsudin S, Sukeri S, Shafei MN, Wan Mohd WMZ, Idris Z, et al.

Int J Environ Res Public Health, 2018 04 06;15(4).
PMID: 29642390 DOI: 10.3390/ijerph15040693

Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew "rat-urine disease" as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (p-values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated (p-values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222-0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204-2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239-0.665), income (AOR = 1.58, 95% CI = 1.041-2.385) and education type (AOR = 3.69, 95% CI = 1.237-10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613-7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community.
Fulltext Leptospirosis and its prevention: knowledge, attitude and practice of urban community in Selangor, Malaysia

Abdullah NM, Mohammad WMZW, Shafei MN, Sukeri S, Idris Z, Arifin WN, et al.

BMC Public Health, 2019 May 22;19(1):628.
PMID: 31117995 DOI: 10.1186/s12889-019-6981-0

BACKGROUND: Leptospirosis is still endemic in Malaysia and has been prevalent in Selangor where cases have been underreported. Primarily, this was due to lack of awareness in the urban community in this region. This study determined the knowledge, attitude and preventive practice (KAP) of leptospirosis, and identified the significant predictors influencing KAP among urban community in Hulu Langat, Selangor.
METHODS: This cross-sectional study was conducted from 2015 to 2017 using validated questionnaire. Sampling methods included multistage cluster sampling, followed by simple random sampling to obtain 315 respondents. Descriptive analysis was performed to determine the KAP while χ2 and the subsequent logistic regression analysis were carried out to identify associations and predictors between variables.
RESULTS: Respondents were mainly Malaysian Bumiputra with a mean (Standard Deviation (SD)) age of 32.5 (13.0) years. Of 315 respondents, 80.3% (n = 253) had poor knowledge, 87.0% (n = 274) had good attitude, and 81.3% (n = 256) showed unacceptable practice towards leptospirosis and its prevention. Regression analysis identified age as the sole predictor influencing good knowledge (AOR 2.388; 95% CI = 1.298, 4.396; p = 0.005). Education level (AOR 2.197; 95% CI = 1.109, 4.352; p = 0.024) was also noted as the significant predictor influencing the overall practice.
CONCLUSIONS: The urban community in Selangor showed a positive attitude in waste management despite having little knowledge regarding the disease itself. The study also discovered inadequacy in preventive practice, hence marking the importance of the proper integration of knowledge and attitude into forming an acceptable practice to reduce transmission of Leptospira among urban population in Malaysia.
Fulltext Deep Brain Stimulation (DBS) for Movement Disorders: An Experience in Hospital Universiti Sains Malaysia (HUSM) Involving 12 Patients

Hooi LL, Fitzrol DN, Rajapathy SK, Chin TY, Halim SA, Kandasamy R, et al.

Malays J Med Sci, 2017 Mar;24(2):87-93.
PMID: 28894408 MyJurnal DOI: 10.21315/mjms2017.24.2.11

Deep brain stimulation (DBS) was first introduced in 1987 to the developed world. As a developing country Malaysia begun its movement disorder program by doing ablation therapy using the Radionics system. Hospital Universiti Sains Malaysia a rural based teaching hospital had to take into consideration both health economics and outcomes in the area that it was providing neurosurgical care for when it initiated its Deep Brain Stimulation program. Most of the patients were from the low to medium social economic groups and could not afford payment for a DBS implant. We concentrated our DBS services to Parkinson's disease, Tourette's Syndrome and dystonia patients who had exhausted medical therapy. The case series of these patients and their follow-up are presented in this brief communication.
Fulltext Epilepsy Surgery in Hospital Universiti Sains Malaysia: Our Experiences since 2004

Yee AS, Tharakan J, Idris Z, Bhaskar S, Halim SA, Razak SA, et al.

Malays J Med Sci, 2017 Dec;24(6):97-102.
PMID: 29379392 DOI: 10.21315/mjms2017.24.6.12

Epilepsy surgery has been performed by a few centres in Malaysia, including Hospital Universiti Sains Malaysia (HUSM). To date, a total of 15 patients have undergone epilepsy surgery in HUSM. The epilepsy surgery included anterior temporal lobectomy (ATL) with amygdalohippocampectomy (AH) and Vagal nerve stimulation (VNS). The surgical outcomes of the patients were assessed using the International League Against Epilepsy (ILAE) outcome scale. The ILAE scores for patients who underwent ATL with AH were comparatively better than those who underwent VNS. One of the patient who underwent ATL with AH and frontal lesionectomy was found to have psychosis during follow up. Epilepsy surgery has proven to be an important treatment for medically resistant epilepsy. Thus it is important to raise public awareness regarding epilepsy and its treatment.
Fulltext History of Neurosurgery in Malaysia: The Past, Present and Future

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

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

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

Idris Z, Ghani AR, Mar W, Bhaskar S, Wan Hassan WN, Tharakan J, et al.

J Clin Neurosci, 2010 Oct;17(10):1343-4.
PMID: 20620064 DOI: 10.1016/j.jocn.2010.01.054

A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulation (DBS) and developed subsequent bilateral subcortical haematomas. Additional blood tests revealed abnormalities of plasma factor XIIIA and tryptophan levels, which may be associated with Tourette syndrome. Neurosurgeons who perform DBS surgery on patients with Tourette syndrome must be aware of possible disastrous complications resulting from factor XIIIA disorders of blood haemostasis. Routine screening for this condition is not typically performed prior to surgery in these patients.
Outcome of severe traumatic brain injury: comparison of three monitoring approaches

Isa R, Wan Adnan WA, Ghazali G, Idris Z, Ghani AR, Sayuthi S, et al.

Neurosurg Focus, 2003 Dec 15;15(6):E1.
PMID: 15305837

The determination of cerebral perfusion pressure (CPP) is regarded as vital in monitoring patients with severe traumatic brain injury. Besides indicating the status of cerebral blood flow (CBF), it also reveals the status of intracranial pressure (ICP). The abnormal or suboptimal level of CPP is commonly correlated with high values of ICP and therefore with poor patient outcomes. Eighty-two patients were divided into three groups of patients receiving treatment based on CPP and CBF, ICP alone, and conservative methods during two different observation periods. The characteristics of these three groups were compared based on age, sex, time between injury and hospital arrival, Glasgow Coma Scale score, pupillary reaction to light, surgical intervention, and computerized tomography scanning findings according to the Marshall classification system. Only time between injury and arrival (p = 0.001) was statistically significant. There was a statistically significant difference in the proportions of good outcomes between the multimodality group compared with the group of patients that underwent a single intracranial-based monitoring method and the group that received no monitoring (p = 0.003) based on a disability rating scale after a follow up of 12 months. Death was the focus of outcome in this study in which the multimodality approach to monitoring had superior results.
Fulltext Quantum and Electromagnetic Fields in Our Universe and Brain: A New Perspective to Comprehend Brain Function

Idris Z, Zakaria Z, Yee AS, Fitzrol DN, Ghani ARI, Abdullah JM, et al.

Brain Sci, 2021 Apr 28;11(5).
PMID: 33925002 DOI: 10.3390/brainsci11050558

The concept of wholeness or oneness refers to not only humans, but also all of creation. Similarly, consciousness may not wholly exist inside the human brain. One consciousness could permeate the whole universe as limitless energy; thus, human consciousness can be regarded as limited or partial in character. According to the limited consciousness concept, humans perceive projected waves or wave-vortices as a waveless item. Therefore, human limited consciousness collapses the wave function or energy of particles; accordingly, we are only able to perceive them as particles. With this "limited concept", the wave-vortex or wave movement comes into review, which also seems to have a limited concept, i.e., the limited projected wave concept. Notably, this wave-vortex seems to embrace photonic light, as well as electricity and anything in between them, which gives a sense of dimension to our brain. These elements of limited projected wave-vortex and limitless energy (consciousness) may coexist inside our brain as electric (directional pilot wave) and quantum (diffused oneness of waves) brainwaves, respectively, with both of them giving rise to one brain field. Abnormality in either the electrical or the quantum field or their fusion may lead to abnormal brain function.
Fulltext Seroprevalence and distribution of leptospirosis serovars among wet market workers in northeastern, Malaysia: a cross sectional study

Rahman MHAA, Hairon SM, Hamat RA, Jamaluddin TZMT, Shafei MN, Idris N, et al.

BMC Infect Dis, 2018 Nov 14;18(1):569.
PMID: 30428852 DOI: 10.1186/s12879-018-3470-5

BACKGROUND: Leptospirosis is a zoonotic disease associated with occupations which exposed workers to environments contaminated with urine of infected animals. The objective of this study was to determine the seroprevalence of leptospirosis among wet market workers in Kelantan.
METHODS: A cross sectional study was conducted in two main wet markets in Kelantan and 232 wet market workers were randomly selected. Blood samples were analysed for microscopic agglutination test (MAT) against 20 live leptospirosis reference serovars. MAT titres of 1:100 or more were considered as seropositive.
RESULTS: It was found that the overall seroprevalence for leptospirosis among the respondents was 33.6% (95% CI = 27.5, 39.7). The samples were tested positive against serovars Melaka (IMR LEP 1), Terengganu (IMR LEP 115), Sarawak (IMR LEP 175), Copenhageni (IMR LEP 803/11), Hardjobovis (IMR LEP 27), Australis, Autumnalis, Bataviae, Canicola, Grippotyphosa, Hardjoprajitno, Icterohaemorrhagiae, Javanica, Pyrogenes, Terrasovi, Djasiman, Patoc and Pomona. The predominant serovars was Autumnalis (18.2%).
CONCLUSION: Wet markets workers were at risk for leptospirosis infection evidenced by high seroprevalence of leptospirosis in this study. Further research need to be conducted to determine factors that favours infection in this groups.
Fulltext Leptospirosis Health Intervention Module Effect on Knowledge, Attitude, Belief, and Practice among Wet Market Workers in Northeastern Malaysia: An Intervention Study

Rahman MHAA, Hairon SM, Hamat RA, Jamaluddin TZMT, Shafei MN, Idris N, et al.

Int J Environ Res Public Health, 2018 07 03;15(7).
PMID: 29970799 DOI: 10.3390/ijerph15071396

Leptospirosis is an infectious disease which can be prevented by increasing awareness and promoting preventive health behaviours among high risk groups including wet market workers. Thus, the aim of this study was to determine the effectiveness of Leptospirosis Health Intervention Program (LHIP) in improving knowledge, attitude, belief and practice towards leptospirosis among wet market workers in Kelantan. This intervention study was conducted in two main wet markets in Kelantan involving 116 participants in each control and intervention groups. The health education intervention was based on Leptospirosis Health Intervention Module. The knowledge, attitude, belief and practice scores were measured before and six weeks after the intervention to examine the effect of the program. The results showed that knowledge (p < 0.001), attitude (p = 0.001), belief (p < 0.001) and practice (p < 0.001) scores changes were significantly higher in the intervention group compared to the control group. The adjusted mean differences were 12.93 (95% CI: 8.47, 17.39) for knowledge, 5.55 (95% CI: 2.28, 8.81) for attitude, 7.21 (95% CI: 3.43, 10.99) for belief and 7.35 (95% CI: 3.64, 11.05) for practice scores. Leptospirosis Health Intervention Program was an effective health educational tools to improve awareness and preventive behaviours among risk groups such as wet market workers.
Fulltext Big Brain Data Initiative in Universiti Sains Malaysia: Challenges in Brain Mapping for Malaysia

Shekh Ibrahim SA, Hamzah N, Abdul Wahab AR, Abdullah JM, Nurul Hashimah Ahamed Hassain Malim, Sumari P, et al.

Malays J Med Sci, 2020 Jul;27(4):1-8.
PMID: 32863741 DOI: 10.21315/mjms2020.27.4.1

Universiti Sains Malaysia has started the Big Brain Data Initiative project since the last two years as brain mapping techniques have proven to be important in understanding the molecular, cellular and functional mechanisms of the brain. This Big Brain Data Initiative can be a platform for neurophysicians and neurosurgeons, psychiatrists, psychologists, cognitive neuroscientists, neurotechnologists and other researchers to improve brain mapping techniques. Data collection from a cohort of multiracial population in Malaysia is important for present and future research and finding cure for neurological and mental illness. Malaysia is one of the participant of the Global Brain Consortium (GBC) supported by the World Health Organization. This project is a part of its contribution via the third GBC goal which is influencing the policy process within and between high-income countries and low- and middle-income countries, such as pathways for fair data-sharing of multi-modal imaging data, starting with electroencephalographic data.
Examination Approach to the Dizzy and Swaying Patient

Said Mogutham NN, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S, Naesarajoo JJJ, et al.

Malays J Med Sci, 2020 Dec;27(6):89-101.
PMID: 33447137 DOI: 10.21315/mjms2020.27.6.9

Background: Dizziness is a common presenting complaint among patients in Malaysia. It is a vague term which could be associated with vertigo, imbalance, ataxia or syncope. In order to deal with this overwhelming complaint, a detailed history-taking is essential in confirming aetiology of disease and this should be followed by a meticulous clinical examination. The purpose of the video manuscript it to provide a step-by-step approach to a dizzy and swaying patient, specially catered for Malaysian medical students and trainees.
Methods: A series of videos were shot, which involved the eye, ear, vestibular system, cerebellar, proprioceptive sense and gait examination. These videos, conducted in Universiti Sains Malaysia (USM) School of Medical Sciences, will be first in Malaysia and will highlight the proper technique and rapport with patients and essential points of each examination. There will be summary at the end of each examination on how to report findings which is a common weakness among students.
Conclusion: We hope that students and junior doctors could be apply these methods in their daily assessment of dizzy patients and ultimately, reach an accurate diagnosis.
Fulltext The Effect of 4-hydroxybenzaldehyde on the γ-aminobutyric Acid Type A Receptor

Zhang J, Mohamad H, Wong JH, Bilal M, Ismail AHB, Lloyd AJ, et al.

Malays J Med Sci, 2017 Mar;24(2):94-99.
PMID: 28894409 DOI: 10.21315/mjms2017.24.2.12

The α1β2γ2 subtype of GABAA receptors is the most commonly found GABAA receptor subtype in the mammalian cortex and hippocampus. It is expressed heterologously in the Xenopus laevis oocyte as a α1β2γ2S/L subtype for application as an in vitro model for the screening of compounds that modulate receptor activities. In fact, 4-hydroxybenzaldehyde (4-HB) has been identified as one of the major components in Dendrocalamus asper bamboo shoots in our previous study, and the current study showed that at 101.7 μM, 4-HB significantly reduced the GABA-induced chloride current of GABAA receptors expressed on Xenopus oocytes, indicating a possible GABAergic antagonistic effect at high concentrations.
Mouse model of intracerebellar haemorrhage

Tijjani Salihu A, Muthuraju S, Aziz Mohamed Yusoff A, Ahmad F, Zulkifli Mustafa M, Jaafar H, et al.

Behav Brain Res, 2016 10 01;312:374-84.
PMID: 27327104 DOI: 10.1016/j.bbr.2016.06.034

The present study aimed to investigate the behavior and neuronal morphological changes in the perihaemorrhagic tissue of the mouse intracerebellar haemorrhage experimental model. Adult male Swiss albino mice were stereotactically infused with collagenase type VII (0.4U/μl of saline) unilaterally in to the cerebellum, following anaesthesia. Motor deficits were assessed using open field and composite score for evaluating the mouse model of cerebellar ataxia at 1, 3, 7, 14 and 21 days after collagenase infusion. The animals were sacrificed at the same time interval for evaluation of perihaematomal neuronal degeneration using haematoxylin and eosin staining and Annexin V-FITC/Propidium iodide assay. At the end of the study, it was found that infusion of 0.4U collagenase produces significant locomotor and ataxic deficit in the mice especially within the first week post surgery, and that this gradually improved within three weeks. Neuronal degeneration evident by cytoplasmic shrinkage and nuclear pyknosis was observed at the perihaematomal area after one day; especially at 3 and 7 days post haemorrhage. By 21 days, both the haematoma and degenerating neurons in the perihaematomal area were phagocytosed and the remaining neuronal cells around the scar tissue appeared normal. Moreover, Annexin-V/propidium iodide-positive cells were observed at the perihaematomal area at 3 and 7 days implying that the neurons likely die via apoptosis. It was concluded that a population of potentially salvageable neurons exist in the perihaematomal area after cerebellar haemorrhage throughout a wide time window that could be amenable to treatment.
Fulltext A qualitative exploration of the misconceptions, knowledge gaps and constructs of leptospirosis among rural and urban communities in Malaysia

Sukeri S, Idris Z, Zahiruddin WM, Shafei MN, Idris N, Hamat RA, et al.

PLoS One, 2018;13(7):e0200871.
PMID: 30021013 DOI: 10.1371/journal.pone.0200871

This qualitative study aimed to explore the misconceptions, knowledge gaps and constructs of leptospirosis among 72 respondents from rural and urban districts in two states of Malaysia. We conducted focus group discussions and data were examined using thematic analyses. The layman term of 'rat urine disease' contributed the most to the misconceptions regarding leptospirosis. There were gaps in the knowledge among urban and rural respondents in the two states, with the majority of subjects demonstrating a poor understanding of the disease. Construction of knowledge about leptospirosis relied mostly on the information provided by mass and social media; reading materials; word-of-mouth publicity; observations; experiences; and knowledge sharing among families, friends, and communities. The study findings may provide the foundation for the development of educational materials that may reduce the gaps in knowledge, and thereby improve health literacy and enhance preventive health behaviours for avoiding leptospirosis.
Role of toll-like receptor 4 antagonist Lipopolysaccharide-Rhodobacter sphaeroides on acute stress-induced voluntary ethanol preference and drinking behaviour: In vivo Swiss Albino mouse model

Chuang HG, Aziz NHA, Wong JH, Mustapha M, Abdullah JM, Idris Z, et al.

Eur Neuropsychopharmacol, 2021 04;45:59-72.
PMID: 32014377 DOI: 10.1016/j.euroneuro.2019.12.121

The present study focused on investigating the effect of toll-like receptor 4 (TLR4) antagonist Lipopolysaccharide-Rhodobacter sphaeroides(LPS-RS) on acute, stress-induced voluntary ethanol preference and drinking behaviour, neuronal components activation, and gene expression associated with stress and addictive behaviour. This study involved the exposure of restraint stress and social isolation using Swiss Albino mice. Two-bottle choice ethanol preference analysis was used in the evaluation of voluntary ethanol seeking and drinking behaviour. Several behavioural assessments were carried out to assess fear and anxiety-like behaviour, neuromuscular ability, motor coordination and locomotion. Morphological and immunoreactivity analysis and gene expression analysis were done after the completion of behavioural assessments. TLR4 antagonist LPS-RS treated stressed-mice showed a significant decrease in ethanol drinking compared with stressed mice. Behavioural results showed that stress exposure induced fear and anxiety-like behaviour; however; no significant deficit was found on motor coordination, neuromuscular ability, locomotion and exploratory behaviour among groups. Morphological analysis showed no significant change in the prefrontal cortex and hippocampus among all groups, while immunoreactivity analysis showed higher expression of c-Fos in prefrontal cortex and hippocampus, higher TLR4 expression in the prefrontal cortex and glial fibrillary acidic protein (GFAP) in hippocampus among stressed-animals. Stressed-mice also showed significant increase in TLR4, Nuclear Factor-Kappa B (NF-kB), inducible nitric oxide synthase (iNOS), dopamine receptor D2 (DRD2), cyclic adenosine monophosphate (cAMP) response element binding protein-1 (CREB-1) and opioid receptor MU-1 (OPRM-1) genes expression compared with control and LPS-RS treated stressed-mice. As a conclusion, the antagonism of TLR4 could provide therapeutic value in the treatment of stress-induced addiction.
Big Brain Data Initiatives in Universiti Sains Malaysia: Data Stewardship to Data Repository and Data Sharing

Hamzah N, Malim NHAH, Abdullah JM, Sumari P, Mokhtar AM, Rosli SNS, et al.

Neuroinformatics, 2023 Jul;21(3):589-600.
PMID: 37344699 DOI: 10.1007/s12021-023-09637-3

The sharing of open-access neuroimaging data has increased significantly during the last few years. Sharing neuroimaging data is crucial to accelerating scientific advancement, particularly in the field of neuroscience. A number of big initiatives that will increase the amount of available neuroimaging data are currently in development. The Big Brain Data Initiative project was started by Universiti Sains Malaysia as the first neuroimaging data repository platform in Malaysia for the purpose of data sharing. In order to ensure that the neuroimaging data in this project is accessible, usable, and secure, as well as to offer users high-quality data that can be consistently accessed, we first came up with good data stewardship practices. Then, we developed MyneuroDB, an online repository database system for data sharing purposes. Here, we describe the Big Brain Data Initiative and MyneuroDB, a data repository that provides the ability to openly share neuroimaging data, currently including magnetic resonance imaging (MRI), electroencephalography (EEG), and magnetoencephalography (MEG), following the FAIR principles for data sharing.
Detection of somatic mutations in the mitochondrial DNA control region D-loop in brain tumors: The first report in Malaysian patients

Mohamed Yusoff AA, Mohd Nasir KN, Haris K, Mohd Khair SZN, Abdul Ghani ARI, Idris Z, et al.

Oncol Lett, 2017 Nov;14(5):5179-5188.
PMID: 29098023 DOI: 10.3892/ol.2017.6851

Although the role of nuclear-encoded gene alterations has been well documented in brain tumor development, the involvement of the mitochondrial genome in brain tumorigenesis has not yet been fully elucidated and remains controversial. The present study aimed to identify mutations in the mitochondrial DNA (mtDNA) control region D-loop in patients with brain tumors in Malaysia. A mutation analysis was performed in which DNA was extracted from paired tumor tissue and blood samples obtained from 49 patients with brain tumors. The D-loop region DNA was amplified using the PCR technique, and genetic data from DNA sequencing analyses were compared with the published revised Cambridge sequence to identify somatic mutations. Among the 49 brain tumor tissue samples evaluated, 25 cases (51%) had somatic mutations of the mtDNA D-loop, with a total of 48 mutations. Novel mutations that had not previously been identified in the D-loop region (176 A-deletion, 476 C>A, 566 C>A and 16405 A-deletion) were also classified. No significant associations between the D-loop mutation status and the clinicopathological parameters were observed. To the best of our knowledge, the current study presents the first evidence of alterations in the mtDNA D-loop regions in the brain tumors of Malaysian patients. These results may provide an overview and data regarding the incidence of mitochondrial genome alterations in Malaysian patients with brain tumors. In addition to nuclear genome aberrations, these specific mitochondrial genome alterations may also be considered as potential cancer biomarkers for the diagnosis and staging of brain cancers.
Deep Tendon Reflex: The Tools and Techniques. What Surgical Neurology Residents Should Know

Lin-Wei O, Xian LLS, Shen VTW, Chuan CY, Halim SA, Ghani ARI, et al.

Malays J Med Sci, 2021 Apr;28(2):48-62.
PMID: 33958960 DOI: 10.21315/mjms2021.28.2.5

The deep tendon reflex (DTR) is a key component of the neurological examination. However, interpretation of the results is a challenge since there is a lack of knowledge on the important features of reflex responses such as the amount of hammer force, the strength of contraction, duration of the contraction and relaxation. The tools used to elicit the reflexes also play a role in the quality of the reflex contraction. Furthermore, improper execution techniques during the DTR assessment may alter the findings and cloud the true assessment of the nervous system. Therefore, understanding the basic principles and the key features of DTR allows for better interpretation of the reflex responses. This paper discusses the brief history of reflexes, the development of the reflex hammer, and also the key features of a reflex response encompassing the amplitude of force needed to elicit a reflex response, the velocity of contraction, the strength of contraction, and the duration of contraction and relaxation phases. The final section encloses the techniques of eliciting DTR in the upper extremities, trunk, and lower extremities, and the interpretation of these reflexes.

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