Displaying publications 1 - 20 of 153 in total

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  1. Balakrishnan, D., Suraini, M.S., Mahmud, R,, Ezamin, A.R., Hazman, M.N., Hariati, J.
    MyJurnal
    This paper highlights a potentially life threatening and unsuspected case of multiple small pseudoaneurysms from the thyrocervical and costocervical branch of the left subclavian artery that was spontaneously ruptured. The cause was not suspected prior to thoracic CT angiography (CTA) because the initial pre-emptive diagnosis was only trivial spontaneous hydropneumothorax which became serious after a chest tube was inserted.
  2. Ponnampalavanar S, Kukreja A, Amir A, Mahmud R
    Trop Biomed, 2020 Mar 01;37(1):24-28.
    PMID: 33612715
    Paragonimiasis is an infection caused by Paragonimus, a lung fluke and is acquired by eating raw or undercooked crustaceans containing the infective metacercariae. Herein, we report a case of paragonimiasis in a Malaysian man who presented with incidental findings from chest radiographs. Examination of his biopsied lung tissue and sputum specimen revealed Paragonimus sp. eggs, whereas stool examination showed the presence of Giardia cysts. Patient was succesfully treated with praziquantel and metronidazole respectively.
  3. Perumal S, Mahmud R, Ramanathan S
    Nat Prod Res, 2015;29(18):1766-9.
    PMID: 25571920 DOI: 10.1080/14786419.2014.999242
    Euphorbia hirta (L.) plant is traditionally used in Malaysia for the treatment of gastrointestinal, bronchial and respiratory ailments caused by nosocomial infectious agents. Bioactivity-guided fractionation of the methanol extract of the aerial parts of E. hirta and analysis using high-performance liquid chromatography have led to the isolation of two antibacterial compounds. These compounds were identified as caffeic acid (CA) and (-)-epicatechin 3-gallate (ECG) based on spectroscopic analyses and comparison with previously published data. Using broth microdilution method, both ECG and CA had demonstrated significant minimum inhibitory concentration of 15.6 and 31.3 μg/mL respectively, against Pseudomonas aeruginosa. Time-kill assessment of ECG and CA displayed bactericidal effect on P. aeruginosa cells.
  4. Perumal S, Mahmud R
    PMID: 24321370 DOI: 10.1186/1472-6882-13-346
    The frequent occurrences of antibiotic-resistant biofilm forming pathogens have become global issue since various measures that had been taken to curb the situation led to failure. Euphorbia hirta, is a well-known ethnomedicinal plant of Malaysia with diverse biological activities. This plant has been used widely in traditional medicine for the treatment of gastrointestinal, bronchial and respiratory ailments caused by infectious agents.
  5. Perumal S, Mahmud R, Ismail S
    Pharmacogn Mag, 2017 Jul;13(Suppl 2):S311-S315.
    PMID: 28808398 DOI: 10.4103/pm.pm_309_15
    BACKGROUND: The escalating dominance of resistant Pseudomonas aeruginosa strains as infectious pathogen had urged the researchers to look for alternative and complementary drugs.

    OBJECTIVE: The objective of this study is to address the biological targets and probable mechanisms of action underlying the potent antibacterial effect of the isolated compounds from Euphorbia hirta (L.) against P. aeruginosa.

    MATERIALS AND METHODS: The action mechanisms of caffeic acid (CA) and epicatechin 3-gallate (ECG) on P. aeruginosa cells were investigated by several bacterial physiological manifestations involving outer membrane permeabilization, intracellular potassium ion efflux, and nucleotide leakage.

    RESULTS: The findings revealed that ECG and CA targeted both cell wall and cytoplasmic membrane of P. aeruginosa. The cellular membrane destruction and ensuing membrane permeability perturbation of P. aeruginosa had led to the ascending access of hydrophobic antibiotics, release of potassium ions, and leakages of nucleotides.

    CONCLUSION: The overall study concludes that ECG and CA isolated from E. hirta possess remarkable anti-infective potentials which can be exploited as drug template for the development of new antibacterial agent against resistant P. aeruginosa pathogen.

    SUMMARY: Epicatechin 3-gallate (ECG) and caffeic acid (CA) exhibited remarkable bactericidal abilities by increasing the outer membrane and plasma membrane permeability of Pseudomonas aeruginosa pathogenECG and CA had facilitated the entry of hydrophobic antibiotics into P. aeruginosa by disintegrating the lipopolysaccharides layer of the outer membraneECG-induced potassium efflux with efficiency close to that obtained with cefepime suggesting mode of action through membrane disruptionBoth ECG and CA had caused consistent leakage of intracellular nucleotide content with the increase in time. Abbreviations used: ECG: Epicatechin 3-gallate; CA: Caffeic acid; E. hirta: Euphoria hirta.

  6. Yeoh TL, Mahmud R, Saim L
    Med J Malaysia, 2003 Aug;58(3):432-6.
    PMID: 14750385
    A four years review from June 1998 to June 2002 of traumatic facial nerve paralysis from temporal bone fractures that required surgical intervention is presented. The aim of this clinical presentation was to determine the current pattern of cases with traumatic facial paralysis which required surgical intervention at our center. There were six cases, of which four (66%) were longitudinal fractures, one each (17%) had transverse fracture and fracture over the lateral wall of mastoid. Hearing loss (83%) was the commonest associated clinical symptom. All cases underwent decompression via the transmastoid surgical approach. Intraoperative findings revealed oedema of facial nerve involving vertical segment and horizontal segment in three cases each respectively. Two cases had concomitant bony impingement. The facial nerve functions in four cases (66%) and one case recovered to House Brackmann grade 2 and 4, 12 months and 3 months respectively postsurgery. The case with transverse fracture remained as House Brackmann grade 5 after two years.
  7. Khammas ASA, Mahmud R
    J Med Ultrasound, 2020 10 01;29(1):26-31.
    PMID: 34084713 DOI: 10.4103/JMU.JMU_53_20
    Background: Ultrasonographic (USG) measurements of the liver length, gallbladder wall thickness (GBWT), diameters of the inferior vena cava (IVC), portal vein (PV), and pancreas are valuable and reliable in diagnosis hepatobiliary and pancreas conditions. This study is aimed to determine the normal values of liver length, GBWT, AP diameters of the IVC and PV, AP diameter of the head and body of the pancreas.

    Methods: A prospective cross-sectional study was carried out in this study. A total of the 408 participants were randomly recruited using a systematic method. According to the USG reports, the subjects who had normal USG report for liver, biliary system, and pancreas were described as normals, whereas the subjects who had hepatobiliary diseases such as fatty liver, liver cysts, hemangioma, cirrhosis, gallbladder wall thickening, acute cholecystitis, gallstones, and polyps were recorded as abnormal subjects.

    Results: Of the 408 participants with a mean of 52.6 ± 8.4 years old. Of those, 294 (72.1%) participants were normal and 114 (27.9%) subjects were reported as abnormal. More than half of the study population was males, 52.9% versus 47.1% of females. There was a significant difference of liver length, head, and body of the pancreas between genders (P = 0.004, 0.002, and P < 0.001, respectively). Moreover, the pancreatic body only was significantly correlated with age (P = 0.026). There also was a significant difference of the liver length, head, and body of the pancreas between normal and abnormal subjects (P < 0.001, P = 0.007, and P < 0.001).

    Conclusion: Liver length, diameter of the head, and body of the pancreas were significantly associated with gender and hepatobiliary diseases. In addition, only the diameter of the body of the pancreas was significantly correlated with age.

  8. Perumal S, Mahmud R, Mohamed N
    PMID: 30108657 DOI: 10.1155/2018/5713703
    Pseudomonas aeruginosa is naturally resistant to many classes of antipseudomonal antibiotics due to the species ability to easily acquire resistance. Plant-based antibacterial agent in combination with the existing antibiotic proposes an alternative treatment regimen for the eradication of resistant bacterial infections. The antibacterial effects of the isolated epicatechin 3-gallate compound from Euphorbia hirta in combination with cefepime were investigated in vitro against resistant P. aeruginosa. The fractional inhibitory concentration index of the combination was determined using checkerboard broth microdilution method. Epicatechin 3-gallate combined with cefepime had produced synergistic effect against P. aeruginosa (with average FIC index of 0.24). The MIC of epicatechin 3-gallate was effectively reduced to MIC/4, MIC/8, MIC/16, and MIC/32 in the presence of cefepime. Time-kill study of epicatechin 3-gallate combined with cefepime exhibited remarkable bactericidal activity where the eradication of P. aeruginosa occurred within 4 h of treatment. Scanning electron micrographs revealed apparent cell membrane damage and leakage of cytoplasmic contents from P. aeruginosa cells which eventually led to the cell lysis after the combination treatment of epicatechin 3-gallate and cefepime. The potential of epicatechin 3-gallate to act synergistically with cefepime against clinically resistant P. aeruginosa strain possibly will maximize the successful outcomes when choosing empirical antibiotic treatment in hospitals or health care institutions.
  9. Mahmud R, Ariffin F, Shanmuganathan P
    Korean J Fam Med, 2020 Jul;41(4):263-266.
    PMID: 32512984 DOI: 10.4082/kjfm.18.0161
    The presence of erythrocytosis along with the diagnosis of chronic obstructive pulmonary disease (COPD) may veer a primary care clinician in a busy clinic towards attributing the erythrocytosis to hypoxia secondary to COPD; however, this is not always the case. This case highlights the importance of investigation and the significance not excluding a primary cause in COPD patients with erythrocytosis. A 57-year-old male, presenting with chronic cough, was subsequently diagnosed with COPD clinically and confirmed by spirometry. Erythrocytosis was also incidentally noted. The patient did not have any symptoms of polycythemia or hepatosplenomegaly. Therefore, the erythrocytosis was initially thought to be caused by hypoxia secondary to COPD. However, the JAK2 V617F gene mutation was detected and hence the diagnosis of polycythemia vera was made. Although the erythrocytosis was initially attributed secondary to the underlying pulmonary disease, investigations proved it to be primary in origin. This case report highlights the importance of investigating the underlying cause and to confirm the diagnosis of erythrocytosis as primary and secondary polycythemia differ in their management approach. This will avoid inappropriate diagnosis, treatment, and undesirable outcomes.
  10. Long YT, Mahmud R, Sani A, Saim L
    Asian J Surg, 2002 Apr;25(2):170-4.
    PMID: 12376240
    Although the incidence of complications of otitis media that require surgical interventions has decreased substantially over the past few years, it is a prevailing condition for which clinicians should remain vigilant.
  11. Al-Qdah M, Ramli AR, Mahmud R
    Comput Biol Med, 2005 Dec;35(10):905-14.
    PMID: 16310014
    This paper uses wavelets in the detection comparison of breast cancer among the three main races in Malaysia: Chinese, Malays, and Indians followed by a system that evaluates the radiologist's findings over a period of time to gauge the radiologist's skills in confirming breast cancer cases. The db4 wavelet has been utilized to detect microcalcifications in mammogram-digitized images obtained from Malaysian women sample. The wavelet filter's detection evaluation was done by visual inspection by an expert radiologist to confirm the detection results of those pixels that corresponded to microcalcifications. Detection was counted if the wavelet-detected pixels corresponded to the radiologist's identified microcalcification pixels. After the radiologist's detection confirmation a new client-server radiologist recording and evaluation system is designed to evaluate the findings of the radiologist over some period of cancer detection working time. It is a system that records the findings of the Malaysian radiologist for the presence of breast cancer in Malaysian patients and provides a way of registering the progress of detecting breast cancer of the radiologist by tracking certain metric values such as the sensitivity, specificity, and receiver operator curve (ROC). The initial findings suggest that no single race mammograms are easier for wavelets' detections of microcalcifications and for the radiologist confirmation even though for this study the Chinese race samples detection average were a few percentages less than the other two races, namely the Malay and Indian races.
  12. Muslim A, Fong MY, Mahmud R, Sivanandam S
    Trop Biomed, 2013 Dec;30(4):727-30.
    PMID: 24522144 MyJurnal
    A case of human eye infection caused by Brugia pahangi was reported in 2010 in a semi rural village in Selangor, peninsular Malaysia. Our report here reveals results of investigation on the vector and animal host for the transmission of the infection. We conducted entomological survey and cat blood examination in the vicinity of the patient's home. The mosquito species Armigeres subalbatus was incriminated as the vector, whereas cat served as the reservoir host.
  13. Kiranda HK, Mahmud R, Abubakar D, Zakaria ZA
    Nanoscale Res Lett, 2018 Jan 02;13(1):1.
    PMID: 29299709 DOI: 10.1186/s11671-017-2411-3
    The evolution of nanomaterial in science has brought about a growing increase in nanotechnology, biomedicine, and engineering fields. This study was aimed at fabrication and characterization of conjugated gold-cockle shell-derived calcium carbonate nanoparticles (Au-CSCaCO3NPs) for biomedical application. The synthetic technique employed used gold nanoparticle citrate reduction method and a simple precipitation method coupled with mechanical use of a Programmable roller-ball mill. The synthesized conjugated nanomaterial was characterized for its physicochemical properties using transmission electron microscope (TEM), field emission scanning electron microscope (FESEM) equipped with energy dispersive X-ray (EDX) and Fourier transform infrared spectroscopy (FTIR). However, the intricacy of cellular mechanisms can prove challenging for nanomaterial like Au-CSCaCO3NPs and thus, the need for cytotoxicity assessment. The obtained spherical-shaped nanoparticles (light-green purplish) have an average diameter size of 35 ± 16 nm, high carbon and oxygen composition. The conjugated nanomaterial, also possesses a unique spectra for aragonite polymorph and carboxylic bond significantly supporting interactions between conjugated nanoparticles. The negative surface charge and spectra absorbance highlighted their stability. The resultant spherical shaped conjugated Au-CSCaCO3NPs could be a great nanomaterial for biomedical applications.
  14. Junaid OQ, Vythilingam I, Khaw LT, Sivanandam S, Mahmud R
    Parasitol Res, 2020 Apr;119(4):1301-1315.
    PMID: 32179986 DOI: 10.1007/s00436-020-06632-4
    Malaria and lymphatic filariasis (LF) are two leading and common mosquito-borne parasitic diseases worldwide. These two diseases are co-endemic in many tropical and sub-tropical regions and are known to share vectors. The interactions between malaria and filarial parasites are poorly understood. Thus, this study aimed at establishing the interactions that occur between Brugia pahangi and Plasmodium berghei ANKA (PbA) co-infection in gerbils. Briefly, the gerbils were matched according to age, sex, and weight and grouped into filarial-only infection, PbA-only infection, co-infection, and control group. The parasitemia, survival and clinical assessment of the gerbils were monitored for a period of 30 days post Plasmodium infection. The immune responses of gerbils to both mono and co-infection were monitored. Findings show that co-infected gerbils have higher survival rate than PbA-infected gerbils. Food and water consumption were significantly reduced in both PbA-infected and co-infected gerbils, although loss of body weight, hypothermia, and anemia were less severe in co-infected gerbils. Plasmodium-infected gerbils also suffered hypoglycemia, which was not observed in co-infected gerbils. Furthermore, gerbil cytokine responses to co-infection were significantly higher than PbA-only-infected gerbils, which is being suggested as a factor for their increased longevity. Co-infected gerbils had significantly elicited interleukin-4, interferon-gamma, and tumor necrotic factor at early stage of infection than PbA-infected gerbils. Findings from this study suggest that B. pahangi infection protect against severe anemia and hypoglycemia, which are manifestations of PbA infection.
  15. Tawfiq Zyoud TY, Abdul Rashid SN, Suppiah S, Abdul Rahim E, Mahmud R
    Med J Malaysia, 2020 07;75(4):411-418.
    PMID: 32724006
    INTRODUCTION: Autopsy is one of the most important approaches to identify clearly the exact cause of death, whether it was due to natural causes, sudden death, or traumatic. Various studies have been done in different countries regarding ways to improve the diagnosis during autopsy. The imaging approach is one of the methods that has been used to complement autopsy findings and to enhance the diagnosis for achieving the most accurate post-mortem diagnosis. The aim of this study is to identify the role of imaging modalities that complement routine autopsy and correlate the findings of diagnostic imaging that can help improve the accuracy of diagnosing the cause of death.

    METHODS: We sourced articles from Scopus, Ovid and PubMed databases for journal publications related to post-mortem diagnostic imaging. We highlight the most relevant full articles in English that explain the type of modality that was utilised and the added value it provided for diagnosing the cause of death.

    RESULTS: Minimally invasive autopsies assisted by imaging modalities added a great benefit to forensic medicine, and supported conventional autopsy. In particular the role of post mortem computed tomography (PMCT), post mortem computed tomography angiography (PMMR) and positron emission tomography computed tomography (PMCTA) that have incremental benefits in diagnosing traumatic death, fractures, tissue injuries, as well as the assessment of body height or weight for corpse identification.

    CONCLUSION: PMCT and PMMR, with particular emphasis on PMCTA, can provide higher accuracy than the other modalities. They can be regarded as indispensable methods that should be applied to the routine autopsy protocol, thus improving the findings and accuracy of diagnosing the cause of death.

  16. Al-Akwaa AA, Asmawi MZ, Dewa A, Mahmud R
    Heliyon, 2020 Jul;6(7):e04588.
    PMID: 32775735 DOI: 10.1016/j.heliyon.2020.e04588
    Background: Vitex pubescens has been used traditionally in hypertension treatment but not yet scientifically assessed. The objective of the study is to investigate the antihypertensive and vasorelaxant activities of V. pubescens, study its underlying pharmacological mechanisms, and identify the relevant vasoactive compounds.

    Methods: Successive extractions of V. pubescens leaf were carried out to produce petroleum ether (VPPE), chloroform (VPCE), methanol (VPME), and water (VPWE) extracts. Spontaneously hypertensive rats (SHRs) received a daily oral administration of the extracts (500 mg/kg/day; n = 6) or verapamil (15 mg/kg/day; n = 6) for 2 weeks, while the systolic and diastolic blood pressures were measured using non-invasive tail-cuff method. Vasorelaxation assays of the extracts were later conducted using phenylephrine (PE, 1 μM) pre-contracted aortic ring preparation. Mechanisms of vasorelaxation by the most potent fraction were studied using vasorelaxation assays with selected blockers/inhibitors. GC-MS was conducted to determine the active compounds.

    Results: VPPE elicited the most significant diminution in systolic and diastolic blood pressure of treated SHRs and produced the most significant vasorelaxation in the aortic rings. Vasorelaxant effects of F2-VPPE were significantly reduced in endothelium-denuded aortic rings by glibenclamide (1 μM), whereas calcium chloride and PE-induced contractions were significantly suppressed. Endothelium removal of the aortic rings or incubation with indomethacin (10 μM), atropine (1 μM), methylene blue (10 μM), propranolol (1μM) and L-NAME (10 μM) did not significantly alter F2-VPPE-induced vasorelaxation. Seven compounds were identified using GC-MS, including spathulenol.

    Conclusion: F2-VPPE exerted its endothelium-independent vasorelaxation by inhibition of vascular smooth muscle contraction induced by extracellular Ca+2 influx through trans-membrane Ca+2 channels and/or Ca+2 release from intracellular stores, and by activation of KATP channels. The vasorelaxation effects of V. pubescens could be mediated by the compound, spathulenol.

  17. Moghbel M, Mashohor S, Mahmud R, Saripan MI
    EXCLI J, 2016;15:406-23.
    PMID: 27540353 DOI: 10.17179/excli2016-402
    Segmentation of liver tumors from Computed Tomography (CT) and tumor burden analysis play an important role in the choice of therapeutic strategies for liver diseases and treatment monitoring. In this paper, a new segmentation method for liver tumors from contrast-enhanced CT imaging is proposed. As manual segmentation of tumors for liver treatment planning is both labor intensive and time-consuming, a highly accurate automatic tumor segmentation is desired. The proposed framework is fully automatic requiring no user interaction. The proposed segmentation evaluated on real-world clinical data from patients is based on a hybrid method integrating cuckoo optimization and fuzzy c-means algorithm with random walkers algorithm. The accuracy of the proposed method was validated using a clinical liver dataset containing one of the highest numbers of tumors utilized for liver tumor segmentation containing 127 tumors in total with further validation of the results by a consultant radiologist. The proposed method was able to achieve one of the highest accuracies reported in the literature for liver tumor segmentation compared to other segmentation methods with a mean overlap error of 22.78 % and dice similarity coefficient of 0.75 in 3Dircadb dataset and a mean overlap error of 15.61 % and dice similarity coefficient of 0.81 in MIDAS dataset. The proposed method was able to outperform most other tumor segmentation methods reported in the literature while representing an overlap error improvement of 6 % compared to one of the best performing automatic methods in the literature. The proposed framework was able to provide consistently accurate results considering the number of tumors and the variations in tumor contrast enhancements and tumor appearances while the tumor burden was estimated with a mean error of 0.84 % in 3Dircadb dataset.
  18. Moghbel M, Mashohor S, Mahmud R, Saripan MI
    EXCLI J, 2016;15:500-517.
    PMID: 28096782 DOI: 10.17179/excli2016-473
    Segmentation of the liver from Computed Tomography (CT) volumes plays an important role during the choice of treatment strategies for liver diseases. Despite lots of attention, liver segmentation remains a challenging task due to the lack of visible edges on most boundaries of the liver coupled with high variability of both intensity patterns and anatomical appearances with all these difficulties becoming more prominent in pathological livers. To achieve a more accurate segmentation, a random walker based framework is proposed that can segment contrast-enhanced livers CT images with great accuracy and speed. Based on the location of the right lung lobe, the liver dome is automatically detected thus eliminating the need for manual initialization. The computational requirements are further minimized utilizing rib-caged area segmentation, the liver is then extracted by utilizing random walker method. The proposed method was able to achieve one of the highest accuracies reported in the literature against a mixed healthy and pathological liver dataset compared to other segmentation methods with an overlap error of 4.47 % and dice similarity coefficient of 0.94 while it showed exceptional accuracy on segmenting the pathological livers with an overlap error of 5.95 % and dice similarity coefficient of 0.91.
  19. Junaid OQ, Wong KT, Khaw LT, Mahmud R, Vythilingam I
    Trop Biomed, 2018 Dec 01;35(4):981-998.
    PMID: 33601846
    Co-infection with multiple different parasites is a common phenomenon in both human and animals. Among parasites that frequently co-infect the same hosts, are the filarial worms and malaria parasites. Despite this, the mechanisms underlying the interactions between these parasites is still relatively unexplored with very few studies available on the resulting pathologies due to co-infection by filarial nematodes and malaria parasites. Hence, this study investigated the histopathological effect of Brugia pahangi and Plasmodium berghei ANKA (PbA) infections in gerbil host. Gerbils grouped into B. pahangi-infected, PbA-infected, B. pahangi and PbA-coinfected, and uninfected control, were necropsied at different time points of post PbA infections. Brugia pahangi infections in the gerbils were first initiated by subcutaneous inoculation of 50 infective larvae, while PbA infections were done by intraperitoneal injection of 106 parasitized red blood cells after 70 days patent period of B. pahangi. Organs such as the lungs, kidneys, spleen, heart and liver were harvested aseptically at the point of necropsy. There was significant hepatosplenomegaly observed in both PbA-infected only and coinfected gerbils. The spleen, liver and lungs were heavily pigmented. Both B. pahangi and PbA infections (mono and coinfections) resulted in pulmonary edema, while glomerulonephritis was associated with PbA infections. The presence of both parasites induced extramedullary hematopoiesis in the spleen and liver. These findings suggest that the pathologies associated with coinfected gerbils were synergistically induced by both B. pahangi and PbA infections.
  20. Ngui R, Lim YA, Traub R, Mahmud R, Mistam MS
    PLoS Negl Trop Dis, 2012;6(2):e1522.
    PMID: 22347515 DOI: 10.1371/journal.pntd.0001522
    Currently, information on species-specific hookworm infection is unavailable in Malaysia and is restricted worldwide due to limited application of molecular diagnostic tools. Given the importance of accurate identification of hookworms, this study was conducted as part of an ongoing molecular epidemiological investigation aimed at providing the first documented data on species-specific hookworm infection, associated risk factors and the role of domestic animals as reservoirs for hookworm infections in endemic communities of Malaysia.
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