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Fulltext Low-dose intrapleural alteplase (without deoxyribonuclease) in complicated parapneumonic effusion: case series and literature reviews

Lai C, Mohammad N, Hassan TM, Abdul Hamid MF

BMJ Case Rep, 2017 Sep 11;2017.
PMID: 28893806 DOI: 10.1136/bcr-2017-221239

This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions. We made the decisions for intrapleural fibrinolytic therapy using low-dose alteplase 2.5 mg each time, in view of the elderly patient as sacrosanct for risk of bleeding. Furthermore, DNase was not used, as it is not yet available in our setting. Both of our patients had good clinical and radiological outcomes, without the need for surgical interventions.
Fulltext Study of heavy metal levels among farmers of Muda Agricultural Development Authority, Malaysia

Ghazali AR, Abdul Razak NE, Othman MS, Othman H, Ishak I, Lubis SH, et al.

J Environ Public Health, 2012;2012:758349.
PMID: 22536276 DOI: 10.1155/2012/758349

Heavy metals, particularly cadmium, lead, and arsenic, constitute a significant potential threat to human health. This study was conducted to determine the levels of cadmium, lead, and arsenic in nail samples from farmers at Muda Agricultural Development Authority (MADA), Kedah, Malaysia, and evaluate factors that can contribute to their accumulations. A total of 116 farmers participated in this study. Inductively coupled plasma mass spectrometry (ICP-MS) was used to analyze concentration of heavy metals in the nail samples and questionnaires were given to participants to get demographic, health status, and their agricultural activities data. In this paper, the level of heavy metals was within the normal range and varies according to demographic factors. We found that there were significant correlations between working period with level of lead and arsenic (r=0.315 and r=0.242, resp., P<0.01) and age with lead level (r=0.175, P<0.05). Our findings suggested that agricultural activities could contribute to the accumulation of heavy metals in farmers. Hence, the control of environmental levels of and human exposure to these metals to prevent adverse health effects is still an important public health issue.
Fulltext ArASL: Arabic Alphabets Sign Language Dataset

Latif G, Mohammad N, Alghazo J, AlKhalaf R, AlKhalaf R

Data Brief, 2019 Apr;23:103777.
PMID: 31372425 DOI: 10.1016/j.dib.2019.103777

A fully-labelled dataset of Arabic Sign Language (ArSL) images is developed for research related to sign language recognition. The dataset will provide researcher the opportunity to investigate and develop automated systems for the deaf and hard of hearing people using machine learning, computer vision and deep learning algorithms. The contribution is a large fully-labelled dataset for Arabic Sign Language (ArSL) which is made publically available and free for all researchers. The dataset which is named ArSL2018 consists of 54,049 images for the 32 Arabic sign language sign and alphabets collected from 40 participants in different age groups. Different dimensions and different variations were present in images which can be cleared using pre-processing techniques to remove noise, center the image, etc. The dataset is made available publicly at https://data.mendeley.com/datasets/y7pckrw6z2/1.
Fulltext An Evaluation on Deep Caries Removal Method and Management Performed by Undergraduate Dental Students: A Malaysia Experience

Othman NI, Ismail HU, Mohammad N, Ghazali N, Alauddin MS

Eur J Dent, 2021 May;15(2):281-289.
PMID: 33368068 DOI: 10.1055/s-0040-1721546

OBJECTIVES: The aim of this study was to investigate the current knowledge and attitude of deep caries removal method among dental students in Malaysia.
MATERIALS AND METHODS: A total of 303 students (n = 303) responded to the online questionnaire. The first part of questionnaire was to evaluate the demographic data of the respondents and focused on the technique and management approach used for deep caries lesion. The second part investigated the preferred treatment used for deep caries based on the designated clinical case, while the third part assessed the factors that affected the decision on deep caries management.
STATISTICAL ANALYSIS: Independent t-test was used to compare difference between the two groups.
RESULTS: Seventy four percent of the students have the knowledge of the different methods of caries removal, while 25.8% were only familiar with complete caries removal. The preferred method for deep caries removal in permanent teeth was partial caries removal (53%). For primary dentition, 45.6% of the students prefer to perform pulpotomy as compared with other techniques. There was no significant difference in caries removal method for permanent teeth between undergraduate year of study (p > 0.05), which was partial caries removal at 52.7 and 53.5%, respectively. For primary dentition, the preferred caries removal method was pulpotomy for year 4 (39.8%) and year 5 (52%) students. The popular material to restore deep caries was resin composite (42%) followed by glass ionomer cement (23.3%).
CONCLUSIONS: This study showed that partial caries removal was the preferred method despite partial understanding on the identification of the clinical indicators of the technique.
Multiclass tumor identification using combined texture and statistical features

Latif G, Bashar A, Awang Iskandar DNF, Mohammad N, Brahim GB, Alghazo JM

Med Biol Eng Comput, 2023 Jan;61(1):45-59.
PMID: 36323980 DOI: 10.1007/s11517-022-02687-w

Early detection and diagnosis of brain tumors are essential for early intervention and eventually successful treatment plans leading to either a full recovery or an increase in the patient lifespan. However, diagnosis of brain tumors is not an easy task since it requires highly skilled professionals, making this procedure both costly and time-consuming. The diagnosis process relying on MR images gets even harder in the presence of similar objects in terms of their density, size, and shape. No matter how skilled professionals are, their task is still prone to human error. The main aim of this work is to propose a system that can automatically classify and diagnose glioma brain tumors into one of the four tumor types: (1) necrosis, (2) edema, (3) enhancing, and (4) non-enhancing. In this paper, we propose a combined texture discrete wavelet transform (DWT) and statistical features based on the first- and second-order features for the accurate classification and diagnosis of multiclass glioma tumors. Four well-known classifiers, namely, support vector machines (SVM), random forest (RF), multilayer perceptron (MLP), and naïve Bayes (NB), are used for classification. The BraTS 2018 dataset is used for the experiments, and with the combined DWT and statistical features, the RF classifier achieved the highest average accuracy whether for separated modalities or combined modalities. The highest average accuracy of 89.59% and 90.28% for HGG and LGG, respectively, was reported in this paper. It has also been observed that the proposed method outperforms similar existing methods reported in the extant literature.
Fulltext Functional and Bioactive Properties of Wheat Protein Fractions: Impact of Digestive Enzymes on Antioxidant, α-Amylase, and Angiotensin-Converting Enzyme Inhibition Potential

Gammoh S, Alu'datt MH, Alhamad MN, Tranchant CC, Rababah T, Al-U'datt D, et al.

Molecules, 2023 Aug 11;28(16).
PMID: 37630264 DOI: 10.3390/molecules28166012

This research aimed to determine the biofunctional properties of wheat flour (WF) protein fractions and modifications to the antioxidant, anti-α-amylase and anti-angiotensin-I converting enzyme (ACE) activities induced by the action of digestive endopeptidases in vitro. A molecular characterization of the most abundant protein fractions, i.e., albumins, glutelins-1, glutelins-2 and prolamins, showed that low- and high-MW polypeptides rich in cysteine, glutamic acid and leucine were present in albumins and glutelins, whereas low-MW subunits with a high proportion of polar amino acids prevailed in prolamins. Prolamins exhibited the second-highest water holding capacity (54%) after WF (84%), while albumins provided superior foam stability (76%). Prolamins, glutenins-1 and globulins demonstrated the highest antioxidant activity (up to 95%, 68% and 59%, respectively) both before and after hydrolysis with pepsin (P-H) or trypsin-chymotrypsin (TC-H). Prolamins, globulins and WF strongly inhibited α-amylase (>90%) before and after TC-H, and before P-H (55-71%). Moreover, P-H significantly increased α-amylase inhibition by albumins from 53 to 74%. The fractions with strong ACE inhibitory activity (70-89%) included prolamins and globulins after TC-H or P-H, as well as globulins before TC-H and WF before P-H. This novel evidence indicates that WF protein fractions and their peptide-enriched P and TC hydrolysates are excellent sources of multifunctional bioactives with antioxidant, antihyperglycemic and antihypertensive potential.
Subtype distribution of Blastocystis isolated from humans and associated animals in an indigenous community with poor hygiene in Peninsular Malaysia

Mohammad NA, Al-Mekhlafi HM, Anuar TS

Trop Biomed, 2018 Dec 01;35(4):849-860.
PMID: 33601835

Blastocystis is one of the most common parasites inhabiting the intestinal tract of human and animals. Currently, human Blastocystis isolates are classified into nine subtypes (STs) based on the phylogeny of their small subunit ribosomal RNA (SSU rRNA) gene. Although its pathogenicity remains controversial, the possibility of zoonotic transmission was recognized since eight of the nine STs (except for ST9) have been reported in both humans and animals. A cross-sectional study was conducted to determine the prevalence and subtype distribution of Blastocystis isolated from humans and associated animals in an indigenous community with poor hygiene in Malaysia, where the risk of parasitic infection is high. A total of 275 stool samples were collected, subjected to DNA extraction and amplified by PCR assay. The Blastocystis-positive amplicons were then purified and sequenced. Phylogenetic tree of positive isolates, reference strains and outgroup were constructed using maximum likelihood method based on Hasegawa-KishinoYano+G+I model. The prevalence of Blastocystis infection among humans and domestic animals by PCR assay were 18.5% (45/243) and 6.3% (2/32), respectively. Through molecular phylogeny, 47 isolates were separated into five clusters containing isolates from both hosts. Among human isolates, ST3 (53.3%) was the predominant subtype, followed by ST1 (31.1%) and ST2 (15.6%). Chicken and cattle had lower proportions of ST6 (50%) and ST10 (50%), that were barely seen in humans. The distinct distributions of the most important STs among the host animals as well as humans examined demonstrate that there is various host-specific subtypes in the lifecycle of Blastocystis.
Fulltext 2D nanostructures: Potential in diagnosis and treatment of Alzheimer's disease

Tufail S, Sherwani MA, Shamim Z, Abdullah, Goh KW, Alomary MN, et al.

Biomed Pharmacother, 2024 Jan;170:116070.
PMID: 38163396 DOI: 10.1016/j.biopha.2023.116070

Two-dimensional (2D) nanomaterials have garnered enormous attention seemingly due to their unusual architecture and properties. Graphene and graphene oxide based 2D nanomaterials remained the most sought after for several years but the quest to design superior 2D nanomaterials which can find wider application gave rise to development of non-graphene 2D materials as well. Consequently, in addition to graphene based 2D nanomaterials, 2D nanostructures designed using macromolecules (such as DNAs, proteins, peptides and peptoids), transition metal dichalcogenides, transition-metal carbides and/or nitrides (MXene), black phosphorous, chitosan, hexagonal boron nitrides, and graphitic carbon nitride, and covalent organic frameworks have been developed. Interestingly, these 2D nanomaterials have found applications in diagnosis and treatment of various diseases including Alzheimer's disease (AD). Although AD is one of the most debilitating neurodegenerative conditions across the globe; unfortunately, there remains a paucity of effective diagnostic and/or therapeutic intervention for it till date. In this scenario, nanomaterial-based biosensors, or therapeutics especially 2D nanostructures are emerging to be promising in this regard. This review summarizes the diagnostic and therapeutic platforms developed for AD using 2D nanostructures. Collectively, it is worth mentioning that these 2D nanomaterials would seemingly provide an alternative and intriguing platform for biomedical interventions.
Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC)

Abdullah BJ, Mohammad N, Sangkar JV, Abd Aziz YF, Gan GG, Goh KY, et al.

Br J Radiol, 2005 Jul;78(931):596-600.
PMID: 15961840

The objective of this study was to prospectively determine the incidence of venous thrombosis (VT) in the upper limbs in patients with peripherally inserted central catheters (PICC). We prospectively investigated the incidence of VT in the upper limbs of 26 patients who had PICC inserted. The inclusion criteria were all patients who had a PICC inserted, whilst the exclusion criterion was the inability to perform a venogram (allergies, previous contrast medium reaction and inability of gaining venous access). Both valved and non-valved catheters were evaluated. Prior to removal of the PICC, an upper limb venogram was performed. The number of segments involved with VT were determined. The duration of central venous catheterization was classified as; less than 6 days, between 6 days and 14 days and more than 14 days. VT was confirmed in 38.5% (10/26) of the patients. The majority 85.7% (12/14) were complete occlusive thrombi and the majority of VT only involved one segment. There was no statistical correlation between the site of insertion of the PICC and the location of VT. Neither was there any observed correlation between the occurrence of VT with the patient's history of hypertension, hypercholesterolaemia, coronary artery disease, diabetes mellitus, cardiac insufficiency, smoking or cancer. There was also no statistical correlation with the size of the catheter. In conclusion, PICCs are associated with a significant risk of upper extremity deep vein thrombosis (UEVT).
Application of a new system for classifying root canal morphology in undergraduate teaching and clinical practice: a national survey in Malaysia

Ahmed HMA, Che Ab Aziz ZA, Azami NH, Farook MS, Khan AA, Mohd Noor NS, et al.

Int Endod J, 2020 Jun;53(6):871-879.
PMID: 32003029 DOI: 10.1111/iej.13271

AIM: To evaluate and compare the feedback of final year undergraduate dental students in eight Malaysian dental schools on the application of a new system for classifying root canal morphology in teaching and clinical practice.
METHODS: One PowerPoint presentation describing two classification systems for root canal morphology (Oral Surgery Oral Medicine Oral Pathology, 1974 38, 456 and its supplemental configurations, International Endodontic Journal 2017, 50, 761) was delivered to final year undergraduate dental students in eight dental schools in Malaysia by two presenters (each presented to four schools). To examine students' feedback on the utility of each system, printed questionnaires consisting of six questions (five multiple choice questions and one open-ended question) were distributed and collected after the lecture. The questionnaire was designed to compare the classification systems in terms of accuracy, practicability, understanding of root canal morphology and recommendation for use in pre-clinical and clinical courses. The exact test was used for statistical analysis, with the level of significance set at 0.05 (P = 0.05).
RESULTS: A total of 382 (out of 447) students participated giving a response rate of 86%. More than 90% of students reported that the new system was more accurate and more practical compared with the Vertucci system (P 0.05). The students' responses for all questions were almost similar for both presenters (P > 0.05).
CONCLUSIONS: The new system of International Endodontic Journal 2017, 50, 761 for classifying root and canal morphology was favoured by final year undergraduate dental students in Malaysia. The new system has the potential to be included in the undergraduate endodontic curriculum for teaching courses related to root and canal morphology.
Fulltext Rationalizations and identity conflict following smoking relapse: a thematic analysis

Wee LH, Binti Ithnin AA, West R, Mohammad N, Chan CM, Hasan Nudin SS

J Subst Use, 2017 Jan 02;22(1):47-52.
PMID: 28217031 DOI: 10.3109/14659891.2016.1143045

Introduction: Little is known about how smokers respond cognitively and emotionally to the experience of "late" relapse after the acute withdrawal phase. This study assessed the kinds of thoughts and feelings that emerge in order to provide a basis for quantitative research assessing prevalence of different types of response and implications for future quit attempts. Methods: Face-to-face in-depth interviews were conducted among 14 people attending a quit smoking clinic in Malaysia who had relapsed after at least 6 weeks of abstinence. Transcripts were analyzed using thematic analysis to enable emergence of important aspects of the experience. Results: Following relapse, smokers often engaged in rationalizations and activities to minimize worry about the harmful effects of smoking by switching to a lower-tar cigarette, reducing the number of cigarette smoked, attempting to reduce cigarette smoke inhalation, comparing themselves with other smokers, and minimizing the health risks associated with smoking. In some cases, smokers retained a "non-smoker" identity despite having relapsed. Conclusion: Smoking relapsers rationalize their failure to quit and minimize their health risk in order to protect their image as non-smokers while it remains a source of identity conflict.
Study site: Quit Smoking Clinic, Hospital Tengku Ampuan Rahimah, Selangor, Malaysia
Fulltext Annual Southeast Asia haze increases respiratory admissions: A 2-year large single institution experience

Ming CR, Ban Yu-Lin A, Abdul Hamid MF, Latif MT, Mohammad N, Hassan T

Respirology, 2018 10;23(10):914-920.
PMID: 29923364 DOI: 10.1111/resp.13325

BACKGROUND AND OBJECTIVE: The Southeast Asia (SEA) haze is an annual problem and at its worst could produce respirable particles of concentrations up to 500 μg/m3 which is five times the level considered as 'unhealthy'. However, there are limited reports examining the direct clinical impact of the annual haze. This study examines the effects of the SEA haze on respiratory admissions.
METHODS: Data from all respiratory admissions in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from 1st January 2014 to 31st December 2015 were collected retrospectively from chart and electronic database. A total of 16 weeks of haze period had been formally dated by the Department of Environment using the definition of weather phenomenon leading to atmospheric visibility of less than 10 km. Multivariable regression analyses were performed to estimate rate ratios and 95% CI.
RESULTS: There were 1968 subjects admitted for respiratory admissions in UKMMC during the study period. Incidence rates per week were significantly different between the two groups with 27.6 ± 9.2 cases per week during the haze versus 15.7 ± 6.7 cases per week during the non-haze period (P < 0.01). A total of 4% versus 2% was admitted to the intensive care unit in the haze and the non-haze groups, respectively (P = 0.02). The mean ± SD lengths of stay was 12.1 ± 5.2 days; the haze group had a longer stay (18.2 ± 9.7 days) compared to the non-haze groups (9.7 ± 3.9) (P < 0.001).
CONCLUSION: The annual SEA haze is associated with increased respiratory admissions.
Fulltext Deep vein thrombosis as a rare presentation in a female with anti-neutrophil cytoplasmic antibodies-associated vasculitis

Wan Ghazali WS, Mohammad N, Ismail AM

Arch Rheumatol, 2017 Jun;32(2):171-174.
PMID: 30375559 DOI: 10.5606/ArchRheumatol.2017.6108

This article aims to report a case of a young female patient with anti-neutrophil cytoplasmic antibodies-associated vasculitis complicated with pulmonary renal syndrome, multiple relapses, and who later developed venous thromboembolism. Pulmonary renal syndrome is a well- recognized and lethal complication; however, incidence of venous thromboembolism has not been well-described. In this article, we described a 38-year-old Malay female patient admitted in 2008 with three-month history of peripheral neuropathy of lower limbs and right ankle ulcers. Initial inflammatory markers were high and perinuclear Anti-Neutrophil Cytoplasmic Antibodies were positive. She was diagnosed as anti-neutrophil cytoplasmic antibodies-associated vasculitis and started on intravenous methylprednisolone with methotrexate. She presented with relapse of skin vasculitis complicated with pulmonary renal syndrome after being stable for one year. She was intubated and proceeded with plasmapheresis and hemodialysis. She completed six cycles of cyclophosphamide. Renal biopsy revealed chronic changes consistent with end stage renal disease. She further relapsed in 2011 with nasal blockage, epistaxis, and nasal deviation. Chest X-ray revealed lung nodules. Prednisolone was increased, her symptoms settled, and she was discharged with azathioprine. She was readmitted at the end of the same year due to two-day history of right deep vein thrombosis and she later succumbed to methicillin-resistant Staphylococcus aureus sepsis.
Fulltext Analysis of selected glutathione S-transferase gene polymorphisms in Malaysian type 2 diabetes mellitus patients with and without cardiovascular disease

Etemad A, Vasudevan R, Aziz AF, Yusof AK, Khazaei S, Fawzi N, et al.

Genet. Mol. Res., 2016 Apr 07;15(2).
PMID: 27173202 DOI: 10.4238/gmr.15025845

Type 2 diabetes mellitus (T2DM) is believed to be associated with excessive production of reactive oxygen species. Glutathione S-transferase (GST) polymorphisms result in decreased or absent enzyme activity and altered oxidative stress, and have been associated with cardiovascular disease (CVD). The present study assessed the effect of GST polymorphisms on the risk of developing T2DM in individuals of Malaysian Malay ethnicity. A total of 287 subjects, consisting of 87 T2DM and 64 CVD/T2DM patients, as well as 136 healthy gender- and age-matched controls were genotyped for selected polymorphisms to evaluate associations with T2DM susceptibility. Genomic DNA was extracted using commercially available kits, and GSTM1, GSTT1, and α-globin sequences were amplified by multiplex polymerase chain reaction. Biochemical parameters were measured with a Hitachi autoanalyzer. The Fisher exact test, the chi-square statistic, and means ± standard deviations were calculated using the SPSS software. Overall, we observed no significant differences regarding genotype and allele frequencies between each group (P = 0.224 and 0.199, respectively). However, in the combined analysis of genotypes and blood measurements, fasting plasma glucose, HbA1c, and triglyceride levels, followed by age, body mass index, waist-hip ratio, systolic blood pressure, and history of T2DM significantly differed according to GST polymorphism (P ˂ 0.05). Genetically induced absence of the GSTT1 enzyme is an independent and powerful predictor of premature vascular morbidity and death in individuals with T2DM, and might be triggered by cigarette smoking's oxidative effects. These polymorphisms could be screened in other ethnicities within Malaysia to determine further possible risk factors.
Multiple polypoid endometriosis--a rare complication following withdrawal of gonadotrophin releasing hormone (GnRH) agonist for severe endometriosis: a case report

Othman NH, Othman MS, Ismail AN, Mohammad NZ, Ismail Z

Aust N Z J Obstet Gynaecol, 1996 May;36(2):216-8.
PMID: 8798320

A 30-year old female who initially had typical endometriosis treated according to a standard regimen later developed numerous highly vascular endometrial polyps on the vagina, cervix, ureter, serosal surfaces of the uterus, pouch of Douglas (POD) and other areas of pelvic peritoneum as well as the endometrium 8 months after withdrawal of treatment with Zoladex gonadotrophin releasing hormone (GnRH) agonist used for treatment of this disease. We postulate that these polyps developed as a rebound phenomenon upon withdrawal of Zoladex. We believe this is the first report of this complication following use of GnRH analogue.
Fulltext Management of prediabetes in Malaysian population: An experts' opinion

Mafauzy M, Khoo EM, Hussein Z, Yusoff Azmi NS, Siah GJ, Mustapha FI, et al.

Med J Malaysia, 2020 07;75(4):419-427.
PMID: 32724007

INTRODUCTION: Prediabetes, typically defined as blood glucose levels above normal but below diabetes thresholds, denotes a risk state that confers a high chance of developing diabetes. Asians, particularly the Southeast Asian population, may have a higher genetic predisposition to diabetes and increased exposure to environmental and social risk factors. Malaysia alone was home to 3.4 million people with diabetes in 2017; the figure is estimated to reach 6.1 million by 2045. Developing strategies for early interventions to treat prediabetes and preventing the development of overt diabetes and subsequent cardiovascular and microvascular complications are therefore important.

METHODS: An expert panel comprising regional experts was convened in Kuala Lumpur, for a one-day meeting, to develop a document on prediabetes management in Malaysia. The expert panel comprised renowned subject-matter experts and specialists in diabetes and endocrinology, primary-care physicians, as well as academicians with relevant expertise.

RESULTS: Fifteen key clinical statements were proposed. The expert panel reached agreements on several important issues related to the management of prediabetes providing recommendations on the screening, diagnosis, lifestyle and pharmacological management of prediabetes. The expert panel also proposed changes in forthcoming clinical practice guidelines and suggested that the government should advocate early screening, detection, and intensive management of prediabetes.

CONCLUSION: This document provides a comprehensive approach to the management of prediabetes in Malaysia in their daily activities and offer help in improving government policies and the decision-making process.
Evaluation of quality and protein structure of natural water kefir-fermented quinoa protein concentrates

Alrosan M, Tan TC, Easa AM, Gammoh S, Alu'datt MH, Aleid GM, et al.

Food Chem, 2023 Mar 15;404(Pt B):134614.
PMID: 36444092 DOI: 10.1016/j.foodchem.2022.134614

The utilisation of quinoa protein concentrates (QPCs) is limited due to their poor protein digestibility (78.54 %). In this study, QPCs (1 % w/v) were fermented in 5 % (v/v) water kefir grains (WKG) for 5 days at 25 °C. The protein quality of the fermented QPCs was enhanced, whereby the protein digestibility increased significantly (P
Malaysian Society of Allergy and Immunology Consensus Statement on Sublingual Immunotherapy in Allergic Rhinitis

Abdullah B, Pawankar R, Abdul Latiff AH, Woo KCK, Wüstenberg E, Khalid MAF, et al.

J Clin Med, 2023 Feb 01;12(3).
PMID: 36769797 DOI: 10.3390/jcm12031151

Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients' quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering increasing doses of the causative allergen to induce clinical and immunologic tolerance to the allergens. It is the only currently available treatment for AR that has been proven to induce disease-modifying effects (i.e., long-term remission of allergic symptoms or potential prevention of asthma and new sensitizations). Although AIT is conventionally recommended for patients who are non-responsive to symptom-relieving pharmacotherapy, it is presently recommended as a first-line treatment for patients with moderate to severe AR who prefer a treatment with the potential for long-term remission. In light of the relatively recent implementation of AIT in Malaysia, guidelines on its appropriate indication and application are important to attain optimal outcomes. This consensus statement was developed by an expert group formed by the Malaysian Society of Allergy and Immunology to provide evidence-based recommendations for the practice of AIT in Malaysia. Patient and product selection, choice of AIT, and strategy towards an effective treatment outcome in AIT are presented.
Fulltext Case series of foreign body aspiration in Paediatric Institute, Hospital Kuala Lumpur

Sahadan DZ, Zainudin NM, Kassim A, Zahari Z, Mahadzir M, Daud CZ, et al.

Med J Malaysia, 2011 Dec;66(5):484-6.
PMID: 22390106 MyJurnal

A retrospective case series was conducted to determine the clinical characteristics and bronchoscopy findings of children with foreign body aspiration in Paediatric Institute, Hospital Kuala Lumpur. Ten boys and two girls were included (range 2-177 months; median 26 months old). They commonly presented with cough (12/100%) and difficulty in breathing (9/75%). All patients had unilateral auscultatory findings and the commonest radiographic findings were unilateral hyperinflation (7/58.3%). The majority of foreign bodies removed was organic (8/66.6%) and more frequently found in the left bronchial tree (7/58.3%). Major complications were pneumonia (11/91.6%) and airway oedema (11/ 91.6%). Eight patients had delayed diagnosis due to parents unawareness (6/50%) and missed diagnosis (2/16.7%).
Fulltext Bilateral Sudden Sensorineural Hearing Loss Following Head Trauma

Misron K, Tengku Kamalden TMI, Mohammad N

Oman Med J, 2021 Jul;36(1):e280.
PMID: 34367684 DOI: 10.5001/omj.2021.42

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