Displaying publications 1 - 20 of 38 in total

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  1. Wan Mahmud WN, Hassan SA, Abd Rahman Z, Wan Abdul Wahab WNA, Ismail N
    Malays J Med Sci, 2024 Apr;31(2):188-198.
    PMID: 38694572 DOI: 10.21315/mjms2024.31.2.17
    BACKGROUND: Streptococcus pneumoniae is one of the leading causes of mortality and morbidity worldwide. The dramatic increase in in-vitro resistance of antimicrobial agents, particularly beta-lactams and macrolides, makes pneumococcal infections difficult to treat. The aim of this study was to describe the drug resistance rate, assess the prevalence of macrolide-resistant genes and review the clinical complications of pneumococcal infections among patients presented to Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.

    METHODS: This is a descriptive cross-sectional study. All S. pneumoniae isolates collected from clinical specimens within a 1-year period were subjected to selected antimicrobial susceptibility testing using E-test strips. Polymerase chain reaction (PCR) analysis was conducted to detect macrolide-resistant determinants. The patient's clinical data were obtained from clinical notes.

    RESULTS: A total of 113 patients with a positive growth of S. pneumoniae were included in the study. The most common predisposing factors among them were bronchopulmonary diseases (15.9%). The penicillin-resistant rate was 7.1%, with minimal inhibitory concentration (MIC) ranging between 0.012 μg/mL and >32 μg/mL, and the erythromycin-resistant rate was 26.5%, with a MIC range of 0.03 μg/mL-> 256 μg/mL. Most of the erythromycin-resistant isolates were found to have the mef(A) gene (50.4%) and the erm(B) gene (20%); 16.7% had a combination of genes mef(A) and erm(B), and 13.3% had none of the two genes. Community-acquired pneumonia is the predominant type of pneumococcal infection. There was no significant association between the presence of macrolide resistance determinants and mortality (P = 0.837) or complications (P > 0.999 for empyema and cardiac complication; P = 0.135 for subdural abscess).

    CONCLUSION: The majority of erythromycin-resistant isolates were found to have the mef(A) gene, followed by the erm(B) gene and a combination of genes mef(A) and erm(B).

  2. Abdul Rahman Z, Mohamad SA, Abdul Hamid H
    Cureus, 2024 Mar;16(3):e55811.
    PMID: 38586634 DOI: 10.7759/cureus.55811
    This is a report on remarkable visual recovery from blindness in a case of isolated optic perineuritis (OPN). A 68-year-old Chinese lady presented with a two-week history of progressive painless bilateral vision loss. Her vision was 6/18 on the right eye and no perception of light (NPL) on the left eye with positive relative afferent pupillary defect (RAPD). Fundus showed hyperaemic and swollen optic disc bilaterally. MRI of the brain and orbit revealed hyperintense periventricular white matter lesions, possibly early changes of multiple sclerosis (MS), and perineural enhancement of optic nerve bilaterally, consistent with OPN. All other investigations were negative. Intravenous methylprednisolone 1g/day for three days was started, followed with oral prednisolone, tapered in three months. At the third month of follow-up, her vision had improved to 6/12 on the left and 6/9 on the right. The hyperaemic and swollen disc has resolved. Intravenous megadose corticosteroid treatment is an effective first-line treatment for OPN.
  3. Ab Rahman Z, Isa B, Shahibi MS, Mansor MI
    PMID: 38026576 DOI: 10.51866/oa.448
    INTRODUCTION: A healthy lifestyle is pivotal for improving mental health. As the concept of a healthy lifestyle is comprehensive, there is a need to prioritise components related to mental health in planning proper mental health interventions. In this regard, physical activity, diet, sleep quality, substance abuse and social support have been identified to enhance mental health. It is necessary to develop a valid scale for assessing healthy lifestyles related to mental health. Thus, this study aimed to adapt and validate an existing scale to evaluate healthy lifestyles related to mental health.

    METHOD: This study included 177 (men: n=73, women: n=104) participants from University Teknologi MARA, Puncak Alam, Selangor. The data were presented using descriptive statistics and subjected to an exploratory factor analysis.

    RESULTS: The 22 scale items evaluated were valid and reliable in assessing the five components of healthy lifestyles related to mental health. The total variance explained for measuring the construct was 68.610%. The Cronbachs alpha value for the five components ranged from 0.784 to 0.903.

    CONCLUSION: The adapted scale is acceptable and reliable in evaluating healthy lifestyles related to mental health within the target population. Thus, it can be used to assess significant components of healthy lifestyles to promote mental health. Accordingly, relevant authorities can formulate the best strategies to enhance mental health.

  4. Ng SW, Syamim Syed Mohd Sobri SN, Zain RB, Kallarakkal TG, Amtha R, Wiranata Wong FA, et al.
    PMID: 35068209 DOI: 10.1177/13558196211053110
    OBJECTIVE: Oral cancer is amenable to early detection but remains a prominent cause of mortality in the Asia Pacific region. This study aimed to identify barriers to early detection and management of oral cancer in the Asia Pacific region.

    METHODS: A mixed-methods approach was employed triangulating findings from a survey and focus groups. The survey was conducted among seven representative members of the Asia Pacific Oral Cancer Network (APOCNET) across six countries. Focus groups were conducted to gain deeper insights into the findings of the survey.

    RESULTS: The identified barriers were a lack of national cancer control strategies and cancer registries and the limited availability of trained health care professionals. Overcoming these challenges in the Asia Pacific region where resources are scarce will require collaborative partnerships in data collection and novel approaches for continuous professional training including eLearning. Further, to overcome the lack of trained health care professionals, innovative approaches to the management of oral potentially malignant lesions and oral cancer including telemedicine were suggested.

    CONCLUSION: The findings of this study should be taken into account when charting national cancer control plans for oral cancer and will form the basis for future collaborative studies in evaluating effective measures to improve oral cancer detection and management in low- and middle-income countries.

  5. Atan AA, Ab Rahman Z, Zayzan KR, Bahaudin N, Ahmad AR
    Cureus, 2021 Nov;13(11):e19918.
    PMID: 34976521 DOI: 10.7759/cureus.19918
    Simultaneous ipsilateral fractures involving all the bones around the shoulder girdle, namely, the scapula, clavicle and humerus, are rare. We describe an interesting case of a 31-year-old patient who presented after a motor vehicle accident with excruciating pain over his left shoulder and a flail left upper limb. Radiographs and computed tomography (CT) scan revealed the presence of comminuted left scapula, clavicle and proximal humerus fractures. He was also diagnosed with a complete brachial plexus injury of the left shoulder. The patient underwent a tedious surgery involving screw fixation and plating of the scapula, clavicle and proximal humerus. Despite achieving stable fixations of the shoulder and radiographic union of all the fractures, he did not recover from the complete brachial plexus injury 14 months after the trauma. The presence of ipsilateral clavicle, scapula and humerus fracture suggests involvement in high-energy trauma, and therefore, associated injuries especially neurovascular compromise should not be missed. Despite its rarity, management of this complex injury should always be individualised to ensure optimal functional outcomes are achieved.
  6. Rathakrishnan B, Bikar Singh SS, Kamaluddin MR, Yahaya A, Mohd Nasir MA, Ibrahim F, et al.
    PMID: 34444042 DOI: 10.3390/ijerph18168291
    This study was conducted to examine the relationship between smartphone addiction, sleep quality, and academic performance. The study presented quantitative research on 323 students in a public university in Sabah to explore the relationship between smartphone addiction, sleep quality, and academic performance. A simple random sampling was used in the study. The Smartphone Addiction Scale Short Version (SAS-SV) and the Pittsburgh Sleep Quality Index (PSQI) were used in this study. SPSS was used as a tool of analysis for descriptive and inferential analysis. Pearson correlation was involved to test the hypothesis of the study. The result indicated that the greater the smartphone addiction, the lower the academic performance of university students. The finding also proved that students with poor sleep quality might exhibit low academic performance. Smartphone addiction was found to be associated with sleep quality where overusing smartphones was related to poor sleep quality in university students. On this basis, the problem of smartphone addiction and sleep quality should be tackled in order to improve the academic performance of university students and their overall health.
  7. Foo QC, Hariri F, Abdul Rahman ZA
    Int J Oral Maxillofac Surg, 2021 Aug;50(8):1095-1099.
    PMID: 33422383 DOI: 10.1016/j.ijom.2020.12.007
    Arthrocentesis and arthroscopy are relatively safe treatments for arthrogenic temporomandibular disorders. Hands-on training in both procedures is essential for surgeons to become competent. In this study, a three-dimensional (3D) temporomandibular joint (TMJ) prototype was developed at a relatively low cost, and arthrocentesis and arthroscopy were performed successfully on the model. Despite its limitations, this model is a viable adjunct to TMJ surgical training and can be fabricated easily by any training centre with a 3D printer.
  8. Moxness Reksten A, Rahman Z, Kjellevold M, Garrido Gamarro E, Thilsted SH, Pincus LM, et al.
    Foods, 2021 May 20;10(5).
    PMID: 34065408 DOI: 10.3390/foods10051147
    Fish represent an important part of the Sri Lankan and Bangladeshi diet. However, fish is also a source of contaminants that may constitute a health risk to consumers. The aim of this study was to analyse the contents of arsenic, cadmium, mercury, and lead in 24 commonly consumed marine fish species from the Bay of Bengal and to assess the potential health risk associated with their consumption. Mercury and lead contents did not exceed the maximum limits for any of the sampled species, and consumer exposure from estimated daily consumption was assessed to be minimal for adults and children. Numerous samples exceeded the maximum limit for cadmium (58%), particularly those of small size (≤25 cm). However, consumer exposure was insignificant, and health assessment showed no risk connected to consumption. These data represent an important contribution to future risk/benefit assessments related to the consumption of fish.
  9. Islam T, Musthaffa S, Hoong SM, Filza J, Jamaris S, Cheng ML, et al.
    Support Care Cancer, 2021 May;29(5):2631-2638.
    PMID: 32968861 DOI: 10.1007/s00520-020-05776-4
    PURPOSE: Wider breast cancer (BC) treatment options, short consultation time with physicians, lack of knowledge, and poor coping skills at the time of diagnosis may affect patients' decisions causing treatment delays and non-adherence. To address this gap, a breast care nurse video orientation program was started. Our aim was to evaluate the video on patients' knowledge, satisfaction, and treatment adherence.

    METHODS: The video was developed using the BC delay explanatory model. A self-administered pre- and post-survey on 241 newly diagnosed BC patients in University Malaya Medical Center was performed. The Wilcoxon matched paired signed rank test was used to evaluate patients' pre and post perceived knowledge using a Likert scale 0 to 4 (0 = "no knowledge," 4 = "a great degree of knowledge"). Treatment adherence among participants were measured after 1-year follow-up.

    RESULTS: Eighty percent of the patients reported that the video met or exceeded their expectations. In total 80.5% reported that the video was very effective and effective in improving their perspective on BC treatments. There was improvement in perceived knowledge for treatment options (mean scores; M = 0.93 versus M = 2.97) (p < 0.001) and also for perceived knowledge on types of operation, information on chemotherapy, radiotherapy, hormone therapy, healthy diet, physical activity after treatments, and care of the arm after operation(p < 0.001). In total 89.4%, 79.3%, and 85.9% adhered to surgical, chemotherapy, and radiotherapy recommended treatment, respectively.

    CONCLUSION: The video improved patients' perceived knowledge and satisfaction. The program improved access not only to new BC patients but also the public and found sustainable using the YouTube platform.

  10. Irekeola AA, Shueb RH, E A R ENS, Wada Y, Abdul Rahman Z, Ahmad S, et al.
    Cancers (Basel), 2021 Apr 14;13(8).
    PMID: 33919987 DOI: 10.3390/cancers13081886
    For more than 50 years, nasopharyngeal carcinoma (NPC) has been associated with dermatomyositis (DM), a rare idiopathic inflammatory disorder that mainly affects the skin and muscles. Although the association between these rare diseases is well-documented, the actual prevalence of NPC in DM patients remains unknown. Here, a systematic review and meta-analysis of published data was conducted in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Electronic databases including PubMed, Scopus, ScienceDirect, and Google Scholar were searched without year or language restrictions for studies reporting the occurrence of NPC in DM patients. The study protocol was lodged with PROSPERO (CRD42021225335). A total of 95 studies covering 303 cases of NPC among 16,010 DM patients was included. Summary estimates were calculated using the random-effects model. The pooled prevalence of NPC in DM was 3.3% (95% CI, 2.5-4.3). When stratified according to study location, higher prevalence estimates were obtained for Hong Kong (36.5%), Malaysia (27.7%), and Singapore (11.9%). There was a predominance of cases among male DM patients compared with females, and most patients were aged 40 and above. Many of the NPC cases were found to be diagnosed after the diagnosis of DM. It is therefore pertinent to screen for NPC in DM patients, especially among older DM patients in the Asian region.
  11. Hariri F, Abdullah MF, Adam KBC, Bahuri NFA, Kulasegarah J, Nathan AM, et al.
    Int J Oral Maxillofac Surg, 2021 Apr;50(4):457-462.
    PMID: 32891466 DOI: 10.1016/j.ijom.2020.08.002
    Paediatric craniomaxillofacial (CMF) surgery requires a multidisciplinary team approach to ensure the optimal and holistic management of children with craniofacial deformities. The aim of this retrospective study was to analyse the complications following functional interventions among 34 CMF deformity patients in a single multidisciplinary craniofacial centre. Electronic data including patient demographic characteristics and clinical entry were analysed. Inclusion criteria were all paediatric patients with CMF deformities who underwent various functional interventions. A total of 64 interventions (48 intermediate and 16 definitive) were conducted. Based on the Sharma classification of complications, 20.3% were type I, 4.7% were type II, 1.6% were type III, and 4.7% were type IV . Most complications were type I, which included local infection (3.1%) and premature opening of tarsorrhaphy (3.1%). More serious complications (types III and IV) included temporary visual loss (1.6%) and intraoperative haemorrhage (1.6%). Although a low complication rate was observed in intermediate interventions, a higher complication rate was observed in more complex definitive interventions such as monobloc distraction osteogenesis. Although most complications were manageable, effective prevention remains mandatory, as serious complications may lead to permanent damage and mortality. This analysis highlights the importance of a multidisciplinary team approach to optimize the outcomes in CMF patient management.
  12. Yazid SN, Ahmad K, Razak MSFA, Rahman ZA, Ramachandran K, Mohamad SNA, et al.
    Braz J Biol, 2021;84:e248359.
    PMID: 34730685 DOI: 10.1590/1519-6984.248359
    Bacterial leaf blight (BLB) is one of the major rice diseases in Malaysia. This disease causes substantial yield loss as high as 70%. Development of rice varieties which inherited BLB resistant traits is a crucial approach to promote and sustain rice industry in Malaysia. Hence, this study aims were to enhance BLB disease resistant characters of high yielding commercial variety MR219 through backcross breeding approach with supporting tool of marker-assisted selection (MAS). Broad spectrum BLB resistance gene, Xa7 from donor parent IRBB7 were introgressed into the susceptible MR219 (recurrent parent) using two flanking markers ID7 and ID15. At BC3F4, we managed to generate 19 introgressed lines with homozygous Xa7 gene and showed resistant characteristics as donor parent when it was challenged with Xanthomonas oryzae pv. oryzae through artificial inoculation. Recurrent parent MR219 and control variety, MR263 were found to be severely infected by the disease. The improved lines exhibited similar morphological and yield performance characters as to the elite variety, MR219. Two lines, PB-2-107 and PB-2-34 were chosen to be potential lines because of their outstanding performances compared to parent, MR219. This study demonstrates a success story of MAS application in development of improved disease resistance lines of rice against BLB disease.
  13. Peter S, Abdul Rahman ZA, Pillai S
    Int J Oral Maxillofac Surg, 2019 Oct;48(10):1317-1322.
    PMID: 31014926 DOI: 10.1016/j.ijom.2019.03.896
    The aim of this study was to document differences in hypernasality during speaking and singing among children with cleft palate and to compare nasality score ratings of trained and untrained listeners. Twenty subjects with cleft palate aged between 7 and 12 years participated in this study. Audio recordings were made of the children reading a passage and singing a common local song, both in the Malay language. The degree of hypernasality was judged through perceptual assessment. Three trained listeners (a speech therapist, a classical singer, and a linguistic expert - all academicians) and two untrained listeners (a cleft volunteer worker and a national high school teacher) assessed the recordings using a visual analogue scale (VAS). Inter-rater and intra-rater reliability for hypernasality in both speaking and singing were verified using the intra-class correlation coefficient (ICC). A significant reduction in hypernasality was observed during singing as compared to speaking, indicating that hypernasality reduces when a child with cleft palate sings. The act of singing significantly reduces hypernasality. The outcome of this study suggests that children with cleft palate would benefit from singing exercises to ultimately reduce hypernasality. However, future research is needed to objectively measure nasality in singing compared to speaking.
  14. Salmuna ZN, Hashim S, Hasan H, Harun A, Abdul Rahman Z, Ismail N, et al.
    IIUM Medical Journal Malaysia, 2019;18(3):144-152.
    MyJurnal
    Influenza-like illnesses (ILI) were defined as a triad of cough, sore throat and fever. The aim of this study is to determine the changes in knowledge, perceptions and practices towards preventive measures of succumbing to ILI before and after hajj among Malaysian hajj pilgrims.Methodology: An open-labeled randomized control trial study performed on five hundred Malaysian hajj pilgrims in the year 2013. After validated pre-hajj questionnaires completed, 250 subjects were given health education, benzalkonium-based handrub and demonstration of the handrub usage together with pamphlets and labelled as an intervention group. Another 250 subjects from another flight batch were given the same questionnaires without health education with unmedicated hand lotion as a control group. The knowledge, perception, practices and compliances to the handrub practice in both groups were compared with the pre-hajj results. Results: No significant difference between pre and post hajj knowledge and practice among hajj pilgrims in intervention group. Pre hajj perception score [ M (IQR) = 30 (5.00), Z= -2.441, p < 0.05 ] is much higher compared to post hajj perception [ M (IQR) = 29 (6.00), Z = -2.441, p < O.O5 ]. No significant difference between pre and post hajj knowledge, perception and practices among hajj pilgrims in control group. Hand hygiene compliance was not improved with provision of health education and free handrub supply. Conclusion: No significant changes in knowledge, perceptions and practices of Malaysian hajj pilgrims pre and post-hajj in both groups. Provision of handrub did not improved hajj pilgrims compliance.
  15. Al-Namnam NM, Hariri F, Thong MK, Rahman ZA
    J Oral Biol Craniofac Res, 2018 08 29;9(1):37-39.
    PMID: 30202723 DOI: 10.1016/j.jobcr.2018.08.007
    Crouzon syndrome exhibits considerable phenotypic heterogeneity, in the aetiology of which genetics play an important role. FGFR2 mediates extracellular signals into cells and the mutations in the FGFR2 gene cause this syndrome occurrence. Activated FGFs/FGFR2 signaling disrupts the balance of differentiation, cell proliferation, and apoptosis via its downstream signal pathways. However, very little is known about the cellular and molecular factors leading to severity of this phenotype. Revealing the molecular pathology of craniosynostosis will be a great value for genetic counselling, diagnosis, prognosis and early intervention programs. This mini-review summarizes the fundamental and recent scientific literature on genetic disorder of Crouzon syndrome and presents a graduated strategy for the genetic approach, diagnosis and the management of this complex craniofacial defect.
  16. Lee BKB, Gan CP, Chang JK, Tan JL, Fadlullah MZ, Abdul Rahman ZA, et al.
    J Dent Res, 2018 07;97(8):909-916.
    PMID: 29512401 DOI: 10.1177/0022034518759038
    Head and neck cancer (HNC)-derived cell lines represent fundamental models for studying the biological mechanisms underlying cancer development and precision therapies. However, mining the genomic information of HNC cells from available databases requires knowledge on bioinformatics and computational skill sets. Here, we developed a user-friendly web resource for exploring, visualizing, and analyzing genomics information of commonly used HNC cell lines. We populated the current version of GENIPAC with 44 HNC cell lines from 3 studies: ORL Series, OPC-22, and H Series. Specifically, the mRNA expressions for all the 3 studies were derived with RNA-seq. The copy number alterations analysis of ORL Series was performed on the Genome Wide Human Cytoscan HD array, while copy number alterations for OPC-22 were derived from whole exome sequencing. Mutations from ORL Series and H Series were derived from RNA-seq information, while OPC-22 was based on whole exome sequencing. All genomic information was preprocessed with customized scripts and underwent data validation and correction through data set validator tools provided by cBioPortal. The clinical and genomic information of 44 HNC cell lines are easily assessable in GENIPAC. The functional utility of GENIPAC was demonstrated with some of the genomic alterations that are commonly reported in HNC, such as TP53, EGFR, CCND1, and PIK3CA. We showed that these genomic alterations as reported in The Cancer Genome Atlas database were recapitulated in the HNC cell lines in GENIPAC. Importantly, genomic alterations within pathways could be simultaneously visualized. We developed GENIPAC to create access to genomic information on HNC cell lines. This cancer omics initiative will help the research community to accelerate better understanding of HNC and the development of new precision therapeutic options for HNC treatment. GENIPAC is freely available at http://genipac.cancerresearch.my/ .
  17. Al-Namnam NMN, Hariri F, Rahman ZAA
    Br J Oral Maxillofac Surg, 2018 06;56(5):353-366.
    PMID: 29661509 DOI: 10.1016/j.bjoms.2018.03.002
    Our aim was to summarise current published evidence about the prognosis of various techniques of craniofacial distraction osteogenesis, particularly its indications, protocols, and complications. Published papers were acquired from online sources using the keywords "distraction osteogenesis", "Le Fort III", "monobloc", and "syndromic craniosynostosis" in combination with other keywords, such as "craniofacial deformity" and "midface". The search was confined to publications in English, and we followed the guidelines of the PRISMA statement. We found that deformity of the skull resulted mainly from Crouzon syndrome. Recently craniofacial distraction has been achieved by monobloc distraction osteogenesis using an external distraction device during childhood, while Le Fort III distraction osteogenesis was used in maturity. Craniofacial distraction was indicated primarily to correct increased intracranial pressure, exorbitism, and obstructive sleep apnoea in childhood, while midface hypoplasia was the main indication in maturity. Overall the most commonly reported complications were minor inflammatory reactions around the pins, and anticlockwise rotation when using external distraction systems. The mean amount of bony advancement was 12.3mm for an external device, 18.6mm for an internal device and 18.7mm when both external and internal devices were used. Treatment by craniofacial distraction must be validated by long-term studies as there adequate data are lacking, particularly about structural relapse and the assessment of function.
  18. Rahman Z, Hashim F, Rasid MFA, Othman M
    PLoS One, 2018;13(6):e0197087.
    PMID: 29874237 DOI: 10.1371/journal.pone.0197087
    Underwater Wireless Sensor Network (UWSN) has emerged as promising networking techniques to monitor and explore oceans. Research on acoustic communication has been conducted for decades, but had focused mostly on issues related to physical layer such as high latency, low bandwidth, and high bit error. However, data gathering process is still severely limited in UWSN due to channel impairment. One way to improve data collection in UWSN is the design of routing protocol. Opportunistic Routing (OR) is an emerging technique that has the ability to improve the performance of wireless network, notably acoustic network. In this paper, we propose an anycast, geographical and totally opportunistic routing algorithm for UWSN, called TORA. Our proposed scheme is designed to avoid horizontal transmission, reduce end to end delay, overcome the problem of void nodes and maximize throughput and energy efficiency. We use TOA (Time of Arrival) and range based equation to localize nodes recursively within a network. Once nodes are localized, their location coordinates and residual energy are used as a matrix to select the best available forwarder. All data packets may or may not be acknowledged based on the status of sender and receiver. Thus, the number of acknowledgments for a particular data packet may vary from zero to 2-hop. Extensive simulations were performed to evaluate the performance of the proposed scheme for high network traffic load under very sparse and very dense network scenarios. Simulation results show that TORA significantly improves the network performance when compared to some relevant existing routing protocols, such as VBF, HHVBF, VAPR, and H2DAB, for energy consumption, packet delivery ratio, average end-to-end delay, average hop-count and propagation deviation factor. TORA reduces energy consumption by an average of 35% of VBF, 40% of HH-VBF, 15% of VAPR, and 29% of H2DAB, whereas the packet delivery ratio has been improved by an average of 43% of VBF, 26% of HH-VBF, 15% of VAPR, and 25% of H2DAB. Moreover, the average end-to-end delay has been reduced by 70% of VBF, 69% of HH-VBF, 46% of VAPR, and 73% of H2DAB. Furthermore, average hope-count has been improved by 57%, 53%, 16% and 31% as compared to VBF, HHVBF, VAPR, and H2DAB, respectively. Also, propagation delay has been reduced by 34%, 30%, 15% and 23% as compared to VBF, HHVBF, VAPR, and H2DAB, respectively.
  19. Chua WC, Mazlan MZ, Ali S, Che Omar S, Wan Hassan WMN, Seevaunnantum SP, et al.
    IDCases, 2017;9:91-94.
    PMID: 28725564 DOI: 10.1016/j.idcr.2017.05.002
    We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic shock and multiple organ failures. A consensus was reached for extensive wound debridement to remove the source of infection; however, this approach was abandoned due to the patient's hemodynamic instability and the extremely high risks of surgery. Both the high vaginal swab and blister fluid culture revealed Group A beta hemolytic streptococcus infection. Intravenous carbapenem in combination with clindamycin was given. Other strategies attempted for streptococcal toxic removal included continuous veno-venous hemofiltration and administration of intravenous immunoglobulin. Unfortunately, the patient's condition worsened, and she succumbed to death on day 7 of hospitalization.
  20. Hasan H, Deris ZZ, Sulaiman SA, Abdul Wahab MS, Naing NN, Ab Rahman Z, et al.
    J Immigr Minor Health, 2015 Aug;17(4):1114-9.
    PMID: 24946936 DOI: 10.1007/s10903-014-0059-y
    Respiratory illness were a major problem and caused high hospital admission during hajj seasons. One of the contributing cause to this illness is infection. Various measures had been implemented to reduce respiratory infections. The aim on the study is to determine the effect of influenza vaccination against acute respiratory illness among Malaysian Hajj pilgrims. This is an observational cohort study. Influenza vaccination was given to pilgrims at least 2 weeks prior to departure. The occurrence of symptoms for respiratory illness such as cough, fever, sore throat and runny nose was monitored daily for 6 weeks during pilgrimage using a health diary. A total of 65 vaccinated hajj pilgrims and 41 controls were analyzed. There was no significant difference in pattern of occurrence of symptoms of respiratory illness by duration of pilgrimage as well as the number of symptoms between both groups. Hajj pilgrims have frequent respiratory symptoms. We were unable to document benefit from influenza vaccination, but our study was limited by a small sample size and lack of laboratory testing for influenza.
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