MyMedR

Alteration of plasma alanine, glutamate, and glycine Level: A potentiate manic episode of bipolar disorder

Wan Nasru WN, Ab Razak A, Yaacob NM, Wan Azman WN

Malays J Pathol, 2021 Apr;43(1):25-32.

INTRODUCTION: The amino acids that function as co-agonists at the N-methyl-D-aspartate (NMDA) receptor have been investigated in bipolar disorder (BD). However, studies comparing amino acid levels in the plasma of BD patients with healthy controls have yielded inconsistent results. We, therefore, conducted a study in Hospital Universiti Sains Malaysia to determine the plasma levels of glutamate, glycine, and alanine in BD patients and compared them with the healthy controls.

MATERIALS AND METHODS: An overnight fast of 10-hour plasma levels of glutamate, glycine, alanine, and tryptophan were measured in 83 bipolar patients, and were compared to a group of 82 healthy controls.

RESULTS: The mean (SD) age of bipolar patients was 40.9 (12.1), while the mean (SD) age for control groups was 35.6 (7.7) years. The median (25th, 75th percentile) of glutamate and alanine levels in bipolar patients was 111.0 (65.0,176.0) and 530.0 (446.0,629.0), respectively, while the mean (SD) of glycine level in bipolar patients was 304.0 (98.1). Significant higher glutamate, glycine, and alanine levels were found in bipolar disorder patients in the manic episode as compared to the healthy controls.

CONCLUSION: Although the exact relationship between peripheral NMDA receptor co-agonist levels in the pathogenesis of BD is not well understood, these findings should be explored and may enlighten some new paths for BD therapy which could reward the patients also clinicians.

Fulltext Cockroaches from urban human dwellings: isolation of bacterial pathogens and control

Vythilingam I, Jeffery J, Oothuman P, Abdul Razak AR, Sulaiman A

Southeast Asian J Trop Med Public Health, 1997 Mar;28(1):218-22.

PMID: 9322309

A study was carried out to determine the distribution of cockroaches in two different housing areas with central sewerage or individual septic tanks in an urban area in Kuala Lumpur, Malaysia. Six species of cockroaches were present and of these Periplaneta americana and Periplaneta brunnea were found in greater abundance. Seventeen species of bacteria were isolated and of these Escherichia coli and Klebsiella p. pneumoniae were isolated in greatest numbers. Control measures carried out using lambda cyhalothrin showed that there was no significant difference between treated and control sites.

Fulltext Aerodigestive amyloidosis presenting as acute asthma

Sreetharan SS, Prepageran N, Razak A, Valuyeetham KA

Med J Malaysia, 2003 Jun;58(2):290-3.

PMID: 14569753

Aerodigestive amyloidosis is a rare disorder characterized by fibrillar protein deposition in the aerodigestive tree. We present a case of a 19-year-old Chinese gentleman whose diagnosis was initially missed as he presented with features suggestive of severe bronchial asthma and was intubated and ventilated. He subsequently presented 2 years later with severe stridor and required emergency tracheostomy. Current literature is reviewed for the histopathology, common clinical features, radiological findings and treatment options for aerodigestive amyloidosis.

Fulltext Training Characteristics, Personal Factors and Coping Strategies Associated with Burnout in Junior Doctors: A Multi-Center Study

Roslan NS, Yusoff MSB, Ab Razak A, Morgan K, Ahmad Shauki NI, Kukreja A, et al.

Healthcare (Basel), 2021 Sep 14;9(9).

PMID: 34574982 DOI: 10.3390/healthcare9091208

Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor-Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02-2.20), prior work experience (OR: 1.56; 95% CI: 1.05-2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30-2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49-3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15-2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary.

Fulltext What Are the Common Themes of Physician Resilience? A Meta-Synthesis of Qualitative Studies

Roslan NS, Yusoff MSB, Morgan K, Ab Razak A, Ahmad Shauki NI

Int J Environ Res Public Health, 2022 Jan 01;19(1).

PMID: 35010729 DOI: 10.3390/ijerph19010469

In the practice of medicine, resilience has gained attention as on of the ways to address burnout. Qualitative studies have explored the concept of physician resilience in several contexts. However, individual qualitative studies have limited generalizability, making it difficult to understand the resilience concept in a wider context. This study aims to develop a concept of resilience in the context of physicians' experience through a meta-synthesis of relevant qualitative studies. Using a predetermined search strategy, we identified nine qualitative studies among 450 participants that reported themes of resilience in developed and developing countries, various specialties, and stages of training. We utilized the meta-ethnography method to generate themes and a line-of-argument synthesis. We identified six key themes of resilience: tenacity, resources, reflective ability, coping skills, control, and growth. The line-of-argument synthesis identified resilient physicians as individuals who are determined in their undertakings, have control in their professional lives, reflect on adversity, utilize adaptive coping strategies, and believe that adversity provides an opportunity for growth. Resilient physicians are supported by individual and organizational resources that include nurturing work culture, teamwork, and support from the medical community and at home. Our findings suggest that resilience in physicians is dynamic and must be supported not only by physician-directed interventions but also by organization-directed interventions.

Patterns of tooth vulnerability to caries in 20-24-year-old subjects

Razak IA, Razak AA

Odontostomatol Trop, 1988 Dec;11(4):145-8.

PMID: 3272009

Caries susceptibility of first permanent molars in 1808 schoolchildren aged 7-12 years

Razak IA, Razak AA

Singapore Dent J, 1984 May;9(1):23-5.

PMID: 6599645

Removal of endocrine disrupting chemicals (EDCs) using low pressure reverse osmosis membrane (LPROM)

Razak AR, Ujang Z, Ozaki H

Water Sci Technol, 2007;56(8):161-8.

PMID: 17978444

Endocrine disrupting chemicals (EDCs) are the focus of current environmental issues, as they can cause adverse health effects to animals and human, subsequent to endocrine function. The objective of this study was to remove a specific compound of EDCs (i.e. pentachlorophenol, C(6)OCL(5)Na, molecular weight of 288 g/mol) using low pressure reverse osmosis membrane (LPROM). A cross flow module of LPROM was used to observe the effects of operating parameters, i.e. pH, operating pressure and temperature. The design of the experiment was based on MINITAB(TM) software, and the analysis of results was conducted by factorial analysis. It was found that the rejection of pentachlorophenol was higher than 80% at a recovery rate of 60 to 70%. The rejection was subjected to increase with the increase of pH. The flux was observed to be increased with the increase of operating pressure and temperature. This study also investigated the interaction effects between operating parameters involved.

Fulltext The olivopontocerebellar atrophies. Report of 4 cases

Razak AR, Pratap RC, Gururaj AK

Med J Malaysia, 1988 Dec;43(4):344-7.

PMID: 3241600

The effect of filler content and processing variables on dimensional accuracy of experimental composite inlay material

Razak AA, Harrison A

J Prosthet Dent, 1997 Apr;77(4):353-8.

PMID: 9104710

Dimensional accuracy of a composite inlay restoration is important to ensure an accurate fit and to minimize cementation stresses.

Fulltext Giant tracheocele

Razak A, Patil PH, Sahota JS, Subramanian S

J. Thorac. Cardiovasc. Surg., 2010 Mar;139(3):e27-8.

PMID: 19660304 DOI: 10.1016/j.jtcvs.2008.08.042

Fulltext Numb chin syndrome: an ominous sign of mandibular metastasis

Razak A, Goh BS, Rajaran JR, Nazimi AJ

BMJ Case Rep, 2018 May 14;2018.

PMID: 29764822 DOI: 10.1136/bcr-2017-223586

A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton. In the head and neck region, left mandibular foramen and oropharynx bilaterally showed increased metabolism suggestive of tumour metastasis. The diagnosis was numb chin syndrome secondary to mandibular metastasis. Apart from supportive treatment, she was started on palliative chemotherapy and radiotherapy. At the time of discharge, there were no active complaints other than the aforementioned hypoesthesia.

Prevalence of asthma, rhinitis and eczema among schoolchildren in Kelantan, Malaysia

Quah BS, Razak AR, Hassan MH

Acta Paediatr Jpn, 1997 Jun;39(3):329-35.

PMID: 9241894

The prevalence and severity of asthma, rhinitis and eczema in Kelantanese schoolchildren were determined as part of an international study of the epidemiology of asthma and allergic diseases. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 7055 schoolchildren from February 1995 to August 1995. The respondents were parents or guardians of 5- to 7-year-old children (n = 3939), and schoolchildren aged 12-14 years (n = 3116). The ISAAC video questionnaire (AVQ3.0) was shown to children aged 12-14 years after the written questionnaire. The overall prevalences of 'ever wheezed' and 'wheezing in last 12 months' were 9.4 and 6.0% respectively. The prevalence of 'ever diagnosed with asthma' was 9.4%. Both 'ever wheezed' and 'wheezing in the last 12 months' were significantly higher in 12- to 14-year-old children than in 5- to 7-year-old children, with P values of 0.0006 and 0.014 respectively. No gender differences in the prevalences were observed. For the complete study group, 4.7% of children had sleep disturbed by wheezing but only 1.1% had a severe attack limiting speech in the preceding 12 months. Sleep disturbance was more common in the 12- to 14-year-old children than in 5- to 7-year-old children (P = 0.006). There was no difference between the age groups for severe attacks limiting speech. The overall prevalence of rhinitis and eczema symptoms were 27 and 12%, respectively. The prevalence of rhinitis in the 12-14 year age group (38.2%) was significantly higher (P < 0.0001) than in the 5-7 year age group (18.2%). The prevalence of eczema in the 5-7 year age group (13.7%) was significantly higher (P = < 0.0001) than in the 12-14 year age group (9.9%). These prevalence data are comparable with previous reports in Malaysian children, but are considerably lower than those reported for most developed countries.

Contributory Factors for Severe Maternal Morbidity: A 10-Year Review of the Literature

Noor NM, Nik Hussain NH, Sulaiman Z, Abdul Razak A

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):9S-18S.

PMID: 26069164 DOI: 10.1177/1010539515589811

Maternal morbidity is a concept of increasing interest in maternal health. This review aims to assess the contributory factors for severe maternal morbidity over the past one decade worldwide. A comprehensive electronic search was conducted. The search was restricted to articles written in the English language published from 2004 to 2013. Qualitative studies were excluded. A total of 24 full articles were retrieved of which 9 cohort, 7 case-control, 3 cross-sectional studies, and 5 unmentioned designs were included. The contributory factors were divided into 3 components: (a) sociodemographic characteristics, (b) medical and gynecological history, and (c) past and present obstetric performance. This review informs emerging knowledge regarding contributory factors for severe maternal morbidity and has implications for education, clinical practice and intervention. It enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy for maternal morbidity and mortality.

Fulltext Evaluation of Retinal Nerve Fiber Layer Thickness, Electroretinogram and Visual Evoked Potential in Patients with Alzheimer's Disease

Ngoo QZ, Wan Hitam WH, Ab Razak A

J Ophthalmol, 2019;2019:6248185.

PMID: 31949951 DOI: 10.1155/2019/6248185

OBJECTIVE: To study the retinal nerve fibre layer (RNFL) thickness and visual electrophysiology testing in patients with Alzheimer's disease (AD).

METHODS: A cross-sectional, hospital-based study: 25 AD subjects and 25 controls were recruited. Candidates who fulfil the criteria with normal ocular examinations were made to proceed with scanning laser polarimetry, pattern electroretinogram (PERG), and pattern visual evoked potential (PVEP) examinations of the right eye. RNFL thickness, PERG, and PVEP readings were evaluated.

RESULTS: In AD, the mean of average RNFL thickness was 45.28 μm, SD = 3.61, P < 0.001 (P < 0.05), while the superior RNFL thickness was 54.44 μm, SD = 2.85, P < 0.001 (P < 0.05) and inferior RNFL thickness was 47.11 μm, SD = 4.52, P < 0.001 (P < 0.05). For PERG, the mean P50 latency was 63.88 ms, SD = 7.94, P < 0.001 (P < 0.05) and the mean amplitudes of P50 waves were 1.79 μV, SD = 0.64, P < 0.001 (P < 0.05) and N95 waves were 2.43 μV, SD = 0.90, P < 0.001 (P < 0.05). For PVEP, the mean latency of P100 was 119.00 ms, SD = 9.07, P < 0.001 (P < 0.05), while the mean latency of N135 was 145.20 ms, SD = 8.53, P < 0.001 (P < 0.05). The mean amplitude of P100 waves was 3.71 μV, SD = 1.60, P < 0.001 (P < 0.05), whereas the mean amplitude of N135 waves was 3.67 μV, SD = 2.02, P < 0.001 (P < 0.05). RNFL thickness strongly correlates with PERG readings, with P50 latency R = 0.582, R2 = 0.339, P=0.002 (P < 0.05), amplitude of P50 wave at R = 0.749, R2 = 0.561, P ≤ 0.001 (P < 0.05), and amplitude of N95 wave at R = 0.500, R2 = 0.250, P=0.011 (P < 0.05). No significant difference and correlation were observed on PVEP readings.

CONCLUSION: The mean of the average, superior and inferior RNFL thickness were significantly lower in the AD group compared with control. There is also significant difference of PERG and PVEP parameters between AD and controls. Regression analysis showed average RNFL thickness having significantly linear relationship with the PERG parameters.

Incidence of pain after biomechanical preparation: a review of 302 cases treated by dental students

Mohd Sulong MZ, Abu-Hassan MI, Abdul Razak AA, Embong A

Singapore Dent J, 1996 Jul;21(1):31-5.

PMID: 10597181

Records of 302 root-filled teeth treated by dental undergraduates were reviewed by four lecturers in the Department of Conservative Dentistry, University of Malaya. Preoperative and operative factors were evaluated for their association with postoperative pain experience of patients during the visit immediately after completion of biomechanical preparation. Eighty four percent of patients did not experience any pain after biomechanical preparation whilst the remaining 16 percent only complained of slight or moderate pain. The incidence of pain after biomechanical preparation is not high even when performed by inexperienced undergraduates. Teeth with a pre-existing painful condition had a higher chances of postoperative of pain. The incidence of postoperative pain was halved when teeth were associated with a sinus tract.

Some mechanical properties of a highly cross-linked, microwave-polymerized, injection-molded denture base polymer

Memon MS, Yunus N, Razak AA

Int J Prosthodont, 2001 May-Jun;14(3):214-8.

PMID: 11484567

PURPOSE: The impact strength and the flexural properties of denture base materials are of importance in predicting their clinical performance upon sudden loading. This study compares the impact and transverse strengths and the flexural modulus of three denture base polymers.
MATERIALS AND METHODS: The investigation included a relatively new microwave-polymerized polyurethane-based denture material processed by an injection-molding technique, a conventional microwave-polymerized denture material, and a heat-polymerized compression-molded poly(methyl methacrylate) (PMMA) denture material. Impact strength was determined using a Charpy-type impact tester. The transverse strength and the flexural modulus were assessed with a three-point bending test. The results were subjected to statistical analysis using a one-way analysis of variance and the Scheffé test for comparison.
RESULTS: The impact strength of the microwave-polymerized injection-molded polymer was 6.3 kl/m2, while its flexural strength was 66.2 MPa. These values were lower than those shown by the two compression-molded PMMA-based polymers. The differences were statistically significant. The flexural modulus of the new denture material was 2,832 MPa, which was higher than the conventional heat-polymerized polymer but was comparable to the other microwave-polymerized PMMA-based polymer. The difference in the flexural modulus was statistically significant.
CONCLUSION: In terms of the impact and flexural strengths, the new microwave-polymerized, injection-molded, polyurethane-based polymer offered no advantage over the existing heat- and microwave-polymerized PMMA-based denture base polymers. However, it has a rigidity comparable to that of the microwave-polymerized PMMA polymer.

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.

Driver characteristics associated with child safety seat usage in Malaysia: a cross-sectional study

Kulanthayan S, Razak A, Schenk E

Accid Anal Prev, 2010 Mar;42(2):509-14.

PMID: 20159074 DOI: 10.1016/j.aap.2009.09.015

The rapidly motorizing environment in Malaysia has made child occupant safety a current public health concern. The usage of child safety seats (CSS) is a widely regarded intervention to enhance child occupant safety, yet no study has been conducted on CSS in Malaysia. This study aims to determine the CSS usage rates in Malaysia and to assess driver characteristics that are associated with CSS usage.

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students

Kawamura M, Wright FA, Declerck D, Freire MC, Hu DY, Honkala E, et al.

Int Dent J, 2005 Aug;55(4):205-11.

PMID: 16167608

To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students.

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