Displaying publications 1 - 20 of 25 in total

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  1. Noordin R, Shenoy RK, Rahman RA
    PMID: 15115085
    Brugia malayi infection is endemic in several Asian countries. Filaria-specific IgG4 antibody detection based on BmR1 recombinant antigen has been shown to be sensitive and specific for the diagnosis of brugian filariasis. Two formats of the test has been reported ie indirect ELISA (BE) and rapid dipstick test (BR). Since different test formats use different amounts of sample and reagents which may affect its sensitivity and specificity, this study was performed to compare these two test formats in the detection of B. malayi. A total of 264 blinded serum samples from India and Malaysia were employed. Group 1 comprised 164 samples from actively infected individuals and group 2 comprised 100 samples from filaria non-endemic areas. Sensitivity was 96.3% (158/164) and 90.8% (149/164) for rapid test and ELISA respectively; chi-square p=0.00. Both test formats demonstrated 100% specificity. Therefore the rapid test format was equally specific but more sensitive than the ELISA format. The ELISA format would be able to demonstrate decline in IgG4 titer post-treatment while the rapid test would be very useful for screening and diagnosis in the field.
  2. Rohana A, Hisham AN
    Asian J Surg, 2009 Apr;32(2):81-4.
    PMID: 19423453 DOI: 10.1016/S1015-9584(09)60015-4
    BACKGROUND: Acute life threatening presentations of thyroid disease are uncommon. The aim of this study was to review our experience of emergency thyroid surgery with regard to the incidence, management and outcome to this approach.
    METHODS: Forty patients who underwent emergency thyroid surgery from December 1998 to December 2007 were prospectively accrued in this study. There were 30 female and 10 male patients. The mean age was 63.8 years (range, 33-83 years). All patients had total thyroidectomy, except one patient who only had a right hemithyroidectomy for a dominant right multinodular goiter. Eight of the patients had been intubated before referring to our centre.
    RESULTS: The mean weight of specimen was 219 g (range, 32-800 g). A histopathology report confirmed 16 patients had multinodular goiters, eight patients had papillary thyroid carcinomas, seven patients had anaplastic cancers, four patients had follicular thyroid carcinomas, two patients had thyroid lymphoma, one patient had medullary carcinoma, one patient had sarcoma and one patient had thyroid abscess. A total of 28 patients were discharged well postoperatively.
    CONCLUSION: Acute life threatening presentations of thyroid disease are uncommon. However, early recognition of these problems is crucial and may life saving. Emergency thyroidectomy is important to release the critically obstructed airways. Nonetheless it is associated with higher risk of surgery and complication rate then any elective thyroid surgery.
  3. Nurul-Farehah S, Rohana AJ
    Malays Fam Physician, 2020;15(2):34-42.
    PMID: 32843943
    Maternal obesity is a global public health concern that affects every aspect of maternity care. It affects the short-term and long-term health of the mother and her offspring. Obese pregnant mothers are at an increased risk of developing complications during antenatal, intrapartum, and postnatal periods. Maternal complications include gestational diabetes mellitus, hypertensive disorder in pregnancy, pre-eclampsia and eclampsia, increased rate of cesarean delivery, pulmonary embolism, and maternal mortality; fetal complications include congenital malformation, stillbirth, and macrosomia. Moreover, both mother and infant are at an increased risk of developing subsequent non-communicable diseases and cardiovascular problems later in life. Several factors are associated with the likelihood of maternal obesity, including sociodemographic characteristics, obstetric characteristics, knowledge, and perception of health-promoting behavior. Gaining a sound understanding of these factors is vital to reaching the targets of Sustainable Developmental Goal 3-to reduce global maternal mortality and end preventable deaths of children under 5 years of age-by 2030. It is essential to identify pregnant women who are at risk of maternal obesity in order to plan and implement effective and timely interventions for optimal pregnancy outcomes. Importantly, maternal obesity as a significant pregnancy risk factor is largely modifiable.
  4. Segasothy M, Suleiman AB, Puvaneswary M, Rohana A
    Nephron, 1988;50(1):50-4.
    PMID: 3050572
    180 patients with end-stage renal disease (ESRD) on maintenance dialysis and those who had undergone renal transplantation were questioned retrospectively. 14 patients had consumed excessive quantities of analgesics (greater than 1 kg) prior to the institution of long-term dialysis or transplantation. Sonographic examination done on these patients indicated that 7 had renal papillary necrosis (RPN). The sonographic features were renal papillary calcifications surrounding the central sinus in a complete or incomplete garland pattern. In 5 of these patients RPN is attibutable to the excessive consumption of paracetamol. We have earlier reported 10 cases of RPN due to excessive consumption of paracetamol. Thus 15 cases of RPN attributable to paracetamol consumption (1.0-15.3 kg over a period ranging from 3 to 23 years) have been documented. It is concluded that paracetamol may assume an increasingly important role in the causation of analgesic nephropathy (AN) and ESRD.
  5. Gunavathy M, Rohana AG, Norlela S, Nor Azmi K
    Med J Malaysia, 2014 Jun;69(3):133-7.
    PMID: 25326355 MyJurnal
    Gastroenteropancreatic neuroendocrine tumours (GEP- nETs) are rare neoplasms with a complex spectrum of presentation. The study cohort (n=64) included the diagnoses of carcinoid, (n=26, 41%), insulinoma, (n=25, 39%), undetermined (n=10, 16%), VIPoma, glucagonoma and multiple endocrine neoplasia (MEn-1) (n= 3). Almost half of the patients (n=31) had distant metastasis at diagnosis, the commonest being carcinoid tumours. Presenting symptoms were due to either hormonal expressions or mass effects. diagnoses in all patients were made based on positive immunohistochemical staining for chromogranin and synaptophysin. Less than half (n=30) had either serum chromogranin A, urinary 5-hydroxyindole acetic acid (5-hIAA), serum insulin or C-peptide levels performed. Commonest diagnostic imaging modalities were computed tomography (CT) scan (94%) and abdominal ultrasound (15%). Curative or palliative surgery was performed in 58 patients. Systemic therapy included long acting somatostatin analogues (n=14), chemotherapy (n=7) and interferon-α2b (n=1). nine patients died, all of who had metastatic disease at diagnosis. All patients with insulinoma (n=25) were assessed by endocrinologists whilst carcinoid tumours were mainly managed by surgeons (n=16/26). Involvements of oncologists and gastroenterologists were minimal. This study showed that patients with GEP-nETs in Malaysia commonly presented late in the disease with presence of distant metastases. Less than half had adequate hormonal and biochemical examinations performed for diagnostic as well as prognostic purposes, and only a third received systemic therapy. Lack of institutionalbased database, clinical expertise and multi-disciplinary involvement contributed to the inadequate surveillance and management of the disease.
  6. Zulkifli KK, Mohamed Shah FZ, Ismail AI, Abdul Rahman TH, Ghani RA
    Chron Respir Dis, 2021;18:14799731211056348.
    PMID: 34797178 DOI: 10.1177/14799731211056348
    OBJECTIVES: Dysglycemia is known to be a common comorbidity of chronic obstructive pulmonary disease (COPD). However, undiagnosed dysglycemia and the associated factors remain under-reported. This study aimed to determine the prevalence and the associated factors of dysglycemia among COPD patients.

    METHODS: This was a cross-sectional, single-center study involving adults with established COPD (n = 186) divided into those with or without hospital admissions for acute exacerbation. Oral glucose tolerance test (OGTT) was performed in patients with no known history of dysglycemia.

    RESULTS: There were 16 patients who had overt diabetes, and 32 had prediabetes following the OGTT. Forty percent had histories of hospital admissions for COPD exacerbations. Both groups demonstrated similar 2-h post prandial glucose, glycated hemoglobin (HbA1c) and fasting blood glucose. The incidences of newly diagnosed dysglycemia were higher in both groups (40.8% vs 34.6%, p = 0.57). Cumulative days of admission (≥6 days/year) and weight (≥65 kg) were identified as predictors for dysglycemia within the study population.

    DISCUSSION: This study demonstrated a high number of overt and newly diagnosed dysglycemia among COPD patients who had no previous history of abnormal glucose. Recent acute exacerbations of COPD could have a negative impact on glycemia, although the results did not attain statistical significance. However, there is a need for adequate screening for dysglycemia, particularly among those with frequent acute exacerbations of their condition.

  7. Rohana AG, Ming W, Norlela S, Norazmi MK
    Med J Malaysia, 2007 Jun;62(2):158-9.
    PMID: 18705452 MyJurnal
    We report a case of a young hypertensive male who was first seen in 1998 with a right thalamic haemorrhage and uncontrolled hypertension. CT abdomen showed a right adrenal tumour and a hyperplastic left adrenal gland. Laparoscopic adrenalectomy performed followed by histopathological examination confirmed the diagnosis of adrenal adenoma. He subsequently presented to us again a year later with persistent hyperkalaemia and asymptomatic hyponatraemia. Further investigations strongly suggested the presence of isolated mineralocorticoid deficiency with normal cortisol levels. This was confirmed to be due to partial or late-onset congenital adrenal hyperplasia (CAH). We discuss the association of partial CAH and adrenal tumours and the unmasking of the mineralocorticoid deficiency following adrenalectomy.
  8. Rahmah N, Lim BH, Azian H, Ramelah TS, Rohana AR
    Trop Med Int Health, 2003 Feb;8(2):158-63.
    PMID: 12581442
    Brugian filariasis infects 13 million people in Asia. The routine prevalence survey method using night thick blood smear is not sensitive enough to reflect the actual infection prevalence. In 1997-2001, only three microfilaraemic cases (of 5601 individuals screened; 0.05%) were reported in Pasir Mas, a district in Kelantan (Malaysia), which shares a border with Thailand. We therefore investigated the infection prevalence in this district by employing a sensitive and specific serological assay (Brugia-Elisa). This test is based on detection of specific IgG4 antibody against a Brugia malayi recombinant antigen. A total of 5138 children, aged 7-12 years, from 16 primary schools, were tested. Eighteen pupils in eight schools, located in five subdistricts, tested positive, giving an overall prevalence rate of 0.35%. Infection in these children is significant as they represent more recent cases. These subdistricts should be included in the national filariasis elimination programme.
  9. Wan Rosli W. I., Rohana, A. J., Gan, S. H., Noor Fadzlina, H., Rosliza, H., Helmy, H., et al.
    MyJurnal
    The total lipid contents and the concentration of eicosapentaenoic (EPA) and docosahexaenoic
    (DHA) fatty acid of fourteen selected marine, three freshwater fish species, four shellfish species and two selected canned fish species of East Coast of Peninsular Malaysia were determined. The fat content of all samples ranged from 1.01 % to 15.83 % with silver catfish reported to have the highest value. Most of the fish had fat amounts lower than 10% of their total weight. In general, DHA concentrations (50.50-165.21 µg/g) were significantly higher than EPA (11.12-55.38 µg/g) in all of the fish species analyzed. Among all marine fish species, the sixbar grouper recorded the highest concentration of DHA (165.21 µg/g) while barramundi had the highest concentration of EPA (55.38 µg/g). In conclusion, all fish and shellfish species are considered a good source of EPA and DHA, representing a very valuable essential nutrient for maintenance of human health.
  10. Mas-Harithulfadhli-Agus AR, Hamid NA, Rohana AJ
    Ethn Health, 2021 02;26(2):264-279.
    PMID: 30041543 DOI: 10.1080/13557858.2018.1494820
    Objectives: The objectives of this study were to determine the prevalence of malnutrition among five-year-olds and factors associated with unsuccessful outcome of a Food Basket Programme (FBP) in a rural district of Kelantan, Malaysia.Design: Administrative health records from selected health clinics were reviewed. Study sample includes indigenous population or Orang Asli of Malaysia. Unsuccessful outcome was defined according to failure to complete the programme according to growth gain and on-time. Multiple logistics regression was used to assess the associated factors of unsuccessful outcome of FBP.Results: This study showed that the prevalence rates of malnutrition among children below five years old were 34.2% underweight, 16.4% thinness, 32.5% stunting and 3.0% overweight, with Orang Asli children faring the worse. Orang Asli children were also five times more likely to be unsuccessful in the FBP (p 
  11. Ihab AN, Rohana AJ, Manan WM, Suriati WN, Zalilah MS, Rusli AM
    Int J Prev Med, 2013 Jun;4(6):690-9.
    PMID: 23930187
    The coexistence of under and over nutrition might be influenced by a marked shift in dietary and lifestyle practices of people in developing countries. This study aims to identify factors associated with the occurrence of dual form of malnutrition in the same households in a rural district in Peninsular Malaysia.
  12. Rohana AR, Rosli MK, Nik Rizal NY, Shatriah I, Wan Hazabbah WH
    Orbit, 2008;27(3):215-7.
    PMID: 18569833 DOI: 10.1080/01676830802009754
    We were presented with a teenage female who developed superior ophthalmic vein thrombosis and cavernous sinus thrombophlebitis after a 1-week history of a single acne-like lesion or furuncle at the anterior tip of the nose. She was managed aggressively with heparin and intravenous antibiotic. Signs and symptoms improved after 2 weeks of treatment, and she was discharged with an anticoagulant.
  13. Hamizah R, Rohana AG, Anwar SA, Ong TZ, Hamzaini AH, Zulkarnaen AN
    Med J Malaysia, 2007 Mar;62(1):70-1.
    PMID: 17682577 MyJurnal
    We report a case of a previously healthy 38-year old lady who presented with prolonged fever and hepatosplenomegaly. Intensive investigations were performed for pyrexia of unknown origin which revealed negative. CT scan of the abdomen showed multiple hypodense lesions which did not respond to broad-spectrum antibiotics. Percutaneous biopsy of the splenic lesion revealed granuloma formation and Langhan's giant cells suggestive of TB. She responded well with anti- TB medication but required extended treatment duration of 24 months due to persistence of the splenic lesion on repeated CT scans. This case illustrates a very rare clinical entity of isolated splenic TB with a therapeutic dilemma following incomplete resolution, despite prolonged treatment.
  14. Rohana AG, Norasyikin AW, Suehazlyn Z, Ming W, Norlela S, Norazmi MK
    Med J Malaysia, 2006 Dec;61(5):638-40.
    PMID: 17623970 MyJurnal
    We report a case of a 65 year old Malay lady with long-standing diabetes mellitus, who presented to our institution with a one month history of worsening neck pain and progressive upper and lower limb weakness. She was stable despite severe hyponatraemia which was initially treated as syndrome of inappropriate anti-diuretic hormone (SIADH). This was consistent with her underlying illness which was concluded as cervical tuberculosis (TB) with spinal cord compression. She underwent decompression and bone grafting. Despite continuous treatment her serum sodium levels remained low. There were no other problems with her adrenals or thyroid. A water loading and hypertonic saline perfusion test was performed and supported the diagnosis of reset osmostat. Her serum sodium remained below the normal range and she was discharged well.
  15. Soehardy Z, Hayati SN, Rozita M, Rohana AG, Halim AG, Norella K, et al.
    Med J Malaysia, 2006 Oct;61(4):484-6.
    PMID: 17243528 MyJurnal
    Membranous glomerulonephritis (MGN) is one of the common forms of nephrotic syndrome in the adult population. The majority of MGN are idiopathic, but the secondary forms can be seen in the setting of autoimmune disease, neoplasia, infection and following exposure to certain therapeutic agents. Histologically, MGN is an immunologically mediated disease in which immune complexes deposit in the subepithelial space. Syphilis is a venereal disease that can also be acquired by exposure to infected blood. Untreated syphilis may progress and develop renal complications such as membranous glomerulonephritis (MGN) or diffuse endocapillary glomerulonephritis with or without crescent formation. Today, with increasing awareness of sexually transmitted diseases especially HIV infection coupled by the practice of protected sexual intercourse and advancement of medicine, we have seen fewer and fewer cases of acquired syphilis. Furthermore, majority will present with typical syphilitic symptoms of such as chancre, rash, fever and lymph node enlargement in which case the diagnosis is easily obtained. We are reporting a case of acquired syphilis masquerading as membranous glomerulonephritis without typical syphilitic symptoms.
  16. Soehardy Z, Yuhanisa A, Thein SS, Rohana AG, Fauzi AR, Norlinah MI, et al.
    Med J Malaysia, 2005 Dec;60(5):655-6.
    PMID: 16515122
    We report a 40-year-old man who has Marfan's syndrome and was recently diagnosed to have pulmonary tuberculosis when he presented with chronic cough. He was admitted with bilateral lower limb weakness which was ascending in nature. He eventually required ventilation. It was initially thought to be isoniazid-neuropathy. However, stopping the drug did not improve the condition and the patient developed bilateral lower motor neuron 7th cranial nerve palsy. Nerve conduction, MRI and CSF studies were done to confirm a first case report of AMSAN variant progressing to CIDP in a patient with Marfan's syndrome and pulmonary tuberculosis.
  17. Tengku AT, Wan AM, Zaharah S, Rohana AJ, Nik Normanieza NM
    Malays J Nutr, 2012 Apr;18(1):15-25.
    PMID: 23717858 MyJurnal
    Despite evidence from various studies on exclusive breastfeeding (EBF) being best for infants, many women do not or are unable to practise EBF. This study aimed to examine perceptions on EBF and its influencing factors among a sample of Malay women in rural and urban areas in Kelantan, Malaysia.
  18. Zaizuhana S, Puteri J Noor MB, Noral'ashikin Y, Muhammad H, Rohana AB, Zakiah I
    Trop Biomed, 2006 Dec;23(2):214-9.
    PMID: 17322824 MyJurnal
    Kacip Fatimah also known as Labisia pumila (Myrsinaceae), is a traditional herbal medicine with a long history in the Malay community. It has been used by many generations of Malay women to induce and facilitate childbirth as well as a post-partum medicine. We tested the genotoxic potential of Kacip Fatimah in bone marrow cells obtained from Sprague-Dawley rats using micronuclei formation as the toxicological endpoints. Five groups of five male rats each were administered orally for two consecutive days with doses of 100, 700 and 2000 mg/kg body weight of Kacip Fatimah extract dissolved in distilled water. Micronucleus preparation was obtained from bone marrow cells of the animals following standard protocols. No statistically significant increase in micronucleated polychromatic erythrocytes (MNPCEs) was observed at any dose level and sacrifice/harvest time point (24, 48 and 72h). However, a significant decrease in polychromatic erythrocytes/normochromatic erythrocytes (PCE:NCE) ratio was observed from the highest dose level (2000 mg/kg of body weight) at 48h harvest time point. In this study, we investigated the effect of Kacip Fatimah on mammalian bone marrow cells using micronuclei formation to assess the genotoxicity of the herb.
  19. Ng CM, Badon SE, Dhivyalosini M, Hamid JJM, Rohana AJ, Teoh AN, et al.
    Sex Reprod Healthc, 2019 Jun;20:60-65.
    PMID: 31084820 DOI: 10.1016/j.srhc.2019.03.002
    OBJECTIVES: An optimal gestational weight gain is essential for maternal health and to reduce adverse birth outcomes. Current guidelines to monitor gestational weight gain are based on pre-pregnancy body mass index (BMI). However, middle-upper arm circumference (MUAC) is increasingly used as an alternative nutritional status measure for pregnant women. Hence, this study aimed to determine associations of MUAC and pre-pregnancy BMI with gestational weight gain rate among Malaysian pregnant women.

    STUDY DESIGN: A cross-sectional study was conducted among 444 pregnant women (≥20 weeks gestation).

    MAIN OUTCOMES MEASURES: Women completed questionnaires on sociodemographic data, maternal characteristics and pre-pregnancy weight. Height, current weight and MUAC were measured at study visit (from 1st February 2016 to 31st January 2017).

    RESULTS: About a third (34.24%) of pregnant women were overweight or obese prior to pregnancy. MUAC was inversely associated with an inadequate rate of gestational weight gain (OR = 0.77; 95% CI: 0.68, 0.87) as compared to normal gestational weight gain. In contrast, a higher MUAC was associated with a higher odds ratio (OR = 1.28; 95% CI: 1.11, 1.49) of having excessive rate of gestational weight. No associations were found for pre-pregnancy BMI categories for gestational weight gain rate.

    CONCLUSION: Our findings revealed that women with low MUAC were more likely to have an inadequate gestational weight gain rate during pregnancy whereas higher MUAC was associated with an excessive gestational weight gain rate. MUAC may be a useful indicator of nutritional status associated with GWG. Routine measurement of MUAC in pregnant women may help health professionals, particularly in middle-income countries, to counsel women about gestational weight gain.

  20. Sangeetha-Shyam, Fatimah A, Rohana AG, Norasyikin AW, Karuthan C, Nik SS, et al.
    Malays J Nutr, 2013 Apr;19(1):9-23.
    PMID: 24800381 MyJurnal
    Introduction: Gestational diabetes mellitus (GDM) increases risks for type 2
    diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve
    cardio-metabolic outcomes in insulin-resistant individuals. We examined the
    feasibility of lowering GI through GI-based-education among Asian post-GDM
    women. Methods: A 3-month investigation was carried out on 60 Malaysian
    women with a mean age of 31.0±4.5 years and a history of GDM. Subjects were
    randomised into two groups: LGIE and CHDR. The CHDR group received
    conventional healthy dietary recommendations only. The LGIE group received
    GI based-education in addition to conventional healthy dietary recommendations.
    At baseline and after 3-months, dietary intake of energy and macronutrient
    intakes including GI diet and glycaemic load was assessed using 3-day food
    records. Diabetes-Diet and GI-concept scores and physical activity levels were
    assessed using a questionnaire. Adherence to dietary instructions was measured
    at the end of 3 months. Results: At the end of 3 months, the LGIE group had
    significant reductions in energy intake (241.7±522.4Kcal, P=0.037, ES=0.463), total
    carbohydrate (48.7±83.5g, P=0.010, ES=0.583), GI (3.9±7.1, P=0.017, ES=0.549) and
    GL (39.0±55.3, P=0.003, ES=0.705) and significant increases in protein (3.7±5.4g,
    0.003, ES=0.685) and diet fibre (4.6±7.3g, P=0.06). The CHDR group had a significant
    reduction in fat only (5.7±9.4g, P=0.006, ES=0.606). There was a 30% increase in
    GI-concept scores in the LGIE group (p< 0.001). Changes in GI-concept scores
    correlated significantly to the reduction in dietary GI (r = -0.642, P=0.045). Dietary
    adherence was comparable in both groups. Conclusion: GI-education improves
    GI-concept knowledge and helps lower dietary glycaemic index among women
    with a history of GDM.
    Keywords: Diet, gestational diabetes mellitus, glycaemic index, glycaemic load,
    prevention, type 2 diabetes
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