MyMedR

Fulltext Cricotracheal separation: a case of delayed diagnosis and treatment

Hashima AR, Marina MB, Sani A

Med J Malaysia, 2011 Jun;66(2):144-5.

A motorcyclist was involved in a motor vehicle accident and presented with respiratory distress and neck swelling with surgical emphysema. He sustained gross tracheal injury, severe pneumothoraces and lung contusions. As intubation was successful, the tracheal injury was not addressed immediately in view of the other severe respiratory problems. Evidence of aspiration lead to further investigations which confirmed the diagnosis 22 days post trauma. Thyrotracheal anastomosis was carried out without stenting. A complete cricotracheal separation is a rare event and can be easily overlooked in the emergency department.

Fulltext Effects of uvulopalatopharyngoplasty: a seven year review

Aneeza WH, Marina MB, Razif MY, Azimatun NA, Asma A, Sani A

Med J Malaysia, 2011 Jun;66(2):129-32.

PMID: 22106693 MyJurnal

To review the long term outcome of Uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnoea syndrome in a tertiary referral centre. 38 records were traced where UPPP was done from July 2000 to December 2007. 14 patients were followed up for one to seven years where the Epworth sleepiness scale was scored, long term side effects documented and post operative muller's manoeuvre done. Success of UPPP is defined as a reduction in apnoea hypopnea index (AHI) more than 50%. Sixty percent (60%) were successfully treated with UPPP in the long term. Mean ESS was significantly reduced from 12 +/- 6 to 7 +/- 4. 11 out of 14 patients (78.5%) were reported to develop long term side effects of UPPP, the highest being velopharyngeal insufficiency (42.8%). In conclusion, UPPP is effective in improving symptoms of OSA in the long term. However, in view of its side effects, uvula preserving surgery should be considered as a surgical option.

Fulltext Triple primary cancers of the larynx, lung and thyroid presenting in one patient

Iqbal FR, Sani A, Gendeh BS, Aireen I

Med J Malaysia, 2008 Dec;63(5):417-8.

PMID: 19803306 MyJurnal

Patients with multiple malignant primary tumours are often described, based on their chronology of presentation, as simultaneous, synchronous or metachronous tumours. Lung malignancies presenting in association with head and neck tumours are well documented while there have been small series of thyroid synchronous cancers presenting with laryngeal lesions in literature. No cases, to our knowledge, have been reported in literature of a single patient with all three laryngeal, lung and thyroid malignancies. We report one such case of a 71-year-old Chinese man who had undergone a total laryngectomy for a recurrent cancer of the larynx only to be found to have tumours of the lung and thyroid in the post-operative period and he eventually died of post-operative complications. We also discuss screening for lung and thyroid malignancies in patients with head and neck squamous cell carcinoma (SCC).

Fulltext Pleomorphic adenoma of the trachea

Ashwaq AM, Sani A

Med J Malaysia, 2007 Jun;62(2):162-3.

PMID: 18705454 MyJurnal

Primary tracheal tumors are very rare. Pleomorphic adenoma is rarely found in the trachea, despite being the most common histological form of salivary gland neoplasm. We present a case of pleomorphic adenoma of the trachea. Bronchoscopic excision using cold instruments resulted in apparently normal tracheal mucosa.

Fulltext Intramuscular haemangioma in the head and neck

Nurlizams I, Kenalims MS, Sani A

Med J Malaysia, 2007 Dec;62(5):409-10.

PMID: 18705477 MyJurnal

Intramuscular haemangioma is a rare tumour of the head and neck region. This patient presented with progressive painless swelling in the parotid region since she was three years old. Intramuscular haemangioma of the masseter was diagnosed at the age of 34 and she was successfully treated with surgical excision.

Fulltext Concurrent mycobacterial infection and non-Hodgkin's lymphoma at the same site in an AIDS patient

Kenali MS, Fadzilah I, Maizaton AA, Sani A

Med J Malaysia, 2004 Mar;59(1):108-11.

PMID: 15535345

A 31 years old Chinese male with acquired immunodeficiency syndrome (AIDS) presented with concurrent mycobacterial infection and a synchronous non-Hodgkin's lymphoma of the nose. The diagnoses were made over a period of two months. Treatment for the mycobacterial infection was administered but he succumbed to the disease shortly after the diagnosis of NHL was established. This was an unusual case where two pathologies occurred in the same site in a patient with AIDS.

Fulltext Swiftlase assisted CO2 laser ablation in the treatment of nasal obstruction due to hypertrophy of the inferior turbinates

Sani A, Primuharsa P

Med J Malaysia, 2001 Jun;56(2):174-9.

PMID: 11771077

Hypertrophy of the inferior turbinates are the major cause of nasal obstruction. CO2 lasers have been used to reduce the size of the inferior turbinates over the last 20 years. However, the many techniques of delivery of the laser show that there is no one standard method reducing the size of the turbinates. We now describe how the laser can be applied directly to the turbinates using a handpiece with a special nasal tip, thus overcoming the disadvantages delivery via arthroscopic devices, microscopes and fibers. This technique is further enhanced by coupling it with Swiftlase which swirls the focused beam in a 3 mm spot thus ablating tissue more quickly. This procedure is done under local anaesthesia. The ablation of the anterior third of the inferior turbinates effectively overcomes nasal obstruction. This new method was compared to the more traditional submucus diathermy. 22 patients were subjected to laser treatment whilst 20 patients were subjected to diathermy. The outcome was evaluated subjectively by the patients themselves at 2 weeks, 3 months and 6 months. At the end of the study, the laser group reported a more significantly improved nasal airway (91% against 75%) and decreased rhinorrhea (72.7% against 35%) when compared to the diathermy group.

Fulltext Carcinoma of the larynx in Malaysia

Sani A, Said H, Lokman S

Med J Malaysia, 1992 Dec;47(4):297-302.

PMID: 1303483

A retrospective study of cases with carcinoma of the larynx seen in the Universiti Kebangsaan Malaysia (UKM) and General Hospital Kuala Lumpur (GHKL) between 1981 to 1988 was performed. The aim was to document the distribution and the pattern of behaviour of this tumour amongst our patients. There were 137 cases, the majority of whom were Chinese (54%). The peak incidence was in the seventh decade and the male to female ratio was 7.6:1. The most common symptom at presentation was hoarseness (90%). The most common histological type was squamous cell carcinoma (87%) whilst by site, transglottic involvement was commonest (55%). The overall 3 year survival rate was 68%. Supraglottic carcinoma behaved differently in that a significantly large number presented with dysphagia (33.3%) and neck nodes (42%). Compared to tumours of other sites of the larynx, they had the poorest 3 year survival rate of 50%. Amongst the T2 and T3 tumours, the results of surgery appeared better than primary radiotherapy. Considering that 26% of patients presented with stridor, 20% with neck nodes and 55% with multiple site involvement, it can be concluded that our patients present themselves late.

Empirical treatment with pantoprazole as a diagnostic tool for symptomatic adult laryngopharyngeal reflux

Masaany M, Marina MB, Sharifa Ezat WP, Sani A

J Laryngol Otol, 2011 May;125(5):502-8.

PMID: 21356141 DOI: 10.1017/S0022215111000120

To determine the sensitivity and specificity of intensive empirical treatment with pantoprazole in diagnosing laryngopharyngeal reflux in adults.

Prevention of aspiration following recurrent dislodgement of voice prosthesis: a patient's innovation

Masaany M, Marina MB, Asma A, Sani A

J Laryngol Otol, 2009 Jun;123(6):680-2.

PMID: 18544175 DOI: 10.1017/S0022215108002958

To demonstrate a simple, practical, cheap method of preventing potentially fatal aspiration of a dislodged voice prosthesis; this method was developed by a laryngectomised patient.

Ultrasound-guided botulinum toxin A injection: an alternative treatment for dribbling

Marina MB, Sani A, Hamzaini AH, Hamidon BB

J Laryngol Otol, 2008 Jun;122(6):609-14.

PMID: 17640435

Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A. Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure. Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.

Pyopneumothorax--a rare sequelae of retropharyngeal abscess

Lokman S, Sani A, Sidek DS

J Laryngol Otol, 1993 May;107(5):460-2.

PMID: 8326234

A case of massive pyopneumothorax as a rare sequelae of retropharyngeal abscess following fish bone ingestion is reported. An initial attempt at removal of the fish bone in the oesophagus using the fibroptic oesophagoscope was unsuccessful, causing failure of its removal and the development of this rare and potentially fatal complication. The intercommunication of the retropharyngeal space with other spaces of the neck and thorax that allow this and most other complications to occur is described. Rigid endoscopes are the instrument of choice in retrieving sharp foreign bodies in the oesophagus.

Carbon dioxide laser stomaplasty for tracheostomal stenosis

Sani A

J Laryngol Otol, 1998 May;112(5):467-8.

PMID: 9747477

A method of treating tracheostomal stenosis post-laryngectomy is described. The carbon dioxide (CO2) laser is used to fashion and ablate two triangular areas lateral to the stenosed stoma to provide an immediate enlarged stoma for comfortable breathing. This simple procedure is done under local anaesthesia, is almost bloodless, safe and takes just 10 minutes. Over the last five years eight patients underwent this procedure and seven had a satisfactory stoma without the need to use a tracheostomy tube.

Fulltext Newborn hearing screening: experience in a Malaysian hospital

Abdullah A, Hazim MY, Almyzan A, Jamilah AG, Roslin S, Ann MT, et al.

Singapore Med J, 2006 Jan;47(1):60-4.

PMID: 16397723

This study aims to determine the prevalence of hearing loss among newborns delivered at Hospital Universiti Kebangsaan Malaysia and to evaluate the usefulness of our hearing screening protocol.

Fulltext Relationship between sensory neuropathy and body imbalance among diabetic malay women. [Hubungan antara sensori neuropati dan ketidakseimbangan badan di kalangan wanita Melayu diabetik]

Kamaralzaman S, Budin SB, Mohamed J, Sidi H, Yau M, Sani A

Sains Malaysiana, 2011;40(8):945–951.

Neuropathy is a problem often suffered by patients with diabetes mellitus. Types of neuropathy that occur are peripheral neuropathy and autonomic neuropathy. This cross sectional study was conducted to determine the association between duration of diabetes and loss of protective sensation and the association between imbalance and loss of protective sensation among Malay women with diabetes mellitus. Eighty one Malay women with diabetes mellitus, aged 20 to 60 years from three clinics in Hulu Langat District participated in this study. Socio-demographic information were obtained from respondent using a questionnaire. Foot sensory evaluation was conducted using Semmes-Weinstein Monofilament
grade 5.07. Assessment of balance was done using Timed One-leg Stance. Chi-squared test was used to determine the association between the two variables. Result showed that 56.8% of respondent had loss of protective sensation on at least one foot. While, 17.3% had imbalance while eyes were open and 60.5% experienced imbalance while eyes were closed. However, there was no significant correlation (p<0.05) between imbalance while eyes opened [χ2=3.27, p=0.07] and while eyes close [χ2=0.29, p=0.59]) with loss of protective sensation in at least one foot. Similar result were obtained between duration of diabetes and the loss of protective sensation. (χ2=3.27, p=0.20). Although there was no association between these factors, a screening program should start early to ensure early problems are identified before more severe complications occur.
Keywords: Diabetes mellitus; imbalance; loss of protective sensation; Malay women
Study site: Klinik Kesihatan, Hulu Langat, Selangor, Malaysia

Fulltext KCO: Balancing class distribution in just-in-time software defect prediction using kernel crossover oversampling

Ismail AM, Ab Hamid SH, Abdul Sani A, Mohd Daud NN

PLoS One, 2024;19(4):e0299585.

PMID: 38603718 DOI: 10.1371/journal.pone.0299585

The performance of the defect prediction model by using balanced and imbalanced datasets makes a big impact on the discovery of future defects. Current resampling techniques only address the imbalanced datasets without taking into consideration redundancy and noise inherent to the imbalanced datasets. To address the imbalance issue, we propose Kernel Crossover Oversampling (KCO), an oversampling technique based on kernel analysis and crossover interpolation. Specifically, the proposed technique aims to generate balanced datasets by increasing data diversity in order to reduce redundancy and noise. KCO first represents multidimensional features into two-dimensional features by employing Kernel Principal Component Analysis (KPCA). KCO then divides the plotted data distribution by deploying spectral clustering to select the best region for interpolation. Lastly, KCO generates the new defect data by interpolating different data templates within the selected data clusters. According to the prediction evaluation conducted, KCO consistently produced F-scores ranging from 21% to 63% across six datasets, on average. According to the experimental results presented in this study, KCO provides more effective prediction performance than other baseline techniques. The experimental results show that KCO within project and cross project predictions especially consistently achieve higher performance of F-score results.

Fulltext Antimicrobial activities of three different seed extracts of Lansium varieties

Alimon, H, Abdullah Sani, A., Syed Abdul Azziz, S. S., Daud, N., Mohd Arriffin, N., Mhd Bakri, Y.

Pertanika Journal of Science & Technology, 2014;22(2):529-540.

MyJurnal

Lansium domesticum Corr. is a fruit tree of the Meliaceae family, which is commonly found in SouthEast Asia with a wide range of varieties. This study investigated three varieties of L. domesticum; Duku, Langsat and Dokong for the phytochemical screening and antimicrobial activity. Seeds from the matured fruits were extracted using hexane, methanol and water. The crude extracts were screened for antimicrobial activities toward three bacteria, namely, Pseudomonas aeruginosa, Bacillus subtilis, and Staphylococcus aureus. The findings showed that Langsat seed extracts contained more groups of compounds compared with the other two varieties, and its methanol extract demonstrated the highest inhibition zones against the three bacteria. The crude methanol extract of Duku seeds showed inhibition zones only towards Bacillus subtilis at a high concentration (1.0 mgL-1), whilst the seed extracts of Dokong showed no inhibition zones towards any of the tested bacteria.

Validity and Reliability Study of Bahasa Malaysia Version of Voice Handicap Index-10

Ong FM, Husna Nik Hassan NF, Azman M, Sani A, Mat Baki M

J Voice, 2019 Jul;33(4):581.e17-581.e23.

PMID: 29793874 DOI: 10.1016/j.jvoice.2018.01.015

OBJECTIVES: This study aimed to determine the validity and reliability of Bahasa Malaysia version of Voice Handicap Index-10 (mVHI-10).

MATERIALS AND METHODS: This cross-sectional study was carried out in the Otorhinolaryngology, Head and Neck Surgery Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from June 2015 to May 2016. The mVHI-10 was produced following a rigorous forward and backward translation. One hundred participants, including 50 healthy volunteers (17 male, 33 female) and 50 patients with voice disorders (26 male, 24 female), were recruited to complete the mVHI-10 before flexible laryngoscopic examinations and acoustic analysis. The mVHI-10 was repeated in 2 weeks via telephone interview or clinic visit. Its reliability and validity were assessed using interclass correlation.

RESULTS: The test-retest reliability for total mVHI-10 and each item score was high, with the Cronbach alpha of >0.90. The total mVHI-10 score and domain scores were significantly higher (P

Nonselective Laryngeal Reinnervation versus Type 1 Thyroplasty in Patients with Unilateral Vocal Fold Paralysis: A Single Tertiary Centre Experience

Ab Rani A, Azman M, Ubaidah MA, Mohamad Yunus MR, Sani A, Mat Baki M

J Voice, 2021 May;35(3):487-492.

PMID: 31732294 DOI: 10.1016/j.jvoice.2019.09.017

OBJECTIVE: This study compared the voice outcomes of selected patients with unilateral vocal fold palsy (UVFP) who underwent either nonselective laryngeal reinnervation (LR) or Type 1 thyroplasty (thyroplasty) in a Malaysian tertiary centre using multidimensional voice assessments.

PARTICIPANTS: The study included 16 patients with UVFP who underwent either LR (9 patients) or thyroplasty (7 patients) between 2015 and 2018 who fulfilled the inclusion criteria.

MAIN OUTCOME MEASURES: The outcomes were measured subjectively and objectively with: (1) voice handicap index-10 (VHI-10- Malay version); (2) auditory perceptual evaluation using the breathiness component of Grade, Roughness, Breathiness, Asthenia, Strain scale; (3) maximum phonation time (MPT); and (4) acoustic analysis (jitter%, shimmer%, and NHR) using OperaVOXTM. The outcomes were measured at baseline, 6 and 12-months postoperative. The comparison of outcomes between pre and postoperative of each group was evaluated using one-way ANOVA test. Mann-Whitney test was used to compare the outcomes between the two groups.

RESULTS: Comparison of each group at different time points showed significant improvement of VHI-10 and MPT of LR group between baseline and 12 months (P ≤ 0.05) whereas, the improvement in thyroplasty group was observed at all time points (P ≤ 0.05). When comparing between the two groups at 12 months, the VHI-10 and MPT was significantly better in the LR group than thyroplasty group with P = 0.004 and P = 0.001 respectively. Other outcome measures did not reveal significant difference between the two groups.

CONCLUSION: This observational study showed that LR may be better than thyroplasty in improving VHI-10 and MPT in selected patients with UVFP.

Fulltext Myeloid sarcoma: An unusual and rare laryngeal presentation

Tan SN, Gendeh HS, Sani A, Mat-Baki M

Int J Surg Case Rep, 2016;21:99-103.

PMID: 26957189 DOI: 10.1016/j.ijscr.2016.02.012

Myeloid Sarcoma (MS) or Granulocytic Sarcoma is an uncommon laryngeal malignancy. It may arise from myelodysplastic syndromes, malignancy or de novo. Presentation in the larynx is rare and some may present with Acute Myeloid Leukaemia (AML) whereby the later may be asymptomatic.

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