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Fulltext High-flow priapism in a 12-year-old boy: Treatment with superselective embolization

Mossadeq AR, Sasikumar R, Nazli MZ, Shafie AM, Ashraf MD

Indian J Urol, 2009 Oct-Dec;25(4):539-40.
PMID: 19955685 DOI: 10.4103/0970-1591.57918

Priapism is caused by an imbalance between penile blood inflow and outflow. There are two types of priapism: low-flow priapism due to venous occlusion and high-flow priapism due to uncontrolled arterial flow to the veins. High-flow priapism most frequently occurs as a result of penile trauma in which the intercavernosal artery disruption causes an arteriocavernosal fistula. It is rarely encountered in the pediatric and prepubertal population. Clinically, it manifests as a painless, prolonged erection after perineal trauma. Treatment ranges from expectant management to open surgical exploration with vessel ligation. We report the successful treatment of high-flow priapism in a 12-year-old prepubertal boy with superselective embolization.
Fulltext Professional training and roles of community pharmacists in Malaysia: views from general medical practitioners

Ahmad Hassali MA, Awaisu A, Shafie AA, Saeed MS

Malays Fam Physician, 2009;4(2-3):71-6.
PMID: 25606167 MyJurnal

AIM: This pilot study aimed to explore the perceptions of general medical practitioners (GPs) towards the professional training and roles of community pharmacists.
METHODS: A self-administered questionnaire was distributed to all private clinics (n=160) run by GPs in a northern state of Malaysia. The instrument contained questions to evaluate the practitioners' level of agreement using a 5-point Likert-type scale.
RESULTS: Of 160 GPs, 80 returned the questionnaire (response rate 50%). The respondents agreed that: GPs should consider the community pharmacists' recommendations whenever there is/are any problem(s) with the prescriptions given by them (46.3%); community pharmacists are the best healthcare professionals to educate patients about safe and appropriate use of medications (52.5%); the pharmacy profession had undergone a major metamorphosis from a product-oriented profession to a more patient-centred and outcome-oriented one (61.3%); if dispensing separation is implemented, they will work closely with the community pharmacists in monitoring patients' pharmacotherapeutic outcomes (77.5%).
CONCLUSION: The current findings suggest that GPs would support an extension of the role of the community pharmacists in number of activities of patient care activities such as medication counselling. Thus, suggesting potential collaborative care between GPs and community pharmacists towards patient care and the needs to develop and incorporate topics on inter-professional relationship in the current medical and pharmaceutical education curriculums.
KEYWORDS: Community pharmacists; general practitioners; perceptions; roles; training
Fulltext Solitary Skull Metastasis as Initial Manifestation of Hepatocellular Carcinoma - A Case Report

Ellyda, M.N., Mohd Shafie, A.

International Medical Journal Malaysia, 2009;8(2):47-52.
MyJurnal

Metastatic spread of tumors to the skull is quite unusual and often represents diagnostic and therapeutic issues. Skull involvement can be observed in various neoplasms of epithelial origin and are most often due to lung, breast, thyroid, kidney and prostate cancers. However, skull metastases from hepatocellular carcinoma (HCC) have been rarely reported. The prognosis for patients with hepatocellular carcinoma is so poor that treatment of such distant metastatic lesion cannot be achieved before death occurs due to the primary malignancy. Therefore, the clinical manifestations of cranial metastasis prior to that of primary hepatocellular carcinoma have rarely been reported. This case illustrates a rare case of skull metastasis as an initial manifestation of hepatocellular carcinoma. Although a solitary skull metastasis prior to the diagnosis of HCC demonstrates rare metastatic behavior for HCC, especially in Asia, skull metastases from HCC should be included in the differential diagnosis of skull tumors, even if the patient is asymptomatic of liver cirrhosis.
Fulltext Bilateral congenital renal arteriovenous malformation: A rare entity with uncommon presentation.

Radhiana, H., Mohd Shafie, A., Mohd Ariff, M.A.

International Medical Journal Malaysia, 2009;8(1):53-55.
MyJurnal

Renal arteriovenous malformation (AVM) is a rare congenital anomaly of the urinary system. We present a patient with bilateral renal AVMs who presented with back pain and microscopic hematuria. This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria. Renal AVM was found to be the cause of mild back pain and persistent microscopic hematuria in a 45-year-old lady. This case highlights the importance of complete diagnostic work-up in the evaluation of microscopic hematuria in arriving at the correct diagnosis of an uncommon clinical entity.
Vascular intersection detection in retina fundus images using a new hybrid approach

Aibinu AM, Iqbal MI, Shafie AA, Salami MJ, Nilsson M

Comput Biol Med, 2010 Jan;40(1):81-9.
PMID: 20022595 DOI: 10.1016/j.compbiomed.2009.11.004

The use of vascular intersection aberration as one of the signs when monitoring and diagnosing diabetic retinopathy from retina fundus images (FIs) has been widely reported in the literature. In this paper, a new hybrid approach called the combined cross-point number (CCN) method able to detect the vascular bifurcation and intersection points in FIs is proposed. The CCN method makes use of two vascular intersection detection techniques, namely the modified cross-point number (MCN) method and the simple cross-point number (SCN) method. Our proposed approach was tested on images obtained from two different and publicly available fundus image databases. The results show a very high precision, accuracy, sensitivity and low false rate in detecting both bifurcation and crossover points compared with both the MCN and the SCN methods.
Applications of the Box-Wilson design model for bio-hydrogen production using Clostridium saccharoperbutylacetonicum N1-4 (ATCC 13564)

Alalayah WM, Kalil MS, Kadhum AA, Jahim J, Zaharim A, Alauj NM, et al.

Pak J Biol Sci, 2010 Jul 15;13(14):674-82.
PMID: 21848059

Box-Wilson design (BWD) model was applied to determine the optimum values of influencing parameters in anaerobic fermentation to produce hydrogen using Clostridium saccharoperbutylacetonicum N1-4 (ATCC 13564). The main focus of the study was to find the optimal relationship between the hydrogen yield and three variables including initial substrate concentration, initial medium pH and reaction temperature. Microbial growth kinetic parameters for hydrogen production under anaerobic conditions were determined using the Monod model with incorporation of a substrate inhibition term. The values of micro(max) (maximum specific growth rate) and K, (saturation constant) were 0.398 h(-1) and 5.509 g L(-1), respectively, using glucose as the substrate. The experimental substrate and biomass-concentration profiles were in good agreement with those obtained by the kinetic-model predictions. By varying the conditions of the initial substrate concentration (1-40 g L(-1)), reaction temperature (25-40 degrees C) and initial medium pH (4-8), the model predicted a maximum hydrogen yield of 3.24 mol H2 (mol glucose)(-1). The experimental data collected utilising this design was successfully fitted to a second-order polynomial model. An optimum operating condition of 10 g L(-1) initial substrate concentration, 37 degrees C reaction temperature and 6.0 +/- 0.2 initial medium pH gave 80% of the predicted maximum yield of hydrogen where as the experimental yield obtained in this study was 77.75% exhibiting a close accuracy between estimated and experimental values. This is the first report to predict bio-hydrogen yield by applying Box-Wilson Design in anaerobic fermentation while optimizing the effects of environmental factors prevailing there by investigating the effects of environmental factors.
Fulltext A literature review of the cardiovascular risk-assessment tools: applicability among Asian population

Liau SY, Mohamed Izham MI, Hassali MA, Shafie AA

Heart Asia, 2010;2(1):15-8.
PMID: 27325935 DOI: 10.1136/ha.2009.001115

Cardiovascular diseases, the main causes of hospitalisations and death globally, have put an enormous economic burden on the healthcare system. Several risk factors are associated with the occurrence of cardiovascular events. At the heart of efficient prevention of cardiovascular disease is the concept of risk assessment. This paper aims to review the available cardiovascular risk-assessment tools and its applicability in predicting cardiovascular risk among Asian populations.
Observation of a cubical-like microstructure of strontium iron garnet and yttrium iron garnet prepared via sol-gel technique

Nasir N, Yahya N, Kashif M, Daud H, Akhtar MN, Zaid HM, et al.

J Nanosci Nanotechnol, 2011 Mar;11(3):2551-4.
PMID: 21449424

This is our initial response towards preparation of nano-inductors garnet for high operating frequencies strontium iron garnet (Sr3Fe5O12) denoted as SrIG and yttrium iron garnet (Y3Fe5O12) denoted as YIG. The garnet nano crystals were prepared by novel sol-gel technique. The phase and crystal structure of the prepared samples were identified by using X-ray diffraction analysis. SEM images were done to reveal the surface morphology of the samples. Raman spectra was taken for yttrium iron garnet (Y3Fe5O12). The magnetic properties of the samples namely initial permeability (micro), relative loss factor (RLF) and quality factor (Q-Factor) were done by using LCR meter. From the XRD profile, both of the Y3Fe5O12 and Sr3Fe5O12 samples showed single phase garnet and crystallization had completely occurred at 900 degrees C for the SrIG and 950 degrees C for the YIG samples. The YIG sample showed extremely low RLF value (0.0082) and high density 4.623 g/cm3. Interesting however is the high Q factor (20-60) shown by the Sr3Fe5O12 sample from 20-100 MHz. This high performance magnetic property is attributed to the homogenous and cubical-like microstructure. The YIG particles were used as magnetic feeder for EM transmitter. It was observed that YIG magnetic feeder with the EM transmitter gave 39% higher magnetic field than without YIG magnetic feeder.
Hippocampal MR Volumetric Studies in Paediatric Patients with Epilepsy and Normal Controls

Win Mar Salmah J, Noorfizura A, Mohd Shafie A, Helmy A, Salmi AR, Naing L

Neuroradiol J, 2011 Aug 31;24(4):503-10.
PMID: 24059706

The aim of this study was to determine and compare the hippocampal volume in children with epilepsy and in children in a control group and to compare the mean of right and left hippocampal volume in control subjects. This study was carried out at University Sains Malaysia (USM) from January 2008 to June 2009. This is a cross sectional study of 40 children with epilepsy and 40 children in a control volunteer group. Serial MRI of brain and temporal lobe were performed using a Signa Horizon LX 1.0 Tesla system. Oblique coronal sections perpendicular to the axis of temporal lobe were done with 4 mm slice thickness and 1 mm gap. T1, T2, FLAIR and SPGR series were done. The whole hippocampal volume was measured. Volumetry was done manually by using Osirix workstation (v 3.5.1-64 bit). All slices were measured three times and the average volume was taken. Data were analyzed by paired t test and independent t test for univariate data. The mean hippocampal volume in the control group was 2.81 cm(3) (SD=0.38) and 2.65 cm(3) (SD=0.41) for right and left hippocampus respectively. The mean hippocampal volume in epilepsy patients was 2.47 cm(3) (SD=0.52) and 2.39 cm(3) (SD=0.44) for right and left respectively. The hippocampal volume in epileptic children was significantly smaller than normal control children in average volume (p=0.001) and both right (p=0.002) and left (p=0.007) individually. In the control group, the right hippocampus volume was much greater than the left (p<0.001). The data of this study provide a useful reference for the study of hippocampal volume in the Malay paediatric population. It is useful in doubtful cases to determine which side is affected and also serves as part of the study to establish the whole age-related hippocampal growth.
Fulltext LINAC based radiosurgery and radiotherapy for neurosurgical diseases: what have we learnt so far

Zamzuri I, Badrisyah I, Rahman GI, Pal HK, Muzaimi M, Jafri AM, et al.

Med J Malaysia, 2011 Oct;66(4):346-9.
PMID: 22299555 MyJurnal

Stereotactic radiosurgery uses a single fraction high dose radiation while stereotactic radiotherapy uses multifractionated lower dose focused radiation.
Wavelet neural networks applied to pulping of oil palm fronds

Zainuddin Z, Wan Daud WR, Pauline O, Shafie A

Bioresour Technol, 2011 Dec;102(23):10978-86.
PMID: 21996481 DOI: 10.1016/j.biortech.2011.09.080

In the organosolv pulping of the oil palm fronds, the influence of the operational variables of the pulping reactor (viz. cooking temperature and time, ethanol and NaOH concentration) on the properties of the resulting pulp (yield and kappa number) and paper sheets (tensile index and tear index) was investigated using a wavelet neural network model. The experimental results with error less than 0.0965 (in terms of MSE) were produced, and were then compared with those obtained from the response surface methodology. Performance assessment indicated that the neural network model possessed superior predictive ability than the polynomial model, since a very close agreement between the experimental and the predicted values was obtained.
Fulltext Drug attitude and adherence: a qualitative insight of patients with hypertension

Saleem F, Hassali M, Shafie A, Atif M

J Young Pharm, 2012 Apr;4(2):101-7.
PMID: 22754262 DOI: 10.4103/0975-1483.96624

The study is aimed to explore the perceptions and experiences of hypertensive patients toward medication use and adherence. The study was qualitative in nature conducted at Sandamen Provisional Hospital of Quetta city, Pakistan; a public hospital catering to the health needs of about 40% of the population. A qualitative approach was used to gain an in-depth knowledge of the issues. Sixteen patients were interviewed, and the saturation point was achieved after the 14(th) interview. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Perceived benefits and risks of medications, (2) physician's interaction with patients, (3) perception toward traditional remedies, (4) layman concept toward medications, and (5) beliefs toward hypertension and its control. The majority of the patients carried specific unrealistic beliefs regarding the long-term use of medication; yet these beliefs were heavily accepted and practiced by the society. The study indicated a number of key themes that can be used in changing the beliefs and experiences of hypertensive patients. Physician's attitude, patient's past experiences, and knowledge related to hypertension were noted as major contributing factors thus resulting in nonadherence to therapy prescribed.
Fulltext General Public Expectation from the Communication Process with their Healthcare Providers

Hassali M, Shafie A, Khan T

J Young Pharm, 2012 Jul;4(3):193-8.
PMID: 23112539 DOI: 10.4103/0975-1483.100028

The current study aimed to explore the public views and expectation about a successful communication process between the healthcare providers/physicians and patients in Penang Island, Malaysia. A cross-sectional study was conducted in Penang Island using a 14-item questionnaire. Statistical Package for Social Sciences (SPSS) software version 15.0(®) were used to analyze the collected data. A nonparametric statistics was applied; the Chi-square test was applied to measure the association among the variables. P-values less than 0.05 were considered statistically significant. A total of N (500) respondents have shown willingness to participate in the study with a response rate of 83.3%. The majority 319 (63.9%) have disclosed to communicate with their healthcare providers in the Malay language and about 401 (80.4%) of the respondents were found satisfied with the information provided by the physician. It was a common expectation by the most of the sample to focus more on the patient history before prescribing any medicine. Moreover, about 60.0% of the respondents expected that the healthcare providers must show patience to the patient's queries. The level of satisfaction with the information shared by the healthcare providers was higher among the respondents with a higher education level. Furthermore, patients with higher level of education expect that physician shouldwell understand their views and medical history to prescribe a better therapeutic regimen.
Carbon nanotubes fibres/aluminium-NiZnFe2O4 based electromagnetic transmitter for improved magnitude versus offset (MVO) in a scaled marine environment

Yahya N, Akhtar MN, Nasir N, Shafie A, Jabeli MS, Koziol K

J Nanosci Nanotechnol, 2012 Oct;12(10):8100-9.
PMID: 23421185

In seabed logging the magnitude of electromagnetic (EM) waves for the detection of a hydrocarbon reservoir in the marine environment is very important. Having a strong EM source for exploration target 4000 m below the sea floor is a very challenging task. A new carbon nanotubes (CNT) fibres/aluminium based EM transmitter is developed and NiZn ferrite as magnetic feeders was used in a scaled tank to evaluate the presence of oil. Resistive scaled tank experiments with a scale factor of 2000 were carried out. X-ray Diffraction (XRD), Raman Spectroscopy and Field Emission Scanning Electron Microscope (FESEM) were done to characterize the synthesized magnetic feeders. Single phase Ni0.76Mg0.04Zn0.2Fe2O4, obtained by the sol-gel method and sintered at 700 degrees C in air, has a [311] major peak. FESEM results show nanoparticles with average diameters of 17-45 nm. Samples which have a high Q-factor (approximately 50) was used as magnetic feeders for the EM transmitter. The magnitude of the EM waves of this new EM transmitter increases up to 400%. A curve fitting method using MATLAB software was done to evaluate the performance of the new EM transmitter. The correlation value with CNT fibres/aluminium-NiZnFe2O4 base transmitter shows a 152.5% increase of the magnetic field strength in the presence of oil. Modelling of the scale tank which replicates the marine environment was done using the Finite Element Method (FEM). In conclusion, FEM was able to delineate the presence of oil with greater magnitude of E-field (16.89%) and the B field (4.20%) due to the new EM transmitter.
Cost-Effectiveness of Clinical Pharmacy Education on Infection Management among Patients with Chronic Kidney Disease in an Indonesian Hospital

Nasution A, Syed Sulaiman SA, Shafie AA

Value Health Reg Issues, 2013 May;2(1):43-47.
PMID: 29702851 DOI: 10.1016/j.vhri.2013.02.009

OBJECTIVES: This study evaluated the clinical and economic impacts of clinical pharmacy education (CPE) on infection management among patients with chronic kidney disease (CKD) stages 4 and 5 in Haji Adam Malik Hospital, Indonesia.
METHODS: A quasi-experimental economic evaluation comparing CPE impact on 6-month CKD mortality was conducted on the basis of payer perspective. The experimental group (n = 63) received care by health care providers who were given CPE on drug-related problems and dose adjustment. The control group (n = 80) was based on the historical cohort of patients who received care before the CPE. Measure of clinical outcome applied in this study was number of lives saved/100 patients treated. Cost-effectiveness ratios for CKD stages 4 and 5 patients without CPE and with CPE and incremental cost-effectiveness ratios (ICERs) for CKD stages 4 and 5 patients were analyzed.
RESULTS: Lives saved (%) in the treatment of CKD without CPE: CKD stage 4, 78.57; CKD stage 5, 57.58. Lives saved (%) in the treatment of CKD with CPE: CKD stage 4, 88.89; CKD stage 5, 65.45. Cost-effectiveness ratios for stage 4 with and without CPEs were Rp3,348,733.27 and Rp3,519,931.009, respectively. Cost-effectiveness ratios for stage 5 with and without CPEs were Rp7,137,874.93 and Rp7,871,822.27, respectively. ICERs were Rp2,045,341.22 for CKD stage 4 and Rp1,767,585.60 for CKD stage 5.
CONCLUSIONS: Treatment of CKD stages 4 and 5 with CPE was more effective and cost-effective compared with treatment of CKD stages 4 and 5 without CPE. The ICERs indicated that extra costs were required to increase life saved in both stages.
Fulltext Willingness to pay for voluntary community-based health insurance: findings from an exploratory study in the state of Penang, Malaysia

Shafie AA, Hassali MA

Soc Sci Med, 2013 Nov;96:272-6.
PMID: 23528670 DOI: 10.1016/j.socscimed.2013.02.045

Health care in Malaysia is funded primarily through taxation and is no longer sustainable. One funding option is voluntary community-based health insurance (VCHI), which provides insurance coverage for those who are unable to benefit immediately from either a social or private health insurance plan. This study is performed to assess the willingness of Malaysians to participate in a VCHI plan. A cross-sectional study was performed in the state of Penang between August and mid-September 2009 with 472 randomly selected respondents. The respondents were first asked to select their preferred health financing plan from three plans (out-of-pocket payment, compulsory social health insurance and VCHI). The extent of the household's willingness to pay for the described VCHI plan was later assessed using the contingent valuation method in an ex-ante bidding game approach until the maximum amount they would be willing to pay to obtain such a service was agreed upon. Fifty-four per cent of the participants were female, with a mean age of 34 years (SD = 11.9), the majority of whom had a monthly income of Int$1157-2312. The results indicated that more than 63.1% of the respondents were willing to join and contribute an average of Int$114.38 per month per household towards VCHI. This amount was influenced by ethnicity, educational level, household monthly income, the presence of chronic disease and the presence of private insurance coverage (p
Vertical infestation of the dengue vectors Aedes aegypti and Aedes albopictus in apartments in Kuala Lumpur, Malaysia

Roslan MA, Shafie A, Ngui R, Lim YA, Sulaiman WY

J Am Mosq Control Assoc, 2013 Dec;29(4):328-36.
PMID: 24551965

Dengue is a serious public health problem in Malaysia. The aim of this study was to compare the vertical infestation of Aedes population in 2 apartments in Kuala Lumpur with different status of dengue incidence (i.e., high-dengue-incidence area and area with no reported dengue cases). The study was also conducted to assess the relationship between environmental factors such as rainfall, temperature, and humidity and Aedes population that may influence Aedes infestation. Surveillance with a mosquito larvae trapping device was conducted for 28 continuous weeks (January to July 2012) in Vista Angkasa (VA) and Inderaloka (IL) apartments located in Kuala Lumpur, Malaysia. The results indicated that both Aedes spp. could be found from ground to higher floor levels of the apartments, with Aedes aegypti being more predominant than Ae. albopictus. Data based on mixed and single breeding of Aedes spp. on different floors did not show any significant difference. Both rainfall (R3; i.e., the amount of rainfall collected during the previous 3 wk before the surveillance period began) and RH data showed significant relationship with the number of Aedes larvae collected in VA and IL. No significant difference was found between the numbers of Aedes larvae in both study areas as well as maximum and minimum temperatures. Results also indicated adaptations of Ae. aegypti to the ecosystem at each elevation of high-rise buildings, with Ae. albopictus staying inside of apartment units.
Determinants of Caesarean Risk Factor in Northern Region of Bangladesh: A Multivariate Analysis

Rahman M, Ahmad Shariff A, Shafie A, Saaid R, Md Tahir R

Iran J Public Health, 2014 Jan;43(1):16-27.
PMID: 26060675

Caesarean section (c-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional fac-tors. Therefore, this study examines the impact of maternal, socio-demographic and relevant characteristics on caesar-ean delivery in the northern region of Bangladesh.
Performance of ANFIS versus MLP-NN dissolved oxygen prediction models in water quality monitoring

Najah A, El-Shafie A, Karim OA, El-Shafie AH

Environ Sci Pollut Res Int, 2014 Feb;21(3):1658-1670.
PMID: 23949111 DOI: 10.1007/s11356-013-2048-4

We discuss the accuracy and performance of the adaptive neuro-fuzzy inference system (ANFIS) in training and prediction of dissolved oxygen (DO) concentrations. The model was used to analyze historical data generated through continuous monitoring of water quality parameters at several stations on the Johor River to predict DO concentrations. Four water quality parameters were selected for ANFIS modeling, including temperature, pH, nitrate (NO3) concentration, and ammoniacal nitrogen concentration (NH3-NL). Sensitivity analysis was performed to evaluate the effects of the input parameters. The inputs with the greatest effect were those related to oxygen content (NO3) or oxygen demand (NH3-NL). Temperature was the parameter with the least effect, whereas pH provided the lowest contribution to the proposed model. To evaluate the performance of the model, three statistical indices were used: the coefficient of determination (R (2)), the mean absolute prediction error, and the correlation coefficient. The performance of the ANFIS model was compared with an artificial neural network model. The ANFIS model was capable of providing greater accuracy, particularly in the case of extreme events.
Fulltext Knowledge and perceptions of prescribers regarding adherence to standard treatment guidelines for malaria: a comparative cross-sectional study from Pakistan

Malik M, Hassali MA, Shafie AA, Hussain A

East Mediterr Health J, 2014 Apr;20(4):221-8.
PMID: 24952118

Despite the availability of standard treatment guidelines for malaria in Pakistan adherence to protocols by prescribers is poor. This descriptive, cross-sectional study aimed to explore the perceptions and knowledge of prescribers in Islamabad and Rawalpindi cities towards adherence to standard treatment guidelines for malaria. A questionnaire was distributed to a random sample of 360 prescribers; 64.7% were satisfied with the available antimalarial drugs and 41.3% agreed that antimalarial drugs should only be prescribed after diagnostic testing. Only half the prescribers had the guidelines available in their health facility. Almost all the prescribers (97.7%) agreed that there was a need for more educational programmes about the guidelines. Most prescribers were unaware of the correct standard treatment regimen for Plasmodium falciparum and P. vivax malaria. There were no differences in knowledge between males and females, but prescribers having more experience, practising as general practitioners and working in private health-care facilities possessed significantly better knowledge than their counterparts.

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