Displaying publications 1 - 20 of 26 in total

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  1. Chong KN, E HC, Zaki RA, Mohd SH, Majid HA, Ng AK, et al.
    Asia Pac J Clin Nutr, 2021 Dec;30(4):632-642.
    PMID: 34967192 DOI: 10.6133/apjcn.202112_30(4).0010
    BACKGROUND AND OBJECTIVES: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life.

    METHODS AND STUDY DESIGN: This prospective cohort study included healthy motherinfant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months.

    RESULTS: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86], p=0.03) and 3 months old (aOR 0.43 [95% CI: 0.20, 0.93], p=0.03), while intake of confectionery items was associated with increased unscheduled doctor visits at 3 months (aOR 2.01 [95% CI 1.33, 3.06], p=0.001) and increased nebuliser treatment at both 3 months (aOR 1.88 [95% CI 1.12, 3.17], p=0.02) and 6 months (aOR 1.64 [95% CI 1.05, 2.54], p=0.03). Finally, at 6 months, hypertensive disorders during pregnancy was associated with increased nebuliser treatment (aOR 17.3 [95% CI 1.50, 199], p=0.02) while exclusive breastfeeding was associated with reduced incidence of respiratory symptoms (OR 0.47 [95% CI 0.26, 0.83], p=0.01).

    CONCLUSIONS: Increased antenatal maternal consumption of milk and dairy products may reduce respiratory morbidity while increased consumption of confectionery items may increase respiratory morbidity in their infants during the first 6 months of life.

  2. Yasin SM, Taib KM, Zaki RA
    Asian Pac J Cancer Prev, 2011;12(6):1439-43.
    PMID: 22126478
    The transtheoretical model (TTM) has been used as one of the major constructs in developing effective cognitive behavioural interventions for smoking cessation and relapse prevention, in Western societies. This study aimed to examine the reliability and construct validity of the translated Bahasa Malaysia version of TTM questionnaire among adult smokers in Klang Valley, Malaysia. The sample consisted of 40 smokers from four different worksites in Klang Valley. A 26-item TTM questionnaire was administered, and a similar set one week later. The questionnaire consisted of three measures; decisional balance, temptations and impact of smoking. Construct validity was measured by factor analysis and the reliability by Cronbach' s alpha (internal consistency) and test-retest correlation. Results revealed that Cronbach' s alpha coefficients for the items were: decisional balance (0.84; 0.74) and temptations (0.89; 0.54; 0.85). The values for test retest correlation were all above 0.4. In addition, factor analysis suggested two meaningful common factors for decisional balance and three for temptations. This is consistent with the original construct of the TTM questionnaire. Overall results demonstrated that construct validity and reliability were acceptable for all items. In conclusion, the Bahasa Malaysia version of TTM questionnaire is a reliable and valid tool in ass.
  3. P S L, Miskan MM, Y Z C, Zaki RA
    BMC Anesthesiol, 2017 Oct 11;17(1):137.
    PMID: 29020936 DOI: 10.1186/s12871-017-0430-3
    BACKGROUND: Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study.

    METHODS: A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0.02 mg/kg with glycopyrrolate (neostigmine group).

    RESULTS: We found 70% of patients (n = 28) reversed with single boluses of sugammadex had Grade 3 emergence cough compared to 12.5% (n = 5) in the staggered sugammadex group and 17.5% (n = 7) in the neostigmine group (p 

  4. Hii YL, Zaki RA, Aghamohammadi N, Rocklöv J
    Curr Environ Health Rep, 2016 Mar;3(1):81-90.
    PMID: 26931438 DOI: 10.1007/s40572-016-0078-z
    Dengue is a climate-sensitive infectious disease. Climate-based dengue early warning may be a simple, low-cost, and effective tool for enhancing surveillance and control. Scientific studies on climate and dengue in local context form the basis for advancing the development of a climate-based early warning system. This study aims to review the current status of scientific studies in climate and dengue and the prospect or challenges of such research on a climate-based dengue early warning system in a dengue-endemic country, taking Malaysia as a case study.
  5. Ramakreshnan L, Aghamohammadi N, Fong CS, Bulgiba A, Zaki RA, Wong LP, et al.
    Environ Sci Pollut Res Int, 2018 Jan;25(3):2096-2111.
    PMID: 29209970 DOI: 10.1007/s11356-017-0860-y
    Seasonal haze episodes and the associated inimical health impacts have become a regular crisis among the ASEAN countries. Even though many emerging experimental and epidemiological studies have documented the plausible health effects of the predominating toxic pollutants of haze, the consistency among the reported findings by these studies is poorly understood. By addressing such gap, this review aimed to critically highlight the evidence of physical and psychological health impacts of haze from the available literature in ASEAN countries. Systematic literature survey from six electronic databases across the environmental and medical disciplines was performed, and 20 peer-reviewed studies out of 384 retrieved articles were selected. The evidence pertaining to the health impacts of haze based on field survey, laboratory tests, modelling and time-series analysis were extracted for expert judgement. In specific, no generalization can be made on the reported physical symptoms as no specific symptoms recorded in all the reviewed studies except for throat discomfort. Consistent evidence was found for the increase in respiratory morbidity, especially for asthma, whilst the children and the elderly are deemed to be the vulnerable groups of the haze-induced respiratory ailments. A consensual conclusion on the association between the cardiovascular morbidity and haze is unfeasible as the available studies are scanty and geographically limited albeit of some reported increased cases. A number of modelling and simulation studies demonstrated elevating respiratory mortality rates due to seasonal haze exposures over the years. Besides, evidence on cancer risk is inconsistent where industrial and vehicular emissions are also expected to play more notable roles than mere haze exposure. There are insufficient regional studies to examine the association between the mental health and haze. Limited toxicological studies in ASEAN countries often impede a comprehensive understanding of the biological mechanism of haze-induced toxic pollutants on human physiology. Therefore, the lack of consistent evidence among the reported haze-induced health effects as highlighted in this review calls for more intensive longitudinal and toxicological studies with greater statistical power to disseminate more reliable and congruent findings to empower the institutional health planning among the ASEAN countries.
  6. Singh S, Zaki RA, Farid NDN
    J Adolesc, 2019 07;74:154-172.
    PMID: 31216495 DOI: 10.1016/j.adolescence.2019.06.004
    INTRODUCTION: Depression is a common mental health disorder and affects many adolescents worldwide. Depression literacy can improve mental health outcomes. The aim of this study was to collate and analyse the extant evidence on depression literacy among adolescents, with particular focus on tools used to examine depression literacy and the findings on components of depression literacy.

    METHODS: Nine electronic databases and 1 grey literature source were searched for studies published in English between January 2006 and December 2018 and involving adolescents aged 10-19 years. We included studies that reported on components of depression literacy such as knowledge, help-seeking and stigmatising attitudes. We excluded qualitative studies. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their characteristics. The data were descriptively analysed and appraised using the Newcastle-Ottawa Scale (NOS), Cochrane Collaboration's tool and the Quality Assessment Tool for Quantitative Studies (QATSQ).

    RESULTS AND CONCLUSION: Fifty of the 14,626 references identified met the inclusion criteria. Depression literacy was most commonly (58%) assessed using tools that utilize a vignette-based methodology. A lack of uniformity in reporting of depression literacy was noted. Adolescents were poor at recognising depression, likely to seek help from informal sources and tended to attach stigma to depression. The implications of the findings are discussed and suggestions made for future research.

  7. Thanigasalam T, Reddy SC, Zaki RA
    J Ophthalmic Vis Res, 2016 4 7;10(4):375-84.
    PMID: 27051481 DOI: 10.4103/2008-322X.158892
    PURPOSE: Cataract surgery is the most common intraocular surgery performed all over the world and has advanced technically in recent years. As in all surgeries, complications are unavoidable. Herein we report factors associated with complications and visual outcomes of cataract surgery.

    METHODS: This retrospective cohort study included data of 1,632 cataract surgeries performed from 2007 to 2010 which was obtained from the cataract registry of the Malaysian National Eye Database. Demographic features, ocular and systemic comorbidites, grade of surgeon expertise and duration of surgery, type of anesthesia, intraoperative and postoperative complications, and the type of intraocular lens were recorded. Best corrected visual acuities were compared before and after the operation.

    RESULTS: Mean patient age was 66.9 years with equal gender distribution. The majority of subjects had age related cataracts. Phacoemulsification was done faster than other surgeries, especially by specialist surgeons. History of prior ocular surgery and operations performed under general anesthesia were associated with greater complications. Phacoemulsification was associated with less complications and better visual outcomes. The age and etiology of cataract did not affect complications. Malays, absence of ocular comorbidities, left eyes and eyes operated under local anesthesia were more likely to experience more visual improvement. Gender, age, cause of cataract, systemic comorbidities and surgeon expertise as well as intra-and postoperative complications did not affect the visual outcomes.

    CONCLUSION: Phacoemulsification had good visual outcomes in cataract surgery. Duration of surgery, expertise of the surgeon and complications did not affect the visual outcomes.

  8. Sharif SP, Friedmacher F, Amin A, Zaki RA, Hird MF, Khashu M, et al.
    J Pediatr Surg, 2020 Dec;55(12):2625-2629.
    PMID: 32771214 DOI: 10.1016/j.jpedsurg.2020.07.003
    PURPOSE: To investigate whether serum albumin (SA) concentration can predict the need for surgical intervention in neonates with necrotizing enterocolitis (NEC).

    METHODS: Retrospective review of all cases with NEC Bell's stage 2 and 3 that were treated in a single center between 2009 and 2015. Data on patient demographics, clinical parameters, laboratory findings and surgical status were recorded. Receiver operating characteristics analysis was used to evaluate optimal cutoffs and predictive values.

    RESULTS: Overall, 151 neonates with NEC were identified. Of these, 132 (87.4%) had confirmed NEC Bell's stage 2. The median gestational age was 28.4 (range, 23.1-39.0) weeks and 69 (52.3%) had a birth weight of ≤1000 g. Sixty-eight (51.5%) underwent surgery, showing a sustained reduction in SA over time with significantly lower median SA levels compared to 64 (48.5%) cases that responded well to medical treatment (18.3 ± 3.7 g/L vs. 26.0 ± 2.0 g/L; P 

  9. Lachyan A, Zaki RA, Banerjee B, Aghamohammadi N
    J Res Health Sci, 2023 Dec 29;23(4):e00596.
    PMID: 38315911 DOI: 10.34172/jrhs.2023.131
    BACKGROUND: This study aimed to assess the efficacy of a dengue intervention program in economically deprived urban regions of India, with a particular emphasis on housing conditions and community involvement. Given the global significance of dengue fever as a vector-borne disease, successful vector management requires effective community engagement. Study Design: A quasi-experimental study.

    METHODS: This study was conducted with 314 participants from Delhi's Sanjay Colony, divided into control and intervention groups. The study spanned 14 months (August 2020 to September 2021). The intervention program comprised two educational sessions held one month apart, covering dengue awareness, health self-care, and environmental maintenance. Data were collected at baseline, after each intervention session, and during a final follow-up assessment three months later.

    RESULTS: The primary outcome, the house index (HI), revealed statistically significant differences (P<0.001) favoring the intervention group. The total score (TS) for mosquito-borne disease, TS of knowledge, TS of attitude, and TS of practices all exhibited significant improvements in the intervention group. Participants showed an enhanced understanding of dengue causes, symptoms, and mosquito behavior related to breeding and biting. The HI in the intervention group decreased significantly from 21.65% to 4.45% (P<0.05).

    CONCLUSION: This study, grounded in the health belief model (HBM), demonstrated the effectiveness of the intervention program in reducing HI and improving knowledge and preventive practices regarding dengue fever in impoverished urban neighborhoods of Delhi. The intervention program may be beneficial in such a poor urban community.

  10. Shrestha N, Shad MY, Ulvi O, Khan MH, Karamehic-Muratovic A, Nguyen UDT, et al.
    One Health, 2020 Dec 20;11:100180.
    PMID: 33072836 DOI: 10.1016/j.onehlt.2020.100180
    Globalization has altered the way we live and earn a livelihood. Consequently, trade and travel have been recognized as significant determinants of the spread of disease. Additionally, the rise in urbanization and the closer integration of the world economy have facilitated global interconnectedness. Therefore, globalization has emerged as an essential mechanism of disease transmission. This paper aims to examine the potential impact of COVID-19 on globalization and global health in terms of mobility, trade, travel, and countries most impacted. The effect of globalization were operationalized in terms of mobility, economy, and healthcare systems. The mobility of individuals and its magnitude was assessed using airline and seaport trade data and travel information. The economic impact was measured based on the workforce, event cancellations, food and agriculture, academic institutions, and supply chain. The healthcare capacity was assessed by considering healthcare system indicators and preparedness of countries. Utilizing a technique for order of preference by similarity to ideal solution (TOPSIS), we calculated a pandemic vulnerability index (PVI) by creating a quantitative measure of the potential global health. The pandemic has placed an unprecedented burden on the world economy, healthcare, and globalization through travel, events cancellation, employment workforce, food chain, academia, and healthcare capacity. Based on PVI results, certain countries were more vulnerable than others. In Africa, more vulnerable countries included South Africa and Egypt; in Europe, they were Russia, Germany, and Italy; in Asia and Oceania, they were India, Iran, Pakistan, Saudi Arabia, and Turkey; and for the Americas, they were Brazil, USA, Chile, Mexico, and Peru. The impact on mobility, economy, and healthcare systems has only started to manifest. The findings of this study may help in the planning and implementation of strategies at the country level to help ease this emerging burden.
  11. Ananth S, Shrestha N, Treviño C JA, Nguyen US, Haque U, Angulo-Molina A, et al.
    Pathogens, 2020 Nov 19;9(11).
    PMID: 33228120 DOI: 10.3390/pathogens9110964
    Arboviruses such as Chikungunya (CHIKV), Dengue (DENV), and Zika virus (ZIKV) have emerged as a significant public health concern in Mexico. The existing literature lacks evidence regarding the dispersion of arboviruses, thereby limiting public health policy's ability to integrate the diagnosis, management, and prevention. This study seeks to reveal the clinical symptoms of CHIK, DENV, and ZIKV by age group, region, sex, and time across Mexico. The confirmed cases of CHIKV, DENV, and ZIKV were compiled from January 2012 to March 2020. Demographic characteristics analyzed significant clinical symptoms of confirmed cases. Multinomial logistic regression was used to assess the association between clinical symptoms and geographical regions. Females and individuals aged 15 and older had higher rates of reported significant symptoms across all three arboviruses. DENV showed a temporal variation of symptoms by regions 3 and 5, whereas ZIKV presented temporal variables in regions 2 and 4. This study revealed unique and overlapping symptoms between CHIKV, DENV, and ZIKV. However, the differentiation of CHIKV, DENV, and ZIKV is difficult, and diagnostic facilities are not available in rural areas. There is a need for adequately trained healthcare staff alongside well-equipped lab facilities, including hematological tests and imaging facilities.
  12. Sallih ASM, Wee MW, Zaki RA, Hng SY, Eg KP, Nathan AM, et al.
    Pediatr Pulmonol, 2023 Jun;58(6):1784-1797.
    PMID: 37014160 DOI: 10.1002/ppul.26403
    BACKGROUND: Few studies have examined the impact of Coronavirus disease 2019 (COVID-19) infection on children with chronic lung disease (CLD).

    OBJECTIVE: To perform a systematic review and meta-analysis to determine the prevalence, risk factors for contracting COVID-19, and complications of COVID-19, in children with CLD.

    METHODS: This systematic review was based on articles published between January 1, 2020 and July 25, 2022. Children under 18 years old, with any CLD and infected with COVID-19 were included.

    RESULTS: Ten articles involving children with asthma and four involving children with cystic fibrosis (CF) were included in the analyses. The prevalence of COVID-19 in children with asthma varied between 0.14% and 19.1%. The use of inhaled corticosteroids (ICS) was associated with reduced risk for COVID-19 (risk ratio [RR]: 0.60, 95% confidence interval [CI]: 0.40-0.90). Uncontrolled asthma, younger age, AND moderate-severe asthma were not significant risk factors for contracting COVID-19. Children with asthma had an increased risk for hospitalization (RR: 1.62, 95% CI: 1.07-2.45) but were not more likely to require assisted ventilation (RR: 0.51, 95% CI: 0.14-1.90). The risk of COVID-19 infection among children with CF was <1%. Posttransplant and cystic fibrosis-related diabetes mellitus (CFRDM) patients were at an increased risk for hospitalization and intensive care treatment.

    CONCLUSION: Hospitalizations were higher in children with asthma with COVID-19 infection. However, using ICS reduced the risk of COVID-19 infection. As for CF, postlung transplantation and CFRDM were risk factors for severe disease.

  13. Mohd Amin AT, Zaki RA, Friedmacher F, Sharif SP
    Pediatr Surg Int, 2021 Jul;37(7):881-886.
    PMID: 33779823 DOI: 10.1007/s00383-021-04879-1
    PURPOSE: The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The CRP/albumin (CRP/ALB) ratio is often associated with higher mortality, organ failure and prolonged hospital stay. We hypothesized that the serum CRP/ALB ratio has a prognostic value in predicting surgery and mortality in neonates with necrotizing enterocolitis (NEC).

    METHODS: Retrospective review of all neonates with clinical and radiological evidence of non-perforated NEC that were treated in a tertiary-level referral hospital between 2009 and 2018. General patient demographics, laboratory parameters and outcomes were recorded. Receiver operating characteristics analysis was performed to evaluated optimal cut-offs and area under the curve (AUC) with 95% confidence intervals (CI).

    RESULTS: A total of 191 neonates were identified. Of these, 103 (53.9%) were born at ≤ 28 weeks of gestation and 101 (52.9%) had a birth weight of ≤ 1000 g. Eighty-four (44.0%) patients underwent surgical intervention for NEC. The overall survival rate was 161/191 (84.3%). A CRP/ALB ratio of ≥ 3 on day 2 of NEC diagnosis was associated with a statistically significant higher likelihood for surgery [AUC 0.71 (95% CI 0.63-0.79); p 

  14. Lim SH, Lim YC, Zaki RA, Johari BM, Chang CY, Omar SFS, et al.
    PLoS One, 2024;19(4):e0298376.
    PMID: 38626017 DOI: 10.1371/journal.pone.0298376
    BACKGROUND: Post Acute COVID Syndrome (PACS), a complex and poorly understood condition characterised by persistent symptoms following the acute phase of COVID-19 infection, has emerged as a significant global health concern. Healthcare workers who had been at the forefront of the pandemic response are at heightened risk of contracting the virus and subsequently developing PACS. Therefore, we aim to determine the prevalence and risk factors for PACS among healthcare workers infected with COVID-19.

    METHODS: A cross-sectional study was conducted between October 2022 and August 2023 using an online REDCap electronic data capture tool questionnaire. PACS was defined as new or persistent symptoms lasting more than 28 days after a positive SARS-CoV-2 polymerase chain reaction or rapid test kit antigen test. Multivariable logistic regression was performed to determine predictors associated with PACS.

    RESULTS: Among 609 infected healthcare workers, they were predominantly female (71.8%), Malays (84.6%), and aged 18-39 years (70.1%). 50.7% of infected healthcare workers experienced PACS. The most common PACS symptoms experienced were fatigue (27.9%), cough (25.1%), decreased physical strength (20.5%), and musculoskeletal pain (19.2%). Those who are more likely to develop PACS were females, underlying asthma, and COVID-19 severity category 3. On the other hand, those who received booster vaccinations were less likely to develop PACS.

    CONCLUSION: PACS is prevalent among healthcare workers with COVID-19 at the University Malaya Medical Centre. These findings emphasise the critical need for those with higher risk to receive regular health monitoring and checkups to detect any early signs of PACS. It underscores the need for continuous support and healthcare interventions to mitigate the impacts of PACS and ensure the physical and mental well-being of healthcare workers.

  15. Singh S, Zaki RA, Farid NDN, Kaur K
    Prev Med Rep, 2021 Dec;24:101585.
    PMID: 34976645 DOI: 10.1016/j.pmedr.2021.101585
    Depression is a common mental disorder that affects many adolescents worldwide. Therefore, there is a need for reliable instruments to screen for depression symptoms among adolescents. This study aims to determine the reliability of the Malay version of the Centre of Epidemiological Studies Depression Scale (CESD) among adolescents in Malaysia. A cross-sectional study was conducted among 65 adolescents ages between 12 and 14 years from two secondary schools in the Federal Territory of Kuala Lumpur from May 2017 to July 2017. Cronbach's alpha (α), McDonald's omega (ω), Spearman Brown split half reliability (rSB), and Intra-class Correlation Coefficient (ICC) were examine to determine the internal consistency and two week test-retest reliability. The overall CESD scale was found to have good internal consistency with α = 0.882 (95% CI 0.837, 0.914), ω = 0.886 (95% CI 0.837, 0.916) and rSB = 0.909. The CESD subscales, Somatic symptoms (α = 0.824; 95% CI 0.739, 0.878; ω = 0.828; 95% CI 0.738, 0.885; rSB = 0.825), Depressive affect (α = 0.822; 95% CI 0.745, 0.880; ω = 0.834; 95% CI 0.750, 0.884; rSB = 0.847) and Positive affect (α = 0.610; 95% CI 0.326, 0.721; ω = 0.612; 95% CI 0.379, 0.723 and rSB = 0.608) indicated acceptable to good internal consistency. The 2-week test-retest reliability ICC was 0.926 (95% CI 0.851, 0.961) for the total score reliability. The reliability analysis of the Malay version of CESD shows satisfactory α, ω, rSB and ICC values, therefore making it a reliable instrument to screen for depression among adolescents in Malaysia.
  16. Lubis R, Satria FB, Zaki RA, Nurjazuli N, Hendrati LY
    Public Health Pract (Oxf), 2022 Dec;4:100311.
    PMID: 36072129 DOI: 10.1016/j.puhip.2022.100311
    OBJECTIVES: The COVID-19 pandemic started over 2 years ago and spread rapidly throughout the world. The total number of cases and deaths is still increasing and the situation remains active across the globe. In the Asian region, COVID-19 vaccination began in early 2021; however, the COVID-19 situation remains uncertain. This study aims to compare the factors that influenced the COVID-19 pandemic situation in three countries in Asia (namely, Indonesia, Malaysia and Taiwan) throughout 2021.

    STUDY DESIGN: This ecological study utilises the data from the 'Our World in Data' website.

    METHODS: In this study, the COVID-19 pandemic situation in each country is described by looking at the average daily number of deaths and cases per million population throughout 2021. A paired t-test was conducted to compare the significance of differences in the pandemic situation between 2020 and 2021. In addition, the COVID-19 vaccination profiles throughout 2021 were investigated. A multiple linear regression analysis was then performed to develop models to explain the factors influencing the COVID-19 pandemic situation in these three countries.

    RESULTS: The COVID-19 pandemic situation in Indonesia, Malaysia and Taiwan in 2021 is significantly different from 2020. Malaysia had the highest COVID-19 vaccination coverage (79.4%), followed by Taiwan (78.5%) and Indonesia (58.3%). This study found that the following three factors consistently influenced the number of deaths and cases in these three countries [1]: positivity rate [2]; number of tests per 1000 population; and [3] number of tests per case.

    CONCLUSIONS: Although the severity of the COVID-19 pandemic situations in Indonesia, Malaysia and Taiwan was different, it is significantly influenced by the quality and quantity of COVID-19 testing and screening, in addition to the vaccination programmes and restriction policies implemented in each country. As a result of the ability of the SARS-CoV-2 virus to mutate, it is recommended that each country strengthen their comprehensive approach to have an effective and efficient coping strategy for the COVID-19 pandemic.

  17. Loh PS, Yeong CH, Masohood NS, Sulaiman N, Zaki RA, Fabell K, et al.
    Sci Rep, 2021 01 27;11(1):2299.
    PMID: 33504909 DOI: 10.1038/s41598-021-81913-1
    Microwave ablation (MWA) is gaining popularity for the treatment of small primary hepatocellular carcinoma and metastatic lesions especially if patients are not candidates for surgical resection. Deep neuromuscular blockade (DMB) is perceived to improve surgical working conditions compared to moderate neuromuscular blockade (MMB) but no studies have examined the same benefits in MWA of liver tumours. This study aimed to compare the clinical outcomes of DMB and MMB in MWA of liver tumours in terms of liver excursion, performance scores by the interventional radiologists and patients, requirements of additional muscle relaxants and complications. 50 patients were recruited and 45 patients (22 in MMB group, 23 in DMB group) completed the study. The mean liver excursion for the MMB group (1.42 ± 1.83 mm) was significantly higher than the DMB group (0.26 ± 0.38 mm) (p = 0.001). The mean Leiden-Surgical Rating Scale (L-SRS) rated by the two interventional radiologists were 4.5 ± 0.59 and 3.6 ± 0.85 for the DMB and MMB groups, respectively (p = 0.01). There was also statistically significant difference on patient satisfaction scores (0-10: Extremely Dissatisfied-Extremely Satisfied) between DMB (8.74 ± 1.1) and MMB (7.86 ± 1.25) groups (p = 0.01). 5 patients from MMB group and none from DMB group required bolus relaxant during the MWA procedure. Adverse events were also noted to be more severe in the MMB group. In conclusion, DMB significantly reduced liver excursion and movement leading to improved accuracy, safety and success in ablating liver tumour.
  18. Selvarajoo S, Liew JWK, Chua TH, Tan W, Zaki RA, Ngui R, et al.
    Sci Rep, 2022 01 12;12(1):571.
    PMID: 35022501 DOI: 10.1038/s41598-021-04643-4
    Dengue remains a major public threat and existing dengue control/surveillance programs lack sensitivity and proactivity. More efficient methods are needed. A cluster randomized controlled trial was conducted for 18 months to determine the efficacy of using a combination of gravid oviposition sticky (GOS) traps and dengue non-structural 1 (NS1) antigen for early surveillance of dengue among Aedes mosquito. Eight residential apartments were randomly assigned into intervention and control groups. GOS traps were placed at the intervention apartments weekly to trap Aedes mosquitoes and these tested for dengue NS1 antigen. When dengue-positive pool was detected, the community were notified and advised to execute protective measures. Fewer dengue cases were recorded in the intervention group than the control. Detection of NS1-positive mosquitoes was significantly associated with GOS Aedes index (rs = 0.68, P 
  19. Selvarajoo S, Liew JWK, Tan W, Lim XY, Refai WF, Zaki RA, et al.
    Sci Rep, 2020 Jun 12;10(1):9534.
    PMID: 32533017 DOI: 10.1038/s41598-020-66212-5
    Dengue has become a global public health problem. Despite reactive efforts by the government in Malaysia, the dengue cases are on the increase. Adequate knowledge, positive attitude and correct practice for dengue control are essential to stamp out the disease. Hence, this study aims to assess the factors associated with dengue knowledge, attitude and practice (KAP), as well as the association with dengue IgM and IgG seropositivity. A community-based cross-sectional study was conducted in a closed, dengue endemic area with multi-storey dwellings . Five hundred individuals (aged 18 years and above) were approached for pre-tested KAP and seroprevalences assessment. The study showed only half of the total participants have good knowledge (50.7%) but they had insufficient knowledge about dengue during pregnancy. 53.2% of people had poor attitude and 50.2% reported poor practice for dengue control. Out of 85 respondents who agreed to participate in the dengue seroprevalence study, 74.1% (n = 63) were positive for dengue IgG and 7.1% (n = 6) were positive for dengue IgM. Among all sociodemographic variable, race is the only independent predicator for all KAP levels (P 
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