MyMedR

Displaying publications 181 - 200 of 376 in total

Abstract:

Sort:

Fulltext Comparison of 3 Grading Systems (House-Brackmann, Sunnybrook, Sydney) for the Assessment of Facial Nerve Paralysis and Prediction of Neural Recovery

Mat Lazim N, Ismail H, Abdul Halim S, Nik Othman NA, Haron A

Medeni Med J, 2023 Jun 20;38(2):111-119.
PMID: 37338861 DOI: 10.4274/MMJ.galenos.2023.42383

OBJECTIVE: Currently, multiple classification systems exist for the assessment of facial nerve paralysis. This study was designed to choose the most practical system for use in a clinical setting depending on the clinician need. We compared the responsiveness of the 3 facial nerve grading systems, i.e., House-Brackmann, Sydney, and Sunnybrook, as the subjective method and compared the outcomes with the objective method, i.e., the nerve conduction study. The correlation between the subjective and objective assessments was determined.
METHODS: A total of 22 consented participants with facial palsy was assessed with photos and videography recordings where they performed 10 standard facial expressions. The severity of facial paralysis was evaluated with the House-Brackmann, Sydney, and Sunnybrook grading scales subjectively and with the facial nerve conduction study objectively. The assessments were repeated after 3 months.
RESULTS: A Wilcoxon signed-rank test showed that there were statistically significant change in all three gradings after 3-month of assessment. The responsiveness of the nerve conduction study was significant for the nasalis and orbicularis oris muscles. It was not significant for the orbicularis oculi muscle. The nasalis and orbicularis oculi showed statistically significant correlation with the three classification systems except for the orbicularis oculi muscle.
CONCLUSIONS: All three grading systems, House-Brackmann, Sydney, and Sunnybrook, showed statistically significant responsiveness after 3 months of evaluation. The nasalis and orbicularis oculi muscle can be used to predict facial palsy recovery because they showed strong positive and negative correlations with the extent of facial nerve degeneration from the nerve conduction study.
Fulltext Usage of topical insulin for the treatment of diabetic keratopathy, including corneal epithelial defects

Leong CY, Naffi AA, Wan Abdul Halim WH, Bastion MC

World J Diabetes, 2023 Jun 15;14(6):930-938.
PMID: 37383598 DOI: 10.4239/wjd.v14.i6.930

BACKGROUND: Diabetic keratopathy (DK) occurs in 46%-64% of patients with diabetes and requires serious attention. In patients with diabetes, the healing of corneal epithelial defects or ulcers takes longer than in patients without diabetes. Insulin is an effective factor in wound healing. The ability of systemic insulin to rapidly heal burn wounds has been reported for nearly a century, but only a few studies have been performed on the effects of topical insulin (TI) on the eye. Treatment with TI is effective in treating DK.
AIM: To review clinical and experimental animal studies providing evidence for the efficacy of TI to heal corneal wounds.
METHODS: National and international databases, including PubMed and Scopus, were searched using relevant keywords, and additional manual searches were conducted to assess the effectiveness of TI application on corneal wound healing. Journal articles published from January 1, 2000 to December 1, 2022 were examined. The relevancy of the identified citations was checked against predetermined eligibility standards, and relevant articles were extracted and reviewed.
RESULTS: A total of eight articles were found relevant to be discussed in this review, including four animal studies and four clinical studies. According to the studies conducted, TI is effective for corneal re-epithelialization in patients with diabetes based on corneal wound size and healing rate.
CONCLUSION: Available animal and clinical studies have shown that TI promotes corneal wound healing by several mechanisms. The use of TI was not associated with adverse effects in any of the published cases. Further studies are needed to enhance our knowledge and understanding of TI in the healing of DK.
Fulltext Prevalence and Associated Factors of E-Cigarette Use among Adolescents in Southeast Asia: A Systematic Review

Jane Ling MY, Abdul Halim AFN, Ahmad D, Ahmad N, Safian N, Mohammed Nawi A

Int J Environ Res Public Health, 2023 Feb 22;20(5).
PMID: 36900893 DOI: 10.3390/ijerph20053883

The use of e-cigarettes in adolescents remains a major public health concern. Like other tobacco products, e-cigarettes pose health risks to adolescents. Understanding the magnitude of this problem and identification of its associated factors will serve as a guide for development of preventive interventions. This systematic review aims to identify and discuss current epidemiological data on the prevalence and associated factors of e-cigarette use among adolescents in Southeast Asia. The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original English-language articles published between 2012 and 2021. A total of 10 studies were included in this review. The prevalence of current e-cigarette uses ranges from 3.3% to 11.8%. Several associated factors of e-cigarette use were identified, including sociodemographic factors, traumatic childhood experience, peer and parental influence, knowledge and perception, substance use, and accessibility of e-cigarettes. These factors should be addressed though multifaceted interventions which simultaneously target multiple factors. Laws, policies, programs, and interventions must be strengthened and tailored to the needs of adolescents at risk of using e-cigarettes.
Fulltext Visual Loss As Primary Manifestation of Olfactory Groove Meningioma

Sulaiman FN, Sultan Abdul Kader MI, Sawri Rajan R, Wan Abdul Halim WH

Cureus, 2023 Apr;15(4):e37632.
PMID: 37200640 DOI: 10.7759/cureus.37632

Differential diagnosis of vision loss in a space-occupying lesion can be exhaustive. Olfactory groove meningioma (OGM) is a rare, benign, slow-growing tumour originating from the anterior cranial base. OGM is one of the differential diagnoses of intracranial tumours. We report a case of an OGM compressing the optic nerve and frontal lobe causing bilateral vision loss for six months. Multidisciplinary management by ophthalmologists, neurosurgeons, radiologists, and pathologists led to the diagnosis and tumour resection of OGM in the patient. Possible mechanisms of vision loss, imaging features, and treatment are discussed in this report.
Fulltext An Uncommon Presentation of Eagle Syndrome in a Primary Care Patient with Chronic Neck Pain: A Case Report and Literature Review

Abdul Halim N, Md Yassin M, Mohamad Ali ND, Miptah HN

Am J Case Rep, 2024 Sep 11;25:e944399.
PMID: 39256984 DOI: 10.12659/AJCR.944399

BACKGROUND Eagle syndrome is an uncommon medical illness that can manifest as neck pain in primary care. It results from an abnormally unilateral or bilateral long styloid process that may compress and affect adjacent structures, which leads to the symptoms. Classical Eagle syndrome has been commonly reported, but this case highlights the uncommon involvement of autonomic nerve dysfunction. CASE REPORT This case report details a 43-year-old woman with chronic neck pain for 5 years who saw numerous medical professionals and underwent 8 physiotherapy sessions. Marginal improvement of her neck pain and recent development of imbalance and a floating sensation prompted escalation of radiological imaging that eventually led to the diagnosis of Eagle syndrome. She was subsequently subjected to tonsillectomy and styloidectomy to address the sources of her neck pain. CONCLUSIONS Neck pain is a common complaint in primary care, but Eagle syndrome is often overlooked due to its complex symptoms, which mimic other conditions resulting in missed diagnoses and prolonged diagnostic evaluations. To improve patient care and outcomes, primary care physicians should consider Eagle syndrome when evaluating neck pain. This involves taking a detailed clinical history, conducting a thorough physical examination, using appropriate imaging techniques, and knowing the treatment options. By considering this potential diagnosis, primary care physicians, other healthcare professionals, and physical therapists play an important role in referring these patients to an otorhinolaryngologist or a maxillofacial surgeon for a comprehensive evaluation and management.
Unilateral Abducens Nerve Palsy as the Lone Sign of Cerebral Venous Sinus Thrombosis: A Case Report and Literature Review

Ee See Ong D, Meng Hsien Y, Mohd Khialdin S, Wan Abdul Halim WH

Cureus, 2023 Jul;15(7):e41350.
PMID: 37546125 DOI: 10.7759/cureus.41350

Cerebral venous thrombosis (CVT) is a rare condition characterized by the obstruction of cerebral venous sinuses or cortical veins, leading to stroke-like symptoms. This case report presents a case of a 74-year-old male with isolated unilateral abducens nerve palsy as the sole sign of CVT, without accompanying symptoms or focal deficits. Neuroimaging, including CT and magnetic resonance venography, confirmed the diagnosis of CVT with a thrombus in the right transverse sinus. The patient was co-managed with the medical team and initiated on anticoagulation therapy. Follow-up showed resolution of diplopia and improvement in extraocular muscle movements. Unilateral abducens nerve palsy in CVT is rare, with most cases presenting as bilateral palsy. The case report emphasizes the importance of considering CVT in the differential diagnosis of isolated abducens nerve palsy and highlights the role of neuroimaging in early detection. Timely diagnosis and appropriate management are crucial for favorable outcomes in CVT cases. Further research is needed to enhance understanding of the pathophysiology, prognosis, and optimal management of this uncommon presentation.
Fulltext Depression and Nystagmus as the Rare Masquerading Presentations of Pineal Germinoma

Wong KH, Cheng TC, Md Pauzi SH, Wan Abdul Halim WH, Md Din N

Cureus, 2023 Jul;15(7):e42497.
PMID: 37637548 DOI: 10.7759/cureus.42497

Convergence-retraction nystagmus alongside behavioral changes can be rare manifestations of a potentially life-threatening midbrain lesion. After experiencing headaches for three months, a 13-year-old boy was diagnosed with depression due to exhibiting reduced speech, hypersomnia, and psychomotor slowing for three weeks. It was preceded by headache for three months. Examination revealed visual acuity of 6/6 bilaterally, convergence-retraction nystagmus worst on upgaze, limited bilateral ocular motility in upgaze, and light-near dissociation on pupil examination, all of which point towards Parinaud's syndrome. However, there was no lid retraction to suggest Collier's sign. Fundus examination revealed papilledema. Magnetic resonance imaging showed a large pineal mass extending to both thalami, dilated ventricles due to obstructive hydrocephalus, and cerebral edema. An urgent external ventricular drain was inserted, and biopsy revealed pineal gland germinoma. Chemotherapy and radiotherapy resulted in adequate tumor shrinkage. This case report highlights that subacute behavioral changes may mask a potentially life-threatening intracranial tumor, especially when associated with abnormal eye movement.
Fulltext Laparoscopic cystectomy in pregnancy, a viable solution - A 14 years series

Wan Ghazali WAHB, Shukri NA, Abdul Halim NHANB

Gynecol Minim Invasive Ther, 2017;6(4):157-161.
PMID: 30254905 DOI: 10.1016/j.gmit.2017.05.001

STUDY OBJECTIVE: To evaluate the safety and maternal fetal outcome of laparoscopic surgery in the management of ovarian mass in pregnant women and the usage of analgesia in postoperative period.
MATERIALS AND METHODS: This is a retrospective cross-sectional study which was carried out at department of O&G, Putrajaya Hospital. A total of 120 cases of ovarian mass in pregnancy between Jan 2000-December 2014 were evaluated. 115 patients had undergone laparoscopy cystectomy/salpingo-oophorectomy. Women's age, parity, gestational age, surgical technique, operative findings and time, estimated blood loss, postoperative hospital stay, post operative pain score, usage of analgesia, complications of surgery, outcome of the pregnancy and histopathology reports were evaluated.
MEASUREMENT AND MAIN RESULTS: Outcome of the pregnancy and post operative pain score and usage of analgesic were evaluated. The mean gestational week at the time of surgery was 14 weeks 1 day (±2 weeks 1 day). The duration of surgery was 87.4 mins (±34.8 mins) with average blood loss of 110.3 ml (±32.0). Median size of ovarian cyst was 6 cm (IQR 2 cm). 2 cases converted to laparotomy. Only 2 cases were reported with second trimester loss which was diagnosed after 4 weeks and 10 weeks respectively. 5 women received tocolytic agent post operatively, all of them delivered at term.The mean length of hospitalization was 1.51 day (±0.597). The average gestational age of delivery was 37.78 (±3.42) mean birth weight 2.97 kg (±0.65 kg). There was one intrauterine growth restriction baby with birth weight of 1.89 kg at 35 weeks of gestation and another baby with bladder exstrophy with ambiguous genitalia which was not related to surgery. The mean of pain score was 1.5 (±1.6) over 10. 87.9% of the women had mild pain which only 64.6% require paracetamol or no analgesia.
CONCLUSION: Majority of women with ovarian masses in pregnancy can be treated with ensured safety and reduced morbidity using the endoscopic approach.
Case Report: Branch Retinal Vein Occlusion Post mRNA SARS-CoV-2 (COVID-19) Vaccination

Lee J, Ong KW, Wan Abdul Halim WH, Mohd Khialdin S, Yong MH

Optom Vis Sci, 2023 Oct 17.
PMID: 37844608 DOI: 10.1097/OPX.0000000000002075

SIGNIFICANCE: Systemic thromboembolic complications are well documented to be associated with Coronavirus disease 2019 (COVID-19), however, there has been a growing number of reports regarding ocular complications stemming from COVID-19 vaccinations. This case illustrates a clear temporal and possible causal relationship of COVID-19 vaccination with an ocular microvascular disorder, namely retinal vein occlusion.
PURPOSE: To report a case of inferotemporal branch retinal vein occlusion after mRNA SARS-CoV-2 vaccination.
CASE REPORT: A middle-aged female developed right eye central scotoma two days after COVID-19 vaccination. She had transient hypertension during the first two days post-vaccination. A decrease in visual acuity (6/18) was documented. Initial retinal findings included flame-shaped hemorrhages and cotton wool spots along inferotemporal branch retinal vessels. Optical coherence tomography revealed right eye cystoid macular edema. Laboratory investigation revealed mildly raised erythrocyte sedimentation rate and C-reactive protein . Other systemic examinations were unremarkable. She was treated for right eye inferotemporal branch retinal vein occlusion with cystoid macular edema and was given intravitreal anti-vascular endothelial growth factor monthly in three doses. Her visual acuity improved to 6/6 with resolved cystoid macular edema.
CONCLUSIONS: This case illustrates a clear temporal and possible causal relationship between COVID-19 vaccination and retinal vein occlusion. Post vaccination transient hypertension, or the immunological and inflammatory response to the vaccine may have contributed to the venous occlusive event in this case. Eye care providers should remain aware of this possibility. The effectiveness of intravitreal anti-vascular endothelial growth for the treatment of macular edema secondary to branch retinal vein occlusion was demonstrated in this patient.
Molecular characterisation and potential pathogenicity analysis of Acanthamoeba isolated from recreational lakes in Peninsular Malaysia

Abdul Halim R, Mohd Hussain RH, Aazmi S, Halim H, Ahmed Khan N, Siddiqui R, et al.

J Water Health, 2023 Sep;21(9):1342-1356.
PMID: 37756200 DOI: 10.2166/wh.2023.186

The present study aims to identify the Acanthamoeba genotypes and their pathogenic potential in three recreational lakes in Malaysia. Thirty water samples were collected by purposive sampling between June and July 2022. Physical parameters of water quality were measured in situ while chemical and microbiological analyses were performed in the laboratory. The samples were vacuum filtered through nitrate filter, cultured onto non-nutrient agar and observed microscopically for amoebic growth. DNAs from positive samples were extracted and made to react with polymerase chain reaction using specific primers. Physiological tolerance tests were performed for all Acanthamoeba-positive samples. The presence of Acanthamoeba was found in 26 of 30 water samples by PCR. The highest rate in lake waters contaminated with amoeba was in Biru Lake (100%), followed by Titiwangsa Lake (80%) and Shah Alam Lake (80%). ORP, water temperature, pH and DO were found to be significantly correlated with the presence of Acanthamoeba. The most common genotype was T4. Temperature- and osmo-tolerance tests showed that 8 (30.8%) of the genotypes T4, T9 and T11 were highly pathogenic. The presence of genotype T4 in habitats related to human activities supports the relevance of this amoeba as a potential public health concern.
Fulltext Desmoplastic Fibroma of the Phalanx of the Hand: A Rare Case Report

Singh BP, Abdul Halim S, Yahaya S, Mat Zin NA, Tuan Sharif SE, Wan Ismail WF

Case Rep Oncol, 2023;16(1):478-483.
PMID: 37485013 DOI: 10.1159/000529895

Desmoplastic fibroma is a rare primary benign bone tumour that typically affects the long bones, mandible, and pelvis. It has a similar local aggressiveness to soft tissue fibromatosis. It rarely involves the small bones of the hand. We describe an extremely rare case of desmoplastic fibroma of the proximal phalanx of the hand in a patient who presented with an aggressively enlarging but painless mass on the left ring finger. Radiological features suggested malignancy; however, an initial biopsy revealed fibrotic tissue. Trans-metacarpal amputation of the ring and little fingers and soft tissue reconstruction were performed using a local ulnar-based flap of the little finger. The final histopathological evaluation revealed desmoplastic fibroma. Aggressively growing masses in the hand should be treated according to a sarcoma management protocol, and desmoplastic fibroma should be included in the differential diagnosis.
Case Report: Unilateral Hemispheric Hemorrhage with Bilateral Ptosis and Upgaze Palsy

Wong KH, Yong MH, Mohd Khialdin S, Wan Abdul Halim WH

Optom Vis Sci, 2023 Dec 01;100(12):895-899.
PMID: 38019959 DOI: 10.1097/OPX.0000000000002089

SIGNIFICANCE: Determining the anatomic location of insult in cases of concurrent bilateral upgaze palsy with bilateral ptosis can be challenging because of the various overlapping pathways and shared functions. It is more commonly related to bilateral oculomotor nerve palsies and myasthenia gravis. However, the possibility of unilateral cerebrovascular events may be overlooked because of the lack of laterality of disease manifestations.
PURPOSE: This report documents the uncommon presentation of bilateral ptosis and upgaze palsy in unilateral hemispheric hemorrhage with the corresponding clinical and anatomical review.
CASE REPORT: A 46-year-old gentleman presented to the emergency department with left-sided hemiplegia, concurrent bilateral ptosis, and upgaze palsy. He was found to have acute hemorrhagic stroke secondary to significantly elevated blood pressure. Computed tomography of the brain revealed acute extensive intraparenchymal hemorrhage involving the right basal ganglia, frontal lobe, and temporal lobe. There was an extension of hemorrhage into the third ventricle and subarachnoid extension to the Sylvian fissure with obstructive hydrocephalus. An emergency right craniotomy was performed to evacuate the blood clot, and the hydrocephalus subsequently resolved. Post-operatively, bilateral ptosis and upgaze palsy improved and then resolved.
CONCLUSIONS: Acute bilateral ptosis and upgaze palsy suggest the possibility of unilateral hemispheric hemorrhage, even though there is no direct involvement of the brainstem and its nuclei.
Fulltext Intra-axial Cortical-Based Tumour Presented as Homonymous Hemianopia in a Young Patient: A Diagnostic Dilemma

Aminuddin L, Wan Hitam WH, Mohamad SA, Abdul Halim S, Sapiai NA

Cureus, 2024 Jul;16(7):e64963.
PMID: 39161507 DOI: 10.7759/cureus.64963

Intra-axial cortical-based tumours are rare tumours affecting children and young adults. These tumours can be classified as either low-grade or high-grade, depending on their aggressiveness and rate of growth. We report a case of homonymous hemianopia secondary to an intra-axial cortical-based tumour in a young patient. A 26-year-old lady presented with bilateral blurring of vision for three weeks associated with a headache. Visual acuity was 6/6 in both eyes. Bilateral optic nerve functions were normal. The Humphrey visual field test showed left-homonymous hemianopia. A CT scan and MRI of the brain revealed an intra-axial cortical-based tumor. Differential diagnoses include pleomorphic xanthoastrocytoma (PXA), ganglioglioma, oligodendroglioma, and dysembryoplastic neuroepithelial tumour (DNET). The patient was treated conservatively and closely monitored through clinic follow-up.
Fulltext Prevalence of aspirin resistance in diabetic patients and its associated factors

Habizal NH, Abdul Halim S, Bhaskar S, Wan Bebakar WM, Abdullah JM

Malays J Med Sci, 2015 Jan-Feb;22(1):50-7.
PMID: 25892950 MyJurnal

BACKGROUND: Aspirin resistance has posed a major dilemma in the prevention of cardiovascular disease and stroke. There have been many factors that have been associated with aspirin resistance. Among these factors, the inflammatory processes of diabetes and glycaemic control have been significantly associated with aspirin resistance. Our study evaluated the prevalence of aspirin resistance and its associated factors.
METHODS: This was a cross-sectional, interventional study, which was implemented from October to November 2012 at the Hospital Universiti Sains Malaysia (HUSM). Sixty-nine patients with diabetes who were taking aspirin were enrolled. The glycosylated haemoglobin (HbA1c) and C-reactive protein (CRP) levels were measured in these patients. The thromboelastography (TEG) level was measured using a TEG machine by a trained technician employing standard methods. The variables obtained were analysed for prevalence of aspirin resistance, HbA1c, CRP, and TEG level. The Chi-square test (and Fisher exact test where applicable) were used to evaluate the associations between aspirin resistance with glycaemic control (HbA1c) and inflammatory markers (CRP).
RESULTS: The prevalence of aspirin resistance was 17.4% (95%; CI 9.3, 28.4). Glycaemic control (HbA1c) and inflammatory markers (CRP) were not associated with aspirin resistance. Aspirin resistance was prevalent in our study population and was comparable to other studies. The mean HbA1c in the aspirin-resistant group was 8.9%, whereas the mean HbA1c in the aspirin-sensitive group was 8.6%.
CONCLUSION: There was no significant difference in HbA1c between the two groups. There was no significant association between CRP levels and aspirin resistance.
KEYWORDS: aspirin resistance; diabetes mellitus; thromboelastography
Study site: NeuroMedical Specialist Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Neurological Examination Techniques of Speech in Bahasa Malaysia for Adults: Simple Approach Practiced in Hospital Universiti Sains Malaysia

Noorsham AH, Abdullah MM, Abdul Halim S, Ghani ARI, Idris Z, Abdullah JM

Malays J Med Sci, 2020 Dec;27(6):148-182.
PMID: 33447142 DOI: 10.21315/mjms2020.27.6.14

There are four classification levels for speech disorders namely dysphonia, dysarthria, dysprosody and dysphasia. In general, speech examination mainly focuses on three main components that are spontaneous speech, auditory comprehension, and oral motor examination. Quick bedside assessment on speech in Bahasa Malaysia is essential to assist the speech language therapist (SLT) and other physicians to determine the disorders. Speech therapy is also essential in monitoring and continuous assessment for patients with speech and language disorders such as dysphasia and dysarthria. Speech clinicians in Hospital Universiti Sains Malaysia (HUSM) have been adapting two most widely used batteries of speech assessment tools namely Western aphasia battery-revised (WAB-R) by Andrew Kertesz and Boston diagnostic aphasia examination (BDAE). These tools have been modified into simple and validated speech assessments in Bahasa Malaysia. This video manuscript will demonstrate the use of both tools in performing bedside speech assessment for patients with speech disorders. The Bahasa Malaysia speech examination should not be difficult when WAB-R and BDAE speech assessment tools are applied. The aim of this simple approach using the adapted version of BDAE and WAB-R is to assist the clinician to achieve quick and accurate diagnosis with a validated scoring system.
Fulltext Structure and Properties of Poly(Ethylene-co-vinyl Acetate) Nanocomposites with Dual-Functionalized Dolomite Nanoparticles

Ahmad Fauzi AA, Osman AF, Alosime EM, Abdul Halim KA, Abdullah MAA

Int J Mol Sci, 2024 Nov 21;25(23).
PMID: 39684232 DOI: 10.3390/ijms252312519

Poly(ethylene-co-vinyl acetate) (PEVAc) is a copolymer that consists of non-polar polyethylene (PE) and a polar polyvinyl acetate (PVAc) monomer. PEVAc has high elasticity and is resilient, making it suitable for a variety of applications. However, the tensile strength of this copolymer needs to be improved for specific applications that require enough strength to tolerate high external tension or stress. This study proposed the use of dual-functionalized dolomite nanoparticles (DF-DNPs) composed of polar and non-polar nano-dolomite (P-DNPs and NP-DNPs) as nanofillers to reinforce the PEVAc. PEVAc/DF-DNP film appears to have a more homogeneous mixture, which is better for forming an optimal nanocomposite material. It also exhibits the highest tensile strength (10.48 MPa), elongation at break (1175.73%), and tensile toughness (62.12 MPa), which are higher by increments of 46.8%, 9.4%, and 20.3%, respectively, as compared to the neat PEVAc. The result proved that using DF-DNPs as a nanofiller can improve the strength of PEVAc while maintaining its flexibility to avoid brittleness of the nanocomposite film. Furthermore, its thermal characteristics were also successfully enhanced. A biostability assessment showed that the use of DF-DNPs as nanofiller caused the PEVAc copolymer to achieve the best water resistance, as it only exhibited a 2.63% weight increase, the lowest reduction in tensile properties among the studied fillers, and the best retention in surface degradation upon 3-month exposure to the in vitro environment. These findings indicate that the DF-DNPs help in developing a homogeneous nanocomposite by interacting with PE and PVAc.
What are Your Eyes Revealing? The Contemporary Bedside Neuro-Ophthalmological Examination

Ng PM, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S

Malays J Med Sci, 2021 Oct;28(5):142-148.
PMID: 35115897 DOI: 10.21315/mjms2021.28.5.15

The neuro-ophthalmological evaluation is done to assess the integrity of cranial nerves II, III, IV, VI. This work does not intend to substitute the examination in a fully equipped ophthalmology suite. The aim of this manuscript is to describe bedside examination of the eye by using simple apparatus that are easily available. This work incorporates the usage of smartphone application, as smartphone is deemed an accessory in almost every resident's pocket during review of patients as a consult in the emergency department. However, the essence of traditional physical examination remains the fundamental. Understanding of neuroanatomy and neurophysiology of the eye and the central nervous system can enhance the clinician's performance at the bedside.
Fulltext Structured Manual Muscle Testing of the Lower Limbs

Lim XY, Wong JKC, Idris Z, Ghani ARI, Abdul Halim S, Abdullah JM

Malays J Med Sci, 2023 Oct;30(5):206-220.
PMID: 37928783 DOI: 10.21315/mjms2023.30.5.17

An accurate and reliable neurological examination is pivotal in diagnosing patients with neurological and neurosurgical conditions. Despite the advancement of neuroscientific knowledge and the ever-progressing technologies and modalities that are being adopted to help achieve the challenge of accurate diagnosis, the neurologic examination is still crucial in both ambulatory and emergency settings. It provides the physician a tool to recognise neurologic involvement in certain disease states, and thereby allow proper work-up and treatment for patients. A basic neurologic examination can be performed rapidly with practice. Manual muscle testing of the lower limbs was carried out in accordance with a bedside clinical examination involving a clinical personnel examiner and a patient. This testing was performed in a rostro-caudal manner, starting from the hip and progressing to the toes. The neurological exam can be intimidating to perform for a lot of physicians. Deficiencies in accurate muscle testing have always presented a challenge for medical students and clinicians. By referring to the examination methods mentioned in our text and with the help of related video, it is our aim to improve the quality of neurological examination among medical personnel so that diseases may be recognised and managed earlier in their course.
Fulltext Manual Muscle Testing of the Scapula and the Upper Limb through Bedside Examination

Vijian K, Cheng YT, Idris Z, Izaini Ghani AR, Abdul Halim S, Abdullah JM

Malays J Med Sci, 2023 Feb;30(1):198-212.
PMID: 36875200 DOI: 10.21315/mjms2023.30.1.17

Neurological examination is an important tool in diagnosing patients with neurological and neurosurgical conditions. As the complexity and knowledge of neurological and neurosurgical conditions increases, we are now required to learn and indoctrinate our peers and students with the correct skills and methods of examination. Emphasis on the correct techniques of testing muscle strength is essential to avoid errors in recording muscle power and in testing specific muscles which may have overlapping functions. The manual muscle testing of muscles of scapula and upper limbs was performed as to mimic a bedside clinical examination and involved an examiner, a patient and a videographer. The manual muscle testing has been performed in rostrocaudal manner starting from the scapula and ending with the thumbs. A reliable and consistent method of manual muscle testing is lacking among students and clinicians. By adhering to the methods delineated in our text and accompanying video, we hope to reduce inter-examiner variability and increase the reliability and validity of this important examination.
Fulltext Examination Approaches to Brachial Plexus Injury for Neurosurgical Residents

Saleh U, Tan GY, Fuad M, Abdullah JM, Idris Z, Ghani ARI, et al.

Malays J Med Sci, 2023 Dec;30(6):61-69.
PMID: 38239251 DOI: 10.21315/mjms2023.30.6.7

BACKGROUND: Brachial plexus injury is a severe peripheral nerve injury that affects the upper extremities and causes functional damage and disability. A detailed and accurate clinical examination is required to accurately localise the site of injury. This video manuscript aims to provide guidelines for the structured assessment of a patient with brachial plexus injury, specifically tailored to Malaysian medical students and trainees.
METHODS: A video demonstrating the examination of the brachial plexus was made. This video, created at the School of Medical Sciences at Universiti Sains Malaysia (USM), demonstrates the proper examination technique for brachial plexus.
CONCLUSION: We hope that this video will help students and young doctors evaluate patients with brachial plexus injury and reach accurate localisation of the injury.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links