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Histopathological diagnoses in soft tissue tumours: an experience from a tertiary centre in Malaysia

Jalaludin ND, Mohd Dusa N, Hassan MR, Abd Shukor N

Malays J Pathol, 2017 Dec;39(3):209-216.
PMID: 29279582 MyJurnal

Soft tissue tumours are a group of remarkably diverse neoplasms that frequently pose significant diagnostic challenges to general pathologists. This study aimed to compare the agreement of histopathological diagnoses between general pathologists from various referral institutes and the referred soft tissue pathologist in a tertiary centre. The common discrepancies and their causes are also presented here. A retrospective study was conducted on 243 cases of potential soft tissue tumours referred to Hospital Kuala Lumpur, Malaysia over a period of 5 years. Reports by the referring pathologists and the soft tissue pathologist were compared based on tumour classification and tumour behaviour. Overall, there was moderate agreement in soft tissue tumour diagnoses in both tumour classification (weighted κ = 0.423) and tumour behavior (weighted κ = 0.548). The highest agreement of tumour classification was seen in the adipocytic tumours (21/28 cases), Ewing sarcoma (5/7 cases) and smooth-muscle tumours (3/5 cases). The highest rates of discrepancies were the so-called fibrohistiocytic tumours (7/11 cases), vascular tumours (9/15 cases) and undifferentiated/ unclassified sarcomas (19/32 cases). Full agreement for tumour behaviour was seen in 178 cases and there were 21 cases of zero agreement. Liposarcoma, alveolar soft part sarcoma and benign fibrous histiocytoma were the most frequent benign/malignant diagnostic discrepancies. The most common causes of discrepancy were wrong morphological interpretation followed by insufficient immunohistochemical stains performed. In conclusion, review of diagnosis by a pathologist specialized in soft tissue improves the quality of diagnosis in these heterogenous and rare tumours. A good panel of immunohistochemical stains with additional molecular study is crucial in the general hospital laboratories practice.
Psychological markers underlying murder weapon profile: a quantitative study

Kamaluddin MR, Othman A, Ismail KH, Mat Saat GA

Malays J Pathol, 2017 Dec;39(3):217-226.
PMID: 29279583 MyJurnal

The horrific nature of murder using different types of weapons has been an important focal point of many criminological studies. Weapons that are used in murders seem to play dominant roles in murder investigations as they may provide information leading to arrest. The established factors for weapon usage include environmental context, demography and availability of weapons. However, there is insufficient research attention on the psychological functioning of murderers for particular weapon usage. In light of this, the current study seeks to narrow this gap of information by identifying the influences of psychological traits on weapon usage among a sample of male murderers. The present cross-sectional study was conducted among 71 male murderers incarcerated in 11 prisons within Peninsular Malaysia. The selection of the sample was based on predetermined selection criteria using a purposive sampling method. A guided self-administered questionnaire comprising sociodemography variables and four Malay validated psychometric instruments: Zuckerman-Kuhlman Personality Questionnaire-40-Cross-Culture, Self-control Scale, "How I Think" Questionnaire and Aggression Questionnaire; was used. Independent sample t-test was performed to establish the mean score differences of psychological traits between the murderers who used single and multiple weapons while Kruskal-Wallis tests were carried out to ascertain the differences between the specific types of weapons used among the murderers. Following this, one-way ANOVA was carried out to ascertain the psychological trait differences among the murderers according to the different sources of weapon. Results indicated specific psychological traits influenced the number(s), source(s) and type(s) of weapon used in committing murder. The findings have implications for the psychological profiling of unknown murderers within the Malaysian context.
Fulltext Incidence and demographical characteristics of patients with post-traumatic stress disorder due to motor vehicle accidents

Bahari R, Mohamad Alwi MN, Ahmad MR, Mohd Saiboon I

Malays Fam Physician, 2017;12(3):2-7.
PMID: 29527273 MyJurnal

Introduction: Motor vehicle accidents (MVAs) are daily occurrences in Malaysia but the extent to which victims are psychologically affected is not well known. The objective of this study is to determine the incidence and demographic characteristics of patients with post-traumatic stress disorder (PTSD) due to MVAs at a university hospital in Malaysia.
Methods: Patients presenting to the emergency department from August to October 2014 due to MVA-related injuries were recruited. After a period of at least one month, they were followed-up and screened using the validated Malay Post Traumatic Stress Disorder Checklist Civilian version. A score of 30 was chosen as the cut-off point for PTSD.
Results: In total, 112 patients presented to the emergency department following MVAs during the study period. Of these, 60.7% agreed for the follow-up. Among the respondents, the mean age was 26 years, 91.2% were males, 66.2% were married, 85.3% were Malays and 88.3% were Muslims. The calculated incidence of PTSD was 7.4%. There was no significant difference noted between the PTSD and non-PTSD groups.
Conclusion: A considerable number of MVA victims in Malaysia may develop PTSD after the accident. Further research is needed to explore the factors that contribute or protect to develop the condition.
Comparison of various creatinine-based estimates of glomerular filtration rate equations in the Malaysian setting

Mohd Hanafiah FH, Azrina MR, Abdul Rahim MS

Med J Malaysia, 2022 Nov;77(6):684-688.
PMID: 36448385

INTRODUCTION: Kidney disease is a worldwide health concern with an increasing mortality in the past 10 years. The Kidney Disease Improving Global Outcomes (KDIGO) guideline advocates the use of estimated glomerular filtration rate equation (eGFR) to estimate renal function. We evaluated the performance of Cockroft Gault (CG), Modified Diet of Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations to measured GFR 99mTc- DTPA taking into account body mass index (BMI) and age group.
MATERIALS AND METHODS: This is a cross-sectional study of patients referred for 99mTc-DTPA scan at the Nuclear Medicine Centre of International Islamic University Malaysia. The record was taken from patients visiting the centre from January 2016 to December 2019.
RESULTS: The mean measured GFR by 99mTc-DTPA scan was 42.2 ± 20.38 ml/min. These were lower than that estimated by CG, MDRD, and CKD-EPI equations. CKD-EPI had the highest correlation of 0.72, least bias (mean bias of 11.08 ± 23.08) and was more precise (r2 = 0.4) as compared to MDRD and CG. In patients < 65 years old, CKD-EPI had the highest correlation; however, MDRD had the least bias and highest accuracy. In terms of BMI, CKD-EPI had the least bias and highest accuracy for BMI >30 and with the highest correlation for all classes of BMI.
CONCLUSION: CKD-EPI has the best estimation of GFR taking into account the effect of BMI and age. A further study can be done to determine the correlation of estimated GFR equations with different ethnicity in Malaysia.
Fulltext Predominance of G to A codon 12 mutation K-ras gene in Dukes' B colorectal cancer

Zulhabri O, Rahman J, Ismail S, Isa MR, Wan Zurinah WN

Singapore Med J, 2012 Jan;53(1):26-31.
PMID: 22252179

K-ras gene mutations in codons 12 and 13 are one of the earliest events in colon carcinogenesis.
Fulltext Epidemiology of Haemophilus influenzae invasive disease in hospitalised Kelantanese children, 1985-1994

Nik Khairulddin NY, Choo KE, Johari MR

Singapore Med J, 1999 Feb;40(2):96-100.
PMID: 10414167

Data is lacking with regard to the epidemiology of invasive haemophilus influenzae (HI) disease in Malaysia. This study was carried out to document the epidemiology of invasive HI disease in hospitalised Kelantanese children.
Fulltext Painful oral ulcers with hydroxyurea therapy

Norhaya MR, Cheong SK, Ainoon O, Hamidah NH

Singapore Med J, 1997 Jul;38(7):283-4.
PMID: 9339092

Five patients treated with hydroxyurea for various haematological malignancies developed multiple painful oral ulcers. Their neutrophil counts were either normal or elevated. The ulcers disappeared with cessation of hydroxyurea. Oral ulcers recurred when hydroxyurea was resumed in one of the patients. As the patients were unable to tolerate this painful side effect, hydroxyurea had to be discontinued. Appearance of painful oral ulceration seems to be independent of dosing rate or total cumulative dose of hydroxyurea.
Fulltext Sweet-like syndrome in a patient with acute myeloid leukaemia

Norhaya MR, Cheong SK, Hamidah NH, Ainoon O

Singapore Med J, 1996 Jun;37(3):320-2.
PMID: 8942241

A 45-year-old Malay lady developed brisk vesicular, plaque-like reaction to a Mantoux test concomitant with a diagnosis of acute myeloid leukaemia (AML). The lesion resolved one month after chemotherapy. Similar lesions developed later after she was bitten by mosquitoes on the forearms. She also had the lesions over her cheek. A skin biopsy showed infiltration of the dermis with neutrophils and some monocytoid cells. The lesion resolved one week after prednisolone therapy.
Fulltext Training of occupational safety and health: knowledge among healthcare professionals in Malaysia

Lugah V, Ganesh B, Darus A, Retneswari M, Rosnawati MR, Sujatha D

Singapore Med J, 2010 Jul;51(7):586-92.
PMID: 20730400

Awareness of occupational safety and health (OSH) plays an important role in the prevention of occupational injuries and diseases. Following the enactment of the Occupational Safety and Health Act (OSHA) in 1994, various programmes have been implemented by different agencies to increase awareness and knowledge of OSH in the workplace, including among healthcare workers. The objective of this study was to determine the level of OSH awareness and knowledge among healthcare professionals in Malaysia.
Fulltext Computed tomography of blunt renal trauma

Razali MR, Azian AA, Amran AR, Azlin S

Singapore Med J, 2010 Jun;51(6):468-73; quiz 474.
PMID: 20658105

Renal injury is observed in 10 percent of cases of abdominal trauma, and the majority (80 percent to 90 percent) of these are attributable to blunt trauma. Intravenous urography and ultrasonography of the abdomen were previously the modalities of choice in the imaging of renal injuries. However, computed tomography (CT) is currently the imaging modality of choice in the evaluation of blunt renal injury, since it provides the exact staging of renal injuries. The purpose of this article is to describe the CT staging of renal injuries observed in blunt abdominal trauma based on the Federle Classification and the American Association for the Surgery of Trauma renal injury severity scale.
Fulltext Pregnancy in a patient receiving busulphan for chronic myeloid leukaemia

Norhaya MR, Cheong SK, Hamidah NH, Ainoon O

Singapore Med J, 1994 Feb;35(1):102-3.
PMID: 8009265

A 33-year-old Malay lady with chronic myeloid leukaemia (CML) became amenorrhoeic during therapy with busulphan. Pregnancy was diagnosed via a urine pregnancy test and an ultrasound confirmed a viable foetus at 16 weeks. The busulphan was stopped. Her pregnancy was unremarkable and continued till term. She delivered a healthy child.
Fulltext Neonatal melioidosis

Halder D, Abdullah WA, Johari MR, Choo KE

Singapore Med J, 1993 Feb;34(1):85-6.
PMID: 8266140

We report a neonate with melioidosis. The presentation, progress and treatment are described, followed by a discussion on melioidosis.
Fulltext Lymphangioleiomyomatosis with chylous ascites

Raymond AA, Isa MR, Abdullah T, Kudva MV

Singapore Med J, 1993 Jun;34(3):276-8.
PMID: 8266193

A 41-year-old Malay housewife presented with recurrent chylous ascites and progressive cachexia over 17 years. A diagnosis of lymphangioleiomyomatosis (LAM) was established by laparotomy where biopsy of the liver, peritoneum and adhesions from previous surgery showed smooth muscle proliferation in the blood vessels and lymphatics. Clinically and radiologically, there was no evidence of pulmonary involvement. She was treated with dietary fat restriction and medium-chain triglycerides. This is the first case of LAM reported in Malaysia.
Fulltext Rhabdomyolysis associated with hypokalaemic periodic paralysis of renal tubular acidosis

Hanip MR, Cheong IK, Chin GL, Khalid BA

Singapore Med J, 1990 Apr;31(2):159-61.
PMID: 2371581

Two cases of hypokalaemia with serum potassium levels of 1.4 mmol/L and 1.9 mmol/L causing severe periodic paralysis since childhood are presented. There were associated with muscular aches and markedly raised muscle enzymes suggesting massive rhabdomyolysis. These abnormalities were due to renal tubular acidosis with markedly acidic arterial pH. The hypokalaemia and rhabdomyolysis responded to potassium and bicarbonate replacement. We postulate these patients had sporadic distal type of renal tubular acidosis and that the hypokalaemia and acidosis had caused the rhabdomyolysis.
Analysis on the effect of the distances and inclination angles between human head and mobile phone on SAR

Hossain MI, Faruque MR, Islam MT

Prog Biophys Mol Biol, 2015 Nov;119(2):103-10.
PMID: 25863147 DOI: 10.1016/j.pbiomolbio.2015.03.008

The aim of this paper is to investigate the effects of the distances between the human head and internal cellular device antenna on the specific absorption rate (SAR). This paper also analyzes the effects of inclination angles between user head and mobile terminal antenna on SAR values. The effects of the metal-glass casing of mobile phone on the SAR values were observed in the vicinity of the human head model. Moreover, the return losses were investigated in all cases to mark antenna performance. This analysis was performed by adopting finite-difference time-domain (FDTD) method on Computer Simulation Technology (CST) Microwave Studio. The results indicate that by increasing the distance between the user head and antenna, SAR values are decreased. But the increase in inclination angle does not reduce SAR values in all cases. Additionally, this investigation provides some useful indication for future design of low SAR mobile terminal antenna.
Fulltext Validity of an established metabolic disorder index as a predictor for metabolic eliminations in endurance horses

Izzati MRNZ, Noraniza MA, Adamu L, Rasedee A

Int J Vet Sci Med, 2018 Dec;6(2):227-232.
PMID: 30564600 DOI: 10.1016/j.ijvsm.2018.08.002

Endurance horses are usually eliminated from the race due to lameness, metabolic ailments or technical reasons. The purpose of the study was to determine the validity and reliability of the metabolic disorder index (MDI) in predicting metabolic eliminations in endurance horses during an endurance race. Fifty-four endurance horses competing on two local endurance tracks were involved in the study. Blood samples were collected a day prior to the event to determine packed cell volume (PCV), chloride (Cl-), interleukin-6 (IL-6), creatine kinase (CK) and glutathione reductase (GR) concentrations from all participating horses. These parameters were used for the determination of metabolic disorder index in endurance horses at rest (one day before the competition). All data were statistically analysed. In 40, 80 and 120 km race distances, the successfully completed horses had a significant lower serum concentration of CK and a significant higher serum concentration of Cl- than the eliminated horses (P 
Radiation shielding assessment for interventional radiology personnel: Geant4 dosimetry of lead-free compositions

Moradi F, Jalili M, Saraee KRE, Abdi MR, Rashid HAA

Biomed Phys Eng Express, 2024 Feb 14;10(2).
PMID: 38320327 DOI: 10.1088/2057-1976/ad26d5

The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel's inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.
Fulltext Does Inhalation of Virgin Coconut Oil Accelerate Reversal of Airway Remodelling in an Allergic Model of Asthma?

Kamalaldin NA, Sulaiman SA, Yusop MR, Yahaya B

Int J Inflam, 2017;2017:8741851.
PMID: 28660089 DOI: 10.1155/2017/8741851

Many studies have been done to evaluate the effect of various natural products in controlling asthma symptoms. Virgin coconut oil (VCO) is known to contain active compounds that have beneficial effects on human health and diseases. The objective of this study was to evaluate the effect of VCO inhalation on airway remodelling in a rabbit model of allergic asthma. The effects of VCO inhalation on infiltration of airway inflammatory cells, airway structures, goblet cell hyperplasia, and cell proliferation following ovalbumin induction were evaluated. Allergic asthma was induced by a combination of ovalbumin and alum injection and/or followed by ovalbumin inhalation. The effect of VCO inhalation was then evaluated via the rescue or the preventive route. Percentage of inflammatory cells infiltration, thickness of epithelium and mucosa regions, and the numbers of goblet and proliferative cells were reduced in the rescue group but not in preventive group. Analysis using a gas chromatography-mass spectrometry found that lauric acid and capric acid were among the most abundant fatty acids present in the sample. Significant improvement was observed in rescue route in alleviating the asthma symptoms, which indicates the VCO was able to relieve asthma-related symptoms more than preventing the onset of asthma.
Metabolites alterations associated with obesity: A scoping review

Abdullah A, Haron N, Mohamed E, Yusof MIM, Shahril MR

Med J Malaysia, 2024 Mar;79(Suppl 1):158-167.
PMID: 38555901

INTRODUCTION: Obesity can be considered a major public health concern throughout the world. Various studies have been conducted to combat the rising number of cases of this health problem. Therefore, identifying the roots of the disease is critical in developing the desperately needed treatment approaches. However, in order to fully understand the origin of this disease, figuring out the metabolites present, and the alterations that occurred in a particular metabolism are crucial, and the information regarding the metabolites involved is limited. The aim of this study is to analyse the literature relevant to the metabolites involved in obesity conditions through a scoping review.
MATERIALS AND METHODS: This review utilises three databases (SCOPUS, Science Direct, and PubMed). The search phrases used are (Metabolomic* OR Metabolite*) for metabolomic study, (3T3-L1 OR Adipocyte OR "Adipose Tissue") for experimental design, and (Obesity) for obesity condition. Each of the search keywords was separated by an "AND" term in the databases. Other terms related to obesity, such as insulin resistance, heart disease, type 2 diabetes, muscular disorders, respiratory problems, and psychological problems were omitted because they did not contribute to the total number of studies discovered.
RESULTS: A total of 27 research publications were included in this scoping review. Most of the study focuses on metabolomics in obesity. Metabolites detected were found in various metabolic pathways including amino acids, carbohydrates, lipids as well as other metabolisms. Most of these metabolites discovered in obese conditions showed an alteration when compared to the level of the metabolite in normal conditions.
CONCLUSION: Unfortunately, these studies had some limitations in which the metabolites detected varied between the articles and the information concerning the relationship between the technique or instrument utilised and the metabolites detected in the samples were not well described. Therefore, using the findings obtained in this study, it can help to determine the direction of the study in the future.
Isolation of Mycobacterium fortuitum in sputum specimens of a patient with chronic cough: Is it clinically significant?

Radzniwan MR, Tohid H, Ahmad S, Mohd AF, Md Anshar F

Malays Fam Physician, 2014;9(3):38-41.
PMID: 26425304 MyJurnal

Managing chronic cough is diagnostically challenging especially in primary care. This case report highlights the difficulties experienced in approaching a case of chronic cough from a primary care perspective. The discussion also involves the clinical significance and treatment dilemma of M. fortuitum chelonae complex that was isolated from the sputum cultures of an elderly woman who presented with chronic cough for more than a year.

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