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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.
Fulltext A Case Report of Bilateral Optic Perineuritis With Idiopathic Intracranial Hypertension: Challenges in Diagnosis and Management

Shahrudin NH, Muhammed J, Wan Hitam WH, Sapiai NA, Abdul Halim S

Cureus, 2024 Feb;16(2):e54692.
PMID: 38523970 DOI: 10.7759/cureus.54692

Optic perineuritis (OPN) refers to the inflammation of the optic nerve sheath and it is a rare form of idiopathic orbital inflammatory disease. We report a rare case of bilateral OPN in an obese female teenager with idiopathic intracranial hypertension (IIH). She was initially presented with painless bilateral blurring of vision that was progressively worsening for three weeks duration. Visual acuity of both eyes was hand movement with no relative afferent pupillary defect detected. The confrontation visual field test showed central scotoma. Both anterior segments were unremarkable. Fundoscopy showed a swollen optic disc bilaterally, with extensive flame-shaped hemorrhages surrounding the disc area and dot blot hemorrhages in the posterior pole. A magnetic resonance imaging scan of the brain and orbit revealed the presence of bilateral optic nerve sheath enhancement with empty sella turcica. The patient was diagnosed with bilateral OPN with IIH. She received an initial high dose of systemic corticosteroid followed by a slow tapering dose. She was monitored by the neuromedical team for her IIH. She was followed up for about a year. The final best corrected visual acuity in the right eye was 6/36 and the left eye was 6/60. In conclusion, OPN poses challenges in diagnosis and management. This case emphasizes the importance of considering OPN in the differential diagnosis of optic nerve-related symptoms, as prompt recognition and intervention are crucial for favorable outcomes.
High-intensity combination exercise has the highest effect on increasing serum irisin and interleukin 6 levels in women with obesity

Hasanah U, Rejeki PS, Wungu CDK, Pranoto A, Izzatunnisa N, Rahmanto I, et al.

J Basic Clin Physiol Pharmacol, 2024 Jan 01;35(1-2):71-78.
PMID: 38482824 DOI: 10.1515/jbcpp-2023-0150

OBJECTIVES: Lifestyle, overnutrition, socioeconomic status, environmental conditions, and genetics are factors that cause obesity. Lifestyle modification with a nonpharmacological approach based on physical exercise is the starting point in overcoming obesity. However, physical exercise with the appropriate and effective intensity for obese subjects is still debated. Therefore, this study aims to prove the effect of intensity differences with aerobic-resistance combination exercise on increasing irisin and IL-6 levels in obese women.
METHODS: A total of 32 obese women were selected as subjects and administered the interventions of low-intensity combination exercise (Q2), moderate-intensity combination exercise (Q3), and high-intensity combination exercise (Q4). ELISA was used to measure irisin and IL-6 levels in all samples. Statistical analysis used one-way ANOVA and Turkey's-Honest Significant Difference (HSD) post hoc test.
RESULTS: The mean Δ IL-6 levels in the control groups (Q1), Q2, Q3, and Q4 were 0.27 ± 2.54, 2.07 ± 2.55, 5.99 ± 6.25, and 7.98 ± 2.82 pg/mL with (p=0.015). The mean Δ irisin levels were 0.06 ± 0.81 ng/mL in Q1, 0.59 ± 0.67 ng/mL in Q2, 1.99 ± 1.65 ng/mL in Q3, 4.63 ± 3.57 ng/mL in Q4 with (p=0.001).
CONCLUSIONS: This study proved that all three types of combined exercise intensity increased myokine levels, such as irisin and IL-6. However, high-intensity combination exercise provided the most optimal improvement in myokine levels in obese women. Future studies are needed to design long-term exercise programs specifically for obese adolescent women using the findings from this study.
Fulltext A Non-Convex Economic Dispatch Problem with Point-Valve Effect Using a Wind-Driven Optimisation Approach

Ramli NF, Kamari NAM, Abd Halim S, Zulkifley MA, Sahri MSM, Musirin I

J Electr Eng Technol, 2022;17(1):85-95.
PMID: 38624623 DOI: 10.1007/s42835-021-00859-6

This study presents the efficiency of the wind-driven optimisation (WDO) approach in solving non-convex economic dispatch problems with point-valve effect. The best economic dispatch for a power system is one wherein the system can generate energy at a low cost. The calculation of the generating cost is subject to a number of constraints, such as the power demand for the entire system and the generation limit for each generator unit in the system. In addition, the system should also produce low power loss. The WDO optimisation technique is developed based on the concept of natural wind movement, which serves as a stabiliser to equalise the inequality of air pressure in the atmosphere. One major advantage of WDO over other techniques is its search accuracy. The proposed algorithm has been implemented in two systems, namely, the 10-generator and 40-generator systems. Both systems were tested in a Matlab environment. To highlight the capabilities of WDO, the results using this proposed technique are compared with the results obtained using flower pollination algorithm, moth flame optimisation, particle swarm optimisation and evolutionary programming techniques to determine the efficiency of the proposed approach in solving economic dispatch. The simulation results show the capability of WDO in determining the optimal power generation value with minimum generation cost and low rate of power loss.
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
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.
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 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.
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 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.
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.
Radiation and temperature effects on conductivity properties of PVA-KOH-PC composite

Mohd Asri MT, Elias S, Iskandar SM, Abd Halim S, Jumiah H, Zaki AR, et al.

Med J Malaysia, 2004 May;59 Suppl B:139-40.
PMID: 15468857

The aim of this work was to study radiation and the effects of temperature on conductivity properties of polyvinyl alcohol (PVA)-based potassium hydroxide (KOH) and propylene carbonate (PC), where the ionic conduction preferentially occurs in the amorphous phase by free radicals ions through gamma-irradiation. Alkaline composite polymer electrolyte (ACPE) consisting of PVA, KOH and PC of different concentration ratios were prepared by solvent-casting technique. The ACPE were irradiated with different doses from 5 kGy up to 200 kGy. The conductivity properties of the electrolyte films were measured at different frequencies in the range 20 Hz to 1 MHz using LCR meter. The results showed that the conductivity properties were dependent on the radiation dose, temperature and the concentration of the polymer blends.
Fulltext Quality prediction and classification of resistance spot weld using artificial neural network with open-sourced, self-executable and GUI-based application tool Q-Check

Abd Halim S, Manurung YHP, Raziq MA, Low CY, Rohmad MS, Dizon JRC, et al.

Sci Rep, 2023 Feb 21;13(1):3013.
PMID: 36810419 DOI: 10.1038/s41598-023-29906-0

Optimizing Resistance spot welding, often used as a time and cost-effective process in many industrial sectors, is very time-consuming due to the obscurity inherent within process with numerous interconnected welding parameters. Small changes in values will give effect to the quality of welds which actually can be easily analysed using application tool. Unfortunately, existing software to optimize the parameters are expensive, licensed and inflexible which makes small industries and research centres refused to acquire. In this study, application tool using open-sourced and customized algorithm based on artificial neural networks (ANN) was developed to enable better, fast, cheap and practical predictions of major parameters such as welding time, current and electrode force on tensile shear load bearing capacity (TSLBC) and weld quality classifications (WQC). A supervised learning algorithm implemented in standard backpropagation neural network gradient descent (GD), stochastic gradient descent (SGD) and Levenberg-Marquardt (LM) was constructed using TensorFlow with Spyder IDE in python language. All the display and calculation processes are developed and compiled in the form of application tool of graphical user interface (GUI). Results showed that this low-cost application tool Q-Check based on ANN models can predict with 80% training and 20% test set on TSLBC with an accuracy of 87.220%, 92.865% and 93.670% for GD, SGD and LM algorithms respectively while on WQC 62.5% for GD and 75% for both SGD and LM. It is also expected that tool with flexible GUI can be widely used and enhanced by practitioner with minimum knowledge in the domain.
Fulltext COVID-19 Infection and Circulating Microparticles-Reviewing Evidence as Microthrombogenic Risk Factor for Cerebral Small Vessel Disease

Che Mohd Nassir CMN, Hashim S, Wong KK, Abdul Halim S, Idris NS, Jayabalan N, et al.

Mol Neurobiol, 2021 Aug;58(8):4188-4215.
PMID: 34176095 DOI: 10.1007/s12035-021-02457-z

Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) due to novel coronavirus disease 2019 (COVID-19) has affected the global society in numerous unprecedented ways, with considerable morbidity and mortality. Both direct and indirect consequences from COVID-19 infection are recognized to give rise to cardio- and cerebrovascular complications. Despite current limited knowledge on COVID-19 pathogenesis, inflammation, endothelial dysfunction, and coagulopathy appear to play critical roles in COVID-19-associated cerebrovascular disease (CVD). One of the major subtypes of CVD is cerebral small vessel disease (CSVD) which represents a spectrum of pathological processes of various etiologies affecting the brain microcirculation that can trigger subsequent neuroinflammation and neurodegeneration. Prevalent with aging, CSVD is a recognized risk factor for stroke, vascular dementia, and Alzheimer's disease. In the background of COVID-19 infection, the heightened cellular activations from inflammations and oxidative stress may result in elevated levels of microthrombogenic extracellular-derived circulating microparticles (MPs). Consequently, MPs could act as pro-coagulant risk factor that may serve as microthrombi for the vulnerable microcirculation in the brain leading to CSVD manifestations. This review aims to appraise the accumulating body of evidence on the plausible impact of COVID-19 infection on the formation of microthrombogenic MPs that could lead to microthrombosis in CSVD manifestations, including occult CSVD which may last well beyond the pandemic era.
Fulltext Pain as a Guide in Glasgow Coma Scale Status for Neurological Assessment

Nallaluthan V, Tan GY, Murni MF, Saleh U, Abdul Halim S, Idris Z, et al.

Malays J Med Sci, 2023 Oct;30(5):221-235.
PMID: 37928790 DOI: 10.21315/mjms2023.30.5.18

Neurological status is essential and often challenging for neurosurgical residents and also for neurosurgeons to determine surgical management. Pain as a component of the Glasgow Coma Scale (GCS) can be used as a tool in patients, especially an unconscious or comatose patient. In order to elicit this adequate noxious stimulus, a certain amount of pressure-pain threshold is required upon performing either as the central or peripheral technique. The scientific explanation behind each technique is required and needs to be well understood to aid the localisation of the defect in the neurological system. This paper will briefly review the aid of pain as a neurological guide in GCS status assessment.
Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

Rosli MA, Wan Ismail WF, Wan Sulaiman WA, Mat Zin NA, Abdul Halim S, Mat Johar F, et al.

Foot Ankle Int, 2021 Dec;42(12):1570-1578.
PMID: 34286617 DOI: 10.1177/10711007211025280

BACKGROUND: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors.
METHODS: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case.
RESULTS: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either.
CONCLUSION: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes.
LEVEL OF EVIDENCE: Level IV, case series.
Fulltext Big Brain Data Initiative in Universiti Sains Malaysia: Challenges in Brain Mapping for Malaysia

Shekh Ibrahim SA, Hamzah N, Abdul Wahab AR, Abdullah JM, Nurul Hashimah Ahamed Hassain Malim, Sumari P, et al.

Malays J Med Sci, 2020 Jul;27(4):1-8.
PMID: 32863741 DOI: 10.21315/mjms2020.27.4.1

Universiti Sains Malaysia has started the Big Brain Data Initiative project since the last two years as brain mapping techniques have proven to be important in understanding the molecular, cellular and functional mechanisms of the brain. This Big Brain Data Initiative can be a platform for neurophysicians and neurosurgeons, psychiatrists, psychologists, cognitive neuroscientists, neurotechnologists and other researchers to improve brain mapping techniques. Data collection from a cohort of multiracial population in Malaysia is important for present and future research and finding cure for neurological and mental illness. Malaysia is one of the participant of the Global Brain Consortium (GBC) supported by the World Health Organization. This project is a part of its contribution via the third GBC goal which is influencing the policy process within and between high-income countries and low- and middle-income countries, such as pathways for fair data-sharing of multi-modal imaging data, starting with electroencephalographic data.
Examination Approach to the Dizzy and Swaying Patient

Said Mogutham NN, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S, Naesarajoo JJJ, et al.

Malays J Med Sci, 2020 Dec;27(6):89-101.
PMID: 33447137 DOI: 10.21315/mjms2020.27.6.9

Background: Dizziness is a common presenting complaint among patients in Malaysia. It is a vague term which could be associated with vertigo, imbalance, ataxia or syncope. In order to deal with this overwhelming complaint, a detailed history-taking is essential in confirming aetiology of disease and this should be followed by a meticulous clinical examination. The purpose of the video manuscript it to provide a step-by-step approach to a dizzy and swaying patient, specially catered for Malaysian medical students and trainees.
Methods: A series of videos were shot, which involved the eye, ear, vestibular system, cerebellar, proprioceptive sense and gait examination. These videos, conducted in Universiti Sains Malaysia (USM) School of Medical Sciences, will be first in Malaysia and will highlight the proper technique and rapport with patients and essential points of each examination. There will be summary at the end of each examination on how to report findings which is a common weakness among students.
Conclusion: We hope that students and junior doctors could be apply these methods in their daily assessment of dizzy patients and ultimately, reach an accurate diagnosis.
Fulltext Biomechanical System Versus Observational Rating Scale for Parkinson's Disease Tremor Assessment

Chan PY, Mohd Ripin Z, Abdul Halim S, Kamarudin MI, Ng KS, Eow GB, et al.

Sci Rep, 2019 May 31;9(1):8117.
PMID: 31148550 DOI: 10.1038/s41598-019-44142-1

There is a lack of evidence that either conventional observational rating scale or biomechanical system is a better tremor assessment tool. This work focuses on comparing a biomechanical system and the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale in terms of test-retest reliability. The Parkinson's disease tremors were quantified by biomechanical system in joint angular displacement and predicted rating, as well as assessed by three raters using observational ratings. Qualitative comparisons of the validity and function are made also. The observational rating captures the overall severity of body parts, whereas the biomechanical system provides motion- and joint-specific tremor severity. The tremor readings of the biomechanical system were previously validated against encoders' readings and doctors' ratings; the observational ratings were validated with previous ratings on assessing the disease and combined motor symptoms rather than on tremor specifically. Analyses show that the predicted rating is significantly more reliable than the average clinical ratings by three raters. The comparison work removes some of the inconsistent impressions of the tools and serves as guideline for selecting a tool that can improve tremor assessment. Nevertheless, further work is required to consider more variabilities that influence the overall judgement.
Fulltext Preparing Malaysia for Population Aging through the Advanced Memory and Cognitive Service in Hospital Universiti Sains Malaysia

Ab Razak A, Rahman NA, Zulkifly MFM, Sapiai NA, Phoa PKA, Mohamed Mustafar MF, et al.

Malays J Med Sci, 2023 Oct;30(5):1-6.
PMID: 37928788 DOI: 10.21315/mjms2023.30.5.1

Improving healthcare and living conditions has led to an increase in life expectancies and challenges of population aging in Malaysia. The Advanced Memory and Cognitive Service builds on integrated healthcare among multidisciplinary specialists to provide holistic and patient-centred healthcare. The service treats older adults experiencing neurocognitive impairment as well as young individuals with complex neurocognitive disorders and thoroughly screens asymptomatic individuals at high risk of developing neurocognitive disorders. This early intervention strategy is a preventive effort in the hope of reducing disease burden and improving quality of life to prepare Malaysia for the forthcoming population aging.

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