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Fulltext Glucose oxidase complexed gold-graphene nanocomposite on a dielectric surface for glucose detection: a strategy for gestational diabetes mellitus

Ge Y, Lakshmipriya T, Gopinath SC, Anbu P, Chen Y, Hariri F, et al.

Int J Nanomedicine, 2019;14:7851-7860.
PMID: 31632005 DOI: 10.2147/IJN.S222238

BACKGROUND: Gestational diabetes mellitus is a commonly occurring metabolic disorder during pregnancy, affecting >4% of pregnant women. It is generally defined as the intolerance of glucose with the onset or initial diagnosis during pregnancy. This illness affects the placenta and poses a threat to the baby as it affects the supply of proper oxygen and nutrients.
PURPOSE: Due to the high percentage of affected pregnant women, it should be mandatory to evaluate glucose levels during pregnancy and there is a need for a continuous monitoring system.
METHODS: Herein, the investigators modified the interdigitated (di)electrodes (IDE) sensing surface to detect the glucose on covalently immobilized glucose oxidase (GOx) with the graphene. The characterization of graphene and gold nanoparticle (GNP) was performed by high-resolution microscopy.
RESULTS: Sensitivity was found to be 0.06 mg/mL and to enhance the detection, GOx was complexed with GNP. GNP-GOx was improved the sensitive detection twofold from 0.06 to 0.03 mg/mL, and it also displayed higher levels of current changes at all the concentrations of glucose that were tested. High-performance of the above IDE sensing system was attested by the specificity, reproducibility and higher sensitivity detections. Further, the linear regression analysis indicated the limit of detection to be between 0.02 and 0.03 mg/mL.
CONCLUSION: This study demonstrated the potential strategy with nanocomposite for diagnosing gestational diabetes mellitus.
Fulltext Oral health knowledge, attitude and practice among parents of children with craniofacial syndromes

Rosnan NA, Mohamad Faithal NFA, Azizi NZ, Hariri F, Abdullah NA

J Clin Pediatr Dent, 2024 Jan;48(1):163-170.
PMID: 38239169 DOI: 10.22514/jocpd.2024.018

Parents play an important role in caring for their children's oral health, especially for those with craniofacial deformities. In this study, we analyzed the oral health knowledge, attitude and practice (KAP) among parents of children of 1 to 16 years-of-age with craniofacial syndromes (CS) at Universiti Malaya Medical Center (UMMC), Malaysia. This was a case-controlled study conducted between March and December 2021 involving 30 parents of children with CS and 30 parents of normal children as controls. A modified validated KAP questionnaire was distributed to all parents. Statistical analysis was carried out using SPSS 26.0 and descriptive analysis was performed, with data expressed as mean, standard deviation, frequency and percentage (%). Most respondents from both groups were mothers (73.3%) between 31 to 40 years-of-age. Both groups of parents had similar levels of oral health knowledge; there was no significant difference between the two groups for 10 of the KAP questions (p > 0.05). However, there was a significant different between the two groups with regards to two 2 relating to the definition of plaque and its relationship to dental caries (p = 0.035 and p = 0.032, respectively). Some parents of CS children believed that primary teeth were not important (23.33%) and were not concerned if their children showed changes in tooth color (26.67%). Despite parental acknowledgement of ideal practice, both groups of children showed irregular dental attendance and reduced toothbrushing frequency. Parents of children with CS had a similar depth of oral health knowledge and a slightly reduced positive attitude when compared to parents in the control group. However, both groups of parents had poor knowledge relating to the transmission and causes of dental caries. Healthcare providers should increase their awareness strategies for parents to be more aware of the ways to improve their children's oral health.
Characteristics and Young's Modulus of Collagen Fibrils from Expanded Skin Using Anisotropic Controlled Rate Self-Inflating Tissue Expander

Manssor NA, Radzi Z, Yahya NA, Mohamad Yusof L, Hariri F, Khairuddin NH, et al.

Skin Pharmacol Physiol, 2016;29(2):55-62.
PMID: 26836267 DOI: 10.1159/000431328

Mechanical properties of expanded skin tissue are different from normal skin, which is dependent mainly on the structural and functional integrity of dermal collagen fibrils. In the present study, mechanical properties and surface topography of both expanded and nonexpanded skin collagen fibrils were evaluated. Anisotropic controlled rate self-inflating tissue expanders were placed beneath the skin of sheep's forelimbs. The tissue expanders gradually increased in height and reached equilibrium in 2 weeks. They were left in situ for another 2 weeks before explantation. Expanded and normal skin samples were surgically harvested from the sheep (n = 5). Young's modulus and surface topography of collagen fibrils were measured using an atomic force microscope. A surface topographic scan showed organized hierarchical structural levels: collagen molecules, fibrils and fibers. No significant difference was detected for the D-banding pattern: 63.5 ± 2.6 nm (normal skin) and 63.7 ± 2.7 nm (expanded skin). Fibrils from expanded tissues consisted of loosely packed collagen fibrils and the width of the fibrils was significantly narrower compared to those from normal skin: 153.9 ± 25.3 and 106.7 ± 28.5 nm, respectively. Young's modulus of the collagen fibrils in the expanded and normal skin was not statistically significant: 46.5 ± 19.4 and 35.2 ± 27.0 MPa, respectively. In conclusion, the anisotropic controlled rate self-inflating tissue expander produced a loosely packed collagen network and the fibrils exhibited similar D-banding characteristics as the control group in a sheep model. However, the fibrils from the expanded skin were significantly narrower. The stiffness of the fibrils from the expanded skin was higher but it was not statistically different.
Optic Canal Analysis in Syndromic Craniosynostosis: Volumetric and Surface Area Validation Study Using Different Measurement Modalities

Hariri F, Zainudin NAA, Anuar AMS, Ibrahim N, Abdullah NA, Aziz IA, et al.

J Craniofac Surg, 2020 11 7;32(1):355-359.
PMID: 33156163 DOI: 10.1097/SCS.0000000000006981

BACKGROUND: In syndromic craniosynostosis (SC), unlike persistent corneal irritation due to severe exophthalmos and increased intracranial pressure, optic canal (OC) stenosis has been scarcely reported to cause visual impairment. This study aimed to validate the OC volumetric and surface area measurement among SC patients.
METHODS: Sixteen computed tomography scan of SC patients (8 months-6 years old) were imported to Materialise Interactive Medical Image Control System (MIMICS) and Materialise 3-matics software. Three-dimensional (3D) OC models were fabricated, and linear measurements were obtained. Mathematical formulas were used for calculation of OC volume and surface area from the 3D model. The same measurements were obtained from the software and used as ground truth. Data normality was investigated before statistical analyses were performed. Wilcoxon test was used to validate differences of OC volume and surface area between 3D model and software.
RESULTS: The mean values for OC surface area for 3D model and MIMICS software were 103.19 mm2 and 31.27 mm2, respectively, whereas the mean for OC volume for 3D model and MIMICS software were 184.37 mm2 and 147.07 mm2, respectively. Significant difference was found between OC volume (P = 0.0681) and surface area (P = 0.0002) between 3D model and software.
CONCLUSION: Optic canal in SC is not a perfect conical frustum thus making 3D model measurement and mathematical formula for surface area and volume estimation not ideal. Computer software remains the best modality to gauge dimensional parameter and is useful to elucidates the relationship of OC and eye function as well as aiding intervention in SC patients.
Ophthalmic features of craniosynostosis: A Malaysian experience

Rafique Ali AA, Ismail F, May May C, Mohd Abdullah AA, Khaliddin N, Hariri F, et al.

Eur J Ophthalmol, 2021 Jul 05.
PMID: 34219491 DOI: 10.1177/11206721211030093

BACKGROUND: This study aims to collect local Malaysian data regarding the ophthalmic features and complications in craniosynostosis patients who attended the Combined Craniofacial Clinic (CFC) in University Malaya Medical Centre (UMMC).
METHODS: Retrospective study of medical notes of craniosynostosis patients who attended the CFC in UMMC from 2014 to December 2020.
RESULTS: Out of 37 patients, 29 had syndromic craniosynostosis, and 8 had non-syndromic craniosynostosis. Visual impairment was present in 32.1% of patients. Causes for visual impairment were as follows - amblyopia (25.0%), exposure keratopathy (3.6%), and optic atrophy (3.6%). Hypermetropia and myopia were each seen in 20.6% of patients. Astigmatism was seen in 47.1% of patients, and 29.1% had anisometropia. Proptosis was present in 78.6% and lagophthalmos in 53.3% of patients. Strabismus in primary position occurred in 51.7% of patients. Thirty-one percent of the patients had exposure keratopathy. Optic disc atrophy was seen in 13.7% of patients, and 8.3% had optic disc swelling. Optic disc swelling was resolved in all patients who underwent craniofacial surgery.
CONCLUSION: Our experience in Malaysia was consistent with previously reported data on ophthalmic features of craniosynostosis patients. Additionally, we found that non-syndromic craniosynostosis patients are also at risk of ocular complications just as much as syndromic patients. Appropriate treatment of amblyogenic risk factors, ocular complications, and timely detection of papilledema, and prompt surgical intervention are crucial in preserving long-term visual function in these patients.
Optic canal characteristics in pediatric syndromic craniosynostosis

Hariri F, Farhana NA, Abdullah NA, Ibrahim N, Ramli NM, Mohd Abdullah AA, et al.

J Craniomaxillofac Surg, 2021 Dec;49(12):1175-1181.
PMID: 34247917 DOI: 10.1016/j.jcms.2021.06.017

The aim of this study was to compare optic canal parameters of syndromic craniosynostosis patients with those of normal patients to visit the possibility of optic nerve impingement as a cause of visual impairment. Computed tomography scan images were processed using the Materialise Interactive Medical Image Control System (MIMICS) Research 21.0 software (Materialise NV, Leuven, Belgium). Eleven optic canal parameters were measured: 1) height of optic canal on the cranial side, 2) height of optic canal on the orbital side 3) length of the medial wall of the optic canal, 4) length of the lateral canal wall of the optic canal, 5) diameter of the optic canal at five points (Q1-Q4 and mid canal), and 6) area and perimeter of optic canal. These measurements were obtained for both the right and left optic canals. The study sample comprised four Crouzon syndrome, five Apert syndrome, and three Pfeiffer syndrome patients. The age of these syndromic craniosynostosis patients ranged from 2 to 63 months. The height of the optic canal on the orbital side (p = 0.041), diameter of the mid canal (p = 0.040), and diameter between the mid-canal and the cranial opening (Q3) (p = 0.079) for syndromic craniosynostosis patients were statistically narrower compared with those of normal patients when a significance level of 0.1 was considered. Scatter plots for the ages of patients versus the above parameters gave three separated clusters that suggested the arresting of optic canal development with age. The findings from this study demonstrated a narrowing of the optic canal in syndromic craniosynostosis patients, and indicate that optic canal anatomical characteristics may have an association with visual impairment among pediatric syndromic craniosynostosis patients.
Analysis of complications following multidisciplinary functional intervention in paediatric craniomaxillofacial deformities

Hariri F, Abdullah MF, Adam KBC, Bahuri NFA, Kulasegarah J, Nathan AM, et al.

Int J Oral Maxillofac Surg, 2021 Apr;50(4):457-462.
PMID: 32891466 DOI: 10.1016/j.ijom.2020.08.002

Paediatric craniomaxillofacial (CMF) surgery requires a multidisciplinary team approach to ensure the optimal and holistic management of children with craniofacial deformities. The aim of this retrospective study was to analyse the complications following functional interventions among 34 CMF deformity patients in a single multidisciplinary craniofacial centre. Electronic data including patient demographic characteristics and clinical entry were analysed. Inclusion criteria were all paediatric patients with CMF deformities who underwent various functional interventions. A total of 64 interventions (48 intermediate and 16 definitive) were conducted. Based on the Sharma classification of complications, 20.3% were type I, 4.7% were type II, 1.6% were type III, and 4.7% were type IV . Most complications were type I, which included local infection (3.1%) and premature opening of tarsorrhaphy (3.1%). More serious complications (types III and IV) included temporary visual loss (1.6%) and intraoperative haemorrhage (1.6%). Although a low complication rate was observed in intermediate interventions, a higher complication rate was observed in more complex definitive interventions such as monobloc distraction osteogenesis. Although most complications were manageable, effective prevention remains mandatory, as serious complications may lead to permanent damage and mortality. This analysis highlights the importance of a multidisciplinary team approach to optimize the outcomes in CMF patient management.