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Fulltext A CAD/CAM Zirconium Bar as a Bonded Mandibular Fixed Retainer: A Novel Approach with Two-Year Follow-Up

Zreaqat M, Hassan R, Hanoun AF

Case Rep Dent, 2017;2017:1583403.
PMID: 28819572 DOI: 10.1155/2017/1583403

Stainless steel alloys containing 8% to 12% nickel and 17% to 22% chromium are generally used in orthodontic appliances. A major concern has been the performance of alloys in the environment in which they are intended to function in the oral cavity. Biodegradation and metal release increase the risk of hypersensitivity and cytotoxicity. This case report describes for the first time a CAD/CAM zirconium bar as a bonded mandibular fixed retainer with 2-year follow-up in a patient who is subjected to long-term treatment with fixed orthodontic appliance and suspected to have metal hypersensitivity as shown by the considerable increase of nickel and chromium concentrations in a sample of patient's unstimulated saliva. The CAD/CAM design included a 1.8 mm thickness bar on the lingual surface of lower teeth from canine to canine with occlusal rests on mesial side of first premolars. For better retention, a thin layer of feldspathic ceramic was added to the inner surface of the bar and cemented with two dual-cured cement types. The patient's complaint subsided 6 weeks after cementation. Clinical evaluation appeared to give good functional value where the marginal fit of digitized CAD/CAM design and glazed surface offered an enhanced approach of fixed retention.
Fulltext Biology of Incidental Catch Sea Star Stellaster childreni Gray, 1840 (Echinodermata: Asteroidea), from Malaysian Borneo Exclusive Economic Zone

Hassan R, Lee SY, Morni WZW

ScientificWorldJournal, 2017;2017:1489360.
PMID: 28695188 DOI: 10.1155/2017/1489360

Sea star (class Asteroidea, phylum Echinodermata) is one of the most successful marine organisms inhabiting a wide range of habitats. As one of the key stone species, sea stars are responsible for maintaining much of the local diversity of species within certain communities. Malaysian Exclusive Economic Zone (EEZ) Resource Survey had been carried out from 16th Aug to 6th Nov 2015 and one of the invertebrate by-catch organisms is sea star Stellaster childreni Gray, 1840. This study documents morphological characters and diet of the sea star, besides providing brief descriptions of the habitats based on particle size analysis and vessel log data sheet. A total of 217 individuals had been examined throughout this study. Fragments of flora and fauna were found in the gut including Mollusca (gastropod, bivalves, and scaphopods), sponge seagrass, and seaweed as well as benthic Foraminifera. Stellaster childreni were found at depth of 45 m to 185 m in the South China Sea off Sarawak Malaysia, with various sea bottom substrata. Approximately 41% of S. childreni were found at a mixture of sandy and muddy substratum, followed by mixture of sandy and coral (19.3%), muddy substratum (17.5%), coral substratum (11.5%), and sandy areas (10.6%). The widely distributed sea star on different types of sea beds suggested healthy deep sea ecosystem; thus Malaysia should explore further potential fisheries resources in the EEZ off Sarawak coast.
Fulltext Role of fibrinolytic markers in acute stroke

Abdullah WZ, Idris SZ, Bashkar S, Hassan R

Singapore Med J, 2009 Jun;50(6):604-9.
PMID: 19551314

The fibrinolytic system plays an important role in normal haemostasis and endothelial function. This study was conducted to compare three fibrinolytic markers, i.e. plasminogen, tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor type-1 (PAI-1) between acute stroke and stable non-stroke patients and to investigate the clinical significance of these markers.
Fulltext COVID-19 Pandemic Impact on Students Intention to Use E-Learning Among Malaysian Higher Education Institutions

Ramasamy SP, Shahzad A, Hassan R

J Educ (Boston), 2023 Jul;203(3):596-604.
PMID: 37415619 DOI: 10.1177/00220574211032599

In the emergence of pandemic Coronavirus Disease (COVID-19), the delivery of education service becomes a global issue, and many traditional higher education institutes are shifting toward digital alternatives methods. E-learning is considered the most appropriate effective method of knowledge delivery to meet the current academic requirements. This study investigates the key determinants which influence the Intentions to use e-learning among students in higher education institutes in Malaysia due to the outbreak of the novel Covid-19 pandemic. The data were collected through structured questionnaires from students. The data were analyzed using the structural equation modeling using partial least squares (SEMPLS). The research findings revealed that Attitude, Subjective Norm, Perceived usefulness, and Perceived behavioral becomes a positive predictor of Intention to use e-learning. However, Subjective norms found no significant effect on Intention to use e-learning in the Malaysian context. It is due to the COVID-19 emergency that an individual must choose for the e-learning method disregarding their perceptions. Perceived ease of use and Perceived usefulness has a significant positive effect on attitude. These findings offer guidelines to educational institutes for the implementation of the e-learning system during unavoidable circumstances for the sustainable education system.
Effects of Twin-Block Appliance Therapy on Urinary Leukotriene E4 and Serum C-Reactive Protein Levels in Obstructive Sleep Apnea Children with Class II Malocclusion and Mandibular Retrognathia: A Prospective Longitudinal Study

Zreaqat M, Hassan R, Samsudin R, Alforaidi S

Indian J Pediatr, 2023 Jul;90(7):729.
PMID: 37261707 DOI: 10.1007/s12098-023-04601-0
Fulltext Incidence and Factors Associated With Post-Sternotomy Pain Syndrome in the National Heart Institute, Malaysia

Sudin A, Chong C, Hassan R

J Cardiothorac Vasc Anesth, 2024 Feb;38(2):466-474.
PMID: 38114372 DOI: 10.1053/j.jvca.2023.11.014

OBJECTIVE: To determine the incidence of poststernotomy pain syndrome (PSPS) after open cardiac surgery in 2021. To determine characteristics and assess the severity of symptoms in patients diagnosed with PSPS. To identify factors that can be associated with patients who were positive for PSPS.
DESIGN AND METHODOLOGY: This study used a retrospective observational approach. Logistic regression analysis was employed to identify factors associated with the positive group.
SETTING: This study included all adult patients who underwent open cardiac surgery at the National Heart Institute, Malaysia, in 2021.
PARTICIPANTS: A total of 1,395 patients were enrolled.
INTERVENTIONS: The study involved conducting phone interviews to assess the presence of PSPS, followed by administering the Brief Pain Inventory questionnaire in the positive group to identify characteristics and severity of chronic pain.
MEASUREMENTS AND MAIN RESULTS: The incidence of PSPS after open cardiac surgery in 2021 was 20.35%. A total of 17.7% of patients reported that pain affected their daily activities, sleep, or emotions. Univariate analysis identified factors associated with PSPS, including age <60 years old, body mass index >30 kg/m2, history of previous percutaneous coronary intervention, ejection fraction <50%, the absence of chronic kidney disease (CKD), and internal mammary artery harvesting (p < 0.05). Multivariate analysis revealed that 4 independent factors were associated with PSPS: age <60 years old, history of previous percutaneous coronary intervention, ejection fraction <50%, and the absence of CKD (as compared with CKD) (p < 0.05).
CONCLUSIONS: Poststernotomy pain syndrome is a complex issue affected by various factors. Although the pain score may not be as severe as previously believed, it remains crucial to recognize PSPS because a significant proportion of patients are affected.
Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate

Alforaidi S, Zreaqat M, Hassan R

J Contemp Dent Pract, 2023 Dec 01;24(12):987-990.
PMID: 38317397 DOI: 10.5005/jp-journals-10024-3606

AIM: To determine dental arch relationships of Saudi children born with nonsyndromic complete unilateral cleft lip and palate (UCLP).
MATERIAL AND METHODS: This is a retrospective cohort study that comprised dental study models of 74 UCLP Saudi children aged 8-10 years who were recruited from 14 referral cleft centers. All participants had their cleft lip and palate repaired with no history of alveolar bone graft or any orthodontic treatment. Dental arch relationships of UCLP patients were assessed using the Great Ormond Street, London, and Oslo (GOSLON) Yardstick-a clinical tool that categorizes dental relationships of UCLP children into five discrete grades from I to V. The reliability of the rating was assessed with weighted kappa (κ) statistics.
RESULTS: Three children (4.1%) had excellent surgical outcomes (grade I), 18 children (24.3%) filled into grade II (good outcome), 22 subjects (29.7%) had grade III (fair outcome), 27 children (36.5%) had grade IV (poor outcome), and 4 subjects (5.4%) were ranked as having very poor outcomes (grade V). The mean GOSLON score was 3.39. Intrarater and interrater agreements were high indicating good reproducibility.
CONCLUSION: Based on the dental arch relationships, the treatment outcome of UCLP Saudi children was unsatisfactory, with a mean GOSLON score of 3.39. Delayed palate repair and the use of presurgical orthopedics may be considered in the future for cleft deformity management.
CLINICAL SIGNIFICANCE: To address the effect of particular cleft surgical protocol on dental arch relationships of UCLP patients. How to cite this article: Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023;24(12):987-990.
Gene Therapy Approaches in an Autoimmune Demyelinating Disease: Multiple Sclerosis

Islam MA, Kundu S, Hassan R

Curr Gene Ther, 2020;19(6):376-385.
PMID: 32141417 DOI: 10.2174/1566523220666200306092556

Multiple Sclerosis (MS) is the most common autoimmune demyelinating disease of the Central Nervous System (CNS). It is a multifactorial disease which develops in an immune-mediated way under the influences of both genetic and environmental factors. Demyelination is observed in the brain and spinal cord leading to neuro-axonal damage in patients with MS. Due to the infiltration of different immune cells such as T-cells, B-cells, monocytes and macrophages, focal lesions are observed in MS. Currently available medications treating MS are mainly based on two strategies; i) to ease specific symptoms or ii) to reduce disease progression. However, these medications tend to induce different adverse effects with limited therapeutic efficacy due to the protective function of the blood-brain barrier. Therefore, researchers have been working for the last four decades to discover better solutions by introducing gene therapy approaches in treating MS generally by following three strategies, i) prevention of specific symptoms, ii) halt or reverse disease progression and iii) heal CNS damage by promoting remyelination and axonal repair. In last two decades, there have been some remarkable successes of gene therapy approaches on the experimental mice model of MS - experimental autoimmune encephalomyelitis (EAE) which suggests that it is not far that the gene therapy approaches would start in human subjects ensuring the highest levels of safety and efficacy. In this review, we summarised the gene therapy approaches attempted in different animal models towards treating MS.
Fulltext Selection and classification of gene expression in autism disorder: Use of a combination of statistical filters and a GBPSO-SVM algorithm

Hameed SS, Hassan R, Muhammad FF

PLoS One, 2017;12(11):e0187371.
PMID: 29095904 DOI: 10.1371/journal.pone.0187371

In this work, gene expression in autism spectrum disorder (ASD) is analyzed with the goal of selecting the most attributed genes and performing classification. The objective was achieved by utilizing a combination of various statistical filters and a wrapper-based geometric binary particle swarm optimization-support vector machine (GBPSO-SVM) algorithm. The utilization of different filters was accentuated by incorporating a mean and median ratio criterion to remove very similar genes. The results showed that the most discriminative genes that were identified in the first and last selection steps included the presence of a repetitive gene (CAPS2), which was assigned as the gene most highly related to ASD risk. The merged gene subset that was selected by the GBPSO-SVM algorithm was able to enhance the classification accuracy.
Fulltext Fatal airbag-mediated atlanto-occipital dislocation in a child

Hassan R, Mohd Yusof M, Kamarudin NA

Malays J Med Sci, 2010 Oct;17(4):67-70.
PMID: 22135564 MyJurnal

An atlanto-occipital dislocation is a rare airbag-induced injury in trauma patients. We report a case of an atlanto-occipital dislocation in a 6-year-old patient who was an unrestrained passenger in the front seat of a vehicle involved in a low-speed motor vehicle accident. This case illustrates the fatal threat of airbag deployment to the child passenger travelling in the vehicle front seat even in a low-speed collision, and supports the recommendation that children under 12 years of age travelling in vehicles with dual airbag systems should be seated in the back.
Fulltext Retrocaval ureter: the importance of intravenous urography

Hassan R, Aziz AA, Mohamed SK

Malays J Med Sci, 2011 Oct;18(4):84-7.
PMID: 22589677

Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.
Orthodontic treatment need and demand among 12- and 16 year-old school children in Malaysia

Zreaqat M, Hassan R, Ismail AR, Ismail NM, Aziz FA

Oral Health Dent Manag, 2013 Dec;12(4):217-21.
PMID: 24390019

Assessment of orthodontic treatment need and demand helps in planning orthodontic services and estimating the required resources and man power. The aim of this study was to assess the orthodontic treatment need and demand and to assess the association between the orthodontic treatment demand and factors such as ITON, gender, and age.
Fulltext Single-center experience of von Willebrand disease (vWD) among patients with menorrhagia: a diagnosis which could be missed

Hassan R, Yusof WA, Hussain NH, Abdullah WZ

Indian J Hematol Blood Transfus, 2012 Sep;28(3):157-61.
PMID: 23997452 DOI: 10.1007/s12288-011-0135-6

Menorrhagia is one of the gynecological complaints, seen in women of reproductive age. In majority of cases no organic pathology is found. To date there is no consensus on application of von Willebrand disease (vWD) testing as part of the routine investigations in menorrhagia. Diagnosis of vWD is challenging. It is complicated by intra-individual variations in von Willebrand antigen, activity, and factor VIII levels due to fluctuation of these factor levels during the menstrual cycle or hormonal therapy. The aim of this study is to detect vWD presenting with menorrhagia among Malays attending gynecology clinic by using a standard panel of haemostatic profiles. Thirty Malay patients attending gynecology clinic with unexplained menorrhagia were included in this study. Haemostatic profile such as platelet count, prothrombin time, activated partial thromboplastin time (APTT), factor VIII assay, von Willebrand factor antigen, and von Willebrand factor activity, and collagen binding assay were measured in all patients. Pre- and post hormonal haemostatic profiles were also performed in the patients diagnosed as vWD. All patients had normal APTT. Based on von Willebrand factor work-up, vWD was diagnosed in four patients (13.3%). Three of them were Type 1 and the other one was Type 2M. Investigation for vWD is essential in patients with menorrhagia and thus the laboratories performing vWD testing should provide a complete panel of diagnostic work-up in order to reduce the interpretation error. Screening for vWD should be performed before hormonal treatment as haemostatic profile post treatment could mask the diagnosis.
Study site: Gynaecology clinic, Hospital of Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Fulltext Pituitary apoplexy: a rare cause of middle cerebral artery infarction

Hassan R, Sharis Othman S, Ahmad Mukari SA, Abu Bakar A

Med J Malaysia, 2013 Jun;68(3):264-6.
PMID: 23749020 MyJurnal

Pituitary apoplexy is a well-known complication of a pituitary adenoma. However, an ischaemic event caused by pituitary apoplexy is rare. We reported a case of pituitary apoplexy with middle cerebral artery infarction in a 44-year old man who presented with a sudden onset of altered sensorium. Vasospasm is the most likely underlying cause of the infarction in this case secondary to transdiaphragmatic rupture of the sella tumour into the subarachnoid space.
Overview of non-invasive factors (low level laser and low intensity pulsed ultrasound) accelerating tooth movement during orthodontic treatment

Jawad MM, Husein A, Alam MK, Hassan R, Shaari R

Lasers Med Sci, 2014 Jan;29(1):367-72.
PMID: 22986701 DOI: 10.1007/s10103-012-1199-8

The need for orthodontic treatment is increasing all the time. As the treatment is time consuming ranging from a year to several years, any method of reducing the period of treatment and increasing the quality of the tissue will be beneficial to patients. The use of non-invasive techniques such as low level laser therapy and low intensity pulsed ultasound in accelerating orthodontic tooth movement are promising. Thus, this overview study will help to generate more understanding about the background information and the possible applications of them in daily orthodontics, depending on previous literature searching for reviews and original research articles.
Developmental haemostasis for factor V and factor VIII levels in neonates: a case report of spontaneous cephalhaematoma

Abdullah WZ, Ismail R, Nasir A, Mohamad N, Hassan R

Fetal Pediatr Pathol, 2013 Apr;32(2):77-81.
PMID: 22536947 DOI: 10.3109/15513815.2012.671447

Combined factor V and VIII deficiency is a rare bleeding disorder. Diagnosis of congenital coagulation factor deficiency in a neonate is challenging due to "immaturity" of the hemostatic system. A 2-day-old baby girl presented with spontaneous cephalhematoma. She was found to have persistent abnormal coagulation tests and finally diagnosed as combined factor V and VIII deficiency. Interestingly, factor V and factor VIII in developmental hemostasis are quite similar with adult levels in newborn, and hence early diagnosis is possible. An investigation to detect underlying hemostatic defects is recommended in newborns with spontaneous cephalhematoma.
Variations in tooth size and arch dimensions in Malay schoolchildren

Hussein KW, Rajion ZA, Hassan R, Noor SN

Aust Orthod J, 2009 Nov;25(2):163-8.
PMID: 20043553

To compare the mesio-distal tooth sizes and dental arch dimensions in Malay boys and girls with Class I, Class II and Class III malocclusions.
Isolation and characterization of microsatellite loci in the Malaysian giant freshwater prawn, Macrobrachium rosenbergii

Bhassu S, See LM, Hassan R, Siraj SS, Tan SG

Mol Ecol Resour, 2008 Sep;8(5):983-5.
PMID: 21585948 DOI: 10.1111/j.1755-0998.2008.02127.x

Eight single locus microsatellite markers were developed to characterize the Malaysian giant freshwater prawn, Macrobrachium rosenbergii. These microsatellites were isolated from an enriched genomic library contained by using a 5'-anchored polymerase chain reaction technique. Primers were designed to flank the repeat sequences and subsequently used to characterize 30 unrelated individuals of the giant freshwater prawn. The polymerase chain reaction amplification products of these eight microsatellite loci were polymorphic with the number of alleles ranging from two to 10 alleles per locus while the levels of heterozygosity ranged from 0.6333 to 0.8667.
Vitamin D status in patients with systemic lupus erythematosus (SLE): A systematic review and meta-analysis

Islam MA, Khandker SS, Alam SS, Kotyla P, Hassan R

Autoimmun Rev, 2019 Sep 11.
PMID: 31520805 DOI: 10.1016/j.autrev.2019.102392

BACKGROUND: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease where chronic inflammation and tissue or organ damage is observed. Due to various suspected causes, inadequate levels of vitamin D (a steroid hormone with immunomodulatory effects) has been reported in patients with SLE, however, contradictory.
AIMS: The aim of this systematic review and meta-analysis was to evaluate the serum levels of vitamin D in patients with SLE in compared to healthy controls.
METHODS: PubMed, SCOPUS, ScienceDirect and Google Scholar electronic databases were searched systematically without restricting the languages and year (up to March 2, 2019) and studies were selected based on the inclusion criteria. Mean difference (MD) along with 95% confidence intervals (CI) were used and the analyses were carried out by using a random-effects model. Different subgroup and sensitivity analyses were conducted. Study quality was assessed by the modified Newcastle-Ottawa Scale (NOS) and publication bias was evaluated by a contour-enhanced funnel plot, Begg's and Egger's tests.
RESULTS: We included 34 case-control studies (2265 SLE patients and 1846 healthy controls) based on the inclusion criteria. Serum levels of vitamin D was detected significantly lower in the SLE patients than that in the healthy controls (MD: -10.44, 95% CI: -13.85 to -7.03; p 
Polycythaemia Vera among Sudanese Patients with Special Emphasis on JAK2 Mutations

Ibrahim IK, Hassan R, Ali EW, Omer A

Asian Pac J Cancer Prev, 2019 Jan 25;20(1):41-44.
PMID: 30677867

Background: In recent years, a somatic point mutation in the Janus Kinase 2 (JAK2) gene (1849 G→T, V617F)
has been reported to occur in over 90% of patients with polycythemia vera (PV). Another JAK2 mutation in exon 12
had been described and shown capable of activating erythropoietin signaling pathways. Objective: In this study, we
aimed to determine the frequency of Jak2 mutations (JAK2V617F and JAK2 exon 12) as well as their relationships
with hematological parameters in Sudanese patients with myeloproliferative disorders (MPD). A comparison with
findings of published studies from other geographic regions was included. Materials and Methods: From each of
a total of 83 polycythaemia patients, six milliliters (ml) of venous blood were collected and processed for molecular
analysis and measurement of serum erythropoietin level by enzyme-linked immunoassay (ELISA). The JAK2 V617F
mutation was determined using an allele-specific competitive blocker (ACB) -PCR assay and High Resolution Melting
(HRM) analysis was applied for the JAK2 exon 12 mutation. Results: According to patients’ history and the results
for EPO levels, nine (10.7 %) out of 83 patients were found to have secondary polycythaemia and 74 (89.3%) PV. The
overall frequency of the 2 JAK2 mutations was 94.6% in our Sudanese PV patients, JAK2V617F being found in 91%
and JAK2 exon 12 mutations in 8.1%.Conclusion: In summary JAK2 V617F and JAK2 exon 12 mutations are very
common in Sudanese PC cases.

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