Displaying publications 21 - 40 of 436 in total

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  1. Kamarul Imran M, Ismail AA, Naing L, Wan Mohamad WB
    PMID: 17539293
    The objective of this study was to examine the reliability and validity of the Malay version of the 18-item Audit of Diabetes Dependent Quality of Life (the Malay ADDQOL). Patients with type 2 diabetes mellitus who fulfilled the inclusion criteria were systematically selected. The Malay ADDQOL linguistically validated from the 18-item English version ADDQOL was self-administered twice at a 1-week interval. Two hundred eighty-eight respondents were included in the study. Analysis involved checking the feasibility, floor and ceiling effects, internal consistency, test-retest reliability and factor analysis. Item means and standard deviations fulfilled the Likert scale assumptions. The Cronbach's alpha was 0.943 (lower bound of the 95% CI of 0.935) and the intraclass correlation coefficient was 0.81 (95% CI from 0.72 to 0.87). Exploratory one factor analysis showed factor loadings above 0.5 for all the 18 items. The Malay ADDQOL has acceptable linguistic validity. It is feasible, has excellent reliability, content, construct validity, and is recommended to be used among Malay-speaking diabetic patients.
  2. Ahmad R, Ismail A, Saat Z, Lim LH
    PMID: 9322296
    Mosquito adults and larvae were collected from dengue high risk areas and transported to the laboratory for identification. Identified mosquitos were pooled according to the species, date and locality and stored at -70 degrees C. A total of 1,385 pools of Aedes albopictus and 267 pools of Ae. Aegypti were collected from major towns in 12 states in Peninsular Malaysia. Virus isolation was carried out using cell culture (C6/36 clone) of Ae. albopictus and detection of dengue virus by the peroxidase anti-peroxidase staining. All positive isolations were further re-confirmed by the reverse transcriptase-polymerase chain reaction (RT-PCR). Most of the pools were negative with PAP staining and RT-PCR. However, 11 mosquito pools were positive with PAP staining. On the other hand, samples from Terengganu, Pulau Pinang and Johor were positive using both methods.
  3. Jackson AA, Ismail A, Ibrahim TA, Kader ZS, Nawi NM
    PMID: 9139364
    Typhoid fever remains a common problem in Malaysia, but for its diagnosis both blood culture and the Widal test have drawbacks. A dot enzyme immunoassay (EIA) has been developed which detects IgM and IgG antibodies to a specific 50 kDa outer membrane protein on Salmonella typhi. This study was performed among outpatients attending the university hospital in Kelantan, a state on the east coast of Peninsular Malaysia where typhoid is endemic. The dot EIA was done on 149 outpatients of all ages in whom typhoid was suspected. Of these, 60 were not analysable due to insufficient data. The other 89 were retrospectively classed as typhoid (total = 21), or not typhoid (total = 68). The criteria for diagnosis of typhoid was either, blood culture was positive, or with blood culture negative, temperature was at least 38 degrees C and Widal O and/or H titer greater than or equal to 1/160. We then compared the diagnosis with the EIA result. For the result where either IgM or IgG was positive, sensitivity was 90%, specificity 91% and negative predictive value 97%. For IgM positive, specificity was 100%. But the specificity of IgG positive alone was reduced by six false positives, which were probably due to persistence of IgG after acute infection. Other cases were found where IgG positive alone appeared in the first week of typhoid fever, probably due to rapid response in a second or subsequent infection. We also found that IgM-producing patients were significantly younger than those showing IgG alone positive.
    Study site: Community Medicine clinic, Accident & emergency department, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
  4. Zainal D, Riduan A, Ismail AM, Norhayati O
    PMID: 8525403
    Renal biopsy is essential in the management of renal parenchymal diseases. Thus far there is no publish report on the pattern of glomerulonephritis in Kelantan. We decided to establish the pattern of glomerulonephritis in Kelantan and use this information as our reference in future studies. Records of patients who had proven glomerulonephritis histologically were analysed. Their biological data, clinical presentation, etiology and clinicopathological pattern were studied. Where appropriate mean and standard deviation were calculated. A total of 74 biopsies were performed during the study period (between January 1991 and December 1993), out of which 72 biopsies (97.3%) were considered suitable for analysis. The male to female ratio was 1:1.1. Mean age at presentation was 27.6 +/- 12.2 years. Nephrotic syndrome was the commonest clinical presentation (65.3%). The main underlying cause was systemic lupus erythematosus (50%) followed by primary glomerulonephritis. Histologically, IgA nephropathy and minimal change disease were the main patterns among patients with primary glomerulonephritis while diffuse proliferative glomerulonephritis was the commonest pattern among patients with lupus nephritis. Hence the pattern of glomerulonephritis is similar to other reported series. The procedure is considered safe and has a high success rate.
  5. Ismail A, Kader ZS, Kok-Hai O
    PMID: 1820645
    A nitrocellulose membrane strip dotted with a specific 50 kDa outer membrane protein of Salmonella typhi was applied for the serodiagnosis of typhoid fever. Using horseradish peroxidase conjugated IgM and IgG antibodies with 4-chloronaphthol as substrate, antibodies in typhoid patients were clearly visualised as bluish purple dots while sera from patients with non-typhoid fevers gave negative results. The detection of specific IgM and IgG antibodies in typhoid patients suggest either recent or current infection. Combined with the high specificity, reliability and rapidity of the test, the dot EIA technique provides a simple and useful method for the serodiagnosis of typhoid using a single serum specimen.
  6. Ismail A
    PMID: 3217821
    Analysis of diarrhoeal disease patterns in Malaysia from 1981-1986 suggested that infectious hepatitis ranked as the most predominant diarrhoeal disease followed by typhoid, food poisoning, dysentery and cholera. Although these five major food and water-borne diseases are still endemic in this country, diarrhoeal diseases per se no longer become an important public health problem in Malaysia. Enforcement of the cholera control program brought the incidence of the disease to a minimal. Unfortunately, this fatal form of diarrhoeal disease caused the greatest mortality compared to the others. Seasonal influence also played a part in controlling the occurrence of the disease. There was a preponderance of diarrhoeal diseases during the rainy season implicating contaminated water as a source of transmission. Although greater than half of the population has been supplied with piped water and sanitary latrines, a lot more has to be done before diarrhoeal diseases could be eliminated from this country.
  7. Hashim JH, Radzi RS, Aljunid SM, Nur AM, Ismail A, Baguma D, et al.
    Sci Total Environ, 2013 Oct 1;463-464:1210-6.
    PMID: 23759330 DOI: 10.1016/j.scitotenv.2013.04.084
    Natural, inorganic arsenic contamination of groundwater threatens the health of more than 100 million people worldwide, including residents of the densely populated river deltas of South and Southeast Asia. Contaminated groundwater from tube wells in Cambodia was discovered in 2001 leading to the detection of the first cases of arsenicosis in 2006. The most affected area was the Kandal Province. The main objective of this study was to determine the prevalence of arsenicosis in Cambodia based on acceptable criteria, and to investigate the use of hair arsenic as a biomarker not only for arsenicosis-related signs but also for associated symptoms. A cross-sectional epidemiological study of 616 respondents from 3 purposely selected provinces within the Mekong River basin of Cambodia was conducted. The Kandal Province was chosen as a high arsenic-contaminated area, while the Kratie Province and Kampong Cham Province were chosen as moderate and low arsenic-contaminated areas, respectively. The most prevalent sign of arsenicosis was hypomelanosis with a prevalence of 14.5% among all respondents and 32.4% among respondents with a hair arsenic level of ≥1 μg/g. This was followed by hyperkeratosis, hyperpigmentation and mee's lines. Results also suggest a 1.0 μg/g hair arsenic level to be a practical cut off point for an indication of an arsenic contaminated individual. This hair arsenic level, together with the presence of one or more of the classical signs of arsenicosis, seems to be a practical criteria for a confirmed diagnosis. Based on these criteria, the overall prevalence of arsenicosis for all provinces was found to be 16.1%, with Kandal Province recording the highest prevalence of 35.5%. This prevalence is comparatively high when compared to that of other affected countries. The association between arsenicosis and the use of Chinese traditional medicine also needs further investigation.
  8. Yap CK, Cheng WH, Karami A, Ismail A
    Sci Total Environ, 2016 May 15;553:285-96.
    PMID: 26925739 DOI: 10.1016/j.scitotenv.2016.02.092
    A total of 40 marine mussel Perna viridis populations collected (2002-2009) from 20 geographical sites located in two busy shipping lanes namely the Straits of Malacca (10 sites; 16 populations) and the Straits of Johore (8 sites; 21 populations) and three populations (2 sites) on the east coast of Peninsular Malaysia, was determined for Cd, Cu, Fe, Ni, Pb and Zn concentrations. In comparison with the maximum permissible limits (MPLs) set by existing food safety guidelines, all metal concentrations found in all the mussel populations were lower than the prescribed MPLs. In terms of the provisional tolerable weekly intake prescribed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and oral reference doses (ORDs) by the USEPA, all the studied metals (except for Pb) were unlikely to become the limiting factors or unlikely to pose a risk for the consumption of the mussel populations. The estimated daily intake (EDI) for average level mussel (ALM) and high level mussel (HLM) consumers of mussels was found to be lower than the ORD guidelines for Cd, Cu, Fe, Ni and Zn. Furthermore, the target hazard quotient (THQ) was found to be less than 1 for ALM consumers but higher than 1 for HLM consumers in some sites. Therefore, there were no potential human health risks to the ALM consumers of the mussels. However, for Pb THQ values, the Pb levels in some mussel populations could create a health risk problem. Present results indicate that the consumption amounts of mussels should be limited for minimizing potential health risks of heavy metals to the HLM consumers.
  9. Salaudeen A, Shahid S, Ismail A, Adeogun BK, Ajibike MA, Bello AD, et al.
    Sci Total Environ, 2023 Feb 01;858(Pt 2):159874.
    PMID: 36334669 DOI: 10.1016/j.scitotenv.2022.159874
    Recently, there is an upsurge in flood emergencies in Nigeria, in which their frequencies and impacts are expected to exacerbate in the future due to land-use/land cover (LULC) and climate change stressors. The separate and combined forces of these stressors on the Gongola river basin is feebly understood and the probable future impacts are not clear. Accordingly, this study uses a process-based watershed modelling approach - the Hydrological Simulation Program FORTRAN (HSPF) (i) to understand the basin's current and future hydrological fluxes and (ii) to quantify the effectiveness of five management options as adaptation measures for the impacts of the stressors. The ensemble means of the three models derived from the Coupled Model Intercomparison Project Phase 5 (CMIP5) are employed for generating future climate scenarios, considering three distinct radiative forcing peculiar to the study area. Also, the historical and future LULC (developed from the hybrid of Cellular Automata and Markov Chain model) are used to produce the LULC scenarios for the basin. The effective calibration, uncertainty and sensitivity analyses are used for optimising the parameters of the model and the validated result implies a plausible model with efficiency of up to 75 %. Consequently, the results of individual impacts of the stressors yield amplification of the peak flows, with more profound impacts from climate stressor than the LULC. Therefore, the climate impact may trigger a marked peak discharge that is 48 % higher as compared to the historical peak flows which are equivalent to 10,000-year flood event. Whilst the combine impacts may further amplify this value by 27 % depending on the scenario. The proposed management interventions such as planned reforestation and reservoir at Dindima should attenuate the disastrous peak discharges by almost 36 %. Furthermore, the land management option should promote the carbon-sequestering project of the Paris agreement ratified by Nigeria. While the reservoir would serve secondary functions of energy production; employment opportunities, aside other social aspects. These measures are therefore expected to mitigate feasibly the negative impacts anticipated from the stressors and the approach can be employed in other river basins in Africa confronted with similar challenges.
  10. Ho C, Ismail AR
    Med J Malaysia, 2014 Oct;69(5):234-5.
    PMID: 25638240 MyJurnal
    Haemothorax is one of the less common presentations that requires hospital admission. Most cases are associated with underlying causes, but there is such an entity called spontaneous haemothorax. Spontaneous haemothorax is commonly associated with adhesions within the pleural cavity. Here, we reported two cases of young adults who presented with massive spontaneous haemothorax and required emergency thoracotomy for haemostasis purpose.
  11. Mohd Adibi SMA, Chen NR, Azmir NA, Solahan N, Ismail A, Anuar AZ, et al.
    Med J Malaysia, 2013 Aug;68(4):315-22.
    PMID: 24145259 MyJurnal
    Hearing impairment in adolescents is a major public health problem. According to the World Health Organization (WHO) deafness and hearing impairment are common health problems throughout the world. Hearing impairment generally impairs emotional, social, communication and educational function. The aim of this study was to determine the correlation between duration of hearing aid use and improvements in the quality of life. The cross sectional study was conducted at Jalan Peel Primary Special School and Universiti Kebangsaan Malaysia Medical Center (UKMMC) from July 2010 until June 2011. A total of 21 students with hearing impairment involved in this study with mean age of 12.57 (10 to 19 years old). The subjects were divided into 2 groups: first-time hearing aid users and long standing hearing aid users. The hearing assessment was conducted in the first group and hearing aids were fitted. After 1 month hearing aid fitting, the questionnaires were distributed to both groups. Statistical analysis had showed no relation (p>0.05) between duration of hearing aid use and the improvement in the quality of life. However, regardless of the duration of hearing aid usage, there was improvement in the quality of life as shown by the scores of the questionnaires. In conclusion there was no significant relation between duration of hearing aid use and the improvement in the quality of life. Hearing aids were beneficial for hearing loss students regardless of the duration of the hearing aid usage.
  12. Fathil SM, Soong NS, Mustafa NM, Arith A, Ng WN, Bahrum NA, et al.
    Med J Malaysia, 2011 Jun;66(2):89-91.
    PMID: 22106683 MyJurnal
    Pain management in Malaysian Emergency Departments has not been studied well. Convenience sampling was used to recruit 402 patients who presented with acute pain over a 2-week period. The 11-point Numerical Rating Scale was used to quantify pain. Pain relieving medications were prescribed to 178 patients (44.3%) in the Emergency Department. These patients had a median pain score of 7 on arrival. Nonsteroidal anti inflammatory drugs were the most commonly prescribed class of analgesic. Pain was found to be inadequately treated.
  13. Jamal SM, Fathil SM, Nidzwani MM, Ismail AK, Yatim FM
    Med J Malaysia, 2011 Aug;66(3):231-3.
    PMID: 22111446
    The study compared the effectiveness of ketamine and midazolam/fentanyl as procedural sedation and analgesia agents for reduction of fractures and dislocated joints. Forty-one adult patients were enrolled by convenience sampling. They were randomized to receive ketamine or midazolam/fentanyl. Depth of sedation, pain score, procedural outcome and memory of the procedure were documented. The ketamine group had deeper sedation, but there was no statistical difference in other variables between the two groups. Three patients in the midazolam/fentanyl group had oxygen desaturation. More adverse effects were associated with ketamine. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation.
  14. Ramzisham ARM, Sagap I, Ismail AM
    Med J Malaysia, 2003 Mar;58(1):125-7.
    PMID: 14556338
    Bleeding into the rectus sheath is an uncommon but a well-recognised condition that mimics several other diagnoses of acute abdomen. A wide range of etiology has been proposed in association with this condition. It is often self-limiting, but can lead to unnecessary laparotomy if the diagnosis is not recognised.
  15. Lakhwani MN, Ismail AR, Barras CDJ, Tan WJ
    Med J Malaysia, 2000 Dec;55(4):498-505.
    PMID: 11221164
    Despite advancements in endoscopy and pharmacology in the treatment of peptic ulcer disease the overall mortality has remained constant at 10% for the past four decades. The aim of this study was to determine the age, gender, racial distribution, incidence and causes of endoscopically diagnosed cases of upper gastrointestinal (UGI) bleeding to summarise treatments undertaken and to report their outcome. A prospective study of UGI bleeding in 128 patients was performed in two surgical wards of Kuala Lumpur Hospital, involving both elective and emergency admissions. The study group comprised of 113 (88.2%) males and 15 (11.7%) females. The mean age was 51.9 years (range 14 to 85 years) and 37.5% (48 of 128 patients) were older than 60 years. The Indian race was over-represented in all disease categories. Smoking (50.1%), alcohol consumption (37.5%), non-steroidal anti-inflammatory drugs (NSAIDs) (17.2%), traditional remedies (5.5%), anti-coagulants (2.3%) and steroids (0.8%) were among the risk factors reported. Common presenting symptoms and signs included malaena (68.8%), haematemesis (59.4%) and fresh per rectal bleeding (33.6%). The commonest causes of UGI bleeding were duodenal ulcer (32%), gastric ulcer (29.7%), erosions (duodenal and gastric) (21.9%), oesophageal varices (10.9%) and malignancy (3.9%). UGI bleeding was treated non-surgically in 90.6% of cases. Blood transfusions were required in 62.6% (67/107) of peptic ulcer disease patients. Surgical intervention for bleeding peptic ulcer occurred in around 10% of cases and involved under-running of the bleeding vessel in most high risk duodenal and gastric ulcer patients. The overall mortality from bleeding peptic ulcer disease was 4.7%. Six patients died from torrential UGI haemorrhage soon after presentation, without the establishment of a cause. Active resuscitative protocols, early endoscopy, more aggressive interventional therapy, early surgery by more senior surgeons, increasing intensive care unit beds and more active participation of multidisciplinary teams in co-ordinating management are among remedial measures advocated. Broader educational preventive strategies should target the causes of UGI bleeding.
  16. Marzuki NM, Jaeb MZM, Ban A, Ismail AI, Ali IAH, Razali NM, et al.
    Med J Malaysia, 2020 11;75(6):717-721.
    PMID: 33219183
    BACKGROUND: Regarding the long-term safety issues with the use of inhaled corticosteroids (ICS) and the clinical predominance of dual bronchodilators in enhancing treatment outcomes in chronic obstructive pulmonary disease (COPD), ICS is no longer a "preferred therapy" according to the Global Initiative for Chronic Obstructive Lung Disease except on top of a dual bronchodilator. This has necessitated a change in the current therapy for many COPD patients.

    OBJECTIVE: To determine a standardised algorithm to reassess and personalise the treatment COPD patients based on the available evidence.

    METHODS: A consensus statement was agreed upon by a panel of pulmonologists in from 11 institutes in Malaysia whose members formed this consensus group.

    RESULTS: According to the consensus, which was unanimously adopted, all COPD patients who are currently receiving an ICS-based treatment should be reassessed based on the presence of co-existence of asthma or high eosinophil counts and frequency of moderate or severe exacerbations in the previous 12 months. When that the patients meet any of the aforementioned criteria, then the patient can continue taking ICS-based therapy. However, if the patients do not meet the criteria, then the treatment of patients need to be personalised based on whether the patient is currently receiving long-acting beta-agonists (LABA)/ICS or triple therapy.

    CONCLUSION: A flowchart of the consensus providing a guidance to Malaysian clinicians was elucidated based on evidences and international guidelines that identifies the right patients who should receive inhaled corticosteroids and enable to switch non ICS based therapies in patients less likely to benefit from such treatments.

  17. Ismail ASB, Lim KG, Mahadevan DT
    Med J Malaysia, 2020 05;75(3):260-265.
    PMID: 32467542
    BACKGROUND: Malaysia continues to have a very low cadaveric organ donation rate of 0.48 per million population. The aim of this paper is to assess the attitude, beliefs and knowledge of patients and relatives at three different hospitals in Negeri Sembilan towards organ donation to increase the acceptability of organ transplant.

    METHODS: A cross-sectional descriptive study with convenient sampling was carried out Hospital Tuanku Ja'afar, Hospital Port Dickson and Hospital Tuanku Ampuan Najihah in Negeri Sembilan, Malaysia. The participants answered a questionnaire regarding the source of their information about organ donation, their knowledge about brain death and willingness to donate. The association between variables was tested using chi-squared test or Fischer's exact test as appropriate.

    RESULTS: A total of 385 individuals completed the survey of whom 134 (35%) were willing to donate their organs upon death and 25(19%) were registered donors. Higher educational level (41%), age 30 and below (42%) and people who attended organ donation awareness campaigns (60%) were more willing to donate their organs. Correct understanding of brain death was associated with willingness to be an organ donor. The commonest reason cited for unwillingness to donate was opposition from family members.

    CONCLUSION: Marital status, religion, source of knowledge and occupation are significant factors in willingness to donate organs among Malaysians. Lower age and higher educational level were positive factors towards organ donation. Direct personal contact through awareness campaigns, family and friends has a potential for greater positive impact on organ donation.

  18. Dzulkarnain AAA, Rahmat S, Ismail AW, Musa R, Badzis M, Tengku Zam Zam TZH
    Med J Malaysia, 2019 04;74(2):168-173.
    PMID: 31079129
    INTRODUCTION: This paper describes the development and the evaluation of a new Two-dimensional (2D) computer-based (CB) Simulated Learning Environment (SLE) software for routine audiology tests that comes with learning assistance for audiology students. The aim of the study was to serve as preliminary evaluation on the effectiveness of the new 2D CB SLE audiology software among audiology students.

    MATERIALS AND METHODS: The development process of the new 2D CB SLE includes, (i) the identification of common errors made by students in the audiology clinic, (ii) the development of five case simulations that include four routine audiology tests incorporating learning assistance derived from the errors commonly made by audiology students and, (iii) the development of 2D CB SLE from a technical perspective. A preliminary evaluation of the use of the 2D CB SLE software was conducted among twenty-six second-year undergraduate audiology students.

    RESULTS: The pre-analysis evaluation of the new 2D CB SLE showed that the majority of the students perceived the new 2D CB SLE software as realistic and helpful for them in achieving the course learning outcomes and in improving their clinical skills. The mean overall scores among the twenty-six students using the self-reported questionnaire were significantly higher when using the 2D CB SLE software than with the existing software typically used in their SLE training.

    CONCLUSIONS: This new 2D CB SLE software has the potential for use by audiology students for enhancing their learning.

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