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Performance of emergency physicians in point-of-care echocardiography following limited training

Bustam A, Noor Azhar M, Singh Veriah R, Arumugam K, Loch A

Emerg Med J, 2014 May;31(5):369-73.
PMID: 23428721 DOI: 10.1136/emermed-2012-201789

OBJECTIVES: The aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients.
METHODS: Following a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist.
RESULTS: 100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland-Altman limits of agreement for left ventricular function was -9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%.
CONCLUSIONS: Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
Study site: Trauma and emergency department, University of Malaya Medical Centre, Kuala Lumpur
Vermiremoval of heavy metal in sewage sludge by utilising Lumbricus rubellus

Azizi AB, Lim MP, Noor ZM, Abdullah N

Ecotoxicol Environ Saf, 2013 Apr;90:13-20.
PMID: 23294636 DOI: 10.1016/j.ecoenv.2012.12.006

Experiments were conducted to remove heavy metals (Cr, Cd, Pb, Cu and Zn) from urban sewage sludge (SS) amended with spent mushroom compost (SMC) using worms, Lumbricus rubellus, for 105 days, after 21 days of pre-composting. Five combinations of SS/SMC treatments were prepared in triplicate along with a control for each treatment in microcosms. Analysis of the earthworms' multiplication and growth and laboratory analysis were conducted during the tenth and fifteenth week of vermicomposting. Our result showed that the final biomass of earthworms (mg) and final number of earthworms showed significant differences between treatments i.e. F=554.70, P=0.00 and F=729.10, P=0.00 respectively. The heavy metals Cr, Cd and Pb contained in vermicompost were lower than initial concentrations, with 90-98.7 percent removal on week ten. However, concentrations of Cu and Zn, that are considered as micronutrients, were higher than initial concentrations, but they were 10-200-fold lower than the EU and USA biosolid compost limits and Malaysian Recommended Site Screening Levels for Contaminated Land (SSLs). An increment of heavy metals were recorded in vermicompost for all treatments on week fifteen compared to week ten, while concentration of heavy metals in earthworms' tissue were lower compared to vermicompost. Hence, it is suggested that earthworms begin to discharge heavy metals into their surroundings and it was evident that the earthworms' heavy metals excretion period was within the interval of ten to fifteen weeks.
Cryopreservation of whole seeds and excised embryonic axes of Citrus suhuiensis cv. limau langkat in accordance to their desiccation sensitivity

Makeen MA, Noor NM, Dussert S, Clyde MM

Cryo Letters, 2005 Jul-Aug;26(4):259-68.
PMID: 19827255

Following the investigation of desiccation sensitivity and freezing tolerance of the whole seed of Citrus suhuiensis cv. limau langkat, desiccation sensitivity and cryopreservation of the excised embryonic axes from the seeds of the same species were examined. Three drying conditions were employed: desiccation by equilibrium for the whole seeds and desiccation in laminar airflow and over silica gel for the excised embryonic axes. The relevance of desiccation sensitivity (WC50) to cryopreservation of whole seeds and excised axes was investigated. High desiccation tolerance (WC50 = 0.034 g H2O x g(-1)dw) was acquired for axes desiccated with faster dehydration rate (1.5 g x g(-1) x h(-1)) in laminar airflow compared to substantially lower desiccation tolerance (WC50 = 0.132 and 0.110 g H2O x g(-1)dw) acquired under slower dehydration rates (1.0 and 0.005 g x g(-1) x h(-1)) for axes desiccated over silica gel and whole seeds desiccated by equilibrium respectively. While few whole seeds (8.3%) survived freezing, high recovery percentages of axes (83.3% and 62.2%) after freezing were obtained under laminar airflow and silica gel drying conditions respectively. Irrespective of the drying method employed, axes survival percentages after exposure to LN temperature commensurate with the desiccation sensitivity pattern. For the whole seeds, a factor other than desiccation sensitivity that limits the tolerance to exposure to LN temperature seems to exist and still needs to be defined.
New predictive equations for estimation of basal metabolic rates of adolescents: tropics versus temperate

Noor MI, Poh BK, Zawiah H, Henry CJ

Forum Nutr, 2003;56:250-3.
PMID: 15806886

The energy and nutritional requirements of adolescents are influenced primarily by the growth spurt that occurs at puberty, and also by the need to maintain adequate levels of physical activity. Predictions of BMR have gained attention since the publication of the FAO/WHO/UNU (1985) expert consultation report, which adopted the principle of relying on energy expenditure rather than energy intake to derive requirement of individuals. While the report predicts BMR accurately in many individuals from temperate climate, they are said to be less accurate in predicting BMR in populations living in the tropics. The collation of worldwide data on basal metabolism indicated that, relative to adults, there was a paucity of data in other age groups including the adolescents. Although several BMR studies among children had been reported in the 90's, the data in normal weight children are almost exclusively from small control groups in obesity studies. Furthermore, we know little as to whether BMR of children differs in differing climatic conditions. This paper presents predictive equations for estimating BMR from a two-centre study, Bangi (Malaysia) and Oxford (UK) and to compare the results with the currently used predictive equations.
Stability of Silica- and Enzyme-Treated Palm Oil Under Deep Frying Conditions

Karim NA, Noor AM, Lee YY, Lai OM

J Food Sci, 2015 Dec;80(12):C2678-85.
PMID: 26523850 DOI: 10.1111/1750-3841.13119

The oxidative and thermal stability of low diglycerides palm oil produced via silica treatment (sPO) and enzymatic treatment (ePO) compared with standard quality palm oil (SQ) and premium quality palm oil (PQ) was investigated. Both of the oils displayed better oxidative stability compared with SQ as well as significantly higher (P < 0.05) thermal resistance and oxidative strength than SQ and PQ due to lower amounts of partial glycerides. Although the initial induction periods (IPs) of sPO and ePO were significantly lower compared with SQ and PQ, both the oils showed slower drops in their IP values. The darkening effect after frying was significantly (P < 0.05) slower in sPO compared with SQ, PQ, and ePO. Besides, there is no difference p > 0.05 in the rate of FFA formation between sPO and PQ. The anisidine value and peroxide values were lowest in sPO, followed by ePO, PQ, and SQ.
Fulltext Qat Chewing and Periodontal Pathogens in Health and Disease: Further Evidence for a Prebiotic-Like Effect

Al-Alimi A, Taiyeb-Ali T, Jaafar N, Noor Al-hebshi N

Biomed Res Int, 2015;2015:291305.
PMID: 26351631 DOI: 10.1155/2015/291305

AIM: Qat chewing has been reported to induce subgingival microbial shifts suggestive of prebiotic-like properties. The objective here was to assess the effect of qat chewing on a panel of classical and new putative periopathogens in health and periodontitis.
MATERIALS AND METHODS: 40 qat chewers and 40 nonchewers, equally stratified by periodontal health status, were recruited. Taqman, real-time PCR was used to quantify total bacteria, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Parvimonas micra, Filifactor alocis, Synergistetes, and TM7s in pooled subgingival biofilm samples. Differences in microbial parameters between the study groups were analysed using ordinal regression.
RESULTS: In health, the qat chewers harboured significantly lower relative counts of P. gingivalis, T. forsythia, Synergistetes, and TM7s after adjustment for multiple comparisons (P ≤ 0.007). At nominal significance level, they also carried lower counts of TM7s and P. micra (P ≤ 0.05). In periodontitis, the chewers had lower counts of all taxa; however, only T. denticola withstood correction for multiple comparisons (P ≤ 0.0063).
CONCLUSIONS: Qat chewing is associated with lower proportions of periopathogens, particularly in subjects with healthy periodontium, which supports previous reports of its prebiotic-like properties. This potentially beneficial biological effect can be exploited by attempting to isolate the active fraction.
Enhanced Protein-Energy Provision via the Enteral Route in Critically Ill Patients (PEP uP Protocol): A Review of Evidence

Lee ZY, Barakatun-Nisak MY, Noor Airini I, Heyland DK

Nutr Clin Pract, 2016 Feb;31(1):68-79.
PMID: 26385874 DOI: 10.1177/0884533615601638

Nutrition support is an integral part of care among critically ill patients. However, critically ill patients are commonly underfed, leading to consequences such as increased length of hospital and intensive care unit stay, time on mechanical ventilation, infectious complications, and mortality. Nevertheless, the prevalence of underfeeding has not resolved since the first description of this problem more than 15 years ago. This may be due to the traditional conservative feeding approaches. A novel feeding protocol (the Enhanced Protein-Energy Provision via the Enteral Route Feeding Protocol in Critically Ill Patients [PEP uP] protocol) was proposed and proven to improve feeding adequacy significantly. However, some of the components in the protocol are controversial and subject to debate. This article is a review of the supporting evidences and some of the controversy associated with each component of the PEP uP protocol.
Fulltext Myeloma Associated Primary Systemic Amyloidosis

Kamal WS, Taib T, Noor NM, Jong TJ

Indian J Dermatol, 2016 Jan-Feb;61(1):124.
PMID: 26955151 DOI: 10.4103/0019-5154.174166
Fulltext Dataset of Fourier transform-infrared coupled with chemometric analysis used to distinguish accessions of Garcinia mangostana L. in Peninsular Malaysia

Samsir SA, Bunawan H, Yen CC, Noor NM

Data Brief, 2016 Sep;8:1-5.
PMID: 27257614 DOI: 10.1016/j.dib.2016.04.062

In this dataset, we distinguish 15 accessions of Garcinia mangostana from Peninsular Malaysia using Fourier transform-infrared spectroscopy coupled with chemometric analysis. We found that the position and intensity of characteristic peaks at 3600-3100 cm(-) (1) in IR spectra allowed discrimination of G. mangostana from different locations. Further principal component analysis (PCA) of all the accessions suggests the two main clusters were formed: samples from Johor, Melaka, and Negeri Sembilan (South) were clustered together in one group while samples from Perak, Kedah, Penang, Selangor, Kelantan, and Terengganu (North and East Coast) were in another clustered group.
Fulltext A rare case of retropharyngeal hibernoma

Nazli Z, Norizal MN, Noor Kaslina MK, Abdul Fattah AW

Med J Malaysia, 2015 Apr;70(2):98-9.
PMID: 26162385 MyJurnal

Hibernoma is a slow growing, rare benign tumour, which derived from brown adipose tissue. This tumour is usually found in the area where foetal fat persists such as back, axilla, retro peritoneum and thorax. Hibernoma rarely occurs in the retro pharynx. We report a case of retropharyngeal hibernoma in a 44-year-old male. He presented with obstructive symptoms for six months and a retropharyngeal mass upon examination. His CT scan findings showed a mass in the prevertebral region from level of C2 until C5 causing narrowing of upper aero digestive tract. Histopathological examination reported as hibernoma.
Physical characteristics of modified milkfat in high-melting fat preparation

Nor Hayati I, Aminah A, Mamot S, Nor Aini I, Noor Lida HM

Int J Food Sci Nutr, 2002 Jan;53(1):43-54.
PMID: 11820096

Anhydrous milkfat (AMF) was fractionated to obtain a series of high-melting milkfat fractions (HMF). Solid fat content (SFC) of HMF as determined by nuclear magnetic resonance (NMR) was in the range 37.6-43.6% and 21.2-27.5% measured at 20 and 30 degrees C, respectively. The HMF have a higher melting characteristic compared to AMF as analyzed by differential scanning calorimetry (DSC) with melting enthalpies of 92.2-105.0 J/g and melting peak temperatures of 39.3-41.5 degrees C. The AMF was also blended with soft palm stearin (SPOs and/or hard palm stearin (HPOs)) according to a three conventional component mixture design which providing suitable formulations for HMF. This represented three selected blends of AMF:SPOs:HPOs at three different proportions (70:15:15, 60:30:10 and 50:45:5), having SFC and DSC melting characteristics of HMF. The study revealed that higher-melting characteristics of AMF could be achieved equally well by using both fractionation and blending techniques.
Model studies on granular activated carbon adsorption in fixed bed filtration

Jusoh AB, Noor MJ, Plow SB

Water Sci Technol, 2002;46(9):127-35.
PMID: 12448461

The removal of natural organic matter (NOM) using a continuous flow fixed bed granular activated carbon (GAC) column was studied and the results were then fitted with the Adams-Bohart, Bed-Depth-Service-Time and Clarks models. The GAC, KI-6070 and KI-8085 used in the study had external surface areas of 277 m2/g and 547 m2/g, respectively. Adsorption of NOM by the GAC was complex and involved more than one rate-limiting step. The critical bed depths for KI-6070 and KI-8085 were 0.24 m and 0.3 m, respectively. The Clark model was more effective in simulating the absorbent breakthrough process as compared to the Adams-Bohart model. The lower empty bed contact time (EBCT) i.e. 15 minutes gave a better fit to the Clark Model as compared to EBCT of 20 and 30 minutes.
Fulltext Functional outcome of proximal humeral fractures

Yeap JS, Noor Zehan AR, Ezlan S, Borhan Tan A, Harwant S

Med J Malaysia, 2001 Jun;56 Suppl C:13-8.
PMID: 11814242

The functional outcome of 27 patients (16 males, 11 females) with a proximal humeral fracture was evaluated using the Simple Shoulder Test. Fifteen patients were also assessed using the Constant system. The mean age of the patients was 46.3 years (range 16-90 years) and the mean follow-up was 14 months (range 6-29 months). There were ten 2-part fractures, eight minimally displaced fractures, two 3-part fractures, three 4-part fractures, three 1-part fracture-dislocations and one 3 parts fracture-dislocation. Twenty-four fractures were treated conservatively and 3 surgically. Thirteen patients (48%) regained full function on the simple shoulder test and almost all regained range of movement sufficient for activities of daily living. Six patients were not able to return to their previous job. All patients were pain free at rest and were able to sleep on the affected side comfortably, although 9 patients had pain with activity, even though most pain were mild in nature. The mean Constant scores for the fractured arm and the normal arm were 72.5 points and 91 points respectively. The strength of shoulder abduction was reduced by a mean of 34%. Although the outcome was generally satisfactory, there was nevertheless a statistically significant deterioration of function following the fracture.
Holoprosencephaly in neonates

Ram SP, Noor AR, Mahbar Z, Krishna TN

Int J Pediatr Otorhinolaryngol, 1994 Mar;29(1):65-71.
PMID: 8169049

A single nostril associated with alobar holoprosencephaly is a rare congenital lesion. This paper reports two female term neonates with holoprosencephaly. The first neonate asphyxiated at birth had a single nostril, hypotelorism, posterior cleft palate, inferonasal coloboma of the iris and disc and persistent tunica vasculosa lentis. The other neonate had cleft lip and palate and recurrent convulsions. Both neonates had gross motor and developmental delay. Cranial sonography and CT scan showed features consistent with alobar holoprosencephaly. Karyotyping for the first neonate and her family members was normal. Both of them were treated conservatively and supervised.
Fulltext Nutrient intake and socio-economic status among children attending a health exhibition in Malaysian rural villages

Norhayati M, Noor Hayati MI, Oothuman P, Fatmah MS, Zainudin B, Fatimah A

Med J Malaysia, 1995 Dec;50(4):382-90.
PMID: 8668061

A dietary survey was carried out in 216 children (109 males, 107 females) aged 1-7 years, living in rural villages in Selangor, Malaysia to assess their nutrient intake and to determine the association between nutrient consumption and socio-economic background. All the children studied had inadequate intakes of energy, iron and niacin according to Recommended Daily Intake (RDI). Children aged of 4-9 years showed inadequate intake of calcium, thiamine and riboflavin. However, the intake of protein, vitamin A and ascorbic acid were above the recommended value. The mean percentage requirements of protein, iron and niacin were significantly higher in children from small families compared with children from large families. However the employment status of mothers had a significantly effect on the mean percentage requirements of niacin. The results indicate that education level of the mothers, is strongly associated with the mean percentage nutrient requirements of children and we strongly feel that this is a strategy to be adopted for improvement in nutrition of children.
Fulltext Epidemiological features of hepatitis B virus infection in Malaysians

Ross IN, Dass PK, Thavarasah AS, Noor SS

Med J Malaysia, 1988 Dec;43(4):278-83.
PMID: 3241593
Fulltext Micronutrients and its correlation with mental performance among schoolchildren in Bario, Sarawak: a preliminary study

Zaleha MI, Noor Hayaati AR, Mohd Rizam AR, Jamaludin M, Osman A

Med J Malaysia, 2003 Aug;58(3):309-19.
PMID: 14750369

Children who are born in a community with insufficient micronutrients, particularly iodine in remote rural areas are associated with low intellectual functions and mental retardation. The aim of this cross-sectional study is to determine the mental performance of the schoolchildren in Bario, a highland settlement of the Kelabit people in the district of Baram, Sarawak and to determine its correlation with the availability of iodine in the environment, as well as other micronutrients such as selenium, copper and manganese. A total of 25 schoolchildren in Bario age ranging from 7 to 12 years old participated in the study. Mental performance of the schoolchildren were tested using TONI-2 (Test of Nonverbal Intelligence--second edition), a cognitive ability measures with a response format which eliminates language and reduces motoric and cultural factors. The iodine levels from several wells, soils and salt found in Bario were determined using HPLC (software version 3.05.01) whilst serum levels of selenium, copper and manganese were measured using Graphite Furnace Atomic Absorption Spectrophotometer (GFAAS). The results showed that the median and mode scores of intelligence quotient for Bario were 82 and 75, respectively, whilst median and mode scores of intelligence percentile were 11.0 and 5.0, respectively. The maximum score achieved were at the average level with the quotient score between 90-110. It was found that salt produced from one of the wells in Bario contained high quantity of iodine. Based on standards established by the Trace Elements Laboratory, Roben Institute, University of Surrey, United Kingdom, schoolchildren in Bario are having sufficient blood levels of copper and a high selenium and manganese levels. Despite the remoteness of the study area, the schoolchildren in Bario, Sarawak showed higher mental performance compared to other isolated areas. This is probably correlated with the high micronutrients availability, particularly iodine, found naturally in Bario.
Removal and speciation of heavy metals along the treatment path of wastewater in subsurface-flow constructed wetlands

Lim PE, Mak KY, Mohamed N, Noor AM

Water Sci Technol, 2003;48(5):307-13.
PMID: 14621178

This study was conducted to: (1) evaluate the performance of constructed wetlands in removing Zn, Pb and Cd, respectively, and Zn, Pb, Cd and Cu in combination and (2) investigate the speciation patterns of the dissolved metals differentiated according to their detectability by anodic stripping voltammetry (ASV) and their lability towards Chelex resin along the treatment path of metal-containing wastewater in horizontal subsurface-flow constructed wetlands. Four laboratory scale wetland units planted with cattails (Typha latifolia) were operated outdoors for six months. Three of the units were, respectively, fed with primary-treated domestic wastewater spiked with Zn(II), Pb(II) and Cd(II) whilst the fourth was spiked with a combination of Zn(II), Pb(II), Cd(II) and Cu(II). The results demonstrate that a metal removal efficiency of over 99% was achievable for wetland units treating the metals singly or in combination provided the sorption capacity of the media was not exceeded. When treating the metals in combination, an antagonistic effect, more significantly for Pb and Cd, on the sorptive metal uptake by media was observed. Based on the metal speciation patterns, the wetland system seemed to be capable of maintaining the ASV-labile metal species at relatively low level (< 10%) before media exhaustion.
Transcriptome-wide effect of DE-ETIOLATED1 (DET1) suppression in embryogenic callus of Carica papaya

Jamaluddin ND, Rohani ER, Mohd Noor N, Goh HH

J Plant Res, 2019 Mar;132(2):181-195.
PMID: 30649676 DOI: 10.1007/s10265-019-01086-x

Papaya is one of the most nutritional fruits, rich in vitamins, carotenoids, flavonoids and other antioxidants. Previous studies showed phytonutrient improvement without affecting quality in tomato fruit and rapeseed through the suppression of DE-ETIOLATED-1 (DET1), a negative regulator in photomorphogenesis. This study is conducted to study the effects of DET1 gene suppression in papaya embryogenic callus. Immature zygotic embryos were transformed with constitutive expression of a hairpin DET1 construct (hpDET1). PCR screening of transformed calli and reverse transcription quantitative PCR (RT-qPCR) verified that DET1 gene downregulation in two of the positive transformants. High-throughput cDNA 3' ends sequencing on DET1-suppressed and control calli for transcriptomic analysis of global gene expression identified a total of 452 significant (FDR
Efficacy of Montelukast in Allergic Rhinitis Treatment: A Systematic Review and Meta-Analysis

Krishnamoorthy M, Mohd Noor N, Mat Lazim N, Abdullah B

Drugs, 2020 Nov;80(17):1831-1851.
PMID: 32915441 DOI: 10.1007/s40265-020-01406-9

BACKGROUND: In treating allergic rhinitis, montelukast has the potential to be used as an alternative or addition to an oral antihistamine or intranasal corticosteroid.
OBJECTIVE: The objective of this systematic review was to assess the effectiveness of montelukast in treating allergic rhinitis.
METHODS: An electronic literature search was performed using the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from 1966 to 21 January 2019. The eligibility criteria were randomized controlled trials comparing montelukast with placebo or other standard treatments. The primary outcomes assessed were daytime nasal symptom score (DNS) and night-time nasal symptom score (NNS). The secondary outcomes assessed were composite nasal symptom score (CSS), daytime eyes symptom score (DES), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). The meta-analysis was conducted using Review Manager 5.3 software based on the random-effects model.
RESULTS: Fifteen studies of 10387 participants met the inclusion criteria. Montelukast was more effective than placebo in improving DNS (mean difference [MD] - 0.12, 95% confidence interval [CI] - 0.15 to - 0.08; p

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