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Effects of Using Laryngeal High-Speed Videoendoscopy Images Visualizing Partial Views of The Glottis on Measurement Outcomes

Mohd Khairuddin KA, Ahmad K, Ibrahim HM, Yan Y

J Voice, 2022 Jan;36(1):106-112.
PMID: 32456835 DOI: 10.1016/j.jvoice.2020.04.027

Ideally, an analysis method for laryngeal high-speed videoendoscopy (LHSV) based on the glottal area waveforms (GAW) requires images of a complete view of the glottis to ensure findings that are representatives of the vibratory behaviors of the whole vocal folds. However, in practice, the preferred images may not be obtained at all times. Often, the only available images that a clinician has to work with consist of a partial view of the glottis. This study aims to examine the effects of using images of a partial view of the glottis (ie, posterior-middle, anterior-middle, or middle) on the LHSV-based measures (ie, fundamental frequency (F0GAW), frequency perturbation (jitterGAW), amplitude perturbation (shimmerGAW), open quotient (OQGAW), and Nyquist plot). The participants consisted of 9 young normophonic females. The procedures involved LHSV recording of the vibration of the vocal folds. The images of the complete view of the glottis were analyzed to obtain the LHSV-based measures. The same images were used to simulate the images of partial views of the glottis by changing the outline of the region of interest to include only either the posterior-middle, anterior-middle, or middle parts of the glottis. The LHSV-based measures from the images of the partial views were then compared to those with the complete view . The results showed that all LHSV-based measures from the images of the posterior-middle view were similar to those of the complete view. However, only the F0GAW, jitterGAW, and shimmerGAW from the images of the anterior-middle and middle views were similar to those of the complete view. Lower OQGAW and different Nyquist plots than those of the complete view were generated by the images of the anterior-middle and middle views. In conclusion, all LHSV-based measures from the images of the posterior-middle view of the glottis, and only the F0GAW, jitterGAW, and shimmerGAW from the images of the anterior-middle and middle views of the glottis reflect the vibratory behaviors of the whole vocal folds. The same conclusion could not be applied to the OQGAW and Nyquist plots of the images of the anterior-middle and middle views of the glottis. A possible effect of the presence or absence of a posterior glottal gap on the findings warrants further confirmation.
Arabic phoneme-grapheme correspondence by non-native, deaf children with cochlear implants and normal hearing children

Anis FN, Umat C, Ahmad K, Abdul Hamid B

Cochlear Implants Int, 2022 Nov;23(6):347-357.
PMID: 36005236 DOI: 10.1080/14670100.2022.2114583

OBJECTIVE: This study aimed to compare the error patterns of Arabic phoneme-grapheme correspondence by a group of Malay children with cochlear implants (CIs) and normal hearing (NH) and the effects of the visual graphical features of Arabic graphemes (no-dot, single-dot, and multiple-dots) on the phoneme-grapheme correspondence.
METHODS: Participants were matched for hearing age (Mean, M = 7 ± 1.03 years) and duration of exposure to Arabic sounds (M = 2.7 ± 1.2 years). All 28 Arabic phonemes were presented through a loudspeaker and participants pointed to the graphemes associated with the presented phonemes.
RESULTS: A total of 336 and 616 tokens were collected for six children with CI and 11 NH children for each task, i.e., phonemes repetition and phoneme-grapheme correspondence. Both groups found it easier to repeat phonemes than the phoneme-grapheme correspondence. The children with CIs showed more confusion ([ظ, ز, ذ, ض, خ, ب, ه, س, ع, & ث] >10% correct scores) in phoneme-grapheme correspondence than the NH children ([ظ:14%] and [ث: 27%]). There was a significant interaction (p = 0.001) among the three visual graphical features and hearing status (CI and NH).
CONCLUSION: Our results infer that non-native Malay children with CIs and NH use different strategies to process the Arabic graphemes' visual features for phoneme-grapheme correspondence.
Fulltext A secure and dependable trust assessment (SDTS) scheme for industrial communication networks

Khan T, Singh K, Ahmad K, Ahmad KAB

Sci Rep, 2023 Feb 02;13(1):1910.
PMID: 36732583 DOI: 10.1038/s41598-023-28721-x

Due to tamper-resistant sensor nodes and wireless media, Industrial Wireless Sensor Networks (WSNs) are susceptible to various security threats that severely affect industrial/business applications. The survival of sensor networks is highly dependent on the flourishing collaboration of sensor nodes. Trust management schemes seem to be realistic and promising techniques to improve security as well as cooperation (dependability) among sensor nodes by estimating the trust level (score) of individual sensor nodes. This research paper presents a well-organized and motivating secure, dependable trust assessment (SDTS) scheme for industrial WSNs to cope with unexpected behavior such as an on-off attack, bad-mouthing attack, garnished attack, etc., by employing robust trust evaluation components based on success ratio and node misbehaviour. SDTS incorporates an interesting trust evaluation function in which the trust range can be adjusted in accordance with the application requirement. SDTS include direct communication trust, indirect communication trust, data trust, and misbehavior-based trust to defend the multiple internal attacks. SDTS works according to the behavior of nodes, i.e., whether the sensor nodes are interacting frequently or not. Moreover, abnormal attenuation and dynamic slide lengths are incorporated in the proposed model (SDTS) to deal with various natural calamities and internal attacks. SDTS is compared against three recent state-of-the-art methods and found efficient in terms of ease of trust assessment, false-positive rate (2.5%), false-negative rate (2%), attack detection rate (90%), detection accuracy (91%), average energy consumption (0.40 J), and throughput (108 Kbps) under the load of 500 sensor nodes with 50% malicious nodes. Investigational results exhibit the potency of the proposed scheme.
Fulltext Recurrent paediatric supratentorial extraventricular ependymoma associated with genetic mutation at exon 4 of p53 gene

Ghani AR, Abdullah JM, Ghazali M, Ahmad F, Ahmad KA, Madhavan M

Singapore Med J, 2008 Jul;49(7):e192-4.
PMID: 18695856

Recurrent supratentorial extraventricular ependymoma in a four-year-old Malay boy treated twice surgically in combination with cranial radiotherapy is reported. He presented with symptoms of raised intracranial pressure and a history of focal seizure. Computed tomography of the brain showed a left supratentorial extraventricular cystic lesion causing a mass effect. The tumour histology was ependymoma (WHO grade II). The clinical course, radiological characteristics and management of this tumour are discussed. Molecular genetic analysis of p53 and p27 genes revealed substitution of nucleotide G to C at location nucleotide 12139, exon 4 of gene p53. No alteration was detected at exon 5-6 and 8 of p53 gene and exon 1 and 2 of p27 gene.
Evaluating the toxicity of polyurethane during marine clay stabilisation

Saleh S, Ahmad K, Mohd Yunus NZ, Hezmi MA

Environ Sci Pollut Res Int, 2020 Jun;27(17):21252-21259.
PMID: 32266626 DOI: 10.1007/s11356-020-08549-y

In civil engineering, many geotechnical and forensic projects employ polyurethane (PU) for ground improvement, and the results have shown to be effective in terms of time and cost savings. However, similar to many other chemical stabilisers, the use of PU for soil stabilisation may have environmental repercussions. Therefore, this paper utilised a toxicity characteristic leaching procedure (TCLP) to investigate the potential for ground contamination resulting from the application of PU for the stabilisation of marine clay. Furthermore, the hazardousness of PU during the stabilisation of marine clay was investigated by testing its reactivity, ignitability, corrosivity and physical properties. The results reveal that the quantity of heavy metals present in PU is far below the regulatory limits. The results further confirm that PU is odourless and non-corrosive and that it is non-cyanide and non-sulphide-bearing. However, PU is capable of igniting. Overall, the potential application of PU for ground improvement is promising due to its environmental friendliness.
Fulltext Hemodynamic Effects of Subaortic Stenosis on Blood Flow Characteristics of a Mechanical Heart Valve Based on OpenFOAM Simulation

Chen A, Azriff Basri A, Ismail NB, Arifin Ahmad K

Bioengineering (Basel), 2023 Mar 01;10(3).
PMID: 36978704 DOI: 10.3390/bioengineering10030312

Subaortic stenosis (SAS) is a common congenital heart disease that can cause significant morbidity and mortality if not treated promptly. Patients with heart valve disease are prone to complications after replacement surgery, and the existence of SAS can accelerates disease progression, so timely diagnosis and treatment are required. However, the effects of subaortic stenosis on mechanical heart valves (MHV) are unknown. This study aimed to investigate flow characteristics in the presence of subaortic stenosis and computationally quantify the effects on the hemodynamics of MHV. Through the numerical simulation method, the flow characteristics and related parameters in the presence of SAS can be more intuitively observed. Based on its structure, there are three types of SAS: Tunnel-type SAS (TSS); Fibromuscular annulus SAS (FSS); Discrete SAS (DSS). The first numerical simulation study on different types of SAS found that there are obvious differences among them. Among them, the tunnel-type SAS formed a separated vortex structure on the tunnel-type narrow surface, which exhibits higher wall shear force at a low obstacle percentage. However, discrete SAS showed obvious differences when there was a high percentage of obstacles, forming high peak flow, high wall shear stress, and a high-intensity complex vortex. The presence of all three types of SAS results in the formation of high-velocity jets and complex vortices in front of the MHV, leading to increased shear stress and stagnation time. These hemodynamic changes significantly increase the risk of MHV dysfunction and the development of complications. Despite differences between the three types of SAS, the resultant effects on MHV hemodynamics are consistent. Therefore, early surgical intervention is warranted in SAS patients with implanted MHV.
Fulltext Effectiveness of a pharmacist-led, community group-based education programme in enhancing diabetes management: A multicentre randomised control trial

Ahmad K, Anchah L, Ting CY, Lim SE

Contemp Clin Trials Commun, 2024 Apr;38:101280.
PMID: 38435429 DOI: 10.1016/j.conctc.2024.101280

AIMS: This study presents a protocol for the Pharmacy Integrated Community Care (PICC) program, meticulously designed to enhance Hemoglobin A1c (HbA1c) levels and augment knowledge about diabetes mellitus (DM) among individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) in the Sarawak State of Malaysia.
METHODS: From 1 May to December 31, 2023, a prospective, multicenter, parallel-design randomised controlled trial will be conducted with two groups, each consisting of 47 participants. The intervention group will receive a structured, four-session group-based program guided by experienced pharmacists, focusing on medication adherence and diabetes management. The control group will follow the standard Diabetes Mellitus Adherence Clinic program. The primary outcomes of this study encompass enhancements in knowledge regarding diabetes medication management and adherence, followed by subsequent changes in HbA1c levels.
CONCLUSIONS: The successful implementation of the PICC program holds promise for enhancing health outcomes in the T2DM population, potentially leading to more effective diabetes management initiatives and better health practices in the community.
TRIAL REGISTRATION CLINICALTRIALSGOV IDENTIFIER: NCT05106231.
Evidences of in vivo bioactivity of Fe-bioceramic composites for temporary bone implants

Ulum MF, Nasution AK, Yusop AH, Arafat A, Kadir MR, Juniantito V, et al.

J Biomed Mater Res B Appl Biomater, 2015 Oct;103(7):1354-65.
PMID: 25385691 DOI: 10.1002/jbm.b.33315

Iron-bioceramic composites have been developed as biodegradable implant materials with tailored degradation behavior and bioactive features. In the current work, in vivo bioactivity of the composites was comprehensively studied by using sheep animal model. Five groups of specimens (Fe-HA, Fe-TCP, Fe-BCP composites, and pure-Fe and SS316L as controls) were surgically implanted into medio proximal region of the radial bones. Real-time ultrasound analysis showed a decreased echo pattern at the peri-implant biodegradation site of the composites indicating minimal tissue response during the wound healing process. Peripheral whole blood biomarkers monitoring showed a normal dynamic change of blood cellular responses and no stress effect was observed. Meanwhile, the released Fe ion concentration was increasing along the implantation period. Histological analysis showed that the composites corresponded with a lower inflammatory giant cell count than that of SS316L. Analysis of the retrieved implants showed a thicker degradation layer on the composites compared with pure-Fe. It can be concluded that the iron-bioceramic composites are bioactive and induce a preferable wound healing process.
Fulltext N-cyanomethylnorboldine: a new aporphine isolated from Alseodaphne perakensis (Lauraceae)

Nafiah MA, Mukhtar MR, Omar H, Ahmad K, Morita H, Litaudon M, et al.

Molecules, 2011 Apr 20;16(4):3402-9.
PMID: 21512448 DOI: 10.3390/molecules16043402

A phytochemical study of the bark of Alseodaphne perakensis has yielded three aporphine alkaloids: the new compound N-cyanomethylnorboldine (1), and the two known alkaloids N-methyllaurotetanine (2) and norboldine (3). The isolation was achieved by chromatographic techniques and the structural elucidation was performed via spectral methods, notably 1D- and 2D-NMR, UV, IR, and HRFABMS. The vasorelaxation activity of compound 1 has been studied.
Fulltext Association between Serum 25 (OH) Vitamin D Concentrations and Inflammatory Bowel Diseases (IBDs) Activity

Hassan V, Hassan S, Seyed-Javad P, Ahmad K, Asieh H, Maryam S, et al.

Med J Malaysia, 2013;68(1):34-8.
PMID: 23466764

Inflammatory bowel diseases (IBDs) are immune mediated diseases affecting the gastrointestinal tract. Several environmental factors in concert with genetic susceptibilities can trigger IBDs. Recently, one of the important environmental factors contributing to the development of autoimmune diseases is vitamin D (VitD) deficiency. Furthermore, some new evidence points to VitD deficiency and its receptor dysfunction as an underlying factor for the emergence experimental IBDs. The aim of the current study was to evaluate the correlation between serum 25(OH)D concentrations and IBD activity in patients with ulcerative colitis or Crohn's disease. Sixty patients with confirmed diagnosis of IBD were recruited for a cross sectional study. Most of the identified confounders affecting serum VitD concentrations were excluded. Disease activity was assessed using validated questionnaires, including Truelove for Ulcerative Colitis and Crohn Disease Activity Index (CDAI) for Crohn disease. Serum 25(OH)D concentrations were determined by chemiluminescent assay. Serum 25(OH)D≤10 (ng/ml) was considered as VitD deficiency and 11≤25(OH)D<29(ng/ml) as VitD insufficiency. Mean serum 25(OH)D value was 13.1 ± 11.1(ng/ml) in IBD patients. Almost 95% of patients were vitamin D insufficient or deficient. Forty one percent of IBD patients had active disease. VitD deficiency was not associated with IBD activity (p=0.23). However, VitD deficiency was significantly associated with a history of IBD related intestinal surgery (p=0.001). In conclusion, this cross-sectional prospective study suggested that there is no association between vitamin D deficiency and disease activity in a relatively small number of IBD patients in a short period of time.
Simultaneous determination of preservatives (benzoic acid, sorbic acid, methylparaben and propylparaben) in foodstuffs using high-performance liquid chromatography

Saad B, Bari MF, Saleh MI, Ahmad K, Talib MK

J Chromatogr A, 2005 May 06;1073(1-2):393-7.
PMID: 15909546

A reversed-phased HPLC method that allows the separation and simultaneous determination of the preservatives benzoic (BA) and sorbic acids (SA), methyl- (MP) and propylparabens (PP) is described. The separations were effected by using an initial mobile phase of methanol-acetate buffer (pH 4.4) (35:65) to elute BA, SA and MP and changing the mobile phase composition to methanol-acetate buffer (pH 4.4) (50:50) thereafter. The detector wavelength was set at 254 nm. Under these conditions, separation of the four components was achieved in less than 23 min. Analytical characteristics of the separation such as limit of detection, limit of quantification, linear range and reproducibility were evaluated. The developed method was applied to the determination of 67 foodstuffs (mainly imported), comprising soft drinks, jams, sauces, canned fruits/vegetables, dried vegetables/fruits and others. The range of preservatives found were from not detected (nd)--1260, nd--1390, nd--44.8 and nd--221 mg kg(-1) for BA, SA, MP and PP, respectively.
Fulltext Turbulence Model Selection for Low Reynolds Number Flows

Aftab SM, Mohd Rafie AS, Razak NA, Ahmad KA

PLoS One, 2016;11(4):e0153755.
PMID: 27104354 DOI: 10.1371/journal.pone.0153755

One of the major flow phenomena associated with low Reynolds number flow is the formation of separation bubbles on an airfoil's surface. NACA4415 airfoil is commonly used in wind turbines and UAV applications. The stall characteristics are gradual compared to thin airfoils. The primary criterion set for this work is the capture of laminar separation bubble. Flow is simulated for a Reynolds number of 120,000. The numerical analysis carried out shows the advantages and disadvantages of a few turbulence models. The turbulence models tested were: one equation Spallart Allmars (S-A), two equation SST K-ω, three equation Intermittency (γ) SST, k-kl-ω and finally, the four equation transition γ-Reθ SST. However, the variation in flow physics differs between these turbulence models. Procedure to establish the accuracy of the simulation, in accord with previous experimental results, has been discussed in detail.
Bromelain: an overview of industrial application and purification strategies

Arshad ZI, Amid A, Yusof F, Jaswir I, Ahmad K, Loke SP

Appl Microbiol Biotechnol, 2014 Sep;98(17):7283-97.
PMID: 24965557 DOI: 10.1007/s00253-014-5889-y

This review highlights the use of bromelain in various applications with up-to-date literature on the purification of bromelain from pineapple fruit and waste such as peel, core, crown, and leaves. Bromelain, a cysteine protease, has been exploited commercially in many applications in the food, beverage, tenderization, cosmetic, pharmaceutical, and textile industries. Researchers worldwide have been directing their interest to purification strategies by applying conventional and modern approaches, such as manipulating the pH, affinity, hydrophobicity, and temperature conditions in accord with the unique properties of bromelain. The amount of downstream processing will depend on its intended application in industries. The breakthrough of recombinant DNA technology has facilitated the large-scale production and purification of recombinant bromelain for novel applications in the future.
Computational Analysis of Protein-Protein Interactions in Motile T-Cells

Kumar S, Fazil MHUT, Ahmad K, Tripathy M, Rajapakse JC, Verma NK

Methods Mol Biol, 2019;1930:149-156.
PMID: 30610609 DOI: 10.1007/978-1-4939-9036-8_18

Analysis of protein-protein interactions is important for better understanding of molecular mechanisms involved in immune regulation and has potential for elaborating avenues for drug discovery targeting T-cell motility. Currently, only a small fraction of protein-protein interactions have been characterized in T-lymphocytes although there are several detection methods available. In this regard, computational approaches garner importance, with the continued explosion of genomic and proteomic data, for handling protein modeling and protein-protein interactions in large scale. Here, we describe a computational method to identify protein-protein interactions based on in silico protein design.
The prevalence of hypersensitivity reactions to snake antivenoms administered in sultanah nur zahirah hospital from 2013 to 2016

Nur AS, Hamid F, Mohd Shahezwan AW, Mohd Zaki FS, Ahmad KI

Med J Malaysia, 2020 05;75(3):216-220.
PMID: 32467535

INTRODUCTION: Snakebite is an important medical emergency. Antivenoms remain the only proven treatment for snake envenoming. However, the use of antivenom is associated with hypersensitivity reactions. The aims of this study were to determine the prevalence and types of hypersensitivity reactions and types and outcomes of pharmacological and non-pharmacological treatments for antivenom reactions among snakebite patients that received antivenoms.
METHODS: This was a 4-year cross-sectional study of snakebite patients from January 2013 to December 2016 in Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. Data was extracted from the Pharmacy Record on the usage of antivenom and patients of snakebites treated with antivenom were identified. Data of patients were then obtained from the electronic medical records.' Demographic details, clinical features and characteristics of antivenom reactions of patients were recorded in standardized data collection forms and analyzed using chi-square or Mann- Whitney U tests.
RESULTS: Of the 44 patients who received antivenom, 24 (54.5%) developed hypersensitivity reaction. All patients developed reaction early. No patient developed delayed (serum-sickness) reaction. Of the 24 patients, 14 (58.3%) had moderate to severe hypersensitivity reaction and 9 (37.5%) patients had mild reactions. Only one (4.2%) patient presented with bradycardia.
CONCLUSION: The prevalence of early hypersensitivity reaction to snake antivenom in HSNZ was relatively high. Healthcare providers should be aware of the appropriate method of preparing and administering antivenom, and the management for acute hypersensitivity reactions. This will optimize the management of snakebite and ensure patient safety.
First detection of tilapia lake virus (TiLV) in wild river carp (Barbonymus schwanenfeldii) at Timah Tasoh Lake, Malaysia

Abdullah A, Ramly R, Mohammad Ridzwan MS, Sudirwan F, Abas A, Ahmad K, et al.

J Fish Dis, 2018 Sep;41(9):1459-1462.
PMID: 30027657 DOI: 10.1111/jfd.12843
Efficacy of a newly developed auditory-cognitive training system on speech recognition, central auditory processing and cognitive ability among older adults with normal cognition and with neurocognitive impairment

Yusof Y, Mukari SZS, Dzulkifli MA, Chellapan K, Ahmad K, Ishak I, et al.

Geriatr Gerontol Int, 2019 Aug;19(8):768-773.
PMID: 31237107 DOI: 10.1111/ggi.13710

AIM: To evaluate the efficacy of a newly developed auditory-cognitive training system on speech recognition, central auditory processing and cognition among older adults with normal cognition (NC) and with neurocognitive impairment (NCI).
METHODS: A double-blind quasi-experiment was carried out on NC (n = 43) and NCI (n = 33) groups. Participants in each group were randomly assigned into treatment and control programs groups. The treatment group underwent auditory-cognitive training, whereas the control group was assigned to watch documentary videos, three times per week, for 8 consecutive weeks. Study outcomes that included Montreal Cognitive Assessment, Malay Hearing in Noise Test, Dichotic Digit Test, Gaps in Noise Test and Pitch Pattern Sequence Test were measured at 4-week intervals at baseline, and weeks 4, 8 and 12.
RESULTS: Mixed design anova showed significant training effects in total Montreal Cognitive Assessment and Dichotic Digit Test in both groups, NC (P
Fulltext Introgression of bacterial leaf blight (BLB) resistant gene, Xa7 into MARDI elite variety, MR219 by marker assisted backcrossing (MABC) approach

Yazid SN, Ahmad K, Razak MSFA, Rahman ZA, Ramachandran K, Mohamad SNA, et al.

Braz J Biol, 2021;84:e248359.
PMID: 34730685 DOI: 10.1590/1519-6984.248359

Bacterial leaf blight (BLB) is one of the major rice diseases in Malaysia. This disease causes substantial yield loss as high as 70%. Development of rice varieties which inherited BLB resistant traits is a crucial approach to promote and sustain rice industry in Malaysia. Hence, this study aims were to enhance BLB disease resistant characters of high yielding commercial variety MR219 through backcross breeding approach with supporting tool of marker-assisted selection (MAS). Broad spectrum BLB resistance gene, Xa7 from donor parent IRBB7 were introgressed into the susceptible MR219 (recurrent parent) using two flanking markers ID7 and ID15. At BC3F4, we managed to generate 19 introgressed lines with homozygous Xa7 gene and showed resistant characteristics as donor parent when it was challenged with Xanthomonas oryzae pv. oryzae through artificial inoculation. Recurrent parent MR219 and control variety, MR263 were found to be severely infected by the disease. The improved lines exhibited similar morphological and yield performance characters as to the elite variety, MR219. Two lines, PB-2-107 and PB-2-34 were chosen to be potential lines because of their outstanding performances compared to parent, MR219. This study demonstrates a success story of MAS application in development of improved disease resistance lines of rice against BLB disease.
Fulltext The Unmet Needs of Caregiving Skills, Support, Emotions, and Finances of Stroke Caregivers: A Multicenter Study

Mohd Zawawi NS, Abd Aziz NA, Fisher R, Ahmad K, Omar MA, Walker MF

Cureus, 2023 Aug;15(8):e44346.
PMID: 37779760 DOI: 10.7759/cureus.44346

Background Informal stroke caregivers in Malaysia play an important role in supporting stroke survivors following acute care. Nevertheless, there is a lack of available data to inform the sufficiency of help and resources available to address the needs of local stroke caregivers. This study aimed to determine the unmet needs in caregiving skills, support, emotions, and finances as well as the associated factors of stroke caregivers in Malaysia. Methodology This multicenter, cross-sectional study used a self-administered survey developed and validated for the Malaysian population. It was prepared in paper-based and web-based formats, and it was distributed via direct contact with the respondents, post, and email. Respondents were recruited from different sites in Malaysia. In this study, unmet needs were defined as "help that was needed more or was not provided to assist caregivers and address their specific needs." This article only presents the quantitative data of this study. Data were analyzed using descriptive analysis and logistic regression to determine factors associated with unmet needs. Results Almost all study respondents (91%) reported having unmet needs. Unmet needs ranged from 1 to 10, while the mean unmet needs was 5. The highest unmet need was related to financial support (72.5%), followed by support from professionals to address their own needs (59.2%), skills to care for stroke survivors, i.e., skills in caring for stroke survivors with their daily activities (57.9%), and skills in supporting stroke survivors to perform rehabilitation at home (53.1%). The lowest unmet need was related to support in transporting stroke survivors from place to place (45.3%). Additionally, this study did not identify an association between the reported unmet needs and gender, age, ethnicity, duration of caregiving, and site of participation. Conclusions This study reported a range of unmet needs perceived by stroke caregivers in Malaysia. Further research is warranted to understand the gaps in supporting local stroke caregivers to inform future post-stroke support and services in the country.
Fulltext Mathematical modelling and analysis of COVID-19 and tuberculosis transmission dynamics

Singh R, Rehman AU, Ahmed T, Ahmad K, Mahajan S, Pandit AK, et al.

Inform Med Unlocked, 2023;38:101235.
PMID: 37033412 DOI: 10.1016/j.imu.2023.101235

In this paper, a mathematical model for assessing the impact of COVID-19 on tuberculosis disease is proposed and analysed. There are pieces of evidence that patients with Tuberculosis (TB) have more chances of developing the SARS-CoV-2 infection. The mathematical model is qualitatively and quantitatively analysed by using the theory of stability analysis. The dynamic system shows endemic equilibrium point which is stable when R 0 < 1 and unstable when R 0 > 1 . The global stability of the endemic point is analysed by constructing the Lyapunov function. The dynamic stability also exhibits bifurcation behaviour. The optimal control theory is used to find an optimal solution to the problem in the mathematical model. The sensitivity analysis is performed to clarify the effective parameters which affect the reproduction number the most. Numerical simulation is carried out to assess the effect of various biological parameters in the dynamic of both tuberculosis and COVID-19 classes. Our simulation results show that the COVID-19 and TB infections can be mitigated by controlling the transmission rate γ .

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