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Fulltext Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

Islam MA, Khandker SS, Kotyla PJ, Hassan R

Front Immunol, 2020;11:1477.
PMID: 32793202 DOI: 10.3389/fimmu.2020.01477

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement, including the skin, joints, kidneys, lungs, central nervous system and the haematopoietic system, with a large number of complications. Despite years of study, the etiology of SLE remains unclear; thus, safe and specifically targeted therapies are lacking. In the last 20 years, researchers have explored the potential of nutritional factors on SLE and have suggested complementary treatment options through diet. This study systematically reviews and evaluates the clinical and preclinical scientific evidence of diet and dietary supplementation that either alleviate or exacerbate the symptoms of SLE. For this review, a systematic literature search was conducted using PubMed, Scopus and Google Scholar databases only for articles written in the English language. Based on the currently published literature, it was observed that a low-calorie and low-protein diet with high contents of fiber, polyunsaturated fatty acids, vitamins, minerals and polyphenols contain sufficient potential macronutrients and micronutrients to regulate the activity of the overall disease by modulating the inflammation and immune functions of SLE.
Fulltext Effects of COVID-19 in E-learning on higher education institution students: the group comparison between male and female

Shahzad A, Hassan R, Aremu AY, Hussain A, Lodhi RN

Qual Quant, 2020 Aug 04.
PMID: 32836471 DOI: 10.1007/s11135-020-01028-z

In response to the emerging and ever solution to the COVID-19 outbreak. This study proposes a theoretical framework based on literature and model to determined E-learning portal success. The study compared males and females to E-learning portal usage. The study objective is to check the difference between male and female E-learning portals' accessibility among the students' perspective. The study included service quality, system quality, information quality, user satisfaction, system use, and E-learning portal success. The empirical data of 280 students participated from the different universities of Malaysia through google surveys analyzed using the Partial Least Squares Structural Equation Modelling. The study further divided the full model into two domains, which are female and male. In the male model, information quality and system quality have direct relationships with user satisfaction. Information quality also supported the relationship with system use. At the same time, there is a positive relationship between user satisfaction and E-learning portals. Likewise, in the female model, E-service quality and Information quality both are supported by system use and user satisfaction. Similarly, system quality has a positive relationship with user satisfaction, and user satisfaction has a positive relationship with E-learning portals. The study will be further helpful for the Malaysian universities policy-makers such as top management, ministry of higher education, Malaysian universities union in designing the policies and programs on E-learning Portal Success in the country. The findings of the study reveal that males and females have a different level of in terms of usage of towards E-learning portals in Malaysian Universities.
Prevalence of Sleep-disordered Breathing and its Association with Obesity among Saudi Schoolchildren

Zreaqat M, Hassan R, Samsudin AR, Stas Y

J Contemp Dent Pract, 2020 Sep 01;21(9):1022-1026.
PMID: 33568590

AIM AND OBJECTIVE: Epidemiological studies of sleep disturbances are essential to promote awareness among families and educational officials and deliver appropriate treatment at a very early timing. The aim of this population-based study was to determine the frequency of sleep-disordered breathing (SDB) symptoms and its association with obesity among schoolchildren in West Saudi Arabia.
MATERIALS AND METHODS: This cross-sectional study comprised 2,000 schoolchildren aged 6-12 years. Sleep-disordered breathing symptoms were assessed with Arabic version of Pediatric Sleep Questionnaire (PSQ). Overweight/obesity was evaluated using body mass index (BMI) and their association with SDB was tested using a regression analysis model.
RESULTS: Overall, 23% of children were at high risk of SDB. Prevalence of habitual snoring was 15.9% and sleep apnea 4%. Boys were at higher risk of SDB than girls (p = 0.026), while age had no effect (p = 0.254). High-risk SDB had a strong association with sleep symptoms compared to low-risk SDB (p < 0.05). Sleep-disordered breathing increased significantly in overweight and obese children (p = 0.017 and p < 0.001, respectively).
CONCLUSION: Around 23% Saudi schoolchildren are at risk of SDB. Related symptoms were strongly associated with high risk of SDB. Overweight and obesity had a strong and progressive association with SDB.
CLINICAL SIGNIFICANCE: The results will help in identifying children at high risk of developing SDB and plan for early intervention to avoid the progression of SDB later in life.
Fulltext Methadone, Buprenorphine, and Clonidine Attenuate Mitragynine Withdrawal in Rats

Hassan R, Sreenivasan S, Müller CP, Hassan Z

Front Pharmacol, 2021;12:708019.
PMID: 34322028 DOI: 10.3389/fphar.2021.708019

Background: Kratom or Mitragyna speciosa Korth has been widely used to relieve the severity of opioid withdrawal in natural settings. However, several studies have reported that kratom may by itself cause dependence following chronic consumption. Yet, there is currently no formal treatment for kratom dependence. Mitragynine, is the major psychoactive alkaloid in kratom. Chronic mitragynine treatment can cause addiction-like symptoms in rodent models including withdrawal behaviour. In this study we assessed whether the prescription drugs, methadone, buprenorphine and clonidine, could mitigate mitragynine withdrawal effects. In order to assess treatment safety, we also evaluated hematological, biochemical and histopathological treatment effects. Methods: We induced mitragynine withdrawal behaviour in a chronic treatment paradigm in rats. Methadone (1.0 mg/kg), buprenorphine (0.8 mg/kg) and clonidine (0.1 mg/kg) were i.p. administered over four days during mitragynine withdrawal. These treatments were stopped and withdrawal sign assessment continued. Thereafter, toxicological profiles of the treatments were evaluated in the blood and in organs. Results: Chronic mitragynine treatment caused significant withdrawal behaviour lasting at least 5 days. Methadone, buprenorphine, as well as clonidine treatments significantly attenuated these withdrawal signs. No major effects on blood or organ toxicity were observed. Conclusion: These data suggest that the already available prescription medications methadone, buprenorphine, and clonidine are capable to alleviate mitragynine withdrawal signs rats. This may suggest them as treatment options also for problematic mitragynine/kratom use in humans.
Fulltext Morphological Characteristics and Habitats of Red Seaweed Gracilaria spp. (Gracilariaceae, Rhodophyta) in Santubong and Asajaya, Sarawak, Malaysia

Othman MNA, Hassan R, Harith MN, Sah ASRM

Trop Life Sci Res, 2018 Mar;29(1):87-101.
PMID: 29644017 MyJurnal DOI: 10.21315/tlsr2018.29.1.6

Red seaweed Gracilaria, one of the largest genus in Division Rhodophyta inhabits Sarawak coastal water. This study was designed to identify the species of Gracilaria using morphological approach and to assess selected water quality parameters in Gracilaria habitats. Three field samplings were carried out in Santubong and Asajaya, Sarawak from November 2013 to December 2014. Overall, three species were identified namely Gracilaria changii, G. blodgettii and G. coronopifolia, attached to net of cage culture in Santubong and root of mangrove trees in Asajaya. In addition, three different taxa of aquatic macroinvertebrates (polychaete, small crab, bivalve) and single species of red seaweed (Acanthophora sp.) were observed in Gracilaria assemblages. An estimate of 37% to 40% of the upper part of the cage net in Santubong was covered by seaweeds and only 16% to 20% in Asajaya's mangrove. The study had provided better information on identification of Gracilaria and their habitat in Sarawak. Future work involving DNA barcoding of each species is in progress.
Clinical implications of conventional cytogenetics, fluorescence in situ hybridization (FISH) and molecular testing in chronic myeloid leukaemia patients in the tyrosine kinase inhibitor era - A review

Ankathil R, Ismail SM, Mohd Yunus N, Sulong S, Husin A, Abdullah AD, et al.

Malays J Pathol, 2020 Dec;42(3):307-321.
PMID: 33361712

Chronic myeloid leukaemia (CML) provides an illustrative disease model for both molecular pathogenesis of cancer and rational drug therapy. Imatinib mesylate (IM), a BCR-ABL1 targeted tyrosine kinase inhibitor (TKI) drug, is the first line gold standard drug for CML treatment. Conventional cytogenetic analysis (CCA) can identify the standard and variant Philadelphia (Ph) chromosome, and any additional complex chromosome abnormalities at diagnosis as well as during treatment course. Fluorescence in situ hybridization (FISH) is especially important for cells of CML patients with inadequate or inferior quality metaphases or those with variant Ph translocations. CCA in conjunction with FISH can serve as powerful tools in all phases of CML including the diagnosis, prognosis, risk stratification and monitoring of cytogenetic responses to treatment. Molecular techniques such as reverse transcriptase-polymerase chain reaction (RT-PCR) is used for the detection of BCR-ABL1 transcripts at diagnosis whereas quantitative reverse transcriptase-polymerase chain reaction (qRTPCR) is used at the time of diagnosis as well as during TKI therapy for the quantitation of BCR-ABL1 transcripts to evaluate the molecular response and minimal residual disease (MRD). Despite the excellent treatment results obtained after the introduction of TKI drugs, especially Imatinib mesylate (IM), resistance to TKIs develops in approximately 35% - 40% of CML patients on TKI therapy. Since point mutations in BCR-ABL1 are a common cause of IM resistance, mutation analysis is important in IM resistant patients. Mutations are reliably detected by nested PCR amplification of the translocated ABL1 kinase domain followed by direct sequencing of the entire amplified kinase domain. The objective of this review is to highlight the importance of regular and timely CCA, FISH analysis and molecular testing in the diagnosis, prognosis, assessment of therapeutic efficacy, evaluation of MRD and in the detection of BCR-ABL1 kinase mutations which cause therapeutic resistance in adult CML patients.
Fulltext Aberrant Methylation of Tumour Suppressor Gene ADAM12 in Chronic Lympocytic Leukemia Patients: Application of Methylation Specific-PCR Technique

Mohamad A, Hassan R, Husin A, Johan MF, Sulong S

Asian Pac J Cancer Prev, 2021 Jan 01;22(1):85-91.
PMID: 33507683 DOI: 10.31557/APJCP.2021.22.1.85

OBJECTIVE: Chronic Lymphocytic Leukemia (CLL) is a common leukemia among Caucasians but rare in Asians population. We postulated that aberrant methylation either hypermethylation or partial methylation might be one of the silencing mechanisms that inactivates the tumour suppressor genes in CLL. This study aimed to compare the methylation status of tumour suppressor gene, ADAM12, among CLL patients and normal individuals. We also evaluated the association between methylation of ADAM12 and clinical and demographic characteristics of the participants.
METHODS: A total of 25 CLL patients and 25 normal individuals were recruited in this study. The methylation status of ADAM12 was determined using Methylation-Specific PCR (MSP); whereas, DNA sequencing method was applied for validation of the MSP results.
RESULTS: Among CLL patients, 12 (48%) were partially methylated and 13 (52%) were unmethylated. Meanwhile, 5 (20%) and 20 (80.6%) of healthy individuals were partially methylated and unmethylated, respectively. There was a statistically significant association between the status of methylation at ADAM12 and the presence of CLL (p=0.037).
CONCLUSION: The aberrant methylation of ADAM12 found in this study using MSP assay may provide new exposure to CLL that may improve the gaps involved in genetic epigenetic study in CLL.
Fulltext Generation and characterisation of human umbilical cord derived mesenchymal stem cells by explant method

Yusoff Z, Maqbool M, George E, Hassan R, Ramasamy R

Med J Malaysia, 2016 Jun;71(3):105-10.
PMID: 27495882 MyJurnal

Mesenchymal stem cells (MSCs) derived from human umbilical cord (UC) have been considered as an important tool for treating various malignancies, tissue repair and organ regeneration. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) are better alternative to MSCs that derived from bone marrow (BM-MSCs) as they are regarded as medical waste with little ethical concern for research and easily culture-expanded. In this present study, the foetal distal end of human UC was utilised to generate MSC by explant method. Upon in vitro culture, adherent cells with fibroblastic morphology were generated with rapid growth kinetics. Under the respective inductive conditions, these cells were capable of differentiating into adipocytes and osteocytes; express an array of standard MSC's surface markers CD29, CD73, CD90, CD106 and MHC-class I. Further assessment of immunosuppression activity revealed that MSCs generated from UC had profoundly inhibited the proliferation of mitogen-activated T lymphocytes in a dosedependent manner. The current laboratory findings have reinforced the application of explant method to generate UCMSCs thus, exploring an ideal platform to fulfil the increasing demand of MSCs for research and potential clinical use.
Type and Quantity of Shipborne Garbage at Selected Tropical Beaches

Mobilik JM, Ling TY, Husain ML, Hassan R

ScientificWorldJournal, 2016;2016:5126951.
PMID: 27819020

Marine debris is widely distributed at the coastal area of the global oceans; however, shipborne garbage source studies are still lacking to document the pollution in Malaysia Territorial Water. Thus, this study has adopted a standard method of beach marine debris survey at five beaches and inspected 115 vessels to assess the type and amount of debris from shipping source stranded on the beach. This study found that vessel visiting Malaysian ports observed the MARPOL 73/78 Annex V requirements; however, identified objects from shipping activity (1.3%; 2 items/km) found on the beaches indicate that there are vessels disposing of garbage illegally at sea. Therefore, there is a need to promote the use of biodegradable material and introduce environmental education to increase awareness on the vessel.
Fulltext Autophagic Degradation of Misfolded Nuclear Receptor Co-repressor (NCoR) Is Linked to the Growth of Tumor Cells in HBX Positive Hepatocellular Carcinoma (HCC)

Tan SY, Visvanathan S, Abu Hassan R, Khan M

Front Oncol, 2019;9:1335.
PMID: 31850220 DOI: 10.3389/fonc.2019.01335

Hepatitis B virus (HBV) is causally linked to hepatocellular injury and cell death, which are followed by hepatocellular carcinoma (HCC) after a long latent period. The HBV derived X protein (HBX) is the most potent carcinogenic factor for HCC, however, the molecular mechanism of HBX-induced transformation of hepatic cells in HCC is poorly understood. We have shown that nuclear receptor co-repressor (NCoR) is essential for the spatial repression of global transcription by the promyelocytic leukemia oncogenic domains (PODs), a frequent target of viral oncoproteins like HBX and that disintegration of PODs due to misfolded conformation dependent loss (MCDL) of NCoR is linked to promyelocytic and monocytic acute myeloid leukemia (AML). Given the key role of NCoR in cellular homeostasis across various tissue subtypes, we hypothesized that HBX-induced MCDL of NCoR might be linked to HCC through similar mechanism. Based on this hypothesis, the conformation of NCoR in HCC derived tumor cells and primary human tissue sections were analyzed and a selective MCDL of NCoR in HBX positive HCC cells was identified. HBX triggered the misfolding of NCoR through ubiquitination, followed by its degradation by autophagy, thus suggesting a cross talk between ubiquitin proteasome system (UPS) and autophagy lysosomal pathway (ALP) in MCDL of NCoR in HBX positive HCC cells. SiRNA-induced NCoR ablation selectively impaired the growth and survival of HBX positive HCC cells, suggesting a role of MCDL in the growth and survival of HBX positive HCC cells. These finding identify a possible crosstalk between UPS and ALP in the misfolding and loss of NCoR in HBX positive HCC cells and suggest a role of autophagic recycling of misfolded NCoR in the activation of oncogenic metabolic signaling in HCC. The misfolded NCoR reported in this study represents a novel conformation based molecular target which could be valuable in the design and development of tumor cell specific diagnostic and therapeutic approach for HBX positive HCC.
Tonsil Size and Mallampati Score as Clinical Predictive Factors for Obstructive Sleep Apnea Severity in Children

Zreaqat M, Hassan R, Samsudin AR, Stas Y, Hanoun A

J Contemp Dent Pract, 2021 Jul 01;22(7):850-853.
PMID: 34615793

AIM AND OBJECTIVE: The aim of this study was to determine the clinical utility of body mass index (BMI), tonsil size, and Mallampati scoring in predicting both the presence of and severity of pediatric obstructive sleep apnea (OSA).
MATERIALS AND METHODS: This prospective cross-sectional study comprised 78 growing children in the age range of 11-14 years with polysomnography (PSG)-proven OSA and 86 non-OSA corresponding controls. BMI, tonsil size (Friedman grading scale), and Mallampati score were determined for both groups, and related differences were assessed with a t-test, while their independent association with OSA severity was tested with a regression analysis. Statistical significance was set at p <0.05.
RESULTS: Male gender, BMI, tonsil size, and Mallampati score were significantly higher in the OSA group (p < 0.05). A significant correlation was recorded between the Mallampati score and OSA severity (p < 0.01), but not with BMI or tonsil size (p > 0.05). For every 1-point increase in the Mallampati scale, the apnea-hypopnea index (AHI) increased by more than five events per hour in the bivariate analysis and by more than three events per hour in the multivariate analysis.
CONCLUSION: Male gender, increased BMI, high tonsil, and Mallampati scores were clinical indicators of the presence of OSA. However, only Mallampati scale had a significant association with OSA severity. Clinical diagnostic indicators should be established and encouraged especially in community-based studies.
CLINICAL SIGNIFICANCE: Clinical diagnostic indicators are very useful in examining and screening children who are at risk of developing OSA as PSG is expensive and unsuitable for universal use in the pediatric population.
Proteomic analysis reveals brain Rab35 as a potential biomarker of mitragynine withdrawal in rats

Hassan R, Othman N, Mansor SM, Müller CP, Hassan Z

Brain Res Bull, 2021 07;172:139-150.
PMID: 33901587 DOI: 10.1016/j.brainresbull.2021.04.018

Mitragyna speciosa, also known as kratom, has been used for mitigating the severity of opioid withdrawal in humans. Its main indole alkaloid, mitragynine, has been considered as a pharmacotherapy for pain conditions and opioid replacement therapy. However, at high doses, chronic mitragynine may also have an addiction potential. The effects of chronic action of mitragynine in the brain are still unknown. The present study developed a mitragynine withdrawal model in rats and used it for a proteomic analysis of mitragynine withdrawal effects. Mitragynine (30 mg/kg, i.p.) was administered daily over a period of 14 days and then withdrawn. A proteomic analysis revealed that from a total of 1524 proteins identified, 31 proteins were upregulated, and 3 proteins were downregulated in the mitragynine withdrawal model. The Rab35 protein expression increased most profoundly in the mitragynine withdrawal group as compared to vehicle group. Therefore, it is proposed that Rab35 in the brain might be considered as a potential biomarker during mitragynine withdrawal and might be valuable target protein in developing new pharmacotherapies in the future.
Single dose of atezolizumab plus chemotherapy in active psoriasis with advanced non-small cell lung cancer

Wong PY, How SH, Ismail I, Hassan R

J Oncol Pharm Pract, 2022 Mar;28(2):471-474.
PMID: 34565238 DOI: 10.1177/10781552211038899

INTRODUCTION: Immunotherapy has been recognized as the standard of care in addition to chemotherapy in the treatment of advanced non-small cell lung cancer. Most immunotherapy trials, however, exclude patients with autoimmune disease owing to concerns of disease exacerbation.
CASE REPORT: We report a case of a patient with advanced non-small cell lung cancer and underlying active psoriasis who experienced a remarkable response, without developing psoriasis flares, following treatment with a single dose of atezolizumab and first-line chemotherapy.
MANAGEMENT AND OUTCOME: The patient remained asymptomatic 10 months since treatment discontinuation, without disease progression, despite having received only a single dose of atezolizumab and six cycles of chemotherapy.
DISCUSSION: Little is known about the optimum duration required to achieve a durable response with immunotherapy. Patients with autoimmune disease are commonly excluded from immunotherapy trials owing to a higher risk of autoimmune disease flares or immune-related adverse events. The remarkable outcome observed in this case offers some insights into the possible durable response with limited doses of immunotherapy and a safer approach for administering immunotherapy in patients with autoimmune disease. Initiating chemotherapy to induce remission in active autoimmune disease prior to administering immunotherapy could potentially be an ideal approach that facilitates the use of immunotherapy in this patient population.
Fulltext Limited doses of immunotherapy use in advanced non-small cell lung cancer elderly patients with ECOG of 2 and high PDL-1 expression

Wong PY, How SH, Hassan R, Abdul Azih MN

Aging Med (Milton), 2021 Dec;4(4):345-349.
PMID: 34964016 DOI: 10.1002/agm2.12179

Immunotherapy is an effective treatment in advanced non-small cell lung cancer (NSCLC) patients with high PDL-1 expression. Here, we report three such patients with durable response despite limited doses immunotherapy.
Efficacy of Oxy-Ionic Solutions With Varying pH Levels Against Streptococcus mutans In Vitro

Ming X, Hassan R, Mohamad S, Shahidan WNS

Cureus, 2024 May;16(5):e61025.
PMID: 38800772 DOI: 10.7759/cureus.61025

Background Chlorhexidine (CHX) is a widely used antimicrobial agent known for its ability to inhibit cariogenic bacteria, reduce plaque formation, neutralize acidity, and promote remineralization. However, the effectiveness of oxy-ionic solutions at different pH levels as an alternative antimicrobial treatment requires further exploration. This study aims to compare the antimicrobial effects of oxy-ionic solutions at various pH levels with those of CHX and fluoride. Methodology This study employed disc diffusion tests to measure the inhibition zone diameters of each solution and broth dilution assays to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Results The oxy-ionic solutions exhibited varying degrees of antimicrobial effectiveness depending on their pH levels. The solution at pH 5 demonstrated the best antimicrobial performance among the oxy-ionic solutions, with inhibition zones comparable to those of CHX. The MIC and MBC values indicated that oxy-ionic solutions in mildly acidic environments generally resulted in better antimicrobial activity. Conclusions The study concludes that while CHX remains highly effective against cariogenic bacteria, oxy-ionic solutions, particularly at pH 5, offer a promising alternative. The antimicrobial efficacy of oxy-ionic solutions is influenced by their pH levels. Further research is recommended to explore the long-term effects and clinical applications of oxy-ionic solutions in maintaining oral health and preventing disease.
Fulltext A Review on Current Trends of Polymers in Orthodontics: BPA-Free and Smart Materials

Hassan R, Aslam Khan MU, Abdullah AM, Abd Razak SI

Polymers (Basel), 2021 Apr 27;13(9).
PMID: 33925332 DOI: 10.3390/polym13091409

Polymeric materials have always established an edge over other classes of materials due to their potential applications in various fields of biomedical engineering. Orthodontics is an emerging field in which polymers have attracted the enormous attention of researchers. In particular, thermoplastic materials have a great future utility in orthodontics, both as aligners and as retainer appliances. In recent years, the use of polycarbonate brackets and base monomers bisphenol A glycerolate dimethacrylate (bis-GMA) has been associated with the potential release of bisphenol A (BPA) in the oral environment. BPA is a toxic compound that acts as an endocrine disruptor that can affect human health. Therefore, there is a continuous search for non-BPA materials with satisfactory mechanical properties and an esthetic appearance as an alternative to polycarbonate brackets and conventional bis-GMA compounds. This study aims to review the recent developments of BPA-free monomers in the application of resin dental composites and adhesives. The most promising polymeric smart materials are also discussed for their relevance to future orthodontic applications.
Fulltext The transition towards circular economy and waste within accounting and accountability models: a systematic literature review and conceptual framework

Di Vaio A, Hasan S, Palladino R, Hassan R

Environ Dev Sustain, 2023;25(1):734-810.
PMID: 35035274 DOI: 10.1007/s10668-021-02078-5

A transition towards a circular economy is a challenge. It is vital to know that circularity and sustainability are two different segments. So, circular economy can only be achieved in the long-term perspective. This study investigates accounting and accountability for circular economy and waste. Considering these principles and based on a critical review of the literature, economic gains from the transition toward a circular economy are measurable; the problems for corporations and governments are diverse; the way to handle the stakeholders who are losing control in the circular economy is considerable. Diffusion of innovation theory is used to conduct this study. It is essential that an organisational design built should help implement the circular model. Targeted questions responded by adopting a systematic literature review approach by applying PRISMA protocol. This study examines 78 publications in English between 2012 and 2021, which present a map of the circular economy-related knowledge published in web of science and Scopus. Besides, this study includes 03 European Commission reports, 01 Ellen Macarthur Foundation report, 01 Council for the Environment and Infrastructure report, 01 report from SUN IZA, 01 UN Global Compact and 01 the Brundtland Commission report. The results highlight how circular economy, waste management, sustainability, accountability, and management accounting practices help to develop an ecosystem and achieve sustainable development goals of the United Nations 2030 Agenda. Theoretical and practical implications are discussed.
Effects of rapid maxillary expansion on upper airway parameters in OSA children with maxillary restriction: A CBCT study

Zreaqat M, Hassan R, Alforaidi S, Kassim NK

Pediatr Pulmonol, 2024 Oct;59(10):2490-2498.
PMID: 38771201 DOI: 10.1002/ppul.27050

BACKGROUND: Rapid maxillary expansion (RME) has been proposed as an effective treatment for pediatric obstructive sleep apnea (OSA) and maxillary restriction in children. This study aimed to evaluate the effect of RME appliances on the nasomaxillary complex dimensions in children with OSA and maxillary constriction.
METHODS: This prospective longitudinal study included 34 children aged 8-12 years with maxillary restriction and OSA confirmed by polysomnography who had completed RME therapy. The nasomaxillary complex is segmented into the nasal cavity, maxillary sinuses, and nasopharynx. The effect of RME on nasomaxillary complex dimensions was assessed pre and posttreatment using cone-beam computed tomography, analysis, while a second standard overnight polysomnography (PSG) was performed to assess changes in respiratory parameters.
RESULTS: Significant improvements were observed, including inferior maxillary dislocation (S-S1 distance and N-ANS), increased anterior and posterior facial height, and a 5.43 events/h reduction in Apnea-Hypopnea Index (p
Effects of twin-block appliance on upper airway parameters in OSA children with class II malocclusion and mandibular retrognathia: a CBCT study

Zreaqat M, Hassan R, Samsudin AR, Alforaidi S

Eur J Pediatr, 2023 Dec;182(12):5501-5510.
PMID: 37777602 DOI: 10.1007/s00431-023-05226-3

Twin-block appliance had been advocated as a potential treatment option in paediatric obstructive sleep apnoea (OSA) due to their favourable effect in enhancing upper airway parameters and improving OSA symptoms. The aim of this study was to evaluate the effect of twin-block appliance therapy on upper airway parameters/dimensions and the apnoea-hypopnea indexes (AHIs) in OSA children with class II mandibular retrognathic skeletal malocclusion using cone-beam computed tomography. This prospective longitudinal study comprised 34 polysomnography-proven OSA growing children with class II mandibular retrognathic skeletal malocclusion between the ages of 8 and 12 years who had completed myofunctional twin-block therapy and matched corresponding controls. The upper airway was segmented into the nasopharynx, oropharynx, and hypopharynx, and the effect of twin-bock treatment on upper airway parameters/dimensions was assessed pre- and posttreatment using CBCT analysis, while a second standard overnight PSG was performed to determine changes in the AHI. At the nasopharynx level, minimal (nonsignificant) increases in all variables were observed within the twin-block group and between the groups (P > 0.05). At the level of the oropharynx, all variables increased significantly in the treatment group and between groups (P
Fulltext The implementation of teleneurosurgery in the management of referrals to a neurosurgical department in hospital sultanah amninah johor bahru

Hassan R, Siregar JA, A Rahman Mohd NA

Malays J Med Sci, 2014 Mar;21(2):54-62.
PMID: 24876808 MyJurnal

Telemedicine in neurosurgery or teleneurosurgery has been widely used for transmission of clinical data and images throughout the country since its implementation in 2006. The impact is a reduction of patient number that need to be reviewed in the level III hospitals and an increment in the number of patients that are kept in level II hospitals for observation by the primary team. This translates to reduction of unnecessary transfer of patients and subsequently cost benefits for patients and medical providers. The main aim is to determine the amount of reduction in unnecessary transfer by the implementation of teleneurosurgery in the management of referrals to neurosurgical department in Hospital Sultanah Amninah Johor Bahru (HSAJB). Other factors associated with transfer decision are also evaluated.

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