MyMedR

Ultrasonographic Measurements of the Liver, Gallbladder Wall Thickness, Inferior Vena Cava, Portal Vein and Pancreas in an Urban Region, Malaysia

Khammas ASA, Mahmud R

J Med Ultrasound, 2020 10 01;29(1):26-31.

PMID: 34084713 DOI: 10.4103/JMU.JMU_53_20

Background: Ultrasonographic (USG) measurements of the liver length, gallbladder wall thickness (GBWT), diameters of the inferior vena cava (IVC), portal vein (PV), and pancreas are valuable and reliable in diagnosis hepatobiliary and pancreas conditions. This study is aimed to determine the normal values of liver length, GBWT, AP diameters of the IVC and PV, AP diameter of the head and body of the pancreas.

Methods: A prospective cross-sectional study was carried out in this study. A total of the 408 participants were randomly recruited using a systematic method. According to the USG reports, the subjects who had normal USG report for liver, biliary system, and pancreas were described as normals, whereas the subjects who had hepatobiliary diseases such as fatty liver, liver cysts, hemangioma, cirrhosis, gallbladder wall thickening, acute cholecystitis, gallstones, and polyps were recorded as abnormal subjects.

Results: Of the 408 participants with a mean of 52.6 ± 8.4 years old. Of those, 294 (72.1%) participants were normal and 114 (27.9%) subjects were reported as abnormal. More than half of the study population was males, 52.9% versus 47.1% of females. There was a significant difference of liver length, head, and body of the pancreas between genders (P = 0.004, 0.002, and P < 0.001, respectively). Moreover, the pancreatic body only was significantly correlated with age (P = 0.026). There also was a significant difference of the liver length, head, and body of the pancreas between normal and abnormal subjects (P < 0.001, P = 0.007, and P < 0.001).

Conclusion: Liver length, diameter of the head, and body of the pancreas were significantly associated with gender and hepatobiliary diseases. In addition, only the diameter of the body of the pancreas was significantly correlated with age.

Fulltext Safety assessments of subcutaneous doses of aragonite calcium carbonate nanocrystals in rats

Jaji AZ, Zakaria ZAB, Mahmud R, Loqman MY, Hezmee MNM, Abba Y, et al.

J Nanopart Res, 2017;19(5):175.

PMID: 28553160 DOI: 10.1007/s11051-017-3849-z

Calcium carbonate nanoparticles have shown promising potentials in the delivery of drugs and metabolites. There is however, a paucity of information on the safety of their intentional or accidental over exposures to biological systems and general health safety. To this end, this study aims at documenting information on the safety of subcutaneous doses of biogenic nanocrystals of aragonite polymorph of calcium carbonate derived from cockle shells (ANC) in Sprague-Dawley (SD) rats. ANC was synthesized using the top-down method, characterized using the transmission electron microscopy and field emission scanning electron microscope and its acute and repeated dose 28-day trial toxicities were evaluated in SD rats. The results showed that the homogenous 30 ± 5 nm-sized spherical pure aragonite nanocrystals were not associated with mortality in the rats. Severe clinical signs and gross and histopathological lesions, indicating organ toxicities, were recorded in the acute toxicity (29,500 mg/m2) group and the high dose (5900 mg/m2) group of the repeated dose 28-day trial. However, the medium- (590 mg/m2 body weight) and low (59 mg/m2)-dose groups showed moderate to mild lesions. The relatively mild lesions observed in the low toxicity dosage group marked the safety margin of ANC in SD rats. It was concluded from this study that the toxicity of CaCO3 was dependent on the particulate size (30 ± 5 nm) and concentration and the route of administration used.

Fulltext Occurrence of blastocystis in water of two rivers from recreational areas in malaysia

Ithoi I, Jali A, Mak JW, Wan Sulaiman WY, Mahmud R

J Parasitol Res, 2011;2011:123916.

PMID: 21772980 DOI: 10.1155/2011/123916

This study reports the occurrence of Blastocystis in water from two rivers, Sungai Congkak and Sungai Batu, located in recreational areas in Malaysia. This protozoan was detected in samples from both rivers with an average of 33.3% and 22.1%, respectively. It was detected highest at the downstream (73.8% and 33.8%) followed by midstream (17.5% and 25.0%) and upstream (8.8% and 7.5%) stations, with additionally higher detection during holidays (with average 47.5% and 30.8%) than week days (with average 19.2% and 13.3%), in both rivers, respectively. There was a strong association with the daily activities of locals and visitors, who came for water recreational activities, mainly located between midstream and downstream and was observed to be higher at Sungai Congkak. The detection of Blastocystis in these rivers' water implies that this protozoan could potentially be transmitted to humans by the waterborne route. Pearson correlation analysis showed that their occurrence was significantly correlated with faecal coliforms count; inconsistent correlation with dissolved oxygen, temperature and turbidity and no correlation with pH, conductivity and rainfall for both rivers. The correlation of coliforms and Blastocystis suggests the source of the Blastocystis in the water body is likely to be faecal.

Chemical composition, antioxidant and cytotoxicity activities of the essential oils of Myristica fragrans and Morinda citrifolia

Piaru SP, Mahmud R, Abdul Majid AM, Ismail S, Man CN

J Sci Food Agric, 2012 Feb;92(3):593-7.

PMID: 25520982

In this study the chemical composition, antioxidant activities and cytotoxic effect of the essential oils of Myristica fragrans (nutmeg) and Morinda citrifolia (mengkudu) were determined.

Fulltext A randomised controlled trial on hypolipidemic effects of Nigella Sativa seeds powder in menopausal women

Ibrahim RM, Hamdan NS, Mahmud R, Imam MU, Saini SM, Rashid SN, et al.

J Transl Med, 2014;12:82.

PMID: 24685020 DOI: 10.1186/1479-5876-12-82

The risk of cardiovascular diseases (CVD) is increased tremendously among menopausal women, and there is an increasing demand for alternative therapies for managing factors like dyslipidemia that contribute to CVD development.

Sonographic and clinical effects of manual physical therapy for plantar fasciitis: randomized prospective controlled trial

Khammas ASA, Mahmud R, Hassan HA, Ibrahim I, Mohammed SS

J Ultrasound, 2023 Nov 02.

PMID: 37917407 DOI: 10.1007/s40477-023-00833-0

OBJECTIVE: This study aimed to evaluate the efficacy of manual physiotherapy on clinical outcomes, morphology of plantar fascia (PF), thicknesses of calcaneal fat pad (CFP) and Kager's fat pad (KFP) with ultrasound imaging in plantar fasciitis (PFS) patients. Also, to evaluate the PF thickness, pain and foot functional outcomes among PFS phases.

METHODS: A randomized controlled trial was conducted on 122 subjects divided into three groups: group A (40 patients with PFS) underwent manual physiotherapy, group B (42 patients with PFS) without any intervention and group C (40 healthy subjects) were matched by age, gender and BMI with each patient in group A and B. The following outcomes were evaluated at baseline and one-month of follow-ups: morphology of PF and thicknesses of CFP and KFP, pain, foot functional limitation.

RESULTS: PF thickness was significantly thickened in group A and B compared to group C (P

Fulltext An assessment of plantar fascia with ultrasound findings in patients with plantar fasciitis: a systematic review

Khammas ASA, Mahmud R, Hassan HA, Ibrahim I, Mohammed SS

J Ultrasound, 2023 Mar;26(1):13-38.

PMID: 36040577 DOI: 10.1007/s40477-022-00712-0

INTRODUCTION: Plantar fasciitis (PFS) is described by an intense pain over medial tubercle of calcaneus, increased with the first step after waking up, after rest and during weightbearing activity. It is the most common cause of plantar heel pain in adults with the prevalence estimated 10% of the general population. Ultrasound imaging is commonly being used to measure the PF thickness, evaluate the efficacy of different treatments and a guide therapeutic technique in patients with PFS. The objective of this study was to systematically review the studies that were previously published to evaluate the role of ultrasound in the assessment of PF in patients with PFS.

METHODS: A systematic search was carried out over the last 5 years from 2017 to 2022 on basis the following electronic databases: Science Direct, Scopus, Web of Science, Springer and PubMed. The keywords that used in the searching were: ultrasound, sonography, ultrasonography, plantar fasciitis, imaging of plantar fascia, physiotherapy of plantar fasciitis, interventional treatment of plantar fasciitis, randomized controlled trial of plantar fasciitis and interventional ultrasound. The review focused on the assessment of PF in patients with PFS underwent different interventions using B-mode, shear wave elastography (SWE) and color Doppler ultrasound.

RESULTS: During the search process, 1661 were recorded using the proper keywords from 2017 to 2022 in which 666 original articles were found after removing the review and duplicated articles. Of these, thirty articles met the inclusion criteria and included in this review. The articles have assessed the PF in patients with PFS under different conditions using different ultrasound modes. Twenty-six articles evaluated the effectiveness of different treatment on PF in patients with PFS using different ultrasound modes. In 8 of 26 articles, the ultrasound was used as both an assessment tool of PF and guide therapeutic technique in patients with PFS. In 18 articles, the ultrasound was used as only assessment tool to identify the PF thickness and its observation changes in patients with PFS. Four articles compared the PF thickness and its intrafascial changes between patients with PFS and healthy subjects.

CONCLUSION: The ultrasound can be a reliable tool in assessment the effect of different interventions on PF by evaluating its thickness, echogenicity and stiffness changes in patients with PFS. There were different methods and treatments were used among the studies.

Fulltext Polycythaemia Vera JAK 2 Mutation in a Patient with Underlying Chronic Obstructive Pulmonary Disease at a Primary Care Setting

Mahmud R, Ariffin F, Shanmuganathan P

Korean J Fam Med, 2020 Jul;41(4):263-266.

PMID: 32512984 DOI: 10.4082/kjfm.18.0161

The presence of erythrocytosis along with the diagnosis of chronic obstructive pulmonary disease (COPD) may veer a primary care clinician in a busy clinic towards attributing the erythrocytosis to hypoxia secondary to COPD; however, this is not always the case. This case highlights the importance of investigation and the significance not excluding a primary cause in COPD patients with erythrocytosis. A 57-year-old male, presenting with chronic cough, was subsequently diagnosed with COPD clinically and confirmed by spirometry. Erythrocytosis was also incidentally noted. The patient did not have any symptoms of polycythemia or hepatosplenomegaly. Therefore, the erythrocytosis was initially thought to be caused by hypoxia secondary to COPD. However, the JAK2 V617F gene mutation was detected and hence the diagnosis of polycythemia vera was made. Although the erythrocytosis was initially attributed secondary to the underlying pulmonary disease, investigations proved it to be primary in origin. This case report highlights the importance of investigating the underlying cause and to confirm the diagnosis of erythrocytosis as primary and secondary polycythemia differ in their management approach. This will avoid inappropriate diagnosis, treatment, and undesirable outcomes.

Fulltext Diagnosis of an imported Plasmodium ovale wallikeri infection in Malaysia

Liew JW, Mahmud R, Tan LH, Lau YL

Malar J, 2016;15:8.

PMID: 26738724 DOI: 10.1186/s12936-015-1070-z

Plasmodium ovale is rare and not exactly known to be autochthonous in Malaysia. There are two distinct forms of the parasite, namely P. ovale curtisi (classic form) and P. ovale wallikeri (variant form). Here, the first sequence confirmed case of an imported P. ovale wallikeri infection in Malaysia is presented. Microscopy found Plasmodium parasites with morphology similar to P. ovale or Plasmodium vivax in the blood films. Further confirmation using polymerase chain reaction (PCR) targeting the small-subunit rRNA gene of the parasite was unsuccessful. Genus-specific PCR was then performed and the product was sequenced and analysed. Sequence analyses confirmed the aetiological agent as P. ovale wallikeri. New species-specific primers (rOVA1v and rOVA2v) were employed and P. ovale wallikeri was finally confirmed. The findings highlight the need to look out for imported malaria infections in Malaysia and the importance of a constantly updated and validated diagnostic technique.

Fulltext High proportion of knowlesi malaria in recent malaria cases in Malaysia

Yusof R, Lau YL, Mahmud R, Fong MY, Jelip J, Ngian HU, et al.

Malar J, 2014;13:168.

PMID: 24886266 DOI: 10.1186/1475-2875-13-168

Plasmodium knowlesi is a simian parasite that has been recognized as the fifth species causing human malaria. Naturally-acquired P. knowlesi infection is widespread among human populations in Southeast Asia. The aim of this epidemiological study was to determine the incidence and distribution of malaria parasites, with a particular focus on human P. knowlesi infection in Malaysia.

Fulltext Immunogenicity of bacterial-expressed recombinant Plasmodium knowlesi merozoite surface protein-142 (MSP-142)

Cheong FW, Fong MY, Lau YL, Mahmud R

Malar J, 2013;12:454.

PMID: 24354660 DOI: 10.1186/1475-2875-12-454

Plasmodium knowlesi is the fifth Plasmodium species that can infect humans. The Plasmodium merozoite surface protein-1(42) (MSP-1(42)) is a potential candidate for malaria vaccine. However, limited studies have focused on P. knowlesi MSP-1(42).

Fulltext Malaysian child infected with Plasmodium vivax via blood transfusion: a case report

Anthony CN, Lau YL, Sum JS, Fong MY, Ariffin H, Zaw WL, et al.

Malar J, 2013;12:308.

PMID: 24007496 DOI: 10.1186/1475-2875-12-308

Malaria may be a serious complication of blood transfusion due to the asymptomatic persistence of parasites in some donors. This case report highlights the transfusion-transmitted malaria of Plasmodium vivax in a child diagnosed with germ cell tumour. This child had received blood transfusion from three donors and a week later started developing malaria like symptoms. Nested PCR and sequencing confirmed that one of the three donors was infected with P. vivax and this was transmitted to the 12-year-old child. To the best of the authors' knowledge, this is the first reported transfusion-transmitted malaria case in Malaysia.

Fulltext Acute respiratory distress syndrome and acute renal failure from Plasmodium ovale infection with fatal outcome

Lau YL, Lee WC, Tan LH, Kamarulzaman A, Syed Omar SF, Fong MY, et al.

Malar J, 2013;12:389.

PMID: 24180319 DOI: 10.1186/1475-2875-12-389

Plasmodium ovale is one of the causative agents of human malaria. Plasmodium ovale infection has long been thought to be non-fatal. Due to its lower morbidity, P. ovale receives little attention in malaria research.

Fulltext Cloning, expression, and immunocharacterization of surface protein containing an altered thrombospondin repeat domain (SPATR) from Plasmodium knowlesi

Palaeya V, Lau YL, Mahmud R, Chen Y, Fong MY

Malar J, 2013;12:182.

PMID: 23734702 DOI: 10.1186/1475-2875-12-182

Plasmodium knowlesi is the fifth species identified to cause malaria in humans and is often misdiagnosed as Plasmodium malariae due to morphological similarities. The development of an inexpensive, serological detection method utilizing antibodies specific to P. knowlesi would be a valuable tool for diagnosis. However, the identification of specific antigens for these parasites remains a major challenge for generating such assays. In this study, surface protein containing an altered thrombospondin repeat domain (SPATR) was selected as a potentially specific antigen from P. knowlesi. Its multistage expression by sporozoites, asexual erythrocytic forms and gametocytes, along with its possible role in liver cell invasion, suggests that SPATR could be used as a biomarker for diagnosis of P. knowlesi.

Fulltext Hyperparasitaemic human Plasmodium knowlesi infection with atypical morphology in peninsular Malaysia

Lee WC, Chin PW, Lau YL, Chin LC, Fong MY, Yap CJ, et al.

Malar J, 2013;12:88.

PMID: 23496970 DOI: 10.1186/1475-2875-12-88

Plasmodium knowlesi is a potentially life-threatening zoonotic malaria parasite due to its relatively short erythrocytic cycle. Microscopic identification of P. knowlesi is difficult, with "compacted parasite cytoplasm" being one of the important identifying keys. This report is about a case of hyperparasitaemic human P. knowlesi infection (27% parasitaemia) with atypical amoeboid morphology. A peninsular Malaysian was admitted to the hospital with malaria. He suffered anaemia and acute kidney function impairment. Microscopic examination, assisted by nested PCR and sequencing confirmed as P. knowlesi infection. With anti-malarial treatment and several medical interventions, patient survived and recovered. One-month medical follow-up was performed after recovery and no recrudescence was noted. This case report highlights the extreme hyperparasitaemic setting, the atypical morphology of P. knowlesi in the patient's erythrocytes, as well as the medical interventions involved in this successfully treated case.

Fulltext Specific, sensitive and rapid detection of human plasmodium knowlesi infection by loop-mediated isothermal amplification (LAMP) in blood samples

Lau YL, Fong MY, Mahmud R, Chang PY, Palaeya V, Cheong FW, et al.

Malar J, 2011;10:197.

PMID: 21774805 DOI: 10.1186/1475-2875-10-197

The emergence of Plasmodium knowlesi in humans, which is in many cases misdiagnosed by microscopy as Plasmodium malariae due to the morphological similarity has contributed to the needs of detection and differentiation of malaria parasites. At present, nested PCR targeted on Plasmodium ssrRNA genes has been described as the most sensitive and specific method for Plasmodium detection. However, this method is costly and requires trained personnel for its implementation. Loop-mediated isothermal amplification (LAMP), a novel nucleic acid amplification method was developed for the clinical detection of P. knowlesi. The sensitivity and specificity of LAMP was evaluated in comparison to the results obtained via microscopic examination and nested PCR.

Fulltext Plasmodium ovale infection in Malaysia: first imported case

Lim YA, Mahmud R, Chew CH, T T, Chua KH

Malar J, 2010;9:272.

PMID: 20929588 DOI: 10.1186/1475-2875-9-272

BACKGROUND:
Plasmodium ovale infection is rarely reported in Malaysia. This is the first imported case of P. ovale infection in Malaysia which was initially misdiagnosed as Plasmodium vivax.

METHODS:
Peripheral blood sample was first examined by Giemsa-stained microscopy examination and further confirmed using a patented in-house multiplex PCR followed by sequencing.

RESULTS AND DISCUSSION:
Initial results from peripheral blood smear examination diagnosed P. vivax infection. However further analysis using a patented in-house multiplex PCR followed by sequencing confirmed the presence of P. ovale. Given that Anopheles maculatus and Anopheles dirus, vectors of P. ovale are found in Malaysia, this finding has significant implication on Malaysia's public health sector.

CONCLUSIONS:
The current finding should serve as an alert to epidemiologists, clinicians and laboratory technicians in the possibility of finding P. ovale in Malaysia. P. ovale should be considered in the differential diagnosis of imported malaria cases in Malaysia due to the exponential increase in the number of visitors from P. ovale endemic regions and the long latent period of P. ovale. It is also timely that conventional diagnosis of malaria via microscopy should be coupled with more advanced molecular tools for effective diagnosis.

Fulltext Opportunities and obstacles to the elimination of malaria from Peninsular Malaysia: knowledge, attitudes and practices on malaria among aboriginal and rural communities

Al-Adhroey AH, Nor ZM, Al-Mekhlafi HM, Mahmud R

Malar J, 2010;9:137.

PMID: 20497543 DOI: 10.1186/1475-2875-9-137

Despite continuous efforts by the government and private sectors, malaria is still a public health problem in rural Peninsular Malaysia. This study investigated household knowledge, attitude and practices (KAP) regarding malaria in two malaria endemic communities, forest-aboriginal and rural communities, in the Lipis district of Pahang state, Malaysia.

Fulltext Field evaluation of a PfHRP-2/pLDH rapid diagnostic test and light microscopy for diagnosis and screening of falciparum malaria during the peak seasonal transmission in an endemic area in Yemen

Alareqi LM, Mahdy MA, Lau YL, Fong MY, Abdul-Ghani R, Ali AA, et al.

Malar J, 2016 Jan 28;15:49.

PMID: 26821911 DOI: 10.1186/s12936-016-1103-2

Malaria is a public health threat in Yemen, with 149,451 cases being reported in 2013. Of these, Plasmodium falciparum represents 99%. Prompt diagnosis by light microscopy (LM) and rapid diagnostic tests (RTDs) is a key element in the national strategy of malaria control. The heterogeneous epidemiology of malaria in the country necessitates the field evaluation of the current diagnostic strategies, especially RDTs. Thus, the present study aimed to evaluate LM and an RDT, combining both P. falciparum histidine-rich protein-2 (PfHRP-2) and Plasmodium lactate dehydrogenase (pLDH), for falciparum malaria diagnosis and survey in a malaria-endemic area during the transmission season against nested polymerase chain reaction (PCR) as the reference method.

Brain white and gray matter anatomy of MRI segmentation based on tissue evaluation

Salih QA, Ramli AR, Mahmud R, Wirza R

MedGenMed, 2005;7(2):1.

PMID: 16369380

Different approaches to gray and white matter measurements in magnetic resonance imaging (MRI) have been studied. For clinical use, the estimated values must be reliable and accurate when, unfortunately, many techniques fail on these criteria in an unrestricted clinical environment. A recent method for tissue clusterization in MRI analysis has the advantage of great simplicity, and it takes the account of partial volume effects. In this study, we will evaluate the intensity of MR sequences known as T1-weighted images in an axial sliced section. Intensity group clustering algorithms are proposed to achieve further diagnosis for brain MRI, which has been hardly studied. Subjective study has been suggested to evaluate the clustering group intensity in order to obtain the best diagnosis as well as better detection for the suspected cases. This technique makes use of image tissue biases of intensity value pixels to provide 2 regions of interest as techniques. Moreover, the original mathematic solution could still be used with a specific set of modern sequences. There are many advantages to generalize the solution, which give far more scope for application and greater accuracy.

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