Displaying publications 61 - 80 of 151 in total

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  1. Ai CJ, Jabar NA, Lan TH, Ramli R
    J Clin Imaging Sci, 2017;7:28.
    PMID: 28781925 DOI: 10.4103/jcis.JCIS_28_17
    Enlargement of the mandibular canal is a rare radiological finding. Clinically, it may or may not be associated with sensory deficits. We report four cases of widening of the mandibular canal observed with various methods of imaging with different clinical characteristics. We describe this unique radiological finding and elaborate the importance of quality assessment of the imaging that is vital for accurate diagnosis and treatment planning. Clinicians should be mindful when assessing the imaging whenever the size of the mandibular canal is implicated. The case ranged from a benign tumor to malignancy, radiological errors, and artifacts. A more superior imaging or treatment modality was necessary to ascertain the diagnosis.
  2. Abdul Razak N, Nordin R, Abd Rahman N, Ramli R
    Dent Traumatol, 2017 Oct;33(5):400-405.
    PMID: 28649703 DOI: 10.1111/edt.12355
    BACKGROUND/AIMS: The association between facial injury characteristics and mild traumatic brain injury (mTBI) is unclear. The aim of this study was to determine the association between facial injury characteristics and mTBI.

    METHODS: A retrospective review utilizing patients' medical records at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia, was performed. Records of subjects with a history of facial trauma from 1 April 2012 to 31 December 2012 were selected. Various levels and surgical speciality records were reviewed to ascertain the diagnoses of facial injuries and mTBI.

    RESULTS: A total of 348 medical records with the diagnosis of facial injuries were included. The prevalence of mTBI among these patients was 41.4% (95% CI 36.2-46.6). The majority of the patients with mTBI were in the age group of 18-25 years old. Patients with or without facial lacerations that were located on the lower face had a significant association with mTBI, P=.001, compared to other types of soft tissue injury. In addition, a statistically significant association was observed between facial fractures occurring to the middle face and mTBI, P=.018. Pearson chi-square test also showed statistically significant association between the severity of facial injuries and mTBI, P=.018.

    CONCLUSIONS: Mild traumatic brain injury should be suspected in patients with facial injuries and particularly those with lower face lacerations, midface fractures, moderate to severe facial injury and presence of multiple injuries.

  3. Zakaria N, Ramli R
    Neuropsychiatr Dis Treat, 2018;14:117-128.
    PMID: 29343963 DOI: 10.2147/NDT.S115261
    Background: Psychiatric patients have privacy concerns when it comes to technology intervention in the hospital setting. In this paper, we present scenarios for psychiatric behavioral monitoring systems to be placed in psychiatric wards to understand patients' perception regarding privacy. Psychiatric behavioral monitoring refers to systems that are deemed useful in measuring clinical outcomes, but little research has been done on how these systems will impact patients' privacy.

    Methods: We conducted a case study in one teaching hospital in Malaysia. We investigated the physical factors that influence patients' perceived privacy with respect to a psychiatric monitoring system. The eight physical factors identified from the information system development privacy model, a comprehensive model for designing a privacy-sensitive information system, were adapted in this research. Scenario-based interviews were conducted with 25 patients in a psychiatric ward for 3 months.

    Results: Psychiatric patients were able to share how physical factors influence their perception of privacy. Results show how patients responded to each of these dimensions in the context of a psychiatric behavioral monitoring system.

    Conclusion: Some subfactors under physical privacy are modified to reflect the data obtained in the interviews. We were able to capture the different physical factors that influence patient privacy.

  4. Osman AF, M Fitri TF, Rakibuddin M, Hashim F, Tuan Johari SAT, Ananthakrishnan R, et al.
    Mater Sci Eng C Mater Biol Appl, 2017 May 01;74:194-206.
    PMID: 28254285 DOI: 10.1016/j.msec.2016.11.137
    Polymer-clay based nanocomposites are among the attractive materials to be applied for various applications, including biomedical. The incorporation of the nano sized clay (nanoclay) into polymer matrices can result in their remarkable improvement in mechanical, thermal and barrier properties as long as the nanofillers are well exfoliated and dispersed throughout the matrix. In this work, exfoliation strategy through pre-dispersing process of the organically modified montmorillonite (organo-MMT) nanofiller was done to obtain ethyl vinyl acetate (EVA) nanocomposite with improved flexibility, toughness, thermal stability and biostability. Our results indicated that the degree of organo-MMT exfoliation affects its cytotoxicity level and the properties of the resulting EVA nanocomposite. The pre-dispersed organo-MMT by ultrasonication in water possesses higher degree of exfoliation as compared to its origin condition and significantly performed reduced cytotoxicity level. Beneficially, this nanofiller also enhanced the EVA flexibility, thermal stability and biostability upon the in vitro exposure. We postulated that these were due to plasticizing effect and enhanced EVA-nanofiller interactions contributing to more stable chemical bonds in the main copolymer chains. Improvement in copolymer flexibility is beneficial for close contact with human soft tissue, while enhancement in toughness and biostability is crucial to extend its life expectancy as insulation material for implantable device.
  5. Makmor-Bakry M, Ahmat A, Shamsuddin A, Lau CL, Ramli R
    Anaesthesiol Intensive Ther, 2019;51(3):218-223.
    PMID: 31434472 DOI: 10.5114/ait.2019.87362
    BACKGROUND: Failure of antibiotic treatment increases mortality of critically ill patients. This study investigated the association between the treatment resolution of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and vancomycin pharmacokinetic variables.

    METHODS: A total of 28 critically ill patients were included in this study. All data were collected from medical, microbiology and pharmacokinetic records. The clinical response was evaluated on the basis of clinical and microbiological parameters. The 24-h area under the curve (AUC0-24) was estimated from a single trough level using established equations.

    RESULTS: Out of the 28 patients, 46% were classified as responders to vancomycin treatment. The trough vancomycin concentration did not differ between the responders and non-responders (15.02 ± 6.16 and 14.83 ± 4.80 μg mL-1; P = 0.929). High vancomycin minimum inhibitory concentration (MIC) was observed among the non-responders (P = 0.007). The ratio between vancomycin trough concentration and vancomycin MIC was significantly lower in the non-responder group (8.76 ± 3.43 vs. 12.29 ± 4.85 μg mL-1; P = 0.034). The mean ratio of estimated AUC0-24 and vancomycin MIC was 313.78 ± 117.17 μg h mL-1 in the non-responder group and 464.44 ± 139.06 μg h mL-1 in the responder group (P = 0.004). AUC0-24/MIC of ≥ 400 μg h mL-1 was documented for 77% of the responders and 27% of the non-responders (c2 = 7.03; P = 0.008).

    CONCLUSIONS: Ratio of trough concentration/MIC and AUC0-24/MIC of vancomycin are better predictors for MRSA treatment outcomes than trough vancomycin concentration or AUC0-24 alone. The single trough-based estimated AUC may be sufficient for the monitoring of treatment response with vancomycin.

  6. Uni S, Mat Udin AS, Tan PE, Rodrigues J, Martin C, Junker K, et al.
    PMID: 36589876 DOI: 10.1016/j.crpvbd.2022.100078
    Species of the genus Pelecitus Railliet & Henry, 1910 the most widely distributed avian filariae in Africa and South America. Zoonotic cases in humans were reported in South America. While investigating the filarial fauna of wild animals in Malaysia, we discovered an undescribed filaria from the swollen footpad of the left leg of Copsychus malabaricus (Scopoli) in Pahang, Peninsular Malaysia. Adults of both sexes have a corkscrew-shaped body. Based on comparison of their morphological characteristics (i.e. pre-oesophageal cuticular ring distinct, oesophagus divided, vulva protuberant and situated at the level of anterior half of oesophagus, spicules strongly sclerotized and left spicule with broad blade) with other Pelecitus species, they are here described as Pelecitus copsychi Uni, Mat Udin & Martin n. sp. Multi-locus sequence analyses based on seven genes (12S rDNA, cox1, 18S rDNA, 28S rDNA, MyoHC, rbp1 and hsp70) were performed to determine the phylogenetic position of the new species. The calculated p-distance between the cox1 gene sequences for P. copsychi n. sp. and Pelecitus fulicaeatrae (Diesing, 1861) was 14.1%. Intraspecific genetic variation between two individuals of the new species was 0.4%. In both the Bayesian inference and maximum-likelihood trees, P. copsychi n. sp. was positioned in the second clade of ONC5, containing three genera of the subfamily Dirofilariinae (Foleyella Seurat, 1917, Pelecitus and Loa Stiles, 1905). Immunostaining and molecular analyses remained negative for the presence of Wolbachia endosymbionts. Our findings corroborate the division of the subfamily Dirofilariinae into ONC3 with Dirofilaria Railliet & Henry, 1911 and ONC5 with Pelecitus.
  7. Nabil S, Kuppusamy E, Nordin R, Nazimi AJ, Ramli R
    Case Rep Dent, 2019;2019:6810461.
    PMID: 31218085 DOI: 10.1155/2019/6810461
    Anterosuperior temporomandibular joint dislocation is rare. Manual reduction of such dislocation is difficult especially when treatment is delayed. Therefore, it has an increased likelihood of needing surgical intervention to achieve reduction. The authors report a case of an anterosuperior temporomandibular dislocation in a 19-year-old male following a motor vehicle accident. Difficulties were encountered in reducing the dislocation necessitating surgically assisted reduction. The long-term outcome following management by condylotomy is reported. This present report also reviews the literature regarding the classification and management of this uncommon dislocation.
  8. Chung PY, Loh PLN, Neoh HM, Ramli R
    Heliyon, 2023 Jul;9(7):e17892.
    PMID: 37456062 DOI: 10.1016/j.heliyon.2023.e17892
    Staphylococcus aureus has caused life-threatening infections and developed resistance against conventional antimicrobials, posing a significant threat to human health worldwide. Biofilms that surround the bacteria cells act as a protective layer, allowing cells inside the biofilm to be resistant to external stresses such as antimicrobials. Therefore, biofilms further complicate treatment available for infections caused by multi-drug resistant Staphylococcus aureus. A previous study on alpha-amyrin (AM), derived from ursane, was reported to significantly reduce the biomass and inhibit the metabolic activity of reference strain methicillin-resistant and methicillin-sensitive S. aureus (MRSA and MSSA, respectively). In this study, the antibiofilm activity of AM was extended to include clinical isolates of MSSA and MRSA, and laboratory-generated vancomycin-intermediate S. aureus (VISA) collected from University Kebangsaan Malaysia Medical Center (PPUKM) and Universiti Kebangsaan Malaysia Medical Molecular Biology Institute (UMBI). Pre-formed biofilms of biofilm-forming isolates identified from the Congo Red Agar (CRA) assay were then exposed to AM, vancomycin and oxacillin, and evaluated using the crystal violet and resazurin assays. The results showed that AM reduced the biofilm biomass of three isolates of MSSA, eight isolates of MRSA and four isolates of VISA but increased the metabolic activity in certain MSSA, MRSA and VISA isolates, indicating AM may possess biofilm reduction effects but not bactericidal effects. Based on these findings, AM could be further studied and developed as a potential therapeutic agent for chronic S. aureus infections.
  9. Nawawi SH, Wan Ibrahim WZ, Yahya MM, Ramli R
    BMJ Case Rep, 2023 Aug 17;16(8).
    PMID: 37591622 DOI: 10.1136/bcr-2022-253129
    A woman in her early 50s with uncontrolled diabetes mellitus and a huge uterine fibroid presented to the emergency department with diabetic ketoacidosis and bilateral acute lower limb ischaemia. Vascular and advanced imaging studies confirmed distal aortic compression by a huge uterine fibroid, resulting in extensive lower limb arterial thrombosis. After resuscitation, the patient underwent emergency hysterectomy, thromboembolectomy and amputation of the right leg. She remained critically ill and died of fulminant sepsis and multiorgan failure 10 days later. This case reports the effects of external vascular compression by a large pelvic mass.
  10. Mohd Yunus SS, Soh HY, Abdul Rahman M, Peng X, Guo C, Ramli R
    Front Physiol, 2023;14:1021429.
    PMID: 37179831 DOI: 10.3389/fphys.2023.1021429
    Medication related osteonecrosis of the jaw (MRONJ) is a condition caused by inhibition of the osteoclast activity by the anti-resorptive and anti-angiogenic drugs. Clinically, there is an exposure of the necrotic bone or a fistula which fails to heal for more than 8 weeks. The adjacent soft tissue is inflamed and pus may be present as a result of the secondary infection. To date, there is no consistent biomarker that could aid in the diagnosis of the disease. The aim of this review was to explore the literature on the microRNAs (miRNAs) related to medication related osteonecrosis of the jaw, and to describe the role of each miRNA as a biomarker for diagnostic purpose and others. Its role in therapeutics was also searched. It was shown that miR-21, miR-23a, and miR-145 were significantly different in a study involving multiple myeloma patients as well as in a human-animal study while miR-23a-3p and miR-23b-3p were 12- to 14-fold upregulated compared to the control group in an animal study. The role of the microRNAs in these studies were for diagnostics, predictor of progress of MRONJ and pathogenesis. Apart from its potential diagnostics role, microRNAs have been shown to be bone resorption regulator through miR-21, miR-23a and miR-145 and this could be utilized therapeutically.
  11. Mohd Yunus SS, Nabil S, Rashdi MF, Nazimi AJ, Nordin R, Tan HL, et al.
    Antibiotics (Basel), 2023 Apr 02;12(4).
    PMID: 37107058 DOI: 10.3390/antibiotics12040696
    This study explores the opinions of Malaysian clinical specialists on the antibiotic prophylaxis against infective endocarditis (IE) as described in the 2008 National Institute for Health and Care Excellence (NICE) guideline. This cross-sectional study was performed from September 2017 to March 2019. The self-administered questionnaire comprised two sections: background information of the specialists and their opinions on the NICE guideline. The questionnaire was distributed to 794 potential participants, and 277 responded (response rate of 34.9%). In general, 49.8% of the respondents believed that clinicians should adhere to the guideline, although the majority of oral and maxillofacial surgeons (54.5%) actually disagreed with this view. The dental procedures that were perceived as presented moderate-to-high risk for IE were minor surgery for an impacted tooth with a recent episode of infection, dental implant surgery, periodontal surgery and dental extraction in patients with poor oral hygiene. The cardiac conditions that were strongly recommended for antibiotic prophylaxis were severe mitral valve stenosis or regurgitation and previous IE. Less than half of Malaysian clinical specialists agreed with the changes in the 2008 NICE guideline, contributing to their insistence that antibiotic prophylaxis is still needed for high-risk cardiac conditions and selected invasive dental procedures.
  12. Abdul Mulalek N, Wan Abas WR, Muhammad Tamyez F, Ramli R
    BMJ Case Rep, 2023 Dec 18;16(12).
    PMID: 38110342 DOI: 10.1136/bcr-2023-258548
  13. Adam MA, Soegianto A, Risjani Y, Payus CM, Yoga RGP, Sadi NH, et al.
    Scientifica (Cairo), 2023;2023:6649258.
    PMID: 38046196 DOI: 10.1155/2023/6649258
    BACKGROUND: Aquatic organisms demonstrate a high vulnerability to mortality when exposed to Pb, even at low concentrations. The objective of this investigation is to ascertain the histopathological alterations and cortisol concentrations in diverse tissues of Gambusia affinis, with a specific focus on the eggs and larvae, following exposure to varying concentrations of PbCl2.

    METHODS: Adult specimens of G. affinis measuring 5-6 cm in length were obtained from a commercial fish breeding facility. A total of 8 fish with a 1 : 1 ratio of 4 pairs of broodstock were placed in an 8-liter aquarium. Following the adaptation phase, the broodstock underwent a spawning process that lasted for a duration of 7 days. Throughout the spawning process, assessments were conducted on the progression of the abdominal growth of the broodstock. Eggs ready to hatch and Gambusia larvae were taken and exposed to 0.1 mg/L PbCl2, 1 mg/L PbCl2, and control (without PbCl2) for 24 hours, with three replications. At the end of the experiment, histopathological analysis was conducted using the hematoxylin Ehrlich-eosin staining method and scanning electron microscopic (SEM) observation. The levels of Pb in gills were determined by employing atomic absorption spectrophotometer. The cortisol concentration in organ samples of fish was determined through the utilization of a cortisol ELISA Kit.

    RESULTS: The findings of this investigation demonstrated an important bioaccumulation occurrence of Pb within the gills of Gambusia fish that were specifically subjected to 0.1 and 1 mg/L PbCl2. The histological structures of eggs and larvae that were subjected to PbCl2 exhibited impairment in comparison to the control group. The present study observed a significant elevation in cortisol levels among fish specimens that were subjected to PbCl2 exposure.

    CONCLUSIONS: The findings of this investigation suggest that the occurrence of Pb is linked to a rise in cortisol concentrations in various organs of G. affinis larvae. Furthermore, the research indicates that the exposure to Pb has a notable impact on the histological alterations in the eggs and larvae of Gambusia fish, implying that they are undergoing stress as a result of the Pb exposure.

  14. Mat Udin AS, Uni S, Rodrigues J, Martin C, Junker K, Agatsuma T, et al.
    PMID: 38193019 DOI: 10.1016/j.crpvbd.2023.100154
    The genus Mansonella Faust, 1929 includes 29 species, mainly parasites of platyrrhine monkeys in South America and anthropoid apes in Africa. In Malaysia, Mansonella (Tupainema) dunni (Mullin & Orihel, 1972) was described from the common treeshrew Tupaia glis Diard & Duvaucel (Scandentia). In a recent classification of the genus Mansonella, seven subgenera were proposed, with M. (Tup.) dunni as a monotypic species in the subgenus Tupainema. In this study, we collected new material of M. (Tup.) dunni from common treeshrews in Peninsular Malaysia and redescribed the morphological features of this species. We found that M. (Tup.) dunni differs from M. (Cutifilaria) perforata Uni et al., 2004 from sika deer Cervus nippon (Cetartiodactyla) in Japan, with regards to morphological features and predilection sites in their respective hosts. Based on multi-locus sequence analyses, we examined the molecular phylogeny of M. (Tup.) dunni and its Wolbachia genotype. Species of the genus Mansonella grouped monophyletically in clade ONC5 and M. (Tup.) dunni was placed in the most derived position within this genus. Mansonella (Tup.) dunni was closely related to M. (M.) ozzardi (Manson, 1897) from humans in Central and South America, and most distant from M. (C.) perforata. The calculated p-distances between the cox1 gene sequences for M. (Tup.) dunni and its congeners were 13.09% for M. (M.) ozzardi and 15.6-16.15% for M. (C.) perforata. The molecular phylogeny of Mansonella spp. thus corroborates their morphological differences. We determined that M. (Tup.) dunni harbours Wolbachia endosymbionts of the supergroup F genotype, in keeping with all other Mansonella species screened to date.
  15. Shuhardi SA, Mohamed Said MS, Kew TY, Ramli R
    Am J Case Rep, 2023 Dec 29;24:e942163.
    PMID: 38155491 DOI: 10.12659/AJCR.942163
    BACKGROUND Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse manifestations. The involvement of the musculoskeletal system is very common, and infection is one of the manifestations, which can involve any part of the body. We report a case of a middle-aged woman with recurrent episodes of infection of her left temple. CASE REPORT A 51-year old woman was referred to our clinic following failures to eradicate infection on her left temple for 9 months. Examination revealed facial asymmetry, with diffuse non-tender swelling involving her left temple area, which extended to her cheek. Computed tomography and magnetic resonance imaging (MRI) showed a periosteal reaction of the zygomatic bone. Left temporalis muscle thickening and residual osteomyelitis of the zygomatic bone were also shown by MRI. In view of the unresolved infection with incision and drainage and antibiotics, further blood investigations led to the discovery of SLE. The antinuclear antibody and anti-double-stranded DNA were positive. In addition, low nephelometry markers, C3 (26.7 mg/dL) and C4 (8.24 mg/dL), were observed. This patient was treated with 200 mg of oral hydrochloroquine once daily and 5 mg of oral prednisolone once daily. After 6 months of treatment, the infection subsided, and the structures involved showed remarkable healing. The patient is still taking the same dose and frequency of both drugs at the present time. CONCLUSIONS Temporalis pyomyositis and osteomyelitis of the zygomatic bone could be manifestation of SLE disease; however, the involvement of infection cannot be ruled out.
  16. Majid NFH, Muhamad S, Kusairi S, Ramli R
    Data Brief, 2024 Apr;53:110152.
    PMID: 38375144 DOI: 10.1016/j.dib.2024.110152
    This article presents data on occupational stress, job satisfaction, and job performance among male fertility patients. The data were collected from 11 November 2021 until 30 October 2022. A quantitative research approach was employed, involving a questionnaire development and survey. A sample of 309 was selected, using simple random sampling, from the pool of male patients that had undergone seminal fluid analysis (SFA) and received treatment from four private fertility clinics in Malaysia. Respondents were asked to give their consent by signing a consent form, for ethical research purposes. The questionnaire asked respondents about their demographics, sperm quality, occupational stress, job satisfaction, and job performance. The data could help other researchers to develop research on management issue in the context of male fertility, as well as organisations to maintain the health and welfare of their employees.
  17. Mansor MS, Ramli R
    PLoS One, 2017;12(3):e0172836.
    PMID: 28253284 DOI: 10.1371/journal.pone.0172836
    Tropical rainforests are considered as hotspots for bird diversity, yet little is known about the system that upholds the coexistence of species. Differences in body size that are associated with foraging strategies and spatial distribution are believed to promote the coexistence of closely related species by reducing competition. However, the fact that many babbler species do not differ significantly in their morphology has challenged this view. We studied the foraging ecology of nine sympatric babbler species (i.e., Pellorneum capistratum, P. bicolor, P. malaccense, Malacopteron cinereum, M. magnum, Stachyris nigriceps, S. nigricollis, S. maculata, and Cyanoderma erythropterum) in the Krau Wildlife Reserve in Peninsular Malaysia. We investigated; i) how these babblers forage in the wild and use vegetation to obtain food, and ii) how these trophically similar species differ in spatial distribution and foraging tactics. Results indicated that most babblers foraged predominantly on aerial leaf litter and used gleaning manoeuvre in intermediate-density foliage but exhibited wide ranges of vertical strata usage, thus reducing interspecific competition. The principal component analysis indicated that two components, i.e., foraging height and substrate are important as mechanisms to allow the coexistence of sympatric babblers. The present findings revealed that these bird species have unique foraging niches that are distinct from each other, and this may apply to other insectivorous birds inhabiting tropical forests. This suggests that niche separation does occur among coexisting birds, thus following Gause' law of competitive exclusion, which states two species occupying the same niche will not stably coexist.
  18. Abdul Wahab AY, Md Isa ML, Ramli R
    Malays J Med Sci, 2016 May;23(3):40-8.
    PMID: 27418868
    Spermatogonial stem cells (SSCs) are classifiedas a unique adult stem cells that have capability to propagate, differentiate, and transmit genetic information to the next generation. Studies on human SSCs may help resolve male infertility problems, especially in azoospermia patients. Therefore, this study aims to propagate SSCs in-vitro with a presence of growth factor and detect SSC-specific protein cell surface markers.
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