Displaying publications 61 - 80 of 5774 in total

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  1. Abdul Wahid SN, Md Daud MK, Sidek D, Abd Rahman N, Mansor S, Zakaria MN
    Int J Pediatr Otorhinolaryngol, 2012 Sep;76(9):1366-9.
    PMID: 22770594 DOI: 10.1016/j.ijporl.2012.06.008
    OBJECTIVE: To identify the outcomes of hearing screening using different protocols of both Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR) tests in the same ear of the babies in a neonatal unit population.
    METHODS: A cross-sectional study was carried out on babies who were admitted into a neonatal unit. By using a formula of single proportion and considering 20% drop out, the number of sample required was 114. The subjects were chosen by using a systematic random sampling. The infants selected were subjected to DPOAE followed by AABR tests screening at the same setting before discharge.
    RESULTS: There were 73 newborns (61.6% male and 38.4% female) participated in this study with a total of 146 ears screened. Ototoxic medication was the most common risk factor followed by hyperbilirubinaemia and low birth weight. AABR had higher passing rate (82.9%) as compared to DPOAE (77.4%). The highest passing rate was achieved if the protocol of either passed DPOAE or AABR was used (90.4%). The rate was lower when auditory neuropathy spectrum disorder (ANSD) has been considered (82.9%). Hyperbilirubinaemia, prematurity, craniofacial malformation and ototoxic drugs seem to be the high risk factors for auditory neuropathy.
    CONCLUSION: AABR has a higher passing rate as compared to DPOAE. However, the use of both instruments in the screening process especially in NICU will be useful to determine the infants with ANSD who may need different approach to management. Therefore, a protocol in which newborns are tested with AABR first and then followed by DPOAE on those who fail the AABR is recommended.
    Matched MeSH terms: Hearing Disorders/diagnosis*
  2. Abdul-Kadir NA, Mat Safri N, Othman MA
    Comput Methods Programs Biomed, 2016 Nov;136:143-50.
    PMID: 27686711 DOI: 10.1016/j.cmpb.2016.08.021
    BACKGROUND: Atrial fibrillation (AF) can cause the formation of blood clots in the heart. The clots may move to the brain and cause a stroke. Therefore, this study analyzed the ECG features of AF and normal sinus rhythm signals for AF recognition which were extracted by using a second-order dynamic system (SODS) concept.
    OBJECTIVE: To find the appropriate windowing length for feature extraction based on SODS and to determine a machine learning method that could provide higher accuracy in recognizing AF.
    METHOD: ECG features were extracted based on a dynamic system (DS) that uses a second-order differential equation to describe the short-term behavior of ECG signals according to the natural frequency (ω), damping coefficient, (ξ), and forcing input (u). The extracted features were windowed into 2, 3, 4, 6, 8, and 10 second episodes to find the appropriate windowing size for AF signal processing. ANOVA and t-tests were used to determine the significant features. In addition, pattern recognition machine learning methods (an artificial neural network (ANN) and a support vector machine (SVM)) with k-fold cross validation (k-CV) were used to develop the ECG recognition system.
    RESULTS: Significant differences (p 
    Matched MeSH terms: Atrial Fibrillation/diagnosis*
  3. Abdul-Kadir NA, Mat Safri N, Othman MA
    Int J Cardiol, 2016 Nov 01;222:504-8.
    PMID: 27505342 DOI: 10.1016/j.ijcard.2016.07.196
    BACKGROUND: The feasibility study of the natural frequency (ω) obtained from a second-order dynamic system applied to an ECG signal was discovered recently. The heart rate for different ECG signals generates different ω values. The heart rate variability (HRV) and autonomic nervous system (ANS) have an association to represent cardiovascular variations for each individual. This study further analyzed the ω for different ECG signals with HRV for atrial fibrillation classification.

    METHODS: This study used the MIT-BIH Normal Sinus Rhythm (nsrdb) and MIT-BIH Atrial Fibrillation (afdb) databases for healthy human (NSR) and atrial fibrillation patient (N and AF) ECG signals, respectively. The extraction of features was based on the dynamic system concept to determine the ω of the ECG signals. There were 35,031 samples used for classification.

    RESULTS: There were significant differences between the N & NSR, N & AF, and NSR & AF groups as determined by the statistical t-test (p<0.0001). There was a linear separation at 0.4s(-1) for ω of both databases upon using the thresholding method. The feature ω for afdb and nsrdb falls within the high frequency (HF) and above the HF band, respectively. The feature classification between the nsrdb and afdb ECG signals was 96.53% accurate.

    CONCLUSIONS: This study found that features of the ω of atrial fibrillation patients and healthy humans were associated with the frequency analysis of the ANS during parasympathetic activity. The feature ω is significant for different databases, and the classification between afdb and nsrdb was determined.

    Matched MeSH terms: Atrial Fibrillation/diagnosis
  4. Abdul-Nasir AS, Mashor MY, Mohamed Z
    Comput Math Methods Med, 2012;2012:637360.
    PMID: 23082089 DOI: 10.1155/2012/637360
    Malaria is one of the serious global health problem, causing widespread sufferings and deaths in various parts of the world. With the large number of cases diagnosed over the year, early detection and accurate diagnosis which facilitates prompt treatment is an essential requirement to control malaria. For centuries now, manual microscopic examination of blood slide remains the gold standard for malaria diagnosis. However, low contrast of the malaria and variable smears quality are some factors that may influence the accuracy of interpretation by microbiologists. In order to reduce this problem, this paper aims to investigate the performance of the proposed contrast enhancement techniques namely, modified global and modified linear contrast stretching as well as the conventional global and linear contrast stretching that have been applied on malaria images of P. vivax species. The results show that the proposed modified global and modified linear contrast stretching techniques have successfully increased the contrast of the parasites and the infected red blood cells compared to the conventional global and linear contrast stretching. Hence, the resultant images would become useful to microbiologists for identification of various stages and species of malaria.
    Matched MeSH terms: Malaria/diagnosis*
  5. Abdul-Rahman NA, Azman RR, Kumar G
    Saudi Med J, 2016 May;37(5):584-6.
    PMID: 27146625 DOI: 10.15537/smj.2016.5.15042
    Matched MeSH terms: Acute Kidney Injury/diagnosis*
  6. Abdul-Razak S, Rahmat R, Mohd Kasim A, Rahman TA, Muid S, Nasir NM, et al.
    BMC Cardiovasc Disord, 2017 Oct 16;17(1):264.
    PMID: 29037163 DOI: 10.1186/s12872-017-0694-z
    BACKGROUND: Familial hypercholesterolaemia (FH) is a genetic disorder with a high risk of developing premature coronary artery disease that should be diagnosed as early as possible. Several clinical diagnostic criteria for FH are available, with the Dutch Lipid Clinic Criteria (DLCC) being widely used. Information regarding diagnostic performances of the other criteria against the DLCC is scarce. We aimed to examine the diagnostic performance of the Simon-Broom (SB) Register criteria, the US Make Early Diagnosis to Prevent Early Deaths (US MEDPED) and the Japanese FH Management Criteria (JFHMC) compared to the DLCC.

    METHODS: Seven hundered fifty five individuals from specialist clinics and community health screenings with LDL-c level ≥ 4.0 mmol/L were selected and diagnosed as FH using the DLCC, the SB Register criteria, the US MEDPED and the JFHMC. The sensitivity, specificity, efficiency, positive and negative predictive values of individuals screened with the SB register criteria, US MEDPED and JFHMC were assessed against the DLCC.

    RESULTS: We found the SB register criteria identified more individuals with FH compared to the US MEDPED and the JFHMC (212 vs. 105 vs. 195; p 

    Matched MeSH terms: Hyperlipoproteinemia Type II/diagnosis
  7. Abdulameer SA, Syed Sulaiman SA, Hassali MA, Sahib MN, Subramaniam K
    Int J Rheum Dis, 2014 Jan;17(1):93-105.
    PMID: 24472272 DOI: 10.1111/1756-185X.12104
    The aims of this study were to translate and examine the psychometric properties of the Malaysian version of the Osteoporosis Health Belief Scale (OHBS-M) among type 2 diabetes patients (T2DM) and to assess the correlation between osteoporosis knowledge, health belief and self-efficacy scales, as well as assess the osteoporosis risk in the sample population using quantitative ultrasound measurement (QUS).
    Matched MeSH terms: Diabetes Mellitus, Type 2/diagnosis
  8. Abdulamir AS, Hafidh RR, Abu Bakar F
    PMID: 21247505 DOI: 10.1186/1756-9966-30-11
    Streptococcus bovis (S. bovis) bacteria are associated with colorectal cancer and adenoma. S. bovis is currently named S. gallolyticus. 25 to 80% of patients with S. bovis/gallolyticus bacteremia have concomitant colorectal tumors. Colonic neoplasia may arise years after the presentation of bacteremia or infectious endocarditis of S. bovis/gallolyticus. The presence of S. bovis/gallolyticus bacteremia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine. In addition, serological relationship of S. gallolyticus with colorectal tumors and direct colonization of S. gallolyticus in tissues of colorectal tumors were found. However, this association is still under controversy and has long been underestimated. Moreover, the etiological versus non-etiological nature of this associationis not settled yet. Therefore, by covering the most of up to date studies, this review attempts to clarify the nature and the core of S. bovis/gallolyicus association with colorectal tumors and analyze the possible underlying mechanisms.
    Matched MeSH terms: Adenoma/diagnosis; Colorectal Neoplasms/diagnosis
  9. Abdulamir AS, Kadhim HS, Hafidh RR, Ali MA, Faik I, Abubakar F, et al.
    PMID: 19610265
    OBJECTIVES: We studied the role of the regulatory T cells CD4+CD25+ (Treg) and activated CD4+CD30+ cells in the pathogenesis of asthma and their association with apoptosis and NF-kappaB in patients with mild intermittent asthma (MA), severe persistent asthma (SA), and healthy volunteers (HV).
    METHODS: Peripheral blood lymphocytes (PBL) were extracted from asthmatic patients during exacerbations, and CD4+ cells were separated using Dynal beads. Immunostaining of whole PBL for NF-kappaB, Bax, and Bcl-2, and immunostaining of CD4+ cells for CD25+ and CD30+ cells were performed using immunocytochemistry.
    RESULTS: Treg cells were expressed at higher levels in MA than in HV and SA (P < .05), while CD30+ T cells were expressed at higher levels in both SA and MA than in HV (P < .05), although there was no remarkable difference between SA and MA (P>.05). Levels of NF-kappaB, Bcl-2, and Bcl-2/Bax increased, whereas those of Bax decreased, progressively, from MA to SA (P < .05). NF-kappaB levels correlated directly with the Bcl-2/Bax ratio and with CD4+CD30+ cells in SA and MA, whereas CD4+CD30+ cells correlated inversely with the Bcl-2/Bax ratio.
    CONCLUSIONS: Unregulated Treg cells probably return inflammatory responses to normal values during exacerbations in MA; however, expression of Treg cells was extensively diminished in SA, leading to probable loss of suppressive control over underlying immune reactions. CD4+CD30+ cells were associated with the pathogenesis of asthma but not with severity. NF-kappaB seems to be the central inflammatory factor in SA, with a remarkable loss of PBL apoptosis, diminished Treg levels, and high CD30+ cell levels that probably induce NF-kappaB, which in turn blocks the proapoptotic potential of CD30 induction itself.
    Matched MeSH terms: Asthma/diagnosis*
  10. Abdulamir AS, Hafidh RR, Abu Bakar F, Abbas K
    Am J Otolaryngol, 2010 Nov-Dec;31(6):410-7.
    PMID: 20015794 DOI: 10.1016/j.amjoto.2009.06.006
    PURPOSE: This study was designed to find a reliable Epstein-Barr virus (EBV) immunoglobulin (Ig) G-based diagnostic/screening test for nasopharyngeal carcinoma (NPC) able to demarcate between the NPC-related seropositivity of EBV IgG antibodies and that of other head and neck cancer (HNCA) and control groups. The NPC-associated immunosuppression affects EBV IgA much more than IgG, leading to inconsistent detection of NPC using EBV IgA antibodies.
    MATERIALS AND METHODS: One hundred twenty-two HNCA patients, 42 NPC, 66 laryngeal carcinoma, and 14 hypopharyngeal carcinoma and 3 groups of 100 control subjects were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to find a specific cutoff value for the NPC-related seropositivity of EBV IgG antibodies.
    RESULTS: NPC group showed higher serum level of EBV IgG antibodies than control and other HNCA groups (P < .05). However, the traditional cutoff value, mean + 2 SDs of control subjects, failed to demarcate the seropositives of NPC patients from those of healthy population (P > .05). The new cutoff value, mean + 2 SDs of the seropositives group of control subjects who had already been grouped by the traditional cutoff value, proved successful. It succeeded to demarcate between the NPC-related EBV IgG seropositivity and that issued from the persistent, latent, or reactivated EBV infection in the population (P < .05). The sensitivity/specificity of NPC detection by the new cutoff-based ELISA kit, 76.19% and 86%, was close or higher than that of EBV IgA antibodies.
    CONCLUSION: EBV IgG-based ELISA could be used for the diagnosis of NPC using a new cutoff threshold that excludes the population baseline of EBV IgG seropositivity.
    Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis
  11. Abdullah A, Abdullah KL, Yip CH, Teo SH, Taib NA, Ng CJ
    Asian Pac J Cancer Prev, 2013;14(12):7143-7.
    PMID: 24460266
    BACKGROUND: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy.
    OBJECTIVE: This study aimed to explore the decision making experiences of women with early breast cancer.
    MATERIALS AND METHODS: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach.
    RESULTS: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves.
    CONCLUSIONS: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.
    Study site: Breast surgical units, Klang Valley, Malaysia
    Matched MeSH terms: Breast Neoplasms/diagnosis
  12. Abdullah A, Othman S
    BMC Fam Pract, 2011;12:143.
    PMID: 22208768 DOI: 10.1186/1471-2296-12-143
    BACKGROUND:
    Home blood pressure monitoring (HBPM) is gaining popularity among hypertensive patients. This study aimed to explore the influence of self-initiated HBPM on primary care patients with hypertension.
    METHODS:
    Six in-depth interviews and two focus group discussions were conducted, taking into consideration the experiences of 24 primary care patients with hypertension. These patients had been using HBPM as part of their hypertension management. The overriding influences were grouped under themes which emerged from analyzing the data using the grounded theory approach.
    RESULTS:
    There are both positive and negative influences of self-initiated HBPM. Patients used the readings of their HBPM to decide on many aspects of their hypertension management. The HBPM readings both influenced their adherence to diet and exercise and provided certain reassurance when they experienced symptoms. In addition, the act of discussing their HBPM readings with their health care providers resulted in an enhanced doctor-patient therapeutic relationship. Nevertheless, HBPM created confusion at times in some patients, particularly with regard to the target blood pressure level and the need for medication. This led to some patients making their own medical decisions based on their own standards.
    CONCLUSIONS:
    HBPM is becoming an integral part of hypertension management. Primary care patients who self-initiated HBPM reported being more self-efficacious, but lack of participation and guidance from their doctors created confusion, and hindered the true benefit of HBPM.

    Study site: urban primary care clinic, located within the University Malaya Medical Centre
    Matched MeSH terms: Hypertension/diagnosis*
  13. Abdullah A, Putra SH, Saim L
    Med J Malaysia, 2006 Mar;61(1):84-7.
    PMID: 16708739 MyJurnal
    Post-traumatic pseudoaneurysms of internal carotid arteries are uncommon. The patients may present with massive epistaxis due to rupture of the aneurysm into the sphenoid sinus. Early diagnosis and treatment is mandatory as the likelihood of exsanguinations increases with each subsequent episode of epistaxis. The clinical features of unilateral blindness and massive epistaxis after head injury should indicate the diagnosis. The high mortality of this entity underlines the importance of early angiography in these patients to confirm this diagnosis. We present 3 cases of post-traumatic aneurysm of the ICA.
    Matched MeSH terms: Epistaxis/diagnosis
  14. Abdullah A, Long CW, Saim L, Mukari SZM
    Med J Malaysia, 2005 Mar;60(1):21-7.
    PMID: 16250276 MyJurnal
    Early identification and management of hearing impairment is very valuable. The goal standard measurement of hearing loss is by brainstem evoked response (BSER). This prospective study was conducted in Hospital University Kebangsaan Malaysia (HUKM) to determine the sensitivity and specificity of transient evoked otoacoustic emission (TEOAE) as a screening tool for hearing impairment from February 1999 to February 2000. One hundred and thirty-three newborns from postnatal ward and seventy-eight newborns from neonatal intensive care unit (NICU) were screened for possible hearing loss using portable TEOAE. This study showed that TEOAE is a very sensitive but moderately specific screening tool.
    Matched MeSH terms: Hearing Loss/diagnosis*
  15. Abdullah A, Mahmud MR, Maimunah A, Zulfiqar MA, Saim L, Mazlan R
    Ann Acad Med Singap, 2003 Jul;32(4):442-5.
    PMID: 12968546
    INTRODUCTION: Accurate preoperative imaging of the temporal bone in patients receiving cochlear implants is important. High resolution computed tomography (HRCT) and magnetic resonance (MR) imaging are the 2 preoperative imaging modalities that provide critical information on abnormalities of the otic capsule, pneumatisation of the mastoid, middle ear abnormalities, cochlear ducts patency and presence of cochlear nerve.

    MATERIALS AND METHODS: The HRCT and MR imaging in 46 cochlear implant patients in our department were reviewed.

    RESULTS: Majority of our patients [34 patients (73.9%)] showed normal HRCT of the temporal bone; 5 (10.9%) patients had labyrinthitis ossificans, 2 (4.3%) had Mondini's abnormality and 2 (4.3%) had middle ear effusion. One patient each had high jugular bulb, hypoplasia of the internal auditory canal and single cochlear cavity, respectively.

    CONCLUSION: The above findings contribute significantly to our surgical decisions regarding candidacy for surgery, side selection and surgical technique in cochlear implantation.

    Matched MeSH terms: Hearing Loss, Sensorineural/diagnosis; Labyrinth Diseases/diagnosis; Cochlear Diseases/diagnosis
  16. Abdullah A, Mahmud MR, Sabir HA, Saim L
    Med J Malaysia, 2003 Aug;58(3):450-3.
    PMID: 14750390
    Facial nerve schwannomas are rare benign tumors. The tumor can arise anywhere along the course of the facial nerve. The most common presentation for this tumor is a slowly progressive facial nerve paralysis. Sensorineural hearing loss (SNHL) and tinnitus are later symptoms. The symptoms and signs depend on the site of tumor along the nerve. We report three cases of facial nerve schwannomas with different clinical presentations. Appropriate management of a facial nerve schwannoma should be based on the site and extent of the tumor and status of the nerve function.
    Matched MeSH terms: Cranial Nerve Neoplasms/diagnosis*; Facial Nerve Diseases/diagnosis*; Neurilemmoma/diagnosis*
  17. Abdullah A, Abdullah S, Haflah NH, Ibrahim S
    J Chin Med Assoc, 2010 Jan;73(1):47-51.
    PMID: 20103492
    Giant cell tumors are commonly found over the flexor tendon sheath of the hand and wrist. However, giant cell tumors in the knee joint are rare, especially in children. We report an interesting case of an 11-year-old girl who presented with a painful lump on her right knee that enlarged over time. Clinically, she had fullness over the anterolateral part of her knee. Magnetic resonance imaging revealed an encapsulated mass inferior to the patella. The tumor measured 3 x 3.5 x 1.5 cm. Histopathological findings confirmed that it was a tenosynovial giant cell tumor. Because of initial mild symptoms, there was a delay of 2 years from the initial symptoms until tumor excision. Her follow-up period was 35 months, and her health to date is excellent with no recurrence. We believe that reporting this rare case will help clinicians update their knowledge on possible causes of lumps in the knee, and avoid diagnostic delay. It could also prove to be beneficial in arriving at a diagnosis in future cases.
    Matched MeSH terms: Giant Cell Tumors/diagnosis*; Soft Tissue Neoplasms/diagnosis*
  18. Abdullah A, Hazim MY, Almyzan A, Jamilah AG, Roslin S, Ann MT, et al.
    Singapore Med J, 2006 Jan;47(1):60-4.
    PMID: 16397723
    This study aims to determine the prevalence of hearing loss among newborns delivered at Hospital Universiti Kebangsaan Malaysia and to evaluate the usefulness of our hearing screening protocol.
    Matched MeSH terms: Hearing Loss/diagnosis*
  19. Abdullah B, Rajet KA, Abd Hamid SS, Mohammad WM
    Sleep Breath, 2011 Dec;15(4):747-54.
    PMID: 20957444 DOI: 10.1007/s11325-010-0431-7
    OBJECTIVES: We aimed to evaluate the severity of upper airway obstruction at the retropalatal and retroglossal regions in obstructive sleep apnea (OSA) patients.

    METHODOLOGY: This is a descriptive cross-sectional study at the Sleep Clinic, Department of Otorhinolaryngology-Head and Neck Surgery. Flexible nasopharyngolaryngoscopy was performed in seated erect and supine position. Retropalatal and retroglossal regions were continuously recorded during quiet breathing and Mueller's maneuver in both positions. Captured images were measured using Scion Image software and narrowing rate was calculated. Level of each site was classified based on Fujita classification and severity of obstruction using Sher scoring system for Mueller's maneuver.

    RESULTS: A total of 59 patients participated in this study. Twenty-nine (49.2%) participants had type 1 (retropalatal) obstruction, 23 (38.9%) had type 2 (retropalatal and retroglossal), and seven (11.9%) in type 3 (retroglossal) obstruction. Fifty (84.7%) of the patients have severe obstruction at the retropalatal region in supine position (SRP) followed by 35 (59.3%) at retropalatal region in erect position (ERP), 27 (45.8%) at retroglossal region in supine position (SRG) and eight (13.5%) at retroglossal region in erect position (ERG). The average oxygen saturation showed significant association in ERP (P = 0.012) and SRP (P < 0.001), but not significant in ERG and SRG.

    CONCLUSIONS: Videoendoscopy utilizing flexible nasopharyngolaryngoscopy and Scion Image software is reliable, minimally invasive, and useful as an office procedure in evaluating the multilevel obstruction of upper airway in OSA patients. The retropalatal region has more severe obstruction compared with retroglossal region either in erect or supine position.

    Matched MeSH terms: Airway Obstruction/diagnosis*; Sleep Apnea, Obstructive/diagnosis*
  20. Abdullah B
    Biomed Imaging Interv J, 2006 Oct;2(4):e28.
    PMID: 21614327 MyJurnal DOI: 10.2349/biij.2.4.e28
    Predicting the future is a dangerous undertaking at best, and not meant for the faint-hearted. However, viewing the advances in molecular medicine, genomics and proteomics, it is easy to comprehend those who believe that molecular imaging methods will open up new vistas for medical imaging. The knock on effect will impact our capacity to diagnose and treat diseases. Anatomically detectable abnormalities, which have historically been the basis of the practice of radiology, will soon be replaced by molecular imaging methods that will reflect the under expression or over expression of certain genes which occur in almost every disease. Molecular imaging can then be resorted to so that early diagnosis and characterisation of disease can offer improved specificity. Given the growing importance of molecular medicine, imagers will find it profitable to educate themselves on molecular targeting, molecular therapeutics and the role of imaging in both areas.
    Matched MeSH terms: Early Diagnosis
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