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  1. Ahmad Fauzi N, Rosli AH, Jabbari AJ
    Cureus, 2023 Oct;15(10):e47059.
    PMID: 38021653 DOI: 10.7759/cureus.47059
    Panophthalmitis is a severe ocular condition that can lead to devastating outcomes, such as evisceration, if not promptly treated. It typically originates endogenously, with urinary tract infection being a common primary source of infection. This report describes a rare case of a 61-year-old Malay patient with left eye panophthalmitis. Ocular culture revealed Escherichia coli, while systemic septic workup yielded negative results. Due to the severity of the ocular condition at presentation and the disproportionate level of pain the patient had, an immunocompromised state was suspected and later the diagnosis of diabetes mellitus was confirmed via laboratory investigation. Despite the delay in presentation, which hindered early intervention, the patient's eyeball was successfully salvaged through a treatment regimen involving three injections of intravitreal antibiotic administered at 48 to 72-hour intervals and a complete course of intravenous antibiotics. This case report highlights the importance of prompt treatment to salvage an eye from evisceration in the case of panophthalmitis.
  2. Said KS, Shuhaimi-Othman M, Ahmad AK
    Pak J Biol Sci, 2012 May 15;15(10):459-68.
    PMID: 24187900
    A study of water quality parameters (temperature, conductivity, total dissolved solid, dissolved oxygen, pH and water hardness) in Titiwangsa Lake was conducted in January, April, July and October 2010. The water quality parameters were tested and recorded at different sampling stations chosen randomly using hydrolab data sonde 4 and surveyor 4 a water quality multi probe (USA). Six metals i.e., cadmium, chromium, lead, nickel, zinc and copper were determined in five different compartments of the lake namely water, total suspended solids, plankton, sediment and fish. The metals concentration were determined by Inductively Coupled Plasma Mass Spectrometer (ICP-MS), perkin elmer elan, model 9000. The water quality parameters were compared with National Water Quality Standard (NWQS Malaysia) while metal concentrations were compared with Malaysian and international standards. The study shows that water quality parameters are of class 2. This condition is suitable for recreational activities where body contact is allowed and suitable for sensitive fishing activities. Furthermore, metal concentrations were found to be lower than the international standards, therefore toxic effects for these metals would be rarely observed and the adverse effects to aquatic organisms would not frequently occur.
  3. Said KS, Shuhaimi-Othman M, Ahmad AK
    Pak J Biol Sci, 2012 May 01;15(9):437-47.
    PMID: 24163953
    A study of water quality parameters (temperature, conductivity, total dissolved solid, dissolved oxygen, pH and water hardness) in Ampang Hilir Lake was conducted in January, April, July and October 2010. The water quality parameters were tested and recorded at different sampling stations chosen randomly using Hydrolab Data Sonde 4 and Surveyor 4 a water quality multi probe (USA). Six metals which were cadmium, chromium, lead, nickel, zinc and copper were determined in five different compartments of the lake namely water, total suspended solids, plankton, sediment and fish. The metals concentration were determined by Inductively Coupled Plasma Mass Spectrometer (ICP-MS), Perkin Elmer Elan, model 9000.The water quality parameters were compared with National Water Quality Standard (NWQS Malaysia) while metal concentrations were compared with Malaysian and international standards. The study shows that water quality parameters are of class 2. This condition is suitable for recreational activities where body contact is allowed and suitable for sensitive fishing activities. Furthermore, metal concentrations were found to be lower than the international standards, therefore toxic effects for these metals would be rarely observed and the adverse effects to aquatic organisms would not frequently occur.
  4. Sayeed S, Ahmad AF, Peng TC
    F1000Res, 2022;11:17.
    PMID: 38269303 DOI: 10.12688/f1000research.73613.1
    The Internet of Things (IoT) is leading the physical and digital world of technology to converge. Real-time and massive scale connections produce a large amount of versatile data, where Big Data comes into the picture. Big Data refers to large, diverse sets of information with dimensions that go beyond the capabilities of widely used database management systems, or standard data processing software tools to manage within a given limit. Almost every big dataset is dirty and may contain missing data, mistyping, inaccuracies, and many more issues that impact Big Data analytics performances. One of the biggest challenges in Big Data analytics is to discover and repair dirty data; failure to do this can lead to inaccurate analytics results and unpredictable conclusions. We experimented with different missing value imputation techniques and compared machine learning (ML) model performances with different imputation methods. We propose a hybrid model for missing value imputation combining ML and sample-based statistical techniques. Furthermore, we continued with the best missing value inputted dataset, chosen based on ML model performance for feature engineering and hyperparameter tuning. We used k-means clustering and principal component analysis. Accuracy, the evaluated outcome, improved dramatically and proved that the XGBoost model gives very high accuracy at around 0.125 root mean squared logarithmic error (RMSLE). To overcome overfitting, we used K-fold cross-validation.
  5. Ahmad NH, Huang L, Juneja V
    Food Res Int, 2024 Jan;176:113786.
    PMID: 38163703 DOI: 10.1016/j.foodres.2023.113786
    Liquid egg yolk (LEY) is often treated with phospholipase A2 (PLA2) to improve its emulsifying capacity and thermal stability. However, this process may allow certain pathogens to grow. The objective of this study was to evaluate the growth kinetics of mesophilic Bacillus cereus in LEY during PLA2 treatment. Samples, inoculated with B. cereus vegetative cells, were incubated isothermally at different temperatures between 9 and 50 °C to observe the bacterial growth and survival. Under the observation conditions, bacterial growth occurred between 15 and 48 °C, but not at 9 and 50 °C. The growth curves were analyzed using the USDA IPMP-Global Fit, with the no-lag phase model as the primary model in combination with either the cardinal temperatures model (CTM) or the Huang square-root model (HSRM) as the secondary model. While similar maximum growth temperatures (Tmax) were determined (48.4 °C for HSRM and 48.1 °C for CTM), the minimum growth temperature (Tmin) of the HSRM more accurately described the lower limit (9.26 °C), in contrast to 6.51 °C for CTM, suggesting that the combination of the no-lag phase model and HSRM was more suitable to describe the growth of mesophilic B. cereus in LEY. The root mean square error (RMSE) of model validation and development was <0.5 log CFU/g, indicating the combination of the no-lag phase model and HSRM could predict the growth of mesophilic B. cereus in LEY during PLA2 treatment. The results of this study may allow the food industry to choose a suitable temperature for PLA2 treatment of LEY to prevent the growth of mesophilic B. cereus.
  6. Yusoff H, Wan Daud WN, Ahmad Z
    Iran J Public Health, 2013;42(5):467-71.
    PMID: 23802103
    This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia.
  7. Ahmad A, Gnanasan S, Karuppannan M
    PLoS One, 2024;19(8):e0307897.
    PMID: 39190679 DOI: 10.1371/journal.pone.0307897
    The expansion of information technologies, particularly during the COVID-19 pandemic, has notably increased the use of remote services, including telehealth. Telepharmacy, a subset of telehealth, offers remote pharmaceutical care services, benefiting patients by providing advice and consultations without the need for physical pharmacy visits. This study aimed to assess public perceptions and awareness of telepharmacy in Malaysia. A cross-sectional study was conducted from Nov 2022 to May 2023, involving 387 Malaysian citizens aged 18 and above. Data collection utilised Google Forms distributed via social medias, covering demographics, technological readiness, awareness, perceptions, and willingness related to telepharmacy. The study demonstrated high digital readiness among respondents, owning smartphones and being adept in utilising various digital features. However, there was a lack of awareness regarding the concept of telepharmacy. Despite predominantly positive perceptions of its potential, only 48.1% of respondents showed willingness to utilise telepharmacy services. While respondents exhibited readiness for digital engagement, there was a notable deficit in understanding telepharmacy. Though perceptions were positive, willingness to embrace telepharmacy was moderate. Addressing the knowledge gap through targeted education initiatives might enhance acceptance. Future research should focus on integrating telepharmacy into healthcare systems considering public preferences, thereby evaluating its actual implementation and outcomes among diverse demographics.
  8. Zakaria MH, Shaharudin S, Ahmad Saad FF
    Eurasian J Med, 2024 Apr 18;56(2):78-85.
    PMID: 39145500 DOI: 10.5152/eurasianjmed.2024.23047
    The utility of the [18]F fluorodeoxyglucose positron emission tomography-computed tomography ([18]F FDG PET-CT) marker for breast cancer is well established. Given its limitations in localizing FDG-negative malignant tumors, the expression of [18]F-fluorocholine ([18]-FCH) may potentially be helpful to improve the overall accuracy in evaluating breast cancer. This study determined the potential of [18]- FCH PET CT as a potential marker in assessing breast cancer phenotypes. We recruited consecutive patients with biopsy-proven breast carcinoma who underwent [18] F-FCH PET-CT following the [18]F-FDG PET-CT imaging. The subjects were dichotomized into human epidermal growth factor receptor 2 (HER2)-negative and HER2-positive genotypes. The maximum standardized uptake value (SUVmax; g/dL) was used to predict the two groups of variables. Global health status (GHS) score based on the EORTC quality of life questionnaire (QLQ) was used to evaluate the outcome of the cohort subjects at 6, 12, and 24 months. There were 21 females with a mean age of 54.48 ± 12.17 years. Eighteen patients had invasive ductal carcinoma (18/21;85.8%) on histology, with 11 (52.4%) were HER2-negative genotype. There was higher sensitivity and specificity of [18]-FCH-PET/CT in breast lesions at 40% and 68.8% compared to [18]FDGPET/CT with 33.3% and 66.7%, respectively. There were significant differences between [18]F-FCH SUVmax (g/dL) of the HER-negative as compared to the HER2- positive group (1.99 g/dL vs. 0.2 g/dL; P < .05). High SUVmax (g/dL) of [18]F-FCH had predicted the HER-negative genotype at the cutoff value of 0.75 (P < .05). High [18]F-FCH showed significantly poor scoring of GHS parameters compared to low FCH at 6 months (mean SUVmax 8.06 vs. 5.40 respectively; P < .05). [18]F-FCH PET-CT is a potential marker in localizing and predicting aggressive breast carcinoma phenotypes.
  9. Khan A, Khan AH, Ahmad N, Ghafoor A
    J Infect Public Health, 2024 Aug 14;17(9):102522.
    PMID: 39173557 DOI: 10.1016/j.jiph.2024.102522
    BACKGROUND: Despite the introduction of bedaquiline (Bdq) containing all-oral regimens for treating patients with rifampicin resistant/multidrug resistant tuberculosis (MDR/RR-TB) in 2019, data on its effectiveness in Pakistan, which has the fifth highest MDR-TB burden, is lacking. This study evaluates treatment outcomes and identifies factors associated with unsuccessful outcomes among MDR/RR-TB patients treated with an all-oral longer treatment regimen (LTR).

    METHODS: This retrospective record review included all microbiologically confirmed pulmonary MDR/RR-TB patients treated with an all-oral LTR between August 2019 and February 2021 across nine PMDT centres in Pakistan. Sociodemographic and clinical data were retrieved from the Electronic Nominal Recording and Reporting System. Treatment outcomes, defined by WHO criteria, were analysed using SPSS and multivariate binary logistic regression to identify factors associated with unsuccessful outcomes. A p-value  5 drugs (OR:3.12, 95 %CI:1.36-11.64, p = 0.013) were significantly associated with death and treatment failure. Whereas, lung cavitation had statistically significant association with LTFU (OR:2.66, 95 %CI:1.10-7.32, p = 0.045).

    CONCLUSION: Treatment success rate (70.3 %) in this study fell below the WHO recommended target success rate (>90 %). Enhanced clinical management, coupled with special attention to patients exhibiting identified risk factors could improve treatment outcomes.

  10. Ahmad AH, Abdul Aziz CB
    Malays J Med Sci, 2014 Dec;21(Spec Issue):46-54.
    PMID: 25941463 MyJurnal
    Pain, while salient, is highly subjective. A sensation perceived as painful by one person may be perceived as uncomfortable, not painful or even pleasant to others. Within the same person, pain may also be modulated according to its threat value and the context in which it is presented. Imaging techniques, such as functional magnetic resonance imaging and positron emission tomography, have identified a distributed network in the brain, the pain-relevant brain regions, that encode the sensory-discriminative aspect of pain, as well as its cognitive and affective/emotional factors. Current knowledge also implicates the prefrontal cortex as the modulatory area for pain, with its subdivisions forming the cortico-cortical pathway, an alternative pain modulatory pathway distinct from the descending modulatory pathway of pain. These findings from neuroimaging in human subjects have paved the way for the molecular mechanisms of pain modulation to be explored in animal studies.
  11. Dharmalingam TK, Ahmad Zainuddin NA
    Malays J Med Sci, 2013 May;20(3):51-4.
    PMID: 23966825 MyJurnal
    This study was undertaken to evaluate patient satisfaction after spinal anaesthesia, which is the most frequently administered anaesthesia in obstetric patients.
  12. Ab Aziz CB, Ahmad AH
    Malays J Med Sci, 2006 Jul;13(2):11-8.
    PMID: 22589599 MyJurnal
    The thalamus is one of the structures that receives projections from multiple ascending pain pathways. The structure is not merely a relay centre but is involved in processing nociceptive information before transmitting the information to various parts of the cortex. The thalamic nuclei are involved in the sensory discriminative and affective motivational components of pain. Generally each group of nucleus has prominent functions in one component for example ventrobasal complex in sensory discriminative component and intralaminar nuclei in affective-motivational component. The thalamus is also part of a network that projects to the spinal cord dorsal horn and modulates ascending nociceptive information. In the animal models of neuropathic pain, changes in the biochemistry, gene expression, thalamic blood flow and response properties of thalamic neurons have been shown. These studies suggest the important contribution of the thalamus in modulating pain in normal and neuropathic pain condition.
  13. Ahmad TS, Musa G, Lee JK
    Ann Acad Med Singap, 1997 Nov;26(6):840-3.
    PMID: 9522989
    Sixty-one free flaps performed in 59 patients from April 1983 to April 1995 were analysed. Various factors that might have affected the outcome of the surgery were studied. These included the patient's age, history of smoking, pre-existing medical problems such as hypertension and diabetes mellitus, the type of free flaps, flap infection, use of postoperative anticoagulation, postoperative anaemia and re-exploration. The infection rate was 16.4% and this had a strong correlation with the free flap failure in our study population. Postoperative anaemia could adversely affect the tissue oxygenation of the free flap and delay the re-exploration due to the high anaesthetic risk. Dextran was routinely used for postoperative anticoagulation. There were also rescue attempts using heparin infusion when needed. The overall failure rate was 13.1%. Besides good anaesthetic support, a well-prepared protocol is necessary both for the preoperative planning of free flap surgery as well as salvaging a failure.
  14. Biswal BM, Ruzman N, Ahmad NM, Zakaria A
    Malays J Med Sci, 2000 Jan;7(1):54-9.
    PMID: 22844216 MyJurnal
    Short course hypo-fractionated radiotherapy is a standard regime for the palliation of stage IV head and neck cancers. However few patients respond favorably and require further radiotherapy in curative intent. We have used split-course radiotherapy technique to find out this conversion rate from palliative to curative intent. This was a prospective study conducted from November 1998 to October 1999; twenty-six (26) patients with stage IV head & neck cancers were treated with a hypofractionated regime of radiotherapy. A tumor dose of 30 Gy in 10 fractions [time dose fraction (TDF) 62] over 2 weeks was delivered using a 6 MV linear accelerator. A conventional 2 field or 3 field technique was used. Patients were assessed for the regression of tumor on fifth day, tenth day of radiotherapy and 4 weeks after the completion of radiotherapy. Patients showing complete response and good partial response were allowed to receive further radiotherapy of 30 Gy in 15 fractions [TDF 49]. There were 21 males and 5 females in the study with a median age of 44 years (range 19-77 years). All patients completed the initial regime. Complete responses were observed among 14 patients (54%); partial response in 6 patients (23%), and no response was seen among 6 patients (23%). Sixteen patients (61%) were suitable for radical radiotherapy after phase-I course of the above schedule. Seventeen patients (65%) showed an improvement in the general well being with a better quality of life. One year actuarial survival was (76%), with a median survival time of 12 months. Split-course technique is a useful radiotherapy treatment in stage IV head and neck cancers to distinguish between the subset of patients who would require curative treatment and who would not.
  15. Ahmad Hamdan AF, Abu Bakar A
    Malays J Med Sci, 2023 Oct;30(5):169-180.
    PMID: 37928795 DOI: 10.21315/mjms2023.30.5.14
    INTRODUCTION: A no-show appointment occurs when a patient does not attend a previously booked appointment. This situation can cause other problems, such as discontinuity of patient treatments as well as a waste of both human and financial resources. One of the latest approaches to address this issue is predicting no-shows using machine learning techniques. This study aims to propose a predictive analytical approach for developing a patient no-show appointment model in Hospital Kuala Lumpur (HKL) using machine learning algorithms.

    METHODS: This study uses outpatient data from the HKL's Patient Management System (SPP) throughout 2019. The final data set has 246,943 appointment records with 13 attributes used for both descriptive and predictive analyses. The predictive analysis was carried out using seven machine learning algorithms, namely, logistic regression (LR), decision tree (DT), k-near neighbours (k-NN), Naïve Bayes (NB), random forest (RF), gradient boosting (GB) and multilayer perceptron (MLP).

    RESULTS: The descriptive analysis showed that the no-show rate was 28%, and attributes such as the month of the appointment and the gender of the patient seem to influence the possibility of a patient not showing up. Evaluation of the predictive model found that the GB model had the highest accuracy of 78%, F1 score of 0.76 and area under the curve (AUC) value of 0.65.

    CONCLUSION: The predictive model could be used to formulate intervention steps to reduce no-shows, improving patient care quality.

  16. Ahmad N, Nor SFS, Daud F
    Malays J Med Sci, 2019 Jul;26(4):17-27.
    PMID: 31496890 MyJurnal DOI: 10.21315/mjms2019.26.4.3
    The trend of choosing natural birth at home without proper supervision is gaining more attention and popularity in Malaysia. This is partly due to wrong beliefs of modern medical care. It prompts the need to explore further into other myths and wrong beliefs present in communities around the world surrounding pregnancy and childbirth that may lead to harmful consequences. A total of 25 literatures were selected and reviewed. The most reported wrong belief is the eating behaviour such as avoiding certain nutritious fruits besides eating saffron to produce fairer skinned babies which in fact contains high doses of saffron that may lead to miscarriage. The most worrying myth however, is that unregulated birth attendants such as doulas have the necessary knowledge and skills to manage complications in labour which may well end up in perinatal or even maternal death. Other myths suggested that modern medical care such as vaginal examinations and baby's heart monitoring in labour as unnecessary. A well-enforced health education programme by well-trained healthcare personnel besides sufficient number of antenatal care visits are needed to overcome these myths, wrong beliefs and practices. In conclusion, potential harmful beliefs and practices in pregnancy and childbirth are still abound in today's communities, not just in least developed and developing countries but also in developed countries. Women and children are two very vulnerable groups, therefore debunking myths and eliminating harmful practices should be one of a healthcare provider priority especially those in the primary care settings as they are the closest to the community.
  17. Azmawati MN, Najibah E, Hatta MD, Norfazilah A
    Asian Pac J Cancer Prev, 2014;15(13):5283-6.
    PMID: 25040989
    Stage of cervical cancer may adversely affect the quality of life (QOL) among patients. The objective of this study was to predict the QOL among cervical cancer patients by the stage of their cancer. A cross-sectional study from September 2012 until January 2013 was conducted among cervical cancer patients who completed treatment. All patients completed a interviewer-guided questionnaire comprising four sections: (A) socio- demographic data, (B) medical history, (C) QOL measured by general health status questionnaire (QLQ-30) and (D) cervical cancer specific module CX-24 (EORTC) was used to measured patient's functional, symptom scale and their global health status. Results showed that global health status, emotional functioning and pain score were higher in stage III cervical cancer patients while role functioning was higher in stage I cervical cancer patients. Patients with stage IV cancer have a lower mean score in global health status (adjusted b-22.0, 95 CI% -35.6, -8.49) and emotional functioning (adjusted b -22.5, 95 CI% -38.1, -6.69) while stage III had lower mean score in role functioning (adjusted b -14.3, 95 CI% -25.4, -3.21) but higher mean score in pain (adjusted b 22.1, 95 CI% 8.56, 35.7). In conclusion, stage III and IV cervical cancers mainly affect the QOL of cervical cancer patients. Focus should be given to these subgroups to help in improving the QOL.
  18. Mat Zin S, Abbas M, Majid AA, Ismail AI
    PLoS One, 2014;9(5):e95774.
    PMID: 24796483 DOI: 10.1371/journal.pone.0095774
    The generalized nonlinear Klien-Gordon equation plays an important role in quantum mechanics. In this paper, a new three-time level implicit approach based on cubic trigonometric B-spline is presented for the approximate solution of this equation with Dirichlet boundary conditions. The usual finite difference approach is used to discretize the time derivative while cubic trigonometric B-spline is applied as an interpolating function in the space dimension. Several examples are discussed to exhibit the feasibility and capability of the approach. The absolute errors and L∞ error norms are also computed at different times to assess the performance of the proposed approach and the results were found to be in good agreement with known solutions and with existing schemes in literature.
  19. Abbas M, Majid AA, Md Ismail AI, Rashid A
    PLoS One, 2014;9(1):e83265.
    PMID: 24427270 DOI: 10.1371/journal.pone.0083265
    In this paper, a numerical method for the solution of a strongly coupled reaction-diffusion system, with suitable initial and Neumann boundary conditions, by using cubic B-spline collocation scheme on a uniform grid is presented. The scheme is based on the usual finite difference scheme to discretize the time derivative while cubic B-spline is used as an interpolation function in the space dimension. The scheme is shown to be unconditionally stable using the von Neumann method. The accuracy of the proposed scheme is demonstrated by applying it on a test problem. The performance of this scheme is shown by computing L∞ and L2 error norms for different time levels. The numerical results are found to be in good agreement with known exact solutions.
  20. Leong YH, Latiff AA, Ahmad NI, Rosma A
    Mycotoxin Res, 2012 May;28(2):79-87.
    PMID: 23606045 DOI: 10.1007/s12550-012-0129-8
    Aflatoxins are highly toxic secondary fungal metabolites mainly produced by Aspergillus flavus and A. parasiticus. Human exposure to aflatoxins may result directly from ingestion of contaminated foods, or indirectly from consumption of foods from animals previously exposed to aflatoxins in feeds. This paper focuses on exposure measurement of aflatoxins and aflatoxin metabolites in various human body fluids. Research on different metabolites present in blood, urine, breast milk, and other human fluids or tissues including their detection techniques is reviewed. The association between dietary intake of aflatoxins and biomarker measurement is also highlighted. Finally, aspects related to the differences between aflatoxin determination in food versus the biomarker approach are discussed.
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