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Factors associated with unsuccessful quitters in stop smoking services in Perlis, Malaysia

Ikhwan MI, Hamid NA, Nor Izwana H

Med J Malaysia, 2022 Jan;77(1):47-52.
PMID: 35086994

INTRODUCTION: Tobacco smoking is one of major risk factor of non-communicable disease worldwide. As a prevention strategy, stop smoking services has been advocated at primary care. However, evidence suggests that worldwide there is high rate of unsuccessful quitters. In Malaysia, such evidence has come from small studies or single site study, and evidence on factors associated with failure to quit is scarce. This study aimed to identify the factors associated with unsuccessful quitters among smokers in Stop Smoking Services provided by government health clinics at North Peninsular of Malaysia.
MATERIALS AND METHODS: This was a retrospective study record review using data from the Stop Smoking Services registry and patient file card between January 2017 and Jun 2019. Independent variables included in this analysis are sociodemographic data, comorbidity, number appointments attended, duration of smoking, age of starting smoking, previous attempt to quit, fagerstrom score and type of treatment. The outcome of interest, is unsuccessful quitters defined as those who continued to smoke at 6 months after attending the service. A total of 427 sample randomly cases selected from 490 eligible sample was analysed. Logistic regression was used to model factors associated with unsuccessful quitters.
RESULTS: The study suggested that clients who attended 0-3 clinic sessions (AdjOR 6.57; 95% CI: 4.14, 10.43) and being single, unmarried (AdjOR: 2.78; 95%CI: 1.07, 7.18) was associated with increased risk of being unsuccessful quitters among smokers in Northern state of Malaysia CONCLUSION: The number of clinic sessions attended and marital status were factors associated with unsuccessful quitters among smokers in the State of Perlis, of Malaysia.
Fulltext Two cases of isochromosome 18q syndrome

Pal S, Siti MI, Ankathil R, Zilfalil BA

Singapore Med J, 2007 May;48(5):e146-50.
PMID: 17453088

Patients with isochromosome 18q, a rare cytogenetic abnormality, also reported as Edwards syndrome, is the second most common autosomal trisomy. However, the phenotypic features and survival of these patients are not uniform and depend upon the portion of chromosomes getting duplicated or deleted. The survival of these children may be longer, hence a good cytogenetic diagnosis is a must. Morphological characteristics of isochromosome 18q are not yet fully delineated because of the rarity of the cases and as most cases are aborted medically or terminate spontaneously. We report two cases of isochromosome 18q, one male aged two years old and the other a male aged eight months old, and review the literature on this rare syndrome.
Fulltext Angioinvasive cerebral aspergillosis presenting as acute ischaemic stroke in a patient with diabetes mellitus

Norlinah MI, Ngow HA, Hamidon BB

Singapore Med J, 2007 Jan;48(1):e1-4.
PMID: 17245496

Cerebral angioinvasive aspergillosis is a rare manifestation of disseminated aspergillosis which may result in stroke in immunocompromised individuals. Reports of such disease in patients with diabetes mellitus are rare. We describe a 45-year-old man with diabetes mellitus who presented with a three-day history of right-sided limb weakness and aphasia. Cerebral computed tomography showed features of an acute infarct involving the left anterior and middle cerebral arteries. He was initially treated for an acute ischaemic stroke. Further history revealed that he was investigated for a growth in the sphenoid sinus two months earlier. Culture of the biopsied material from the sphenoid sinus grew Aspergillus fumigatus. Magnetic resonance imaging showed an extension of the growth to the brain, causing the acute ischaemic stroke. He was subsequently diagnosed with angioinvasive cerebral aspergillosis and was commenced on intravenous amphotericin B. Unfortunately, he succumbed to his illness despite treatment.
Temporal variation of Malaysian rotavirus electropherotypes

Rasool N, Othman RY, Adenan MI, Hamzah M

J Clin Microbiol, 1989 Apr;27(4):785-7.
PMID: 2470775

An analysis of rotavirus electropherotypes circulating in Kuala Lumpur, Malaysia, over 7 years showed that all except 1 of the 360 electropherotypes encountered were characteristic of group A rotaviruses. The long electropherotype predominated annually, and there was a rarity of short electropherotypes. Extensive genome variability and cocirculation of different electropherotypes were observed annually. A sequential appearance of the predominant electropherotype was observed in all years of the study, except for 1985 and 1988, when one electropherotype predominated throughout the study periods. There was no shift in the predominant electropherotype over a 6-year period.
Fulltext Lipoproteins modulate growth and P-glycoprotein expression in drug-resistant HER2-overexpressed breast cancer cells

Siti ZS, Seoparjoo AMI, Shahrul H

Heliyon, 2019 Apr;5(4):e01573.
PMID: 31183434 DOI: 10.1016/j.heliyon.2019.e01573

BACKGROUND: Drug resistance remains as a challenge in the treatment of HER2-overexpressed breast cancer. Emerging evidence from clinical studies show relation of oxidized low density lipoprotein (LDL) and very low density lipoprotein (VLDL) level with drug resistance. However, the underlying molecular mechanisms for this effect remain unclear. Therefore, the aim of this study was to determine the effects of oxidized-LDL and VLDL in drug-resistant HER2-overexpressed breast cancer cells.
METHODS: An in vitro cell model for tamoxifen-resistant HER2 overexpressed UACC732 cells was created using the pulse method. Cells were exposed to oxidized LDL (oxLDL) and very low density lipoprotein (VLDL) separately. Effects on cell morphology was studied using phase contrast microscopic changes. Percentage of cell viability was measured using proliferation assay kit. Development of tamoxifen resistance was determined based on P-gp expression with flow cytometry. Further analysis includedcell death measurement with flow cytometry method.
RESULTS: UACC732 cells exposed to VLDL exhibited fibroblast-like morphology. This was further supported by proliferation assay, where the percentage of cell viability achieved more than 100% with 100 μg/ml of VLDL exposure, indicating cell proliferation. Findings also showed that VLDL caused reduction in expression of Pgp in resistant cells compared to resistant cells alone (p = 0.02).
CONCLUSION: Results of this study suggest that VLDL may play a role in growth of drug-resistant HER2-overexpressing cells. Lower expression of P-gp in presence of VLDL need to be investigated further.
Fulltext Tailored spectroscopic characteristics of a new type of CuO nanoparticles-inserted borate glass system: Samarium concentration tuning effect

Abdullahi I, Hashim S, Ghoshal SK, Sayyed MI

Heliyon, 2023 Oct;9(10):e20262.
PMID: 37767474 DOI: 10.1016/j.heliyon.2023.e20262

The demand for new glass hosts with emergent properties is constantly growing for various miniaturized applications. Thus, some new types of Sm2O3-activated strontium-telluro-alumino-magnesium-borate glasses with copper oxide nanoparticles (CuONps) insertion were made using melt-quenching approach. The obtained glasses were characterized to determine the effects of Sm2O3 concentration changes on their thermal, structural, and luminescence properties. XRD, FTIR, and HRTEM analyses of the samples verified their glassy nature, presence of different functional units and CuONps, respectively. DTA analysis showed excellent thermal stability of these glasses with a stability factor as much as 125 °C. The optical absorption properties of the glasses were highly sensitive to Sm3+ concentrations variation. The Judd-Ofelt intensity parameters of the glasses with and without CuONps followed the trend of Ω6˃Ω4˃Ω2 and Ω4˃Ω6˃Ω2, respectively. These glasses displayed 4 visible luminescence bands at 561, 598, 645, and 705 nm corresponding to 4G5/2 → 6H5/2, 4G5/2 → 6H7/2, 4G5/2 → 6H9/2, and 4G5/2 → 6H11/2 transitions in Sm3+. In addition, branching ratio above 80% and stimulated emission cross-section up to 135.82 × 10-23 cm2 were achieved. The stimulated emission cross-section and optical gain were enhanced due to the inclusion of CuONps in the glasses. These glasses may be useful for solid state laser and optical amplifier development.
Fulltext Intense up-conversion luminescence from Dy3+-doped multi-component telluroborate glass matrix: Role of CuO nanoparticles embedment

Abdullahi I, Hashim S, Sayyed MI, Ghoshal SK

Heliyon, 2023 May;9(5):e15906.
PMID: 37215796 DOI: 10.1016/j.heliyon.2023.e15906

This paper reports an intense up-conversion luminescence from Dy3+-doped strontium-telluro-alumino-magnesium-borate glasses for the first time. The samples were made via the melt-quenching method and characterized to determine the influence of various CuO nanoparticles contents change on their up-conversion emission traits. Absorption spectral data were used to calculate the Judd-Ofelt intensity parameters. The sample without CuO nanoparticles revealed two intense photoluminescence up-conversion emission peaks at 478 and 570 nm. In addition, CuO nanoparticles-activated sample displayed about 1.4-fold up-conversion emission intensity improvement due to strong light absorption in the visible to the infrared region at 799 nm excitation. The stimulated emission cross-section of the CuO nanoparticles-activated glasses was increased from 102.4 × 10-23 to 1301.1 × 10-23 cm2 (nearly 10-fold amplification) while the branching ratio was reduced to 66.9%. Thus, CuO nanoparticles as an additive in the current glass matrix enhanced the up-conversion emission and strengthened the associated nonlinear optical properties. CIE 1931 color matching revealed the influence of CuO in modifying the up-conversion color coordinates, thereby improving the white color purity. The achieved up-conversion emission coupled with the color tunability of the proposed glasses may be advantageous for the up-conversion UV tunable laser making.
Current status of filariasis in Malaysia

Marzhuki MI, Tham AS, Poovaneswari S

Southeast Asian J Trop Med Public Health, 1993;24 Suppl 2:10-4.
PMID: 7973937

The Filariasis Control Program was established more than 30 years ago in the country and the disease is still a public health problem in some states. Since 1983, a total of 17 filariasis control teams were formed throughout the country to carry out filariasis control work. The teams conduct house and population censuses, nocturnal mass blood surveys and treatment of microscopically confirmed cases. Individual case follow-up is being carried out after 3-5 months while the locality is resurveyed after about 2-3 years. During the years 1988 to 1990, there appeared to be a decreasing trend in the number of filariasis cases detected countrywide. In 1991, brugian filariasis accounted for 92% of the cases detected. The microfilaria rate (MFR) also showed a decreasing trend countrywide for the years 1988 (0.57%) to 1990 (0.35%) but there was an increase in 1991 although it remained well below the 5% MFR targeted in the program objective, In 1991, the filariasis control teams and the district multi-purpose teams collected a total of 167, 151 blood slides out of which 871 were found to be positive for microfilaria. To determine the true endemicity of filariasis in the country, the malaria district multi-purpose teams are also utilized to assist in probe surveys in new areas of the district. Two species of filarial worms, namely Brugia malayi and Wuchereria bancrofti, and the mosquito vectors belonging to the Anopheles and Mansonia genera are involved in the transmission of filariasis in Malaysia. Monkeys and domestic cats are the reservoir hosts for the subperiodic strain of B. malayi.
The prevalence of goitre in remote inland versus coastal areas

Osman A, Zaleha MI, Letchumen R, Khalid BA

Med J Malaysia, 1995 Sep;50(3):256-62.
PMID: 8926905

The study was conducted to compare the prevalence of goitre among Malays and Aborigines in remote inland rural areas to those in coastal areas. All subjects were examined thoroughly by an experienced endocrinologist for the presence of goitre. The overall goitre prevalence in coastal areas was 6.3%; 6.0% (4/67) of Aborigines and 6.7% (4/60) of Malays were affected. However, in remote inland areas, the prevalence of goitre was almost 5 times higher compared to coastal areas. The prevalence of goitre was 30.7% in Baling; 30.2% (19/63) Aborigines and 30.8% (92/299) Malays were affected. Iodine deficiency is the most likely cause for the high prevalence of goitre in the remote inland areas.
Fulltext Learning parts of speech using poems

Syed,A,B,S,S,, Rahim,M, I,, Zainal,A,Dz,

Jurnal Inovasi Malaysia, 2019;1(1):33-42.
MyJurnal

ABSTRACT
Many language learners face difficulties in applying and using the parts
of speech in a given situation. It has become a challenge for teachers to
navigate a grammar lesson in a creative way that can help learners to
understand and apply the concepts most appropriately. Thus, POS-UP
designed as a supplementary teaching tool to allow language learners to
practice using the most suitable parts of speech in a sentence. Targeted at
English language learners, POS-UP is a game which provides players with
the opportunity to learn details of a lesson using poems written by local
poets. In this game, language learners must complete a poem by using
words with the correct parts of speech. In making sure that this game reaches
its objectives and fulfils the needs of the students, a survey was carried out
to find out the perceptions of English language learners towards POS-UP.
The result shows that learners who play this game find it enjoyable and
helpful in enhancing their understanding of parts of speech. It is hoped
that POS-UP will be a useful supplementary teaching tool for teachers in
the classroom. It is also expected that students will build an appreciation
towards poems written by local poets.
Fulltext Diagnostic Performance and Eye Movement Parameters during Radiographic Image Interpretation among Radiographers

Ibrahim, M. I., Mohd Norsuddin, N., Che Isa, I. N., Azman, N. F., Mohamad Shahimin, M.

Physics and Technology in Medicine, 2020;1(2):12-19.
MyJurnal

The radiographer's role in the imaging field is producing the best image to diagnose. Hence, this study is conducted to justify the ability of radiographers in terms of diagnostic performance and visual search patterns during radiographic image interpretation based on their experience. The musculoskeletal radiographic images were chosen as radiographers are expected to perform image interpretation in the red dot system as one of the expanded and extended roles of the radiographer. Sensitivity and specificity in the detection of abnormality are measured. The gaze plot, fixation count and duration are compared between groups of radiographers by using an eye tracker. 19 radiographic images consist of upper and lower extremities are used as stimuli in this study. The result from this study shows no significant difference in terms of sensitivity and specificity with a p-value of 0.818 and 0.146 respectively. For visual search pattern, two images have significant different in term of fixation count (Image 1, p = 0.017; Image 2, p = 0.042) and two images in fixation duration (Image 1, p = 0.001; Image 15, p = 0.021). The gaze plot is not different from an unstructured pattern and less coverage. In conclusion, the experience did not give an influence on the radiographic image interpretation. This may suggest that specific training in areas appropriate to the development of the radiographer could improve the image interpretation.
Fulltext Characterisation of biodegradable protein based films from gelatin alternative: a review

Nazmi, N. N. M., Isa, M. I. N., Sarbon, N. M.

International Food Research Journal, 2020;27(6):971-987.
MyJurnal

Protein-based films are thin and flexible films derived from protein sources. They are
completely biodegradable and used in food engineering, packaging, drug recovery, and other
applications. In food packaging, gelatin is widely used due to properties such as low cost,
availability, functional attributes, mechanical (flexibility and tension) and optical (brightness
and opacity) strength, barrier against gas flow, and structural resistance to water and
microorganisms. Therefore, this paper reviews the characterisation of biodegradable
protein-based films from gelatin alternatives, mainly from fish and chicken skin, as food
packaging materials. The properties of film packaging derived from gelatin alternatives were
compared with films derived from mammalian gelatin. The findings showed that the blended
gelatin alternatives with polysaccharide improved physical properties such as water vapour
permeability, gas permeability, light transmission and transparency, thermal properties,
microstructure, colour, and heat sealability. Moreover, improvements in mechanical
properties such as tensile strength and elongation at break were also investigated. This review
also comes out with suggestions for future research on the compatibility between gelatin films
and food ingredients. This paper provides a comprehensive overview that promotes the
development of biodegradable blended films from gelatin alternatives for packaging
applications in the food industry and related fields.
Fulltext A Giant Parapharynge alSpace Carcinoma Ex-Ple omorphic Ade noma: A Cas e Report

Aishah Harizah AA, Salman A, Khairudin A, Fairuz M I, Mohd Sayuti R, Nor Kamarruzaman E

Asian Journal of Medicine and Biomedicine, 2019;3(2):1-3.
MyJurnal

Parapharyngealspace tumor has been known to be uncommon. It accounts only about 0.5% of head and neck neoplasm.Most of the lesions are benign in nature and salivary gland neoplasm being the most common.A 32-year old Ma lay gentle man presented with long-standing parapharyngeal mass which m ialized the latera l pharyngeal wa ll. Biopsy was taken intraorally by soft pa late mucosal incisionrevealed carcino ma e x-p leo morphic adeno maand t ranscervical approach successfully re moved the mass in total. Post-operative radiotherapy was commenced and patient is we ll until recent fo llo w up.Despite of the rarity of pleomorphic adenoma in parapharyngeal space, it should be a mong the differential diagnosis and a complete removal should be the aim as ma lignant transformation is possible in this type of pathology. Computed tomographyscan e xtending fro m base of skull till upper thora x a re important in p lanning the approach for complete removal of the mass followed by radiotherapy in malignant transformation cases.
Fulltext Preparation and physical properties of gelatin/CMC/chitosan composite films as affected by drying temperature

Jahit, I. S., Nazmi, N. N. M., Isa, M. I. N., Sarbon, N. M.

International Food Research Journal, 2016;23(3):1068-1074.
MyJurnal

This study examined the effects of drying temperatures (25 and 45 °C) on the physical properties
of different formulations of gelatin/CMC/chitosan composite films. The physical properties
of each formulated film were assessed via Fourier Transform Infra-Red (FTIR) spectroscopy,
X-Ray Diffractometry (XRD), Water Vapour Permeability (WVP) and biodegradability. The
incorporation of CMC and chitosan significantly influenced film properties. Increased chitosan
concentrations reduced the film’s amorphous character by increasing its crystalline structure.
The blended films also exhibited amino peaks that shifted from 1542 to ~1548 cm-1 while NH
and/or OH peaks shifted from 3384 to 3288 cm-1. Formulation E had the second lowest WVP
for both drying condition and the highest weight loss for biodegradability after burial in soil for
5 days. In conclusion, different temperature did not affect the properties of film produced and
formulation E qualified as ‘high quality packaging material’ with promising potential for the
food packaging industry.
Fulltext An overview on the performance of nano silica materials on the properties of porous concrete pavement

Mohd Yusak, M. I., Putra Jaya, R., Hainin, M. R., Wan Ibrahim, M. H.

Journal of Advanced Review on Scientific Research, 2014;1(1):344-42.
MyJurnal

Porous concrete technology has been used since 1970s in various parts of the United States
as an option in complex drainage systems and water retention areas. Porous concrete pavements have
become popular as an effective stormwater management device to control stormwater runoff in
pavement. Porous concrete pavement is being used as one of the solutions to decrease the stormwater
runoff by capturing and allowing rainwater to drain into the land surface. The main problem of porous
concrete pavement is its strength. The objective of this paper is to review the use and performance of
nano silica in porous concrete pavement and previous laboratory study on porous concrete pavement.
From the literature review, it was found that the conventional porous concrete pavement does not have
good strength for pavement purpose. An addition of nano-material will improve the physical and
chemical properties of porous concrete pavement. To improve the strength of the porous concrete,
various additives have been studied as a part of porous concrete mix and yet, the optimum condition to
produce good porous concrete has still not been established. From the previous study, it was found that
in preparing the porous concrete laboratory specimen, the use of standard Proctor hammer (2.5 kg)
and pneumatic press (70 kPa compaction effort) resulted in the closest properties to the field porous
concrete.
Synthesis of graphene flakes over recovered copper etched in ammonium persulfate solution

Nizam MK, Sebastian D, Kairi MI, Khavarian M, Mohamed AR

Sains Malaysiana, 2017;46:1039-1045.

The synthesis of high quality graphene via economic way is highly desirable for practical applications. In this study, graphene flake was successfully synthesized on Cu/MgO catalyst derived from recovered Cu via etching in ammonium persulfate solution. Recovered Cu acted as efficient active metal in Cu/MgO catalyst with good crystal structure and composition according to XRD and XRF results. FESEM, EDX, HRTEM, Raman spectroscopy and SAED analysis were carried out on the synthesized graphene. The formation of single, bilayer and few layer of graphene from Cu/MgO catalyst derived from recovered Cu was feasible.
Fulltext Metamaterial-Embedded Low SAR PIFA for Cellular Phone

Faruque MR, Hossain MI, Misran N, Singh M, Islam MT

PLoS One, 2015;10(11):e0142663.
PMID: 26599584 DOI: 10.1371/journal.pone.0142663

A metamaterial-embedded planar inverted-F antenna (PIFA) is proposed in this study for cellular phone applications. A dual-band PIFA is designed to operate both GSM 900 MHz and DCS 1800 MHz. The ground plane of a conventional PIFA is modified using a planar one-dimensional metamaterial array. The investigation is performed using the Finite Integration Technique (FIT) of CST Microwave Studio. The performance of the developed antenna was measured in an anechoic chamber. The specific absorption rate (SAR) values are calculated considering two different holding positions: cheek and tilt. The SAR values are measured using COMOSAR measurement system. Good agreement is observed between the simulated and measured data. The results indicate that the proposed metamaterial-embedded antenna produces significantly lower SAR in the human head compared to the conventional PIFA. Moreover, the modified antenna substrate leads to slight improvement of the antenna performances.
Fulltext Molecular DNA identification of medicinal plants used by traditional healers in Malaysia

Aziz NA, Ahmad MI, Naim DM

Genet. Mol. Res., 2015;14(4):15937-47.
PMID: 26662385 DOI: 10.4238/2015.December.7.5

Plants have been used throughout human history for food and medicine. However, many plants are toxic, and cannot easily be morphologically distinguished from non-toxic plants. DNA identification solves this problem and is widely used. Nonetheless, plant DNA barcode identification faces a number of challenges, and many studies have been conducted to find suitable barcodes. The present study was conducted to test the efficiency of commonly used primers, namely ITS2, rpoC1, and trnH-psbA, in order to find the best DNA barcode markers for the identification of medicinal plants in Malaysia. Fresh leaves from 12 medicinal plants that are commonly used by Malay traditional healers were collected from the Tropical Spice Garden, Pulau Pinang, and subjected to polymerase chain reaction amplification using ITS2, rpoC1, and trnH-psbA DNA markers. We found that trnH-psbA is the best DNA marker for the species-level identification of medicinal plants in Malaysia.
Fulltext Recognizing life-threatening features of dengue in children and health seeking behavior in dengue emergency amongst parents and carers: A cross-sectional study in Gombak district, Malaysia

Ariffin F, Ramli AS, Naim N, Selamat MI, Syed-Jamal SJ

Med J Malaysia, 2014 Oct;69(5):210-5.
PMID: 25638233

Dengue is life-threatening and the paediatric population is highly susceptible to complications. Deterioration can occur rapidly and ability to recognise early warning signs is crucial. This study aims to determine the knowledge and awareness of parents and carers and to predict their ability in recognising life-threatening symptoms and signs of dengue in children and to assess their health-seeking behaviour in dengue emergency. Methods This is a crosssectional study involving parents and carers of children ≤ 12 years old in schools and kindergartens in the Gombak district. Demographic details, knowledge on life-threatening symptoms and signs of dengue and health-seeking behaviour were collected using a self-administered questionnaire and knowledge scoring was done. The questionnaire was pilot tested with a Cronbach alpha of 0.82. The results were analysed using SPSS version 20.0. Results Total respondents were 866 with 44.8% men and 55.2% women. The mean age was 40.3 years (SD ± 5.7). Knowledge score of dengue life threatening features among respondents were good (30.0%) to average (56.8%). Respondents were able to recognise fever (98.5%), petechial rash (97.1%) and bleeding (65.2%) but were less able to recognise abdominal pain (22.3%) and passing less urine (28.2%) as life threatening dengue features. However, the ability to recognise fever is a poor predictor in recognising life threatening dengue in children compared to all other symptoms which were good predictors. A respondent that recognise stomach pain or neck stiffness were five times more likely to recognise life-threatening dengue. Respondents preferred to bring their children to the clinic (50.8%) or hospital (37.8%) themselves Instead of calling for ambulance. Worryingly, some would give antipyretics (3.6%) or wait for improvements (7.8%). Conclusion Concerted efforts by the schools, healthcare professionals and health authorities are required to educate parents and carers to identify life-threatening features of dengue and to improve their health seeking-behaviour.
Multi-sources data fusion framework for remote triage prioritization in telehealth

Salman OH, Rasid MF, Saripan MI, Subramaniam SK

J Med Syst, 2014 Sep;38(9):103.
PMID: 25047520 DOI: 10.1007/s10916-014-0103-4

The healthcare industry is streamlining processes to offer more timely and effective services to all patients. Computerized software algorithm and smart devices can streamline the relation between users and doctors by providing more services inside the healthcare telemonitoring systems. This paper proposes a multi-sources framework to support advanced healthcare applications. The proposed framework named Multi Sources Healthcare Architecture (MSHA) considers multi-sources: sensors (ECG, SpO2 and Blood Pressure) and text-based inputs from wireless and pervasive devices of Wireless Body Area Network. The proposed framework is used to improve the healthcare scalability efficiency by enhancing the remote triaging and remote prioritization processes for the patients. The proposed framework is also used to provide intelligent services over telemonitoring healthcare services systems by using data fusion method and prioritization technique. As telemonitoring system consists of three tiers (Sensors/ sources, Base station and Server), the simulation of the MSHA algorithm in the base station is demonstrated in this paper. The achievement of a high level of accuracy in the prioritization and triaging patients remotely, is set to be our main goal. Meanwhile, the role of multi sources data fusion in the telemonitoring healthcare services systems has been demonstrated. In addition to that, we discuss how the proposed framework can be applied in a healthcare telemonitoring scenario. Simulation results, for different symptoms relate to different emergency levels of heart chronic diseases, demonstrate the superiority of our algorithm compared with conventional algorithms in terms of classify and prioritize the patients remotely.

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