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Fulltext Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

Yusuf A, Mamun ASMA, Kamruzzaman M, Saw A, Abo El-Fetoh NM, Lestrel PE, et al.

BMC Pediatr, 2019 06 29;19(1):213.
PMID: 31255172 DOI: 10.1186/s12887-019-1581-9

BACKGROUND: Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition.
METHODS: Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis.
RESULTS: Data from 2231 children aged 6-59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers (p

Matched MeSH terms: Infant Nutrition Disorders/complications
Single incision laparoscopic surgery (SILS) inguinal hernia repair - recent clinical experiences of this novel technique

Yussra Y, Sutton PA, Kosai NR, Razman J, Mishra RK, Harunarashid H, et al.

Clin Ter, 2013;164(5):425-8.
PMID: 24217830 DOI: 10.7417/CT.2013.1608

Inguinal hernia remains the most commonly encountered surgical problem. Various methods of repair have been described, and the most suitable one debated. Single port access (SPA) surgery is a rapidly evolving field, and has the advantage of affording 'scarless' surgery. Single incision laparoscopic surgery (SILS) for inguinal hernia repair is seen to be feasible in both total extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) approaches. Data and peri-operative information on both of these however are limited. We aimed to review the clinical experience, feasibility and short term complications related to laparoscopic inguinal hernia repair via single port access. A literature search was performed using Google Scholar, Springerlink Library, Highwire Press, Surgical Endoscopy Journal, World Journal of Surgery and Medscape. The following search terms were used: laparoscopic hernia repair, TAPP, TEP, single incision laparoscopic surgery (SILS). Fourteen articles in English language related to SILS inguinal hernia repair were identified. Nine articles were related to TEP repair and the remaining 5 to TAPP. A total of 340 patients were reported within these studies: 294 patients having a TEP repair and 46 a TAPP. Only two cases of recurrence were reported. Various ports have been utilized, including the SILS port, Tri-Port and a custom- made port using conventional laparoscopic instruments. The duration of surgery was 40-100 minutes and the average length of hospital stay was one day. Early outcomes of this novel technique show it to be feasible, safe and with potentially better cosmetic outcome.

Matched MeSH terms: Postoperative Complications/etiology; Postoperative Complications/epidemiology
Cognitive Function Among Obstructive Sleep Apnea Patients in North East Malaysia

Yusop CYC, Mohamad I, Mohammad WMZW, Abdullah B

J Natl Med Assoc, 2017 04 03;109(3):215-220.
PMID: 28987252 DOI: 10.1016/j.jnma.2017.03.004

INTRODUCTION: Obstructive sleep apnea patients may develop deficits in the cognitive domains of attention, concentration, executive function, verbal and visuospatial memory, constructional abilities, and psychomotor functioning. As cognitive performance will improve with the treatment, early screening for cognitive dysfunction should be done to prevent further deterioration.
OBJECTIVE: We aim to evaluate the cognitive function of obstructive sleep apnea patients by using the 'Mini Mental State Examination'.
METHODOLOGY: This was a cross sectional study to evaluate the cognitive function of moderate and severe obstructive sleep apnea patients with age ranged from 18 to 60 old who attended our sleep clinic. These patients were confirmed to have moderate and severe obstructive sleep apnea by Type 1 polysomnography (attended full overnight study). The age, gender and ethnicity were noted and other relevant data such as weight, height, body mass index and apnea and hypopnoea index were recorded accordingly. The cognitive function was evaluated using validated Malay version of Mini Mental State Examination which measured 5 areas of cognitive functions comprising orientation, registration, attention and calculation, word recall and language abilities, and visuospatial.
RESULTS: A total of 38 patients participated in this study. All 19 patients of moderate group and 14 patients of severe group had normal cognitive function while only 5 patients in severe group had mild cognitive function impairment. There was a statistically significant difference between the moderate group and severe group on cognitive performance (p value = 0.042).
CONCLUSIONS: Severe obstructive sleep apnea patients may have impaired cognitive function. Mini Mental State Examination is useful in the screening of cognitive function of obstructive sleep apnea patients but in normal score, more sophisticated test batteries are required as it is unable to identify in 'very minimal' or 'extremely severe' cognitive dysfunction.

Matched MeSH terms: Sleep Apnea, Obstructive/complications*
High prevalence of Southeast Asian ovalocytosis in Malays with distal renal tubular acidosis

Yusoff NM, Van Rostenberghe H, Shirakawa T, Nishiyama K, Amin N, Darus Z, et al.

J Hum Genet, 2003;48(12):650-653.
PMID: 14618420 DOI: 10.1007/s10038-003-0095-2

Southeast Asian ovalocytosis (SAO) is a red blood cell abnormality common in malaria-endemic regions and caused by a 27 nt deletion of the band 3 protein gene. Since band 3 protein, also known as anion exchanger 1, is expressed in renal distal tubules, the incidence of SAO was examined in distal renal tubular acidosis (dRTA) in Malays in Kelantan, Malaysia. Twenty-two patients with dRTA and 50 healthy volunteers were examined for complication of SAO by both morphological and genetic analyses. SAO was identified in 18 of the 22 dRTA patients (81.8%), but only two of the 50 controls (4%). The incidence of SAO was significantly high in those with dRTA (p<0.001), indicating a dysfunctional role for band 3 protein/anion exchanger 1 in the development of dRTA.

Matched MeSH terms: Acidosis, Renal Tubular/complications; Elliptocytosis, Hereditary/complications
Fulltext ALLHAT in perspective: implications to clinical practice and clinical trials

Yusoff K

Med J Malaysia, 2005 Jun;60(2):239-45.
PMID: 16114170

ALLHAT study is the biggest randomized clinical trial in hypertension ever conducted. Its objective was to ompare the efficacy of newer (calcium channel blocker amlodipine and angiotensin-converting enzyme inhibitor inopril) to the older (diuretic chlorthalidone) antihypertensive agents in the treatment of patients with hypertension. After enrolling 42,000 patients who were followed for an average of 4.9 years, ALLHAT did not find significant differences in the primary end-points between these antihypertenive agents. ALLHAT however found significant differences in the secondary end-points such as heart failure and strokes between chlorthalidone and amlodipine or lisinopril. Based on these and on economic reasons, the investigators unequivocally recommended diuretics as the first line therapy for hypertension. Since its publication, ALLHAT has been much discussed, debated A and opined. The choice of drugs for study, the study design, the conduct of the study and the conclusions drawn by the investigators had all been criticised or controversial. Yet ALLHAT has been widely quoted, commented upon or referred to and it has been instrumental in initiating the JNC VII Guidelines. Thus a thorough understanding of ALLHAT is necessary for clinical practice and in designing and evaluating clinical trials in the future. Moving Points: in Medicine will capture the essence of ALLHAT, discusses its implications to clinical trials and explores its possible impact on the practice of medicine in this country.

Matched MeSH terms: Hypertension/complications
Fulltext Acute coronary syndromes. I. Recent advances in pathogenesis

Yusoff K

Med J Malaysia, 1998 Mar;53(1):117-23; quiz 124.
PMID: 10968152

New knowledge on the pathogenesis of the acute coronary syndromes provides the clinician with a better understanding of these important, often life-threatening, events and opens up new ways of managing them. The identification of the vulnerable plaque whilst important and possible pathologically still requires elaborate and often invasive methods. The central role of inflammation and the platelets in these syndromes has already been translated into practical therapeutics. Identifying and predicting which plaque would rupture and thereby facilitating the formation of an acute obstructive thrombus continue as major challenges to the clinician, but, in the meantime, regressing and stabilising these plaques are achievable goals.

Matched MeSH terms: Coronary Artery Disease/complications*
Fulltext Review of the Long-term Effects of Autologous Bone-Marrow Mononuclear Cell Implantation on Clinical Outcomes in Patients with Critical Limb Ischemia

Yusoff FM, Kajikawa M, Matsui S, Hashimoto H, Kishimoto S, Maruhashi T, et al.

Sci Rep, 2019 05 22;9(1):7711.
PMID: 31118440 DOI: 10.1038/s41598-019-44176-5

Critical limb ischemia (CLI) is associated with a high risk of limb amputation. It has been shown that cell therapy is safe and has beneficial effects on ischemic clinical symptoms in patients with CLI. The aim of this study was to further investigate the outcomes of intramuscular injection of autologous bone-marrow mononuclear cells (BM-MNCs) in a long-term follow-up period in atherosclerotic peripheral arterial disease (PAD) patients who have no optional therapy. This study was a retrospective and observational study that was carried out to evaluate long-term clinical outcomes in 42 lower limbs of 30 patients with atherosclerotic PAD who underwent BM-MNC implantation. The median follow-up period was 9.25 (range, 6-16) years. The overall amputation-free rates were 73.0% at 5 years after BM-MNC implantation and 70.4% at 10 years in patients with atherosclerotic PAD. The overall amputation-free rates at 5 years and at 10 years after implantation of BM-MNCs were significantly higher in atherosclerotic PAD patients than in internal controls and historical controls. There were no significant differences in amputation rates between the internal control group and historical control group. The rate of overall survival was not significantly different between the BM-MNC implantation group and the historical control group. Implantation of autologous BM-MNCs is feasible for a long-term follow-up period in patients with CLI who have no optional therapy.

Matched MeSH terms: Peripheral Arterial Disease/complications
Severe progressive periodontal destruction due to radiation tissue injury

Yusof ZW, Bakri MM

J. Periodontol., 1993 Dec;64(12):1253-8.
PMID: 8106955

Cancer radiotherapy to the head and neck region results in short- and long-term radiation tissue injuries. Radiation bone injury is a long-term manifestation which could progress to osteoradionecrosis. A case of radiation tissue injury to the periodontium is presented. The possible pathogenesis of these events is described as they relate to the sequential radiographic changes observed over a period of 6 years until the involved teeth were exfoliated. The post-irradiation management of the teeth with advancing periodontal disease in the path of irradiation was by conservative means, including good personal oral hygiene care, scaling and root planing, periodic chlorhexidine irrigation, and topical fluoride application.

Matched MeSH terms: Periodontitis/complications; Radiation Injuries/complications*
Cervical cord compression due to ossified posterior longitudinal ligament associated with diffuse idiopathic skeletal hyperostosis

Yusof ZB, Pratap RC

Aust N Z J Med, 1990 Oct;20(5):697-8, 700.
PMID: 2126728

We describe a case of cervical cord compression due to ossified posterior longitudinal ligament in association with diffuse idiopathic skeletal hyperostosis, in a young female. Characteristic CT findings are described.

Matched MeSH terms: Hyperostosis, Diffuse Idiopathic Skeletal/complications*; Ossification, Heterotopic/complications*
Multiple external root resorption

Yusof WZ, Ghazali MN

J Am Dent Assoc, 1989 Apr;118(4):453-5.
PMID: 2708724

Presented is an unusual case of multiple external root resorption. Although the cause of this resorption was not determined, several possibilities are presented. Trauma from occlusion, periodontal and pulpal inflammation, and resorption of idiopathic origin are all discussed as possible causes.

Matched MeSH terms: Bone Resorption/complications; Dental Occlusion, Traumatic/complications; Gingival Diseases/complications; Periodontal Abscess/complications
Fulltext Acute vascular complications (flap necrosis and congestion) with one stage and two stage distally based sural flap for wound coverage around the ankle

Yusof NM, Fadzli AS, Azman WS, Azril MA

Med J Malaysia, 2016 04;71(2):47-52.
PMID: 27326940 MyJurnal

INTRODUCTION: The understanding of the skin's vascular anatomy has improved in the last decade. It has lead to technique modification such as the staged procedure in performing sural flaps and improvement in the flap survival rate. The aim of this study was to evaluate the acute vascular complications (flap necrosis or congestion) of 29 patients who underwent distal base sural flap for coverage of wound around the ankle.

METHODS: Twenty-four males and five females with a mean age of 37.1 years old underwent sural flap surgery to cover wounds at around the ankle. There were 12 cases of open fracture, five infected fractures, four spoke injuries, four degloving injuries and four diabetic foot ulcers. Twentythree cases were done as a single stage procedure while six as a two-stage procedure. The flaps were tunnelled under the skin in three cases.

RESULTS: Twenty one flaps healed uneventfully, seven acute vascular complications occur in a single stage group: five developed partial necrosis, one had congestion with epidermolysis, and one had complete flap necrosis. Complications were treated by dressing or skin grafting and only one required a repeat flap surgery.

CONCLUSIONS: Acute vascular complications may be minimised when sural flap is done in stages for elderly, diabetic, smokers and/or patients with large wound around the ankle. Even if the flap appears necrotic, the underlying structure may still be covered as the fasciosubcutaneous layer of the flap may still survive.

Matched MeSH terms: Postoperative Complications
Fulltext Outcomes of infected grade IIIB open tibial fractures

Yusof NM, Halim AS

Singapore Med J, 2012 Sep;53(9):591-4.
PMID: 23023900

Infection following grade IIIB open tibial fracture is common. The primary aim of managing this condition is to achieve control of infection before the bone reconstruction procedure is performed. The outcomes for such patients have not been evaluated in the literature. This study was conducted to examine the outcome of a multi-stage procedure for the treatment of infected grade IIIB open tibial fractures.

Matched MeSH terms: Fractures, Open/complications; Tibial Fractures/complications
Fulltext Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

Yusof NM, Rahman JA, Zulkifly AH, Che-Ahmad A, Khalid KA, Sulong AF, et al.

Singapore Med J, 2015 Nov;56(11):626-31.
PMID: 26668408 DOI: 10.11622/smedj.2015172

Introduction: Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood.
Methods: This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis.
Results: A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.
Conclusion: T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.
Keywords: amputation; diabetes mellitus; diabetic foot; lower limb; type II.

Matched MeSH terms: Diabetes Mellitus, Type 2/complications*
Spinal tuberculosis: the association between pedicle involvement and anterior column damage and kyphotic deformity

Yusof MI, Hassan E, Rahmat N, Yunus R

Spine (Phila Pa 1976), 2009 Apr 1;34(7):713-7.
PMID: 19333105 DOI: 10.1097/BRS.0b013e31819b2159

Pedicle involvement in spinal tuberculosis (TB), the prevertebral abscess formation, severity of vertebral body, and disc collapse were evaluated from magnetic resonance imaging (MRI) of the patients.

Matched MeSH terms: Tuberculosis, Spinal/complications
Fulltext Morphometric analysis of skin microvasculature in the diabetic foot

Yusof MI, Al-Astani AD, Jaafar H, Rashid FA

Singapore Med J, 2008 Feb;49(2):100-4.
PMID: 18301834

INTRODUCTION: This study was designed to evaluate the histopathological features of skin microvasculature in patients with a diabetic foot, specifically the number of blood vessels, number of endothelial cells and endothelial thickness.
METHODS: This study involved 41 diabetic foot patients admitted to Hospital Universiti Sains Malaysia for surgical management of foot problems. Skin biopsies were taken for histological evaluation following surgical procedures, such as wound debridement or local foot amputation. The skin microvasculature features examined were the number of blood vessels, the endothelial thickness of the vessels and the cross-sectional endothelial cell count. The findings were compared with the similar parameters of non-diabetic patients (control) and analysed.
RESULTS: The mean blood vessel count (BVC), endothelial cell thickness (ECT) and endothelial cell count (ECC) for the diabetic group were 12.56 +/- 2.77, 4.81 +/- 1.5 micrometres and 7.07 +/- 1.88, respectively. The mean BVC, ECT and ECC for the non-diabetic control group were 5.25 +/- 1.98, 1.9 +/- 0.55 micrometres and 4.11 +/- 1.17, respectively. The mean BVC, ECT and ECC for the diabetic group were significantly higher than those for the non-diabetic control group.
CONCLUSION: The increased number of blood vessels to the skin and their endothelial cell number and thickness may be the contributing factors for problems related to the diabetic foot, such as tendency for skin ulceration, infection and poor wound-healing in these patients. These may also contribute to secondary changes of diabetic foot lesions, indicating failure of adequate vascularisation of the foot.

Matched MeSH terms: Diabetes Mellitus, Type 2/complications*
Fulltext Acute pulmonary embolism following Achilles tendon repair

Yusof MI

Singapore Med J, 2007 Aug;48(8):e234-6.
PMID: 17657374

Achilles tendon injury is common and surgical procedures related to it are frequently performed and are safe. The incidence of acute pulmonary embolism following these procedures is extremely rare. This case illustrates an incidence of acute pulmonary embolism following Achilles tendon repair in a 35-year-old woman. We discuss the possible causes and the need for thromboprophylaxis.

Matched MeSH terms: Postoperative Complications*
Fulltext Prevalence of glycemic variability and factors associated with the glycemic arrays among end-stage kidney disease patients on chronic hemodialysis

Yusof Khan AHK, Zakaria NF, Zainal Abidin MA, Kamaruddin NA

Medicine (Baltimore), 2021 Jul 30;100(30):e26729.
PMID: 34397709 DOI: 10.1097/MD.0000000000026729

Glycemic variability (GV) confers a significantly higher risk of diabetic-related complications, especially cardiovascular. Despite extensive research in this area, data on end-stage kidney disease (ESKD) patients on chronic hemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs nondiabetic) patients and its associated factors on hemodialysis days (HDD) and non-hemodialysis days (NHDD) where postulation of a higher GV observed among diabetic on HDD.We recruited 150 patients on hemodialysis, 93 patients with type 2 diabetic (DM-ESKD), and 57 with nondiabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage coefficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (fasting to post-meal) (SMBG) profiles on HDD and NHDD. The GV indices and its associated factors of both DM-ESKD and NDM-ESKD were analyzed to compare HDD vs NHDD.Mean blood glucose on HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared with 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (P =

Matched MeSH terms: Diabetes Mellitus, Type 2/complications; Kidney Failure, Chronic/complications
Hydatidiform mole: problems in early diagnosis

Yusof K

Med J Malaysia, 1973 Jun;27(4):275-9.
PMID: 4270785
Matched MeSH terms: Hydatidiform Mole/complications
Phenotypic 'variant' forms of Trichomonas vaginalis trophozoites from cervical neoplasia patients

Yusof AM, Kumar S

Exp Parasitol, 2012 Jul;131(3):267-73.
PMID: 22525014 DOI: 10.1016/j.exppara.2012.03.015

The protozoan Trichomonas vaginalis a sexually transmitted protozoan parasite causes vaginitis, urethritis and cervicitis in humans. The present study highlights phenotypic 'variant' forms of trophozoites isolated from patients suffering from cervical neoplasia condition. The growth curve of 10 isolates i.e., four non-cervical neoplasia (NCN) isolates (NCN1-NCN4) and six cervical neoplasia (CN) isolates (CN1-CN6) showed two distinct and different in vitro growth profiles. The parasite count and growth rates were significantly higher in trophozoites from CN isolates in cultures of day 2 up to day 8 (p<0.05, Mann-Whitney test). The average generation time was 1.84±0.40 and 3.38±0.55h for NCN and CN isolates respectively. The nucleus of trophozoites in CN isolates using acridine orange and DAPI showed more intense staining revealing higher nuclear content. The FITC-labeled Concanavalin A stained stronger green fluorescence with surface of trophozoites in CN isolates showing more rough and creased surface with numerous deep micropores. Transmission electron microscopy studies revealed that there was higher numbers of vacuoles and hydrogenosomes in these forms. The study mounted staining techniques, growth profiles, morphology, morphometry studies using scanning and transmission electron microscopy and confirms that the trophozoites from cervical neoplasia proliferates at a higher rate, shows higher FITC-labeled Concanavalin A binding with rough and creased surface implying that these are virulent forms which can aggravate or exacerbate cervical neoplasia conditions. The large numbers of hyrogenosomes and vacuoles implies that these forms are active and implicates a possible role in such conditions.

Matched MeSH terms: Uterine Cervical Neoplasms/complications; Trichomonas Vaginitis/complications
Elective proximal lower limb amputation in spinal cord injury patients with chronic pressure ulcers: improve quality of life, function, and shorten hospital stay. Case report

Yusmido YA, Hisamud-Din N, Mazlan M

Eur J Phys Rehabil Med, 2014 Oct;50(5):557-60.
PMID: 24694951

Pressure ulcers are common among patients with spinal cord injury and can be very challenging to treat. The treatment involves multidisciplinary approach and ranges from simple pressure relieve and wound dressings to a more radical treatment like proximal lower limb amputations, especially in chronic cases with potential detrimental effects to physical and mental health.

Matched MeSH terms: Spinal Cord Injuries/complications*

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