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Post-traumatic hydrocephalus

Mohd Nor MA, Abdul Rahman NA, Adnan JS

Malays J Med Sci, 2013 Jan;20(1):95-6.
PMID: 23613662
Fulltext Limited Evaluation of Image Quality Produced by a Portable Head CT Scanner (CereTom) in a Neurosurgery Centre

Abdullah AC, Adnan JS, Rahman NA, Palur R

Malays J Med Sci, 2017 Mar;24(1):104-112.
PMID: 28381933 DOI: 10.21315/mjms2017.24.1.11

INTRODUCTION: Computed tomography (CT) is the preferred diagnostic toolkit for head and brain imaging of head injury. A recent development is the invention of a portable CT scanner that can be beneficial from a clinical point of view.
AIM: To compare the quality of CT brain images produced by a fixed CT scanner and a portable CT scanner (CereTom).
METHODS: This work was a single-centre retrospective study of CT brain images from 112 neurosurgical patients. Hounsfield units (HUs) of the images from CereTom were measured for air, water and bone. Three assessors independently evaluated the images from the fixed CT scanner and CereTom. Streak artefacts, visualisation of lesions and grey-white matter differentiation were evaluated at three different levels (centrum semiovale, basal ganglia and middle cerebellar peduncles). Each evaluation was scored 1 (poor), 2 (average) or 3 (good) and summed up to form an ordinal reading of 3 to 9.
RESULTS: HUs for air, water and bone from CereTom were within the recommended value by the American College of Radiology (ACR). Streak artefact evaluation scores for the fixed CT scanner was 8.54 versus 7.46 (Z = -5.67) for CereTom at the centrum semiovale, 8.38 (SD = 1.12) versus 7.32 (SD = 1.63) at the basal ganglia and 8.21 (SD = 1.30) versus 6.97 (SD = 2.77) at the middle cerebellar peduncles. Grey-white matter differentiation showed scores of 8.27 (SD = 1.04) versus 7.21 (SD = 1.41) at the centrum semiovale, 8.26 (SD = 1.07) versus 7.00 (SD = 1.47) at the basal ganglia and 8.38 (SD = 1.11) versus 6.74 (SD = 1.55) at the middle cerebellar peduncles. Visualisation of lesions showed scores of 8.86 versus 8.21 (Z = -4.24) at the centrum semiovale, 8.93 versus 8.18 (Z = -5.32) at the basal ganglia and 8.79 versus 8.06 (Z = -4.93) at the middle cerebellar peduncles. All results were significant with P-value < 0.01.
CONCLUSIONS: Results of the study showed a significant difference in image quality produced by the fixed CT scanner and CereTom, with the latter being more inferior than the former. However, HUs of the images produced by CereTom do fulfil the recommendation of the ACR.
Fulltext History of Neurosurgery in Malaysia

Raffiq A, Abdullah JM, Haspani S, Adnan JS

Malays J Med Sci, 2015 Dec;22(Spec Issue):5-8.
PMID: 27006632 MyJurnal

The development of neurosurgical services and training in Malaysia began in 1963, with the first centre established in its capital city at Hospital Kuala Lumpur, aimed to provide much needed neurosurgical services and training in the field of neurology and neurosurgery. This center subsequently expanded in 1975 with the establishment of the Tunku Abdul Rahman Neuroscience Institute (IKTAR); which integrated the three allied interdependent disciplines of neurosurgery, neurology and psychiatry. The establishment of this institute catalysed the rapid expansion of neurosurgical services in Malaysia and paved the way for development of comprehensive training for doctors, nurses, and paramedics. This culminated in the establishments of a local comprehensive neurosurgery training program for doctors in 2001; followed by a training program for nurses and paramedics in 2006. To date, there are more than 60 neurosurgeons providing expert care in 11 centers across Malaysia, along with trained personnel in the field of neurosciences.
Fulltext Treatment outcome of superficial cerebral abscess: an analysis of two surgical methods

Tan WM, Adnan JS, Mohamad Haspani MS

Malays J Med Sci, 2010 Jan;17(1):23-9.
PMID: 22135522 MyJurnal

The purpose of the study is to compare the two surgical methods (burr hole and craniotomy) used as treatment for superficial cerebral abscess and its outcome in terms of radiological clearance on brain CT, improvement of neurological status, the need for repeated surgery, and survival and morbidity at three months after surgery. This report is a retrospective case review of the patients who were treated surgically for superficial cerebral abscess in Hospital Kuala Lumpur (HKL) and Hospital Sultanah Aminah (HSA) over a period of four years (2004 to 2007).
Fulltext Delayed traumatic intracranial haemorrhage and progressive traumatic brain injury in a major referral centre based in a developing country

Jeng TC, Haspani MS, Adnan JS, Naing NN

Malays J Med Sci, 2008 Oct;15(4):56-67.
PMID: 22589639

A repeat Computer Tomographic (CT) brain after 24-48 hours from the 1(st) scanning is usually practiced in most hospitals in South East Asia where intracranial pressure monitoring (ICP) is routinely not done. This interval for repeat CT would be shortened if there was a deterioration in Glasgow Coma Scale (GCS). Most of the time the prognosis of any intervention may be too late especially in hospitals with high patient-to-doctor ratio causing high mortality and morbidity. The purpose of this study was to determine the important predictors for early detection of Delayed Traumatic Intracranial Haemorrhage (DTICH) and Progressive Traumatic Brain Injury (PTBI) before deterioration of GCS occurred, as well as the most ideal timing of repeated CT brain for patients admitted in Malaysian hospitals. A total of 81 patients were included in this study over a period of six months. The CT scan brain was studied by comparing the first and second CT brain to diagnose the presence of DTICH/PTBI. The predictors tested were categorised into patient factors, CT brain findings and laboratory investigations. The mean age was 33.1 ± 15.7 years with a male preponderance of 6.36:1. Among them, 81.5% were patients from road traffic accidents with Glasgow Coma Scale ranging from 4 - 15 (median of 12) upon admission. The mean time interval delay between trauma and first CT brain was 179.8 ± 121.3 minutes for the PTBI group. The DTICH group, 9.9% of the patients were found to have new intracranial clots. Significant predictors detected were different referral hospitals (p=0.02), total GCS status (p=0.026), motor component of GCS (p=0.043), haemoglobin level (p<0.001), platelet count (p=0.011) and time interval between trauma and first CT brain (p=0.022). In the PTBI group, 42.0% of the patients were found to have new changes (new clot occurrence, old clot expansion and oedema) in the repeat CT brain. Univariate statistical analysis revealed that age (p=0.03), race (p=0.035), types of admission (p=0.024), GCS status (p=0.02), pupillary changes (p=0.014), number of intracranial lesion (p=0.004), haemoglobin level (p=0.038), prothrombin time (p=0.016) as the best predictors of early detection of changes. Multiple logistics regression analysis indicated that age, severity, GCS status (motor component) and GCS during admission were significantly associated with second CT scan with changes. This study showed that 9.9% of the total patients seen in the period of study had DTICH and 42% had PTBI. In the early period after traumatic head injury, the initial CT brain did not reveal the full extent of haemorrhagic injury and associated cerebral oedema. Different referral hospitals of different trauma level, GCS status, motor component of the GCS, haemoglobin level, platelet count and time interval between trauma and the first CT brain were the significant predictors for DTICH. Whereas the key determinants of PTBI were age, race, types of admission, GCS status, pupillary changes, number of intracranial bleed, haemoglobin level, prothrombin time and of course time interval between trauma and first CT brain. Any patients who had traumatic head injury in hospitals with no protocol of repeat CT scan or intracranial pressure monitoring especially in developing countries are advised to have to repeat CT brain at the appropriate quickest time .
Identification and characterization of the yellow pigment synthesized by Cupriavidus sp. USMAHM13

Ramachandran H, Iqbal MA, Amirul AA

Appl Biochem Biotechnol, 2014 Sep;174(2):461-70.
PMID: 25099372 DOI: 10.1007/s12010-014-1080-2

Microbial pigments are gaining intensive attention due to increasing awareness of the toxicity of synthetic colours. In this study, a novel polymer-producing bacterium designated as Cupriavidus sp. USMAHM13 was also found to produce yellow pigment when cultivated in nutrient broth. Various parameters such as temperature, pH and ratio of culture volume to flask volume were found to influence the yellow pigment production. UV-Visible, Fourier transform infrared and (13)C-nuclear magnetic resonance analyses revealed that the crude yellow pigment might probably represent new bioactive compound in the carotenoid family. The crude yellow pigment also exhibited a wide spectrum of antimicrobial activity against Gram-negative and Gram-positive bacteria with their inhibition zones and minimal inhibitory concentrations ranged from 25 to 38 mm and from 0.63 to 2.5 mg/ml, respectively. To the best of our knowledge, this is the first report on the identification and characterization of yellow pigment produced by bacterium belonging to the genus Cupriavidus.
A game of Chinese whispers in Malaysia: contextual analysis of child road safety education

Puvanachandra P, Kulanthayan S, Hyder AA

Qual Health Res, 2012 Nov;22(11):1476-85.
PMID: 22910586 DOI: 10.1177/1049732312457245

In 2006, the Malaysian government began implementing road safety education (RSE) programs in primary schools, involving numerous stakeholders. We interviewed 19 stakeholders. Thematic analysis led to the identification of four themes: road traffic injuries (RTIs) among children in Malaysia, the role of RSE, factors affecting successful implementation, and intersectoral involvement. The latter was identified as a significant strength of the overall approach to implementation, and is one of the first examples in Malaysia and in the region of such an approach. Lack of official documentation surrounding ownership, funding responsibilities, and roles among the various sectors led to resistance from some groups. Although we know from scientific studies what works in terms of reducing RTIs, the more important question is how such interventions can be successfully and sustainably implemented, particularly in low- and middle-income countries (LMIC). The results of this study permit stronger understanding of issues surrounding the implementation of RTI interventions in LMIC.
Fulltext Harmony Search Algorithm for Word Sense Disambiguation

Abed SA, Tiun S, Omar N

PLoS One, 2015;10(9):e0136614.
PMID: 26422368 DOI: 10.1371/journal.pone.0136614

Word Sense Disambiguation (WSD) is the task of determining which sense of an ambiguous word (word with multiple meanings) is chosen in a particular use of that word, by considering its context. A sentence is considered ambiguous if it contains ambiguous word(s). Practically, any sentence that has been classified as ambiguous usually has multiple interpretations, but just one of them presents the correct interpretation. We propose an unsupervised method that exploits knowledge based approaches for word sense disambiguation using Harmony Search Algorithm (HSA) based on a Stanford dependencies generator (HSDG). The role of the dependency generator is to parse sentences to obtain their dependency relations. Whereas, the goal of using the HSA is to maximize the overall semantic similarity of the set of parsed words. HSA invokes a combination of semantic similarity and relatedness measurements, i.e., Jiang and Conrath (jcn) and an adapted Lesk algorithm, to perform the HSA fitness function. Our proposed method was experimented on benchmark datasets, which yielded results comparable to the state-of-the-art WSD methods. In order to evaluate the effectiveness of the dependency generator, we perform the same methodology without the parser, but with a window of words. The empirical results demonstrate that the proposed method is able to produce effective solutions for most instances of the datasets used.
Cryptocaryon irritans recombinant proteins as potential antigens for sero-surveillance of cryptocaryonosis

Lokanathan Y, Mohd-Adnan A, Kua BC, Nathan S

J Fish Dis, 2016 Sep;39(9):1069-83.
PMID: 27086498 DOI: 10.1111/jfd.12474

Cryptocaryonosis is a major problem for mariculture, and the absence of suitable sero-surveillance tools for the detection of cryptocaryonosis makes it difficult to screen Cryptocaryon irritans-infected fish, particularly asymptomatic fish. In this study, we proposed a serum-based assay using selected C. irritans proteins to screen infected and asymptomatic fish. Eight highly expressed genes were chosen from an earlier study on C. irritans expressed sequence tags and ciliate glutamine codons were converted to universal glutamine codons. The chemically synthesized C. irritans genes were then expressed in an Escherichia coli expression host under optimized conditions. Five C. irritans proteins were successfully expressed in E. coli and purified by affinity chromatography. These proteins were used as antigens in an enzyme-linked immunosorbent assay (ELISA) to screen sera from experimentally immunized fish and naturally infected fish. Sera from both categories of fish reacted equally well with the expressed C. irritans recombinant proteins as well as with sonicated theronts. This study demonstrated the utility of producing ciliate recombinant proteins in a heterologous expression host. An ELISA was successfully developed to diagnose infected and asymptomatic fish using the recombinant proteins as antigens.
Evolution of high-level, multiple anthelmintic resistance on a sheep farm in Malaysia

Chandrawathani P, Waller PJ, Adnan M, Höglund J

Trop Anim Health Prod, 2003 Feb;35(1):17-25.
PMID: 12636358

Anthelmintic resistance in nematode parasites of sheep and goats on a government farm in north Malaysia was monitored over a 3-year period (1997-2000). The faecal egg count reduction test (FECRT) was conducted on young sheep at the beginning and end of this period. Changes in management, designed to reduce the selection pressure for the development of anthelmintic resistance, were also implemented during this time. By far the most important parasite problem was Haemonchus contortus. In 1997, this nematode was found to be resistant to levamisole, with suspected resistance to closantel and moxidectin. However, when the FECRT was repeated 3 years later, its resistance status had become much more severe, with resistance to benzimidazole, levamisole and ivermectin, and suspected resistance to moxidectin. This rapid evolution to multiple anthelmintic resistance is a major concern that needs to be arrested. There is an urgent need to evaluate other control strategies that incorporate livestock management, the 'smart' use of drugs and non-chemotherapeutic approaches, such as biological control agents.
Fulltext A Low-Cost Information Monitoring System for Smart Farming Applications

Saqib M, Almohamad TA, Mehmood RM

Sensors (Basel), 2020 Apr 22;20(8).
PMID: 32331212 DOI: 10.3390/s20082367

A low-cost, low-power, and low data-rate solution is proposed to fulfill the requirements of information monitoring for actual large-scale agricultural farms. A small-scale farm can be easily managed. By contrast, a large farm will require automating equipment that contributes to crop production. Sensor based soil properties measurement plays an integral role in designing a fully automated agricultural farm, also provides more satisfactory results than any manual method. The existing information monitoring solutions are inefficient in terms of higher deployment cost and limited communication range to adapt the need of large-scale agriculture farms. A serial based low-power, long-range, and low-cost communication module is proposed to confront the challenges of monitoring information over long distances. In the proposed system, a tree-based communication mechanism is deployed to extend the communication range by adding intermediate nodes. Each sensor node consists of a solar panel, a rechargeable cell, a microcontroller, a moisture sensor, and a communication unit. Each node is capable to work as a sensor node and router node for network traffic. Minimized data logs from the central node are sent daily to the cloud for future analytics purpose. After conducting a detailed experiment in open sight, the communication distance measured 250 m between two points and increased to 750 m by adding two intermediate nodes. The minimum working current of each node was 2 mA, and the packet loss rate was approximately 2-5% on different packet sizes of the entire network. Results show that the proposed approach can be used as a reference model to meet the requirements for soil measurement, transmission, and storage in a large-scale agricultural farm.
Fulltext Frequency and molecular epidemiology of Panton-Valentine leukocidin gene in Staphylococcus aureus colonising HIV-infected patients

Mohd-Zain Z, Mohd-Nawi SFA, Adnan A, Kumar S

Malays J Pathol, 2017 Aug;39(2):115-122.
PMID: 28866692 MyJurnal

BACKGROUND: HIV-infected patients pose a high risk of contracting skin and soft tissue infections caused by Staphylococcus aureus. Those who are colonized with methicillin-resistant S. aureus (MRSA) that carry Panton-Valentine leukocidin (PVL) are predisposed to severe infections that could lead to necrotic skin infections. However the association of S. aureus specifically methicillin sensitive S. aureus carrying PVL gene in HIV patients has not been widely reported. Here, we study the prevalence and the molecular epidemiology of PVL-producing S. aureus in HIV-infected patients.
METHODS: Swabs from four body sites of 129 HIV-infected patients were cultured for S. aureus and identified by standard microbiological procedures. The isolates were subjected to antimicrobial susceptibility testing by disk diffusion against penicillin, erythromycin, clindamycin, and cotrimoxazole. PCR was used to detect the PVL gene and genetic relationship between the isolates was determined by using pulse field gel electrophoresis.
RESULTS: A total of 51 isolates of S. aureus were obtained from 40 (31%) of the patients. The majority (43.1%) of the isolates were obtained from the anterior nares. Thirteen (25.5%) of all the isolates were resistant to more than one category of antibiotics, with one isolate identified as MRSA. Thirty-eight (74.5%) isolates (including the MRSA isolate) carried PVL gene where the majority (44.7%) of these isolates were from the anterior nares. A dendogram revealed that the isolates were genetically diverse with 37 distinct pulsotypes clustered in 11 groups.
CONCLUSION: S. aureus obtained from multiple sites of the HIV patients were genetically diverse without any clonality observed.
Does economic prosperity lead to environmental sustainability in developing economies? Environmental Kuznets curve theory

Ahmad M, Muslija A, Satrovic E

Environ Sci Pollut Res Int, 2021 May;28(18):22588-22601.
PMID: 33420933 DOI: 10.1007/s11356-020-12276-9

Since developing countries experience economic and environmental sustainability challenges, it is desirable digging into the linkages between economic and environmental parameters. The purpose of this work is to evaluate the existence of the environmental Kuznets curve (EKC) theory (i.e., the inverse U-shape connection between real GDP per capita and per capita carbon dioxide emissions) in the sample of 11 developing countries. By using balanced annual panel data in the period between 1992 and 2014 and two alternative estimation techniques, we explored the potential inverted U-shaped linkage between carbon dioxide emissions and real GDP per capita in the sample of interest. For analysis purposes, Pedroni and Westerlund co-integration techniques are employed. Then, fully modified ordinary least squares, pooled mean group methods are applied for long-run parameter estimations. And, the Dumitrescu-Hurlin causality approach is employed for causal directions. Firstly, this work's findings provide the supportive evidence to the inverse U-shaped linkage in the long-run, indicating that an increase in real GDP per capita and electricity consumption tends to mitigate long-run carbon dioxide emissions in the developing countries, for the whole sample. Secondly, the country-specific findings suggested the presence of EKC theory for Brazil, China, India, Malaysia, the Russian Federation, Thailand, and Turkey. It implicated that these countries are on the path of attaining environmental sustainability in the long-run. However, Mexico, Philippines, Indonesia, and South Africa failed to lend credence to the EKC theory. It manifested that these countries need to design strategies directed to reduce carbon dioxide emissions from economic activity and electricity generation through efficiency improvement or promotion of renewables. Finally, bidirectional causal links are observed among all the variables of interest. The findings suggest that country-specific targeted action plans should be implemented to ensure the environmental sustainability in the developing world.
Fulltext Effects of happy music on repetitive and restricted behaviours in children with autism spectrum disorders: a concept paper

Nurul Izzah Wahidul Azam, Amir Muhriz Abdul Latiff, Chandra Kannan Thanapalan, Raja Mohamad Alif Raja Adnan

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):93-93.
MyJurnal

Introduction: Restricted and repetitive behaviours (RRBs) is one of autism spectrum disorders (ASD) core criteria. Exhibitions of RRBs produce profound implications on the functional aspect of these children and family. Evidence found that RRBs is related to the reward system dysfunction in the basal ganglia of these children. RRBs induces intrinsically rewarding effects on children with ASD. Listening to music was found to influence the reward system on the typical population and also discover to be promising as complementary strategies for ASD. A study found that high functioning adolescents with ASD cognitively stimulated through listening to happy music. Planning inter-vention for RRBs by looking towards the mechanism of reward system function remained unexplored. The primary objectives of this study is to examine the effect of happy music on RRBs symptoms. Methods: This study will use a randomised control trial research design with pre-test and post-test assessments in 20 children with ASD. Two parallel randomly assigned group will undergo twelve weeks of intervention sessions. The experimental group will listen to happy music and engage in free play sessions. For the control group, they will engage in free play session only without the music. Parents will complete the Repetitive Behaviour Scale-Revised, which consists of 6 subscales on RRBs to measure the outcome of the study. Results: The study will compare the RRBs between two groups. Con-clusion: Outcome of this study may set forth further investigation on the management of RRB using non-aversive contemporary approach.
Protection of apricot biodiesel from thermal degradation by using natural antioxidants of fagopyrum tataricum(l.) gaertn

Ullah F, Wazir AH, Khattak A, Khan SZ, Hussain I

Sains Malaysiana, 2017;46:981-988.

The present study aims to improve the oxidation stability of wild apricot kernel oil biodiesel (WAKOB) by using natural antioxidants of Tartary buckwheat (Fagopyrum tataricum (L.) Gaertn). Biodiesel was synthesized at different catalyst (NaOH) concentrations, reaction temperatures, reaction time intervals and methanol-to-oil molar ratios. Thermal oxidative stability measurements were carried out according to EN14112 using a Rancimet instrument. Our results showed a high yield of biodiesel (97±1.092) at 65oC in the presence of 1% NaOH (%w/w oil) and methanol/oil molar ratio of 9:1 and for the time duration of 60 min. Proton nuclear magnetic resonance (1H NMR) confirmed the conversion percentage of kernel oil into biodiesel, which was further evidenced by Fourier transform infrared spectroscopy (FT-IR) and refractometer analyses. Methanolic fraction of Tartary buckwheat leaves (MTBWLF) was standardized to contain the highest amount of phenolics (209 mg gallic acid/100 g). In this study, the mixture of synthetic antioxidant butylated hydroxyl toluene (BHT) (0.25%) and methanolic extract of Tartary buckwheat leaves (0.5%) ensured high oxidation stability of biodiesel samples, leading to stabilizing factor of 4.86.
Health risks assessment diagnosis of toxic chemicals (heavy metals) via food crops consumption irrigated with wastewater

Khan MA, Mehmood S, Ullah F, Khattak A, Zeb MA

Sains Malaysiana, 2017;46:917-924.

The present study investigated the concentration of metals in commonly grown vegetables (Luffa acutangula L., Zea mays L., Solanum melongena L.) irrigated with waste water in District Bannu, Khyber Pakhtunkhwa, Pakistan. The pH (5.80) and electrical conductivity (13 dS/m) of waste water indicated the acidic nature that is not suitable for irrigation purposes. Soil and vegetables samples were analyzed for metals concentration through flame atomic absorption spectrometry (Varian FAAS-240). The findings showed that waste water irrigated soil was highly contaminated with Cd (4.62 mg/kg) which was above permissible limits set by European Union Standard (EU 2006, 2002). The concentrations of heavy metals such as Cr and Cd in vegetables were higher than the permissible limits set by World Health Organization/Food and Agriculture Organization U.S.A guidelines 2001. The health hazard quotient (HQ) of waste water irrigated vegetables was observed higher for Ni (0.699-0.1029 mg/kg), (0.0456-0.1040 mg/kg), (0.731-0.0994 mg/kg) in Luffa acutangula, Solanum melongena and Zea mays, respectively. The study concluded that the consumption of commonly grown vegetables in waste water zone of the study area may pose potential health threats in local population.
The effect of graphene content on the structure and conductivity of cellulose/graphene composite

Farzana Abd Hamid, Fauzani Md Salleh, Nor Sabirin Mohamed, Syed Bahari Ramadzan Syed Adnan

Sains Malaysiana, 2017;46:1025-1031.

The effect of graphene content on the structure and conductivity of an eco-friendly cellulose/ graphene (CG) composite was investigated. Different compositions of graphene content from 0 to 70 wt. % were prepared using the sol-gel method. Ionic liquids 1-butyl-3-methyl-imidazolium chloride was used to disperse graphene between the cellulose. The investigation showed that CG composite with higher graphene composition exhibits higher conductivity. The highest conductivity (2.85×10-4 S cm-1) was observed at 60 wt. % graphene composition. Sample without graphene showed the lowest conductivity of 1.77×10-7 S cm-1, which acts as an insulator. The high conductivity of CG composite can be associated with the X-ray diffraction (XRD) patterns. The XRD patterns of α-cellulose exhibits a decrease in crystallinity at peak 15° and 22° due to the depolymerization in CG composite. At 60 wt. % composition, XRD pattern showed the decrease in intensity at peak 26° indicates that graphene is more dispersed in the cellulose mixture. This is supported by Fourier transform infrared spectrum of CG composite where the absorption peaks of C-O stretching are weakened at wavelength of 1163 and 1032 cm-1, suggested dehydration and rupture of cellulose. The dehydration and rupture of cellulose result in the high conductivity of CG composite. This research is believed to provide an eco-friendly method to produce cellulose/graphene composite which is useful in future applications of energy.
Fulltext Instantaneous speed ratio of traffic flowing through a merging area at kilometer 31.6 on the highway from Shah Alam to Kuala Lumpur

Nur Syahirah Husin Basri, Nurul Akmal Mohamed, Muhammad Akram Adnan, Nurul Farihan Mohamed, Nurul Hila Zainuddin

Pertanika Journal of Science & Technology, 2020;28(2):565-578.
MyJurnal

This study aims to evaluate a continuous flow model that involves a ramp area at kilometer 31.6 on the highway from Shah Alam to Kuala Lumpur, to analyze the findings of numerical results of instantaneous speed ratios and to observe the convergence patterns for each section. The continuous flow model assumes traffic flow to be similar to the heat equation in regard to the concept of the one-dimensional viscous flow of a compressible fluid. For the methodology, for solving an initial value-boundary value problem, an initial condition together with a set of boundary conditions are required to solve the partial differential equation. The boundary conditions are chosen to assess the suitableness of the design of the entrance ramp in Malaysia, which is for right hand drive traffic. Highway traffic data were collected on the tapered acceleration lane and obtained by the videotaping method. The Maple programming language was used to write a numerical code in order to evaluate the instantaneous speed ratio in terms of a Fourier series. Our results show that the realistic results of instantaneous speed ratios on the ramp at kilometer 31.6 from Shah Alam to Kuala Lumpur are acceptable when compared to the theoretical results. Therefore, a very minimal collision rate is expected due to the well-designed ramp at kilometer 31.6 from Shah Alam to Kuala Lumpur. It is beneficial to study the mathematical model and theories of traffic flows on the merging area to enhance the efficiency of the traffic flowing on highways.
Fulltext Comparison of patient controlled epidural analgesia (PCEA) with basal infusion and programmed intermittent epidural bolus (PIEB) with PCEA in labour analgesia – A year retrospective study

Zawiah Kassim, Norliza Mohd Nor, Ariffah Mokhtar, Suhaina Mohamad, Sarina Osman, Isqandar Adnan

Journal of Clinical and Health Sciences, 2021;6(1):25-31.
MyJurnal

Introduction: Over three decades, patient-controlled epidural analgesia with a basal infusion
regimen (PCEA+BI) has successfully improved labour analgesia quality due to its advantage
in allowing self-titration by the parturients. Recently, a newer programmed intermittent epidural
bolus with PCEA regimen (PIEB+PCEA) was suggested to improve the epidural spread of
local anaesthetic hence resulted in better analgesia quality and higher maternal satisfaction.
Methods: We conducted a one-year retrospective analysis of data from obstetric analgesia
service record sheet and hospital information system comparing maternal satisfaction towards
their labour analgesia quality, mode of delivery and neonatal Apgar scores between these two
methods of epidural delivery techniques. A total of 343 parturients were recruited in this study
(PCEA+BI n=171, PIEB+PCEA n=172). Results: There were no significant difference in
maternal satisfaction between the two groups (P=0.398) with a higher percentage of excellent
satisfaction were found in the PIEB+PCEA group (PIEB+PCEA 146/172 (84.9%) vs PCEA+BI
138/171 (80.7%)). No significant difference in the mode of delivery (P=0.296). However, the
PIEB+PCEA group shown a higher spontaneous vaginal delivery rate (PIEB+PCEA 87/172
(50.6%) vs PCEA+BI 70/171 (40.9%) and lower Caesarean delivery rate (PIEB+PCEA 71/172
(41.3%) vs PCEA+BI 87/171 (50.9%)). Despite statistically significant differences found in
Apgar scores at 1 minute (P=0.036), there was no significant difference in the scores at 5
minutes (P=0.107). Mean Apgar scores (SD) at 1 minute and 5 minutes for PIEB+ PCEA were
7.77(0.85) and 8.91(0.55) respectively and for PCEA + basal infusion, the scores for 1 minute
and 5 minutes were 7.92(0.39) and 8.98(0.19) respectively. Conclusion: PIEB with PCEA is
a newer epidural delivery technique for labour analgesia which produces a comparable
outcome to PCEA with basal infusion.
Fulltext A cross-sectional assessment of shared-decision making among patients visiting public healthcare institute of Quetta city, Pakistan

Waheed, Hira, Haider, Sajjad, Iqbal, Qaiser, Khalid, Adnan, Hassali, Mohamed Azmi, Bashaar, Mohammad, et al.

Malaysian Journal of Pharmaceutical Science, 2020;18(1):15-29.
MyJurnal

Shared-decision making (SDM), occasionally called “participatory governance” is the approach in healthcare to ensure that patients have the right to participate effectively in the decision-making (DM) process. The aim of this research was to discuss the external aspect of SDM and put forward applicable solutions to ensure SDM at both patient and physician levels. A standardised validated nine-item SDM questionnaire (patient version SDM-Q-9) was employed. SPSS version 25 was used to perform data analysis. Multiple tests such as Mann-Whitney U and Jonckheere-Terpstra were used. Kendall’s Tau coefficient was used for interpretation of the significant relationship among all items of SDM-Q-9 and education. A total of 465 chronically ill patients took part, where majority (63.4%) of patients was above the age of 47. The cohort was dominated by females (67.5%) with 92% of the sample was married. Majority (86.9%) of the patient reported not involved in any decision. During analysis, considerable association was reported between gender and all items of SDM-Q-9, where more men were involved in SDM when compared with women. Our findings did produce significant association between education and SDM-Q-9, which reveals that increase in education can improve the SDM. SDM should not be limited to chronic or emergency in practice. Specific and tailored shared medical DM programmes must be developed for low literacy population implementation. SDM is to be supported at policy and operation levels.

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