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Fulltext Suggested insulin regimen for pregnant women with diabetes who wish to fast in Ramadan.

Ahmad Shuib Yahaya, Adibah Ibrahim, Mohd Shukri Othman, Mohd Pazudin Ismail

IIUM Medical Journal Malaysia, 2018;17(102):231-238.
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Pregnant women are among those who are exempted from Ramadan fasting. Despite that, many pregnant women had chosen to fast despite understanding the risk of complications especially hypoglycaemia. In Hospital USM (HUSM), an insulin regime for pregnant women who wish to fast was designed based on expert opinion of obstetricians, but its safety and efficacy are yet to be determined. Objective: To determine the safety and efficacy of the formulated insulin regime using subcutaneous Actrapid® and Insulatard® amongst pregnant women with diabetes who fast in Ramadan.Methodology: Pregnant patients with diabetes on insulin who wish to fast during Ramadan were invited to participate in the study. The total daily dose of insulin requirement prior to Ramadan was divided 3 parts; 2/3 foriftar(sunset meal) and 1/3 for sahur(pre-dawn meal). For each timing, 2/3 of the calculated dose was given as short-acting insulin Actrapid® and remaining 1/3 as intermediate-acting insulin Insulatard®. Three patients were monitored in the ward while fasting for two days. Blood glucose checked eight times a day. Following that, eight patients were followed up during Ramadan fasting with this regime. Weekly blood sugar profile (BSP) was taken and glycaemic control evaluated. Results: All patients were able to fast without any hypoglycaemic episode, both during in-patient study and during out-patient Ramadan fasting. Mean daily blood glucose per day for in-patient monitoring was 7.3 mmol/l with the lowest being 4.56 mmol/l in the afternoon. During Ramadan fasting, average glucose level was higher (6.79 mmol/l) compared to prior to Ramadan value (5.67 mmol/l) (p> 0.05). However, improvement of glycaemic control was observed towards end of Ramadan. Conclusion: Pregnant women with diabetes treated with insulin can fast safely during Ramadan using the suggested insulin regime with improvement of glycaemic control observed at the end of Ramadan.
Carbon stock and sequestration valuation in a mixed dipterocarp forest of Malaysia

Nitanan Koshy Matthew, Ahmad Shuib, Sridar Ramachandran, Syamsul Herman Mohammad Afandi, Zaiton Samdin, Ismail Muhammad, et al.

Sains Malaysiana, 2018;47:447-455.

Forest degradation and deforestation are some of the major global concerns as they can reduce the forest carbon stock
and sequestration capacity. However, the carbon stock and sequestration potential in a mixed dipterocarp tropical forest
remains unclear due to a lack of information. This study was carried out on the carbon stock and estimated its economic
value to justify its conservation. Six plots were established in the Endau Rompin National Park, Johor and subplots
measuring 50 × 20 m were established in each plot. All trees greater than 15 cm DBH (diameter at breast height) were
identified and the parameters measured included tree height and diameter. The aboveground carbon (AGC) content was
about 222 Mg(C) ha-1, belowground carbon (BGC) was 53 Mg (C) ha-1 and it was 6 Mg (C) ha-1 for other components.
In total, the carbon stock amounted to 281 Mg (C) ha-1. On the other hand, the total CO2 sequestrated in the mixed
dipterocarp forest amounted to 1,040 t CO2
ha-1. The carbon value was estimated at RM32,240 t CO2
ha-1 or $7,280 t CO2
ha-1. Therefore, the study found that the dipterocarp forest should be preserved to mitigate greenhouse gas emissions.
Fulltext A life-threatening condition - ruptured ectopic pregnancy with negative urine pregnancy test: A case report

Mohamad F, Yahya AS, Abdul Rashid A, Devaraj NK, Abdul Manap AH

Malays Fam Physician, 2021 Mar 25;16(1):121-123.
PMID: 33948151 DOI: 10.51866/cr1117

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.
The value of amide proton transfer imaging in predicting parametrial invasion and lymph-vascular space invasion of cervical cancer

Yang C, Hassan HA, Omar NF, Soo TH, Yahaya ASB, Shi T, et al.

Magn Reson Imaging, 2025 Feb;116:110282.
PMID: 39603395 DOI: 10.1016/j.mri.2024.110282

OBJECTIVE: To explore the value of amide proton transfer (APT) imaging in assessing parametrial invasion (PMI) and lymph-vascular space invasion (LVSI) of cervical cancer.
MATERIALS AND METHODS: We retrospectively analyzed the clinical and imaging data of cervical cancer patients diagnosed pathologically at our hospital from January 2021 to June 2024. All patients underwent routine magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and APT imaging before treatment. Apparent diffusion coefficient (ADC) and APT values were measured. Based on the pathological results, patients were categorized into LVSI (+) and LVSI (-) groups, and PMI (+) and PMI (-) groups. Independent sample t-tests were used to compare the ADC and APT values between these groups. Receiver operating characteristic (ROC) curves were used to assess the sensitivity, specificity, and area under the curve (AUC) of ADC, APT, and ADC + APT in predicting PMI and LVSI. The Delong test was employed to compare the diagnostic performance among these measures.
RESULTS: A total of 83 patients were included, with 56 in the LVSI (-) group, 27 in the LVSI (+) group, 35 in the PMI (-) group, and 16 in the PMI (+) group. The ADC values for the LVSI (+) and PMI (+) groups were significantly lower than those for the LVSI (-) and PMI (-) groups (P