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Radiation effects on the intima-media thickness of the common carotid artery in post-radiotherapy patients with head and neck malignancy

Shariat M, Alias NA, Biswal BM

Postgrad Med J, 2008 Nov;84(997):609-12.
PMID: 19103820 DOI: 10.1136/pgmj.2008.068569

Post-radiation large vessel injury has not received as much attention as microvascular irradiation injury. A few studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy to the head and neck. However, in most of these studies, the irradiated subjects also had other major risk factors for atherosclerosis. In this study, irradiated subjects with major risk factors such as hypertension, diabetes, history of previous cerebrovascular accident and connective tissue disorder were excluded.
Red flags in patients presenting with headache: clinical indications for neuroimaging

Sobri M, Lamont AC, Alias NA, Win MN

Br J Radiol, 2003 Aug;76(908):532-5.
PMID: 12893694

Headache is a very common patient complaint but secondary causes for headache are unusual. Neuroimaging is both expensive and has a low yield in this group. Most patients with intracranial pathology have clinical features that would raise a "red flag". Appropriate selection of patients with headache for neuroimaging to look for secondary causes is very important. Red flags act as screening tools to help in identifying those patients presenting with headache who would benefit from prompt neuroimaging, and may increase the yield. The aim of this study is to evaluate clinical features in patients with headache using neuroimaging as a screening tool for intracranial pathology. 20 red flags were defined. A retrospective study of 111 patients was performed and the outcomes were divided into positive and negative. Abnormal neuroimaging was present in 39 patients. Results were analysed using the Logistic Regression model. Sensitivity and specificity of red flags were analysed to establish the cut-off point to predict abnormal neuroimaging and a receiver operating characteristic (ROC) curve plotted to show the sensitivity of the diagnostic test. Three red flag features proved to be statistically significant with the p-value of less than 0.05 on both univariate and multivariate analysis. These were: paralysis; papilloedema; and "drowsiness, confusion, memory impairment and loss of consciousness". In addition, if three or more red flags from the list were present, this showed strong indication of abnormal neuroimaging, from cut-off point of ROC curve (area under the curve =0.76).
Multifocal mucus secreting papillary adenocarcinoma of the bile duct causing obstructive jaundice

Khan TF, Sherazi ZA, Alias NA, Mahmood Z

Ann Acad Med Singap, 1993 Mar;22(2):251-3.
PMID: 8363342

We present a 64-year-old Malay lady who had undergone a choledochoduodenostomy (CDD) two years ago for obstructive jaundice. She was admitted with jaundice and underwent ultrasonography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangio pancreatography (ERCP) and computed tomographic (CT) scanning of the liver and biliary tree. All the investigations confirmed a type IVa choledochal cyst. At operation, the grossly dilated biliary system was packed with a thick mucoid material and the mucosa of the bile ducts was visibly abnormal with scattered nodules. This mucoid material had caused occlusion of the entire biliary tree resulting in obstructive jaundice. To the best of our knowledge, this is probably the first report of obstructive jaundice caused by thick mucus. The peculiar management problems of this case and the risk of malignant change in choledochal cysts are discussed.
Fulltext Association between Stress and Social Support Perceived among Undergraduate Health Sciences Student

Abdul Aziz NA, Baharudin NS, Alias NA

Malays J Med Sci, 2023 Jun;30(3):176-183.
PMID: 37425381 DOI: 10.21315/mjms2023.30.3.16

INTRODUCTION: A high level of perceived social support can lessen stress. However, the lack of knowledge on stress and perceived social support among students during the coronavirus disease (COVID-19) pandemic was explored. Thus, this study aimed to investigate the relationship between stress and perceived social support among undergraduate Health Sciences students.
METHODS: A convenience sampling method was used in a cross-sectional study of 290 undergraduate Health Sciences students in public universities. The Perceived Stress Scale (PSS-10) was used to measure the perception of stress, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support from three sources, including family, friends and significant others.
RESULTS: A statistically significant correlation was found between the stress level and the total score of the MSPSS (r = -0.432), perceived social support from family (r = -0.429), significant others (r = -0.328), and friends (r = -0.219, P < 0.001). Over three-quarters (73.4%) of the students have a moderate stress level (mean = 21.17, SD = 5.75). The highest social support perceived was from a family (mean = 5.21, SD = 1.48).
CONCLUSION: The study suggested that social support from family is the strongest for students to go through the stress of tough times. It also highlighted the need for attention to stress management among undergraduate students for healthy well-being. Future studies that involve other academic fields of study and qualitative research would give useful information on perceived social support among students.
Fulltext The prognostic value of early follow-up computerized tomography of the brain in adult traumatic brain injury

Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN

Med J Malaysia, 2006 Oct;61(4):466-73.
PMID: 17243525 MyJurnal

A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.
A study of the factors related to intima-media thickness of the common carotid artery amongst rural middle age individuals in Hospital Universiti Sains Malaysia

Yunus R, Ariff AR, Shuaib IL, Jelani AM, Alias NA, Abdullah J, et al.

Southeast Asian J. Trop. Med. Public Health, 2006 Jul;37(4):806-11.
PMID: 17121310

There is very little data regarding the factors related to intima-media thickness (IMT) of the common carotid artery in normal individuals in those with non-insulin diabetes mellitus and perimenopausal women in Southeast Asian countries. Ultrasound imaging evaluating the carotid artery IMT in those with diabetes and those on hormone replacement therapy (HRT) was performed beginning in August 2000 for a period of nearly two years at the Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. A total of 153 participants were included. Significant differences between the women on HRT and not on HRT were IMT and systolic blood pressure. When comparing those with non-insulin dependent diabetes mellitus (NIDDM) and normal individuals, the significant differences were IMT, total cholesterol level, systolic blood pressure and diastolic blood pressure. IMT was high in those with NIDDM but not in those on HRT. Both those with NIDDM and those on HRT had associated dyslipidemia and systolic hypertension.
CT scan in minor head injury: a guide for rural doctors

Abdul Latip LS, Ahmad Alias NA, Ariff AR, Shuaib IL, Abdullah J, Naing NN

J Clin Neurosci, 2004 Nov;11(8):835-9.
PMID: 15519858 DOI: 10.1016/j.jocn.2003.12.017

Minor head injury in a developing country like Malaysia is managed by primary care physicians and/or medical assistants in district hospitals. These patients are seen initially in their local hospitals, which have at least an X-ray machine for the purpose of screening. This study aimed to guide these physicians to manage these patients at a primary care level. A cross-sectional study was conducted and the study revealed significant predictors of significant computed tomographic (CT) findings. The presence of a Glasgow coma scale (GCS) score of 14 or 13 was associated with the risk of developing significant CT findings compared to patients with a GCS of 15 (p<0.001). Thirty-seven out of 50 patients with GCS of 14 or 13 developed clinically significant brain injury on CT scan. Similarly, the presence of skull fracture was associated with the risk of developing CT abnormalities (p<0.001). Forty-two out of 51 patients with skull fracture developed clinically significant CT findings. Vomiting was associated with developing CT abnormalities (p=0.017). Twenty-seven out of 40 patients with vomiting showed significant CT findings. Soft tissue injury was also found to be associated with developing CT abnormalities (p=0.007). Therefore, we propose reclassifying minor head injury based on the GCS score. Patients with a GCS score of 15 were classified as having mild head injury, while patients with a GCS score of 13 or 14 were at higher risk of developing brain injury and therefore categorized as high risk mild head injury. This group requires emergency CT scan examination, especially when associated with non-motor vehicle accidents, abnormal central nervous system (CNS) examination, craniofacial injuries or skull fractures. They should be referred to a general surgical unit which can treat head injuries or a neurosurgical tertiary centre.
Fulltext Pap Smear Images Classification Using Machine Learning: A Literature Matrix

Alias NA, Mustafa WA, Jamlos MA, Alquran H, Hanafi HF, Ismail S, et al.

Diagnostics (Basel), 2022 Nov 22;12(12).
PMID: 36552907 DOI: 10.3390/diagnostics12122900

Cervical cancer is regularly diagnosed in women all over the world. This cancer is the seventh most frequent cancer globally and the fourth most prevalent cancer among women. Automated and higher accuracy of cervical cancer classification methods are needed for the early diagnosis of cancer. In addition, this study has proved that routine Pap smears could enhance clinical outcomes by facilitating the early diagnosis of cervical cancer. Liquid-based cytology (LBC)/Pap smears for advanced cervical screening is a highly effective precancerous cell detection technology based on cell image analysis, where cells are classed as normal or abnormal. Computer-aided systems in medical imaging have benefited greatly from extraordinary developments in artificial intelligence (AI) technology. However, resource and computational cost constraints prevent the widespread use of AI-based automation-assisted cervical cancer screening systems. Hence, this paper reviewed the related studies that have been done by previous researchers related to the automation of cervical cancer classification based on machine learning. The objective of this study is to systematically review and analyses the current research on the classification of the cervical using machine learning. The literature that has been reviewed is indexed by Scopus and Web of Science. As a result, for the published paper access until October 2022, this study assessed past approaches for cervical cell classification based on machine learning applications.
Fulltext Improvement method for cervical cancer detection: A comparative analysis

Alias NA, Mustafa WA, Jamlos MA, Alkhayyat A, Rahman KSA, Q Malik R

Oncol Res, 2021;29(5):365-376.
PMID: 37305159 DOI: 10.32604/or.2022.025897

Cervical cancer is a prevalent and deadly cancer that affects women all over the world. It affects about 0.5 million women anually and results in over 0.3 million fatalities. Diagnosis of this cancer was previously done manually, which could result in false positives or negatives. The researchers are still contemplating how to detect cervical cancer automatically and how to evaluate Pap smear images. Hence, this paper has reviewed several detection methods from the previous researches that has been done before. This paper reviews pre-processing, detection method framework for nucleus detection, and analysis performance of the method selected. There are four methods based on a reviewed technique from previous studies that have been running through the experimental procedure using Matlab, and the dataset used is established Herlev Dataset. The results show that the highest performance assessment metric values obtain from Method 1: Thresholding and Trace region boundaries in a binary image with the values of precision 1.0, sensitivity 98.77%, specificity 98.76%, accuracy 98.77% and PSNR 25.74% for a single type of cell. Meanwhile, the average values of precision were 0.99, sensitivity 90.71%, specificity 96.55%, accuracy 92.91% and PSNR 16.22%. The experimental results are then compared to the existing methods from previous studies. They show that the improvement method is able to detect the nucleus of the cell with higher performance assessment values. On the other hand, the majority of current approaches can be used with either a single or a large number of cervical cancer smear images. This study might persuade other researchers to recognize the value of some of the existing detection techniques and offer a strong approach for developing and implementing new solutions.
Fulltext Computed tomography perfusion of ischaemic stroke patients in a rural Malaysian tertiary referral centre

Man K, Kareem AM, Ahmad Alias NA, Shuaib IL, Tharakan J, Abdullah JM, et al.

Singapore Med J, 2006 Mar;47(3):194-7.
PMID: 16518552

Computed tomography (CT) perfusion is a new method to diagnose ischaemic stroke especially in developing countries. It identifies the area and is useful to predict the size of final infarction. The aim of this study was to assess cerebral ischaemia with CT perfusion (CTP) among patients with acute ischaemic stroke in Hospital Universiti Sains Malaysia, a tertiary referral centre in a rural setting.
Fulltext Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study

Fountoulakis KN, Alias NA, Bjedov S, Fountoulakis NK, Gonda X, Hilbig J, et al.

Front Psychiatry, 2023;14:1320156.
PMID: 38293595 DOI: 10.3389/fpsyt.2023.1320156

INTRODUCTION: The aim of the study was to search rates of depression and mental health in university students, during the COVID-19 pandemic.
MATERIALS AND METHODS: This is an observational cross-sectional study. A protocol gathering sociodemographic variables as well as depression, anxiety and suicidality and conspiracism was assembled, and data were collected anonymously and online from April 2020 through March 2021. The sample included 12,488 subjects from 11 countries, of whom 9,026 were females (72.2%; aged 21.11 ± 2.53), 3,329 males (26.65%; aged 21.61 ± 2.81) and 133 "non-binary gender" (1.06%; aged 21.02 ± 2.98). The analysis included chi-square tests, correlation analysis, ANCOVA, multiple forward stepwise linear regression analysis and Relative Risk ratios.
RESULTS: Dysphoria was present in 15.66% and probable depression in 25.81% of the total study sample. More than half reported increase in anxiety and depression and 6.34% in suicidality, while lifestyle changes were significant. The model developed explained 18.4% of the development of depression. Believing in conspiracy theories manifested a complex effect. Close to 25% was believing that the vaccines include a chip and almost 40% suggested that facemask wearing could be a method of socio-political control. Conspiracism was related to current depression but not to history of mental disorders.
DISCUSSION: The current study reports that students are at high risk for depression during the COVID-19 pandemic and identified specific risk factors. It also suggested a role of believing in conspiracy theories. Further research is important, as it is targeted intervention in students' groups that are vulnerable both concerning mental health and conspiracism.