Displaying all 14 publications

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  1. Aljarousha M, Badarudin NE, Che Azemin MZ
    Malays J Med Sci, 2016 May;23(3):72-7.
    PMID: 27418872 MyJurnal
    INTRODUCTION: Diabetes may affect the human body's systems and organs, including the eye. Diabetic retinopathy is the 5th leading cause of blindness globally. Diabetic subjects demonstrated dry eye symptoms that were also supported by the low values of the clinical tests.
    PURPOSE: This study aimed to compare the dry eye symptoms and signs between diabetics and non-diabetics and tear functions between diabetic subjects with and without dry eye.
    METHODS: This retrospective study was based on the observation of 643 medical files. Using a convenience sampling method, 88 subjects were found to report diabetes mellitus. The information extracted from the files included: date of first examination, age at first visit, gender, past ocular history, systemic disease, symptoms of dry eye disease and details of clinical diagnostic signs. Non-contact lens wearers were excluded. A group of 88, age and gender matched, control subjects were included for this comparison study.
    RESULTS: The percentage of dry eye symptoms was higher in diabetic subjects (15.9%) compared with non-diabetic subjects (13.6%; p<0.001). The percentage of dry eye symptoms was also higher in diabetics with dry eye (63%) than in diabetics without dry eye (36.9%; p<0.001). Tear break up time was significantly different between diabetics and non-diabetics (p<0.001) and between diabetics with and without dry eye (p=0.046). The corneal staining was significantly different between diabetic subjects with and without dry eye (p=0.028).
    CONCLUSION: Dry eye symptoms were significantly associated with diabetics. Tear break up time was significantly shorter in diabetics with dry eye compared to diabetics without dry eye.
    KEYWORDS: Diabetes mellitus; cornea; dry eye syndromes; signs and symptoms; tears
    Study site: Klinik Kesihatan Jalan Hospital, Kuantan, Malaysia
  2. Azemin MZ, Daud NM, Ab Hamid F, Zahari I, Sapuan AH
    ScientificWorldJournal, 2014;2014:783525.
    PMID: 25371914 DOI: 10.1155/2014/783525
    The aim of this study was to compare the retinal vasculature complexity between emmetropia, and myopia in younger subjects.
  3. Aliahmad B, Kumar DK, Hao H, Unnikrishnan P, Che Azemin MZ, Kawasaki R, et al.
    ScientificWorldJournal, 2014;2014:467462.
    PMID: 25485298 DOI: 10.1155/2014/467462
    Fractal dimensions (FDs) are frequently used for summarizing the complexity of retinal vascular. However, previous techniques on this topic were not zone specific. A new methodology to measure FD of a specific zone in retinal images has been developed and tested as a marker for stroke prediction. Higuchi's fractal dimension was measured in circumferential direction (FDC) with respect to optic disk (OD), in three concentric regions between OD boundary and 1.5 OD diameter from its margin. The significance of its association with future episode of stroke event was tested using the Blue Mountain Eye Study (BMES) database and compared against spectrum fractal dimension (SFD) and box-counting (BC) dimension. Kruskal-Wallis analysis revealed FDC as a better predictor of stroke (H = 5.80, P = 0.016, α = 0.05) compared with SFD (H = 0.51, P = 0.475, α = 0.05) and BC (H = 0.41, P = 0.520, α = 0.05) with overall lower median value for the cases compared to the control group. This work has shown that there is a significant association between zone specific FDC of eye fundus images with future episode of stroke while this difference is not significant when other FD methods are employed.
  4. Kumar DK, Aliahmad B, Hao H, Che Azemin MZ, Kawasaki R
    ISRN Ophthalmol, 2013;2013:865834.
    PMID: 24558608 DOI: 10.1155/2013/865834
    Pulsatile changes in retinal vascular geometry over the cardiac cycle have clinical implication for diagnosis of ocular and systemic vascular diseases. In this study, we report a Vesselness Mapping of Retinal Image Sequence (VMRS) methodology to visualize the vessel pulsation and quantify the pulsatile motions in the cardiac cycle. Retinal images were recorded in an image sequence corresponding to 8 segments of the cardiac cycle using a nonmydriatic fundus camera (Canon CR45, Canon Inc., Japan) modified with ECG-synchronization. Individual cross-sectional vessel diameters were measured separately and the significance of the variations was tested statistically by repeated measures analysis of variance (ANOVA). The graders observed an improved quality of vessel pulsation on a wide region around the optic disk using the VMRS. Individual cross- sectional vessel diameter measurement after visualization of pulsatile motions resulted in the detection of more significant diameter change for both arterioles (3.3 μm, P = 0.001) and venules (6.6 μm, P < 0.001) compared to individual measurement without visualization of the pulsatile motions (all P values > 0.05), showing an increase of 2.1 μm and 4.7 μm for arterioles and venules, respectively.
  5. Che Azemin MZ, Ab Hamid F, Aminuddin A, Wang JJ, Kawasaki R, Kumar DK
    Exp Eye Res, 2013 Nov;116:355-358.
    PMID: 24512773 DOI: 10.1016/j.exer.2013.10.010
    The fractal dimension is a global measure of complexity and is useful for quantifying anatomical structures, including the retinal vascular network. A previous study found a linear declining trend with aging on the retinal vascular fractal dimension (DF); however, it was limited to the older population (49 years and older). This study aimed to investigate the possible models of the fractal dimension changes from young to old subjects (10-73 years). A total of 215 right-eye retinal samples, including those of 119 (55%) women and 96 (45%) men, were selected. The retinal vessels were segmented using computer-assisted software, and non-vessel fragments were deleted. The fractal dimension was measured based on the log-log plot of the number of grids versus the size. The retinal vascular DF was analyzed to determine changes with increasing age. Finally, the data were fitted to three polynomial models. All three models are statistically significant (Linear: R2 = 0.1270, 213 d.f., p 
  6. Che Azemin MZ, Hassan R, Mohd Tamrin MI, Md Ali MA
    Int J Biomed Imaging, 2020;2020:8828855.
    PMID: 32849861 DOI: 10.1155/2020/8828855
    The key component in deep learning research is the availability of training data sets. With a limited number of publicly available COVID-19 chest X-ray images, the generalization and robustness of deep learning models to detect COVID-19 cases developed based on these images are questionable. We aimed to use thousands of readily available chest radiograph images with clinical findings associated with COVID-19 as a training data set, mutually exclusive from the images with confirmed COVID-19 cases, which will be used as the testing data set. We used a deep learning model based on the ResNet-101 convolutional neural network architecture, which was pretrained to recognize objects from a million of images and then retrained to detect abnormality in chest X-ray images. The performance of the model in terms of area under the receiver operating curve, sensitivity, specificity, and accuracy was 0.82, 77.3%, 71.8%, and 71.9%, respectively. The strength of this study lies in the use of labels that have a strong clinical association with COVID-19 cases and the use of mutually exclusive publicly available data for training, validation, and testing.
  7. Jusoh M, Dzulkarnain AAA, Rahmat S, Musa R, Che Azemin MZ
    Asia Pac Psychiatry, 2021 Jun;13(2):e12414.
    PMID: 32815284 DOI: 10.1111/appy.12414
    The aim of this study is to evaluate the psychometric properties of the Malay version of the Swanson, Nolan, and Pelham Parent Rating Scale of attention deficit hyperactivity disorders (ADHD) symptoms (M-SNAP-IV). For this purpose, the SNAP-IV scale was translated into the Malay language and was pilot-tested on 91 parents of children aged 8 to 11 years (ADHD [n = 36] and non-ADHD children [n = 55]). The findings depicted that the M-SNAP-IV has excellent content validity, internal consistency, and test-retest reliability. The M-SNAP-IV is a valid and reliable screening tool to detect ADHD symptoms in children and has the advantages to assess the specific presentation of ADHD.
  8. Jais FN, Che Azemin MZ, Hilmi MR, Mohd Tamrin MI, Kamal KM
    ScientificWorldJournal, 2021;2021:6211006.
    PMID: 34819813 DOI: 10.1155/2021/6211006
    Introduction: Early detection of visual symptoms in pterygium patients is crucial as the progression of the disease can cause visual disruption and contribute to visual impairment. Best-corrected visual acuity (BCVA) and corneal astigmatism influence the degree of visual impairment due to direct invasion of fibrovascular tissue into the cornea. However, there were different characteristics of pterygium used to evaluate the severity of visual impairment, including fleshiness, size, length, and redness. The innovation of machine learning technology in visual science may contribute to developing a highly accurate predictive analytics model of BCVA outcomes in postsurgery pterygium patients.

    Aim: To produce an accurate model of BCVA changes of postpterygium surgery according to its morphological characteristics by using the machine learning technique. Methodology. A retrospective of the secondary dataset of 93 samples of pterygium patients with different pterygium attributes was used and imported into four different machine learning algorithms in RapidMiner software to predict the improvement of BCVA after pterygium surgery.

    Results: The performance of four machine learning techniques were evaluated, and it showed the support vector machine (SVM) model had the highest average accuracy (94.44% ± 5.86%), specificity (100%), and sensitivity (92.14% ± 8.33%).

    Conclusion: Machine learning algorithms can produce a highly accurate postsurgery classification model of BCVA changes using pterygium characteristics.

  9. Ab Hamid F, Che Azemin MZ, Salam A, Aminuddin A, Mohd Daud N, Zahari I
    Curr Eye Res, 2016 Jun;41(6):823-31.
    PMID: 26268475 DOI: 10.3109/02713683.2015.1056375
    PURPOSE: The goal of this study was to provide the empirical evidence of fractal dimension as an indirect measure of retinal vasculature density.

    MATERIALS AND METHODS: Two hundred retinal samples of right eye [57.0% females (n = 114) and 43.0% males (n = 86)] were selected from baseline visit. A custom-written software was used for vessel segmentation. Vessel segmentation is the process of transforming two-dimensional color images into binary images (i.e. black and white pixels). The circular area of approximately 2.6 optic disc radii surrounding the center of optic disc was cropped. The non-vessels fragments were removed. FracLac was used to measure the fractal dimension and vessel density of retinal vessels.

    RESULTS: This study suggested that 14.1% of the region of interest (i.e. approximately 2.6 optic disk radii) comprised retinal vessel structure. Using correlation analysis, vessel density measurement and fractal dimension estimation are linearly and strongly correlated (R = 0.942, R(2) = 0.89, p 

  10. Amirullah NA, Rahmat S, Dzulkarnain AAA, Maamor N, Jamaludin MKA, Che Azemin MZ
    Med J Malaysia, 2022 Jan;77(1):12-19.
    PMID: 35086989
    INTRODUCTION: Sound therapy is one of the complementary or alternative interventions for various populations. The intensity of the sounds for sound therapy needs to be properly calibrated to ensure their accuracy and effectiveness. This paper aims to provide a general guideline for calibrating sound files using free software, specifically Audacity®.

    MATERIALS AND METHODS: Six sounds (broadband noise, rain, ocean, waterfall, Quranic chapters Al-Fatihah, and Yasin recitations) were calibrated at the intensity levels of 45, 50, 55, 60, 65, 70, 75, and 80dBA. The sounds were delivered through a pair of Sennheiser HD 280 Pro headphones connected to the Sound Blaster X-Fi Surround 5.1 Pro sound card. The long-term average of the sound pressure level over the time of recording (LAseq) was recorded using the 3M SoundPro Class 1 1/3 Octave RTA sound level meter (SLM). The desired intensity levels were obtained by making adjustments to the sound files via the Audacity® software.

    RESULTS: All sound files were calibrated at the targeted levels as verified by the value of LAseq.

    CONCLUSIONS: Calibration of audio files can be done using a free/open-source software, as all six sound files were successfully calibrated at the targeted levels of 45, 50, 55, 60, 65, 70, 75, and 80dBA. The calibration steps provided in this paper can be easily applied by other researchers for similar purposes, with precautions when calibrating at low levels.

  11. Aljarousha M, Badarudin NE, Che Azemin MZ, Aljeesh Y, Amer A, Abdul Rahim MAS
    Int Ophthalmol, 2023 Apr;43(4):1303-1316.
    PMID: 36156181 DOI: 10.1007/s10792-022-02528-7
    PURPOSE: To develop an Arabic version of OSDI for the Gazan population.

    METHODS: A cross-sectional observational study was conducted using a convenience sample technique. The translation procedure included five stages: forward translation, revision of translation, backward translation, refinement of translation, and a final test of the pre-final version. The final sets of questionnaires were constructed using an online JotForm platform. The online platform was chosen to automatically calculate the questionnaire's final overall score. Overall, 260 participants were instructed to fill out the English and the Arab-OSDI version twice to conduct the reliability of the translated version and repeatability evaluation.

    RESULTS: The mean age of the participants was 33.45 ± 11.74 years old. Cronbach's alpha for all items was greater than 0.80, except for the "blurred vision" and "deteriorating vision" items (0.77 and 0.74, respectively). The mean overall score difference between the English-OSDI and Arab-OSDI was 0.86 based on the Bland-Altman chart. For repeatability, no significant difference in the overall scores between the two repeats of the Arab-OSDI (p = 0.632). The Arab-OSDI overall score (sessions 1 and 2) has a clinical difference (bias) of 0.21. Using the varimax rotation method, only three factors (ocular symptoms, vision-related function, and environmental triggers) had eigenvalues greater than one in the structure of the Arab-OSDI.

    CONCLUSION: The Arab-OSDI is an appropriate, reliable, and repeatable tool for the determination of dry eye symptoms, ocular discomfort, and quality of life in the Gazan population. This version could remove the language barrier in answering OSDI items more easily.

  12. Aljarousha M, Badarudin NE, Che Azemin MZ, Aljeesh Y, Amer A, Abdul Rahim MAS
    Malays J Med Sci, 2024 Apr;31(2):72-97.
    PMID: 38694574 DOI: 10.21315/mjms2024.31.2.8
    BACKGROUND: The prevalence of dry eye disease (DED) is rising globally and needs to be urgently addressed by medical professionals because it lowers patients' quality of life. There are as yet no available data in the literature about the prevalence of and risk factors for DED in the Gaza Strip, a gap that the present study seeks to address.

    METHODS: A cross-sectional study was carried out between March and August 2022 in Gaza governorates using a proportional stratified sampling technique. Only Gazan individuals ≥ 18 years old and able to follow the instructions were included. The Ocular Surface Disease Index (OSDI) questionnaire, which has previously been translated into Arabic and validated, was applied to evaluate DED symptoms. Subjective clinical tests for DED conducted were tear meniscus height (TMH), meibomian gland dysfunctions (MGDs), Marx line (ML), conjunctival Lissamine green staining (LGS), tear film break-up time test (TBUT), corneal fluorescein staining (CFS) and Schirmer II tear test (STT). DED was defined based on an Arab-OSDI score ≥ 13 and at least one positive clinical sign.

    RESULTS: A total of 426 participants were assessed from four areas (North Gaza Strip, 82; Gaza City, 147; Mid-Zone Gaza Strip, 62; South Gaza Strip, 135). The prevalence of DED in the present study was 31.5% (95% CI: 27.1, 36.1). Age > 50 years old (odds ratio [OR] = 10.45; 95% CI: 2.95, 37.05; P < 0.001), female gender (OR = 3.24; 95% CI: 1.40, 7.52, P = 0.006), menopause or pregnancy (OR = 2.59; 95% CI: 1.25, 5.35; P = 0.03) and pharmacotherapy (artificial tears; OR = 9.91; 95% CI: 2.77, 35.46; P < 0.001) were each associated with DED symptoms. South Gaza Strip (OR = 0.04; 95% CI: 0.01, 0.12; P < 0.001), unemployed (OR = 11.67; 95% CI: 1.43, 95.44; P = 0.02), non-consumption of caffeine (OR = 0.40; 95% CI: 0.19, 0.88; P = 0.02) and TMH < 0.2 (OR = 1.80; 95% CI: 1.02, 3.19; P = 0.04) were associated with TBUT < 5 s. LGS was associated with those > 50 years old (OR = 2.70; 95% CI: 1.38, 5.28; P = 0.004), previous refractive or ocular surface surgeries (OR = 2.97; 95% CI: 1.34, 6.59; P = 0.008) and CFS ≥ 1 (OR = 1.91; 95% CI: 1.07, 3.44; P = 0.03).

    CONCLUSION: Various aspects of DED were linked with different risk factors, suggesting that DED subtypes have different underlying pathophysiologies.

  13. Hilmi MR, Che Azemin MZ, Mohd Kamal K, Mohd Tamrin MI, Abdul Gaffur N, Tengku Sembok TM
    Curr Eye Res, 2017 Jun;42(6):852-856.
    PMID: 28118054 DOI: 10.1080/02713683.2016.1250277
    PURPOSE: The goal of this study was to predict visual acuity (VA) and contrast sensitivity function (CSF) with tissue redness grading after pterygium surgery.

    MATERIALS AND METHODS: A total of 67 primary pterygium participants were selected from patients who visited an ophthalmology clinic. We developed a semi-automated computer program to measure the pterygium fibrovascular redness from digital pterygium images. The final outcome of this software is a continuous scale grading of 1 (minimum redness) to 3 (maximum redness). The region of interest (ROI) was selected manually using the software. Reliability was determined by repeat grading of all 67 images, and its association with CSF and VA was examined.

    RESULTS: The mean and standard deviation of redness of the pterygium fibrovascular images was 1.88 ± 0.55. Intra-grader and inter-grader reliability estimates were high with intraclass correlation ranging from 0.97 to 0.98. The new grading was positively associated with CSF (p < 0.01) and VA (p < 0.01). The redness grading was able to predict 25% and 23% of the variance in the CSF and the VA, respectively.

    CONCLUSIONS: The new grading of pterygium fibrovascular redness can be reliably measured from digital images and showed a good correlation with CSF and VA. The redness grading can be used in addition to the existing pterygium grading.
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