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Fulltext Termination of pregnancy for a Muslim rape victim and dilemma in Malaysian setting: a case report

Umi Adzlin, S., Azizul, A., Uma, V., Nor’Izam, A.

Malaysian Journal of Psychiatry, 2012;21(2):0-0.
MyJurnal

This case report highlights on the dilemma in making a decision for termination of pregnancy (TOP) for a muslim rape victim in Malaysian setting. We report a case of 17 year-old student at 7 weeks of pregnancy after being gang-raped, who, together with her parents, had requested for a TOP. Psychiatric assessment showed that the patient suffered from a major depressive disorder and post-traumatic stress disorder which justified termination of pregnancy on a psychological and clinical basis. However the available Malaysian Islamic fatwa had caused some uncertainties on the final decision making. This case demonstrated on the needs to understand the relevant issues beyond clinical judgment in relation to TOP in our setting which encompasses the legal provision, ethical obligation as well as the needs for a clear religious understanding and stand to support the medical decision.
Fulltext Discal Cyst of the Lumbar Spine: Case Report of a Rare Clinical Entity

Sanjeevan R, Prabu S, Azizul A, Abdul-Halim Y

Malays Orthop J, 2018 Jul;12(2):56-58.
PMID: 30112131 MyJurnal DOI: 10.5704/MOJ.1807.011

Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc. The patient had immediate relief of his symptoms and no postoperative complications. We recommend that endoscopic surgery can be an effective alternative to conventional open surgery for discal cyst of the lumbar spine.
Phytochemistry, cytotoxicity and antiviral activity of Catharanthus roseus

Wahab NZA, Azizul A, Ibrahim N

Iran J Microbiol, 2020 Oct;12(5):460-465.
PMID: 33604002 DOI: 10.18502/ijm.v12i5.4608

Background and Objectives: Catharanthus roseus is generally used to treat many diseases in folklore remedies. The present study is aimed at determining phytochemical constituents, cytotoxicity and antiviral activities for crude extract of the plant.
Materials and Methods: The whole plant of C. roseus was extracted using methanol extraction method. Phytochemical qualitative screening was carried out for C. roseus extract according to standard procedures used to test for the presence of alkaloid, saponin, terpenoid and steroid. Cytotoxicity was assessed using 3-(4,5-dimethylthiazol-2,5-diphenyltetrazolium bromide (MTT) assay. Plaque reduction assays were carried out to evaluate the antiviral activity of C. roseus extract against herpes simplex virus type 1 (HSV-1). These include post-treatment, pre-treatment and virucidal assays.
Results: C. roseus extract contain secondary metabolites such as alkaloid, saponin and terpenoid but does not contain steroid. Cytotoxicity screening against Vero cells using MTT assay showed that the CC50 values for crude extract of C. roseus was 0.5 mg/mL. The extract prepared from C. roseus possesses phytochemical compound that was non-cytotoxic to the cell with potential antiviral activity. Plaque reduction assays against herpes simplex virus type 1 (HSV-1) showed that the selective indices (SI = CC50 / EC50) of C. roseus extract in post-treatment, pre-treatment and virucidal assays were 36, 20 and 4.7 respectively. The results revealed that the extract prepared from C. roseus possesses phytochemical compound that was non-cytotoxic to the cell with potential antiviral activity.
Conclusion: This study showed that C. roseus extract has promising potential to be explored as anti-HSV-1 agent regardless of the mode of treatment.
Fulltext Lateral Lumbar Spinal Stenosis: Associations With the Oswestry Disability Index, Visual Analogue Scale, and Magnetic Resonance Imaging

Norisyam Y, Salim AA, Bahrin Z, Yusof MI, Paiman M, Nadarajan C

Cureus, 2023 Dec;15(12):e50475.
PMID: 38226127 DOI: 10.7759/cureus.50475

Introduction Degenerative lumbar spinal stenosis is a communal problem in the sixth decade of life involving L4/L5 and L5/S1 levels. Lateral spinal stenosis is often underestimated because of no established relationship between the clinical symptoms and MRI findings. We conducted a study to establish an association between the degree of anatomical lateral stenosis, posterior disc height, and disc degeneration from MRI with the daily disability and pain severity for lateral lumbar spinal stenosis. Methods This was a cross-sectional study involving 121 patients with distinct clinical symptoms of lateral lumbar spinal stenosis evaluated from February 2018 to December 2019. The clinical data were evaluated using the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS), while magnetic resonance imaging (MRI) was assessed qualitatively for the anatomical gradation of lateral spinal stenosis, the magnitude of posterior disc height, and the extent of disc degeneration. Statistical analysis for the correlation between posterior disc height and ODI and VAS scores was evaluated using Pearson's correlation test via SPSS version 23.0 (IBM Inc., Armonk, New York), and the association between the extent of lateral stenosis and disc degeneration on MRI with ODI and VAS scores was determined by the Fisher Exact Test via STATA version 14.0 (StataCorp LLC, College Station, Texas). The association was considered statistically significant with a P-value of less than 0.05. Results The analysis of 121 patients showed the mean age of the patients was 58.7 ± 7.1 years old. The number of female patients was higher compared to male patients, 52.9% and 47.1%, respectively. 97.5% of the patients were married or cohabiting, and 76.0% had an abnormal body mass index. The mean score of ODI and VAS was 62.2 ± 10.7% and 79.3 ± 8.6 respectively. 49.6% of the patient presented with a crippling disability with ODI assessment, while 59.5% presented with high pain intensity with VAS assessment. MRI assessment of anatomical grading lateral stenosis of L4/L5 level revealed that 45.5% of the patients had grade 2 lateral recess stenosis, 63.6% had grade 2 foraminal stenosis, and 44.6% had extraforaminal stenosis. L5/S1 level analysis showed that 43.0% had grade 2 lateral recess stenosis, 62.0% had grade 2 foraminal stenosis, and 29.8% had extraforaminal stenosis. 64.5% of patients had grade 4 disc degeneration of L4/L5 with mean posterior disc height of 7.0mm ±1.7mm while 59.5% had grade 4 disc degeneration of L5/S1 with mean posterior disc height of 6.3mm ±1.8mm. However, no statistically significant association between clinical symptoms and MRI findings was found. Conclusions There was no significant association between the clinical symptoms of pain and disability and the MRI findings for the anatomical gradation of lateral spinal stenosis, the magnitude of posterior disc height, and the extent of disc degeneration. A comprehensive clinical evaluation remains essential for an accurate diagnosis, emphasizing the necessity of appropriately correlating MRI findings with their clinical significance.
Risk factors for suicidal ideation, plans and attempts in Malaysia--results of an epidemiological survey

Maniam T, Marhani M, Firdaus M, Kadir AB, Mazni MJ, Azizul A, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S121-5.
PMID: 24156873 DOI: 10.1016/j.comppsych.2013.08.004

This is an epidemiological study to determine the prevalence of suicidal behavior and its association with generalised anxiety disorder (GAD) and major depressive disorder (MDD) in a nationally representative sample.
Fulltext The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation

Chew KS, Ahmad Razali S, Wong SSL, Azizul A, Ismail NF, Robert SJKCA, et al.

Int J Emerg Med, 2019 Dec 12;12(1):40.
PMID: 31830912 DOI: 10.1186/s12245-019-0256-5

BACKGROUND: The influence of past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events toward willingness to "pay it forward" by helping the next cardiac arrest victim was explored.
METHODS: Using a validated questionnaire, 6248 participants were asked to rate their willingness to perform bystander chest compression with mouth-to-mouth ventilation and chest compression-only CPR. Their past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events were also recorded.
RESULTS: Kruskal-Wallis test with post hoc Dunn's pairwise comparisons showed that the following were significantly more willing to perform CPR with mouth-to-mouth ventilation: familial experience of "nonfatal cardiac events" (mean rank = 447) vs "out-of-hospital cardiac arrest with no CPR" (mean rank = 177), U = 35442.5, z = -2.055, p = 0.04; "in-hospital cardiac arrest and successful CPR" (mean rank = 2955.79) vs "none of these experiences" (mean rank = 2468.38), U = 111903, z = -2.60, p = 0.01; and "in-hospital cardiac arrest with successful CPR" (mean rank = 133.45) vs "out-of-hospital arrest with no CPR" (mean rank = 112.36), U = 4135.5, z = -2.06, p = 0.04. For compression-only CPR, Kruskal-Wallis test with multiple runs of Mann-Whitney U tests showed that "nonfatal cardiac events" group was statistically higher than the group with "none of these experiences" (mean rank = 3061.43 vs 2859.91), U = 1194658, z = -2.588, p = 0.01. The groups of "in-hospital cardiac arrest with successful CPR" and "in-hospital cardiac arrest with transient return of spontaneous circulation" were the most willing groups to perform compression-only CPR.
CONCLUSION: Prior familial experiences of receiving CPR and medical help, particularly among those with successful outcomes in a hospital setting, seem to increase the willingness to perform bystander CPR.