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Fulltext Paddy grading using thermal imaging technology

Azman, N., Jamil, N., Bejo-Khairunniza, S.

International Food Research Journal, 2016;23(101):245-248.
MyJurnal

Rice production depends on good quality of paddy. In this research, the capability of thermal
imaging to determine the quality of paddy based on the properties used in a Deduction Schedule
namely moisture content, immature condition and foreign material is presented. First, the
heating and cooling treatment was applied to the samples. FLIR E60 thermal camera was used
to acquire images of the sample. Therefore, each samples were represented by a thermal index
calculated based on the average value of pixels in the thermal image. Results of the experiment
have shown that highly significant relationship were exist between thermal index and maturity
stage and moisture content of paddy with r = -0.948 and 0.896, respectively. It also worked
well in detecting foreign material (chaff) at 25s after cooling. The method gave accurate results
with 92% for moisture content determination, 90% for maturity stage prediction and 100% for
chaff detection.
Fulltext Lesson learnt: first reported case of complicated cutaneous pythiosis in a dog in Malaysia

Omar, S., Mohd Zainudin, N.A.I., Azman, N., Jessie-Bay, J.X.

Jurnal Veterinar Malaysia, 2019;31(1):34-37.
MyJurnal

This report documents a case of 5-month old intact male German Shepherd dog diagnosed with pythiosis on its left forelimb. This is the first ever reported case of pythiosis presented at the University Veterinary Teaching Hospital (UVH), Universiti Putra Malaysia and may be the first ever reported incidence in Malaysia with a complaint of a chronic non-healing wound. The case became complicated as the dog was concurrently infected with a mixed bacterial infection and the identified bacteria were resistant towards a number of antibiotics tested. The antibiotic that was determined to be sensitive was only able to act on certain bacteria and not to the others. The journey of getting to the final diagnosis was almost impossible if we had not tried different media preparation: with and without Dermasel supplement; and through molecular approach using amplification at ITS region followed by DNA sequence analysis. The unwarranted lack during the diagnosis process of this incidence has made us more aware of the presence of Pythium insidiosum in Malaysia and plan for a more strategize ways of diagnosing the suspected fungus at laboratory setting in future. The objective of this paper is to share our experience and reflection on the diagnosis of the rare incidence of pythiosis present in Malaysia.
Fulltext Diagnostic Performance and Eye Movement Parameters during Radiographic Image Interpretation among Radiographers

Ibrahim, M. I., Mohd Norsuddin, N., Che Isa, I. N., Azman, N. F., Mohamad Shahimin, M.

Physics and Technology in Medicine, 2020;1(2):12-19.
MyJurnal

The radiographer's role in the imaging field is producing the best image to diagnose. Hence, this study is conducted to justify the ability of radiographers in terms of diagnostic performance and visual search patterns during radiographic image interpretation based on their experience. The musculoskeletal radiographic images were chosen as radiographers are expected to perform image interpretation in the red dot system as one of the expanded and extended roles of the radiographer. Sensitivity and specificity in the detection of abnormality are measured. The gaze plot, fixation count and duration are compared between groups of radiographers by using an eye tracker. 19 radiographic images consist of upper and lower extremities are used as stimuli in this study. The result from this study shows no significant difference in terms of sensitivity and specificity with a p-value of 0.818 and 0.146 respectively. For visual search pattern, two images have significant different in term of fixation count (Image 1, p = 0.017; Image 2, p = 0.042) and two images in fixation duration (Image 1, p = 0.001; Image 15, p = 0.021). The gaze plot is not different from an unstructured pattern and less coverage. In conclusion, the experience did not give an influence on the radiographic image interpretation. This may suggest that specific training in areas appropriate to the development of the radiographer could improve the image interpretation.
Nasopharyngeal carcinoma with spinal secondaries

Elango S, Kareem BA, Chandrasekaran S, Azman N

J Laryngol Otol, 1991 Sep;105(9):772-3.
PMID: 1919352 DOI: 10.1017/s0022215100117281

Nasopharyngeal carcinoma has been reported to have a higher incidence of distant metastases as compared to other head and neck cancers. Distant metastases of nasopharyngeal carcinoma has been reported in the bones, lungs, liver, distant lymph nodes, brain and porta hepatis. This report presents a case of nasopharyngeal carcinoma with secondaries in the extradural space at the thoracic level of the spinal cord which hitherto has been an unreported site.
Fulltext Synthesis, biological activity and molecular docking of new tricyclic series as α-glucosidase inhibitors

Abuelizz HA, Iwana NANI, Ahmad R, Anouar EH, Marzouk M, Al-Salahi R

BMC Chem, 2019 Dec;13(1):52.
PMID: 31384800 DOI: 10.1186/s13065-019-0560-4

Diabetes is an emerging metabolic disorder. α-Glucosidase inhibitors, such as acarbose, delay the hydrolysis of carbohydrates by interfering with the digestive enzymes. This action decreases the glucose absorption and the postprandial glucose level. We have synthesized 25 tricyclic 2-phenoxypyrido[3,2-e][1,2,4]triazolo[1,5-a]pyrimidin-5(4H)-ones hybrids and evaluated their α-glucosidase inhibitory activity. Compounds 6h and 6d have shown stronger activity than that of acarbose. Compound 6h exhibited the highest inhibition with an IC50 of 104.07 µM. Molecular modelling studies revealed that compound 6h inhibits α-glucosidase due to the formation of a stable ligand-α-glucosidase complex and extra hydrogen bond interactions, and directed in the binding site by Trp329.25 tricyclic 2-phenoxypyrido[3,2-e][1,2,4]triazolo[1,5-a]pyrimidin-5(4H)-ones hybrids have been synthesized and evaluated their α-glucosidase inhibitory activity. Compounds 6h have shown stronger activity than that of acarbose.
Fulltext Use of FabV-Triclosan Plasmid Selection System for Efficient Expression and Production of Recombinant Proteins in Escherichia coli

Ali SA, Chew YW, Omar TC, Azman N

PLoS One, 2015;10(12):e0144189.
PMID: 26642325 DOI: 10.1371/journal.pone.0144189

Maintenance of recombinant plasmid vectors in host bacteria relies on the presence of selection antibiotics in the growth media to suppress plasmid -free segregants. However, presence of antibiotic resistance genes and antibiotics themselves is not acceptable in several applications of biotechnology. Previously, we have shown that FabV-Triclosan selection system can be used to select high and medium copy number plasmid vectors in E. coli. Here, we have extended our previous work and demonstrated that expression vectors containing FabV can be used efficiently to express heterologous recombinant proteins in similar or better amounts in E. coli host when compared with expression vectors containing β-lactamase. Use of small amount of non-antibiotic Triclosan as selection agent in growth medium, enhanced plasmid stability, applicability in various culture media, and compatibility with other selection systems for multiple plasmid maintenance are noteworthy features of FabV-Triclosan selection system.
Characterisation of micro-sized and nano-sized tungsten oxide-epoxy composites for radiation shielding of diagnostic X-rays

Azman NZ, Siddiqui SA, Low IM

Mater Sci Eng C Mater Biol Appl, 2013 Dec 1;33(8):4952-7.
PMID: 24094209 DOI: 10.1016/j.msec.2013.08.023

Characteristics of X-ray transmissions were investigated for epoxy composites filled with 2-10 vol% WO3 loadings using synchrotron X-ray absorption spectroscopy (XAS) at 10-40 keV. The results obtained were used to determine the equivalent X-ray energies for the operating X-ray tube voltages of mammography and radiology machines. The results confirmed the superior attenuation ability of nano-sized WO3-epoxy composites in the energy range of 10-25 keV when compared to their micro-sized counterparts. However, at higher synchrotron radiation energies (i.e., 30-40 keV), the X-ray transmission characteristics were similar with no apparent size effect for both nano-sized and micro-sized WO3-epoxy composites. The equivalent X-ray energies for the operating X-ray tube voltages of the mammography unit (25-49 kV) were in the range of 15-25 keV. Similarly, for a radiology unit operating at 40-60 kV, the equivalent energy range was 25-40 keV, and for operating voltages greater than 60 kV (i.e., 70-100 kV), the equivalent energy was in excess of 40 keV. The mechanical properties of epoxy composites increased initially with an increase in the filler loading but a further increase in the WO3 loading resulted in deterioration of flexural strength, modulus and hardness.
High frequency of hand foot syndrome with capecitabine

Kamil M, Haron M, Yosuff N, Khalid I, Azman N

J Coll Physicians Surg Pak, 2010 Jun;20(6):421-2.
PMID: 20642979 DOI: 06.2010/JCPSP.421422

A hospital based cross-sectional retrospective study was conducted to determine the frequency of hand foot syndrome (HFS) with Capecitabine as a single agent and in combination with Oxaliplatin. The study included 43 consecutive cases of colorectal carcinoma and conducted from June till December 2008. Patients on palliative care were excluded. SPSS was used for the application of chi-square test, by keeping the level of significance as p < 0.05. Fifteen (34.9%) patients developed HFS, 10 in the single-agent and 5 in the combination group. No significant association of HFS with either regimens was noted (p=0.876).
Fumonisin B1 Production by Fusarium Species and Mycotoxigenic Effect on Larval Zebrafish

Azman N, Zainudin NAIM, Ibrahim WNW

Trop Life Sci Res, 2020 Oct;31(3):91-107.
PMID: 33214858 DOI: 10.21315/tlsr2020.31.3.7

Fumonisin B1 (FB1) is a common mycotoxin produced by Fusarium species particularly F. proliferatum and F. verticillioides. The toxin produced can cause adverse effects on humans and animals. The objectives of this study were to detect the production of FB1 based on the amplification of FUM1 gene, to quantify FB1 produced by the isolates using Ultra-fast Liquid Chromatography (UFLC) analysis, to examine the embryotoxicity effect of FB1 and to determine EC50 toward the larvae of zebrafish (Danio rerio). Fifty isolates of Fusarium species were isolated from different hosts throughout Malaysia. Successful amplification of the FUM1 gene showed the presence of this gene (800 bp) in the genome of 48 out of 50 isolates. The highest level of FB1 produced by F. proliferatum isolate B2433 was 6677.32 ppm meanwhile F. verticillioides isolate J1363 was 954.01 ppm. From the assessment of embryotoxicity test of FB1 on larvae of zebrafish, five concentrations of FB1 (0.43 ppm, 0.58 ppm, 0.72 ppm, 0.87 ppm and 1.00 ppm) were tested. Morphological changes of the FB1 exposed-larvae were observed at 24 to 168 hpf. The mortality rate and abnormality of zebrafish larvae were significantly increased at 144 hpf exposure. Meanwhile, the spontaneous tail coiling showed a significant difference. There were no significant differences in the heartbeat rate. As a conclusion, the presence of FUM1 in every isolate can be detected by FUM1 gene analysis and both of the species produced different concentrations of FB1. This is the first report of FB1 produced by Fusarium species gave a significant effect on zebrafish development.
Fulltext Psychometric Properties of the 34-Item Short-Form Supportive Care Need Survey (SCNS-SF34) Scale in the Malaysian Cancer Healthcare Context

Azman N, Thien LM, Abdullah MFIL, Mohd Shariff N

Int J Environ Res Public Health, 2021 09 06;18(17).
PMID: 34501991 DOI: 10.3390/ijerph18179403

(1) Background: This study aimed to assess the psychometric properties of the Malay version of SCNS-SF34 among Malaysian cancer patients. (2) Methods: This cross-sectional study involved 171 cancer patients. Data were collected using the structured five-factor survey via telephone call or face-to-face interviews. The internal reliability and the construct validity of SCNS-34M were analysed using principal component analysis with varimax rotation. (3) Results: The health system and information need (HSI) was the domain with the highest mean score (2.73 ± 0.88), followed by patient care and support needs (2.16 ± 0.90), as well as physical and daily living needs (1.99 ± 0.98). The confirmatory factor analysis indicated a moderate model fit for RMSEA with 0.070, TLI = 0.911 and CFI = 0.924. (4) Conclusions: The SCNS-SF34M was found to be a conceptually applicable and culturally appropriate scale in measuring the supportive care for cancer patients within the Malaysian context.
Fulltext The effects of virgin coconut oil (VCO) as supplementation on quality of life (QOL) among breast cancer patients

Law KS, Azman N, Omar EA, Musa MY, Yusoff NM, Sulaiman SA, et al.

Lipids Health Dis, 2014;13:139.
PMID: 25163649 DOI: 10.1186/1476-511X-13-139

Breast cancer is the most common cancer amongst Malaysian women. Both the disease and its treatment can disrupt the lives of the woman and adversely affect all aspects of life and thus can alter a woman's quality of life. The aim of this study was to examine the effect of virgin coconut oil (VCO) on the quality of life (QOL) of patients diagnosed with breast cancer.
In Vitro Cytotoxic Activity of Clinacanthus nutans Leaf Extracts Against HeLa Cells

Haron NH, Md Toha Z, Abas R, Hamdan MR, Azman N, Khairuddean M, et al.

Asian Pac J Cancer Prev, 2019 Feb 26;20(2):601-609.
PMID: 30806066

Objective: This study was conducted to investigate the antiproliferative activity of extracts of Clinacanthus nutans
leaves against human cervical cancer (HeLa) cells. Methods: C. nutans leaves were subjected to extraction using 80%
methanol or water. The methanol extract was further extracted to obtain hexane, dichloromethane (DCM), and aqueous
fractions. The antiproliferative activity of the extracts against HeLa cells was determined. The most cytotoxic extract
was furthered analyzed by apoptosis and cell cycle assays, and the phytochemical constituents were screened by gas
chromatography-mass spectrometry (GC-MS). Results: All of the extracts were antiproliferative against HeLa cells, and
the DCM fraction had the lowest IC50 value of 70 μg/mL at 48 h. Microscopic studies showed that HeLa cells exposed
to the DCM fraction exhibited marked morphological features of apoptosis. The flow cytometry study also confirmed
that the DCM fraction induced apoptosis in HeLa cells, with cell cycle arrest at the S phase. GC-MS analysis revealed
the presence of at least 28 compounds in the DCM fraction, most of which were fatty acids. Conclusion: The DCM
fraction obtained using the extraction method described herein had a lower IC50 value than those reported in previous
studies that characterized the anticancer activity of C. nutans against HeLa cells.
Diagnosis of cancer is not a death sentence: Examining posttraumatic growth and its associated factors in cancer patients

Leong Abdullah MFI, Hami R, Appalanaido GK, Azman N, Mohd Shariff N, Md Sharif SS

J Psychosoc Oncol, 2019 03 01;37(5):636-651.
PMID: 30821660 DOI: 10.1080/07347332.2019.1574946

Objectives: Posttraumatic growth (PTG) is the experience of positive psychological growth as a result of struggle with highly challenging life crises. This study was conducted to investigate the degree of PTG and its associated factors, as well as to identify which positive psychological parameters most significantly associated with greater PTG among Malaysian cancer patients. Design, sample, & methods: This cross-sectional survey included 195 patients with different cancer diagnoses. Perceived spousal support, level of hope, level of optimism, and PTG were measured using various validated indexes. Findings: The total mean score for PTG Inventory-Short Form (PTGI-SF) was 39.87 (±9.09). Female gender, Islamic religious belief, and having higher level of hope and greater spousal support were associated with a higher PTGI-SF score, and the most significant predictor was the hope scale. Conclusions: Malaysian cancer patients exhibited a high level of PTG, and hope was the positive psychological factor which was most significantly associated with PTG. Implications for psychosocial providers: Psychosocial interventions that promote positive psychology should be included in the treatment for cancer patients.
Fulltext Multicentre prospective cohort study of unmet supportive care needs among patients with breast cancer throughout their cancer treatment trajectory in Penang: a PenBCNeeds Study protocol

Mohd Shariff N, Azman N, Hami R, Mohd Mujar NM, Leong Bin Abdullah MFI

BMJ Open, 2021 Mar 15;11(3):e044746.
PMID: 33722872 DOI: 10.1136/bmjopen-2020-044746

INTRODUCTION: Proper assessment of unmet supportive care needs of patients with breast cancer and its influencing factors at different treatment intervals will improve the rehabilitation of patients with breast cancer. Therefore, this study aims to determine the prevalence of unmet supportive care needs, changes of needs over time and associated factors during the treatment period.
METHODS AND ANALYSIS: This multicentre, prospective cohort study will be conducted in three governmental hospitals and one tertiary cancer institute in Penang, Malaysia. Adult women diagnosed with primary or recurrent tumour, node, metastases stage I-IV breast cancer based on pathological biopsy will be eligible for this study. At least 281 samples are required for this study. Participants will undergo follow-up at three time intervals: T1 at breast cancer diagnosis; T2 at 3 months after diagnosis and T3 at 6 months after diagnosis. Patients will complete a set of questionnaires at each time. The primary outcome of this study includes the changes in supportive care needs over three time points, followed by the secondary outcome examining patients' characteristics, coping behaviours and positive psychological components as they affect changes in unmet supportive care needs over time.
ETHICS AND DISSEMINATION: The study has received ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-19-268-45809 IIR) and the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/17100443). The results of the prospective study will be submitted for publication in a peer-reviewed journal.
Fulltext Validation of the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among patients with cancer in Malaysia

Song W, Mansor NS, Shari NI, Azman N, Zhang R, Leong Bin Abdullah MFI

PLoS One, 2023;18(11):e0293698.
PMID: 37988357 DOI: 10.1371/journal.pone.0293698

BACKGROUND: The well-being and adaptive functioning of patients with cancer depend on their perception of social support. To accurately assess and understand the impact of social support in a diverse population, validated measurement tools are essential. This study aimed to adapt and validate the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among patients with cancer in Malaysia.
METHODS: A total of 346 cancer patients with mixed disease types were recruited and completed the socio-demographic and clinical characteristics questionnaire and the MSPSS-M. The MSPSS-M was assessed for internal consistency, construct validity, face, content, convergent, discriminant validity, and confirmatory factor analyses.
RESULTS: The MSPSS-M and its three domains demonstrated good internal consistency with Cronbach's α ranging from 0.900 to 0.932. Confirmatory factor analysis (CFA) of the MSPSS-M supported the three-factor model of the original English version of the MSPSS. The MSPSS-M also exhibited good convergent validity and discriminant validity.
CONCLUSION: The MSPSS-M demonstrates favorable psychometric properties among patients with cancer in Malaysia. The validation of the MSPSS-M provides a culturally adapted and linguistically valid instrument to assess perceived social support among Malay-speaking patients with cancer in Malaysia.
Factors influencing final year radiography students' intention to pursue postgraduate education in medical imaging

Mohamed A, Mat Sanusi NSA, Azman NS, Zailani NS, Jasmin NH, Che Isa IN

Radiography (Lond), 2024 Jan;30(1):388-393.
PMID: 38159357 DOI: 10.1016/j.radi.2023.12.006

INTRODUCTION: Postgraduate education in medical imaging is an important platform that can support in preparing radiographers for the role extension and advancement in radiography. Thus, this study aims to identify the factors influencing final year radiography students' intention to pursue postgraduate education in medical imaging.
METHODS: An online cross-sectional survey was conducted among final year students in medical imaging programs from six institutions in Malaysia. Purposive convenience sampling has been employed. Data collection was related to students' interest in postgraduate study and possible factors that may affect students' intention to pursue postgraduate education after study degree completion. The questionnaire was a combination of a Likert Scale and open-ended question.
RESULTS: A total of 148 (female, n = 132 and male, n = 16) responses were included in the analysis. Among the participants, n = 93 (62.8 %) of students intended to pursue study. The highest choice of study was mixed mode (41.9 %) and cardiac imaging was the field of choice by the students (22.3 %). Five factors have been found to significantly correlate with the students' intention to pursue postgraduate study in medical imaging which were student attributes, being an academician, remuneration, finance, and social influences (p 0.05).
CONCLUSION: Five out of seven factors tested were found to significantly influence students' decision to pursue postgraduate education in medical imaging. Effective strategies based on the influencing factors should be strategized to encourage more students to pursue postgraduate education in medical imaging.
IMPLICATIONS FOR PRACTICE: Implementation of effective strategies based on the influencing factors will improve access to education among radiography students, ultimately enhancing future radiographers' capability and competency.
Prospective cohort study of unmet supportive care needs, post-traumatic growth, coping strategy and social supports among patients with breast cancer: The PenBCNeeds study

Azman N, Leong Bin Abdullah MFI, Musa KI, Hassan N, Mohd Shariff N

J Psychosoc Oncol, 2024 Mar 06.
PMID: 38449103 DOI: 10.1080/07347332.2024.2325498

PURPOSE: While the unmet healthcare needs are still being improved upon, the wellbeing of cancer patients has increasingly become a prime concern in Malaysia. The objective of this study is to ascertain the trend of unmet supportive care needs, post-traumatic growth (P T G), coping strategies, and social supports among patients with breast cancer over the three time points of treatment: T1 at early diagnosis, T2 for three months after diagnosis, and T3 for six months after diagnosis.
METHODS: A total of 240 cancer patients participated in this prospective cohort study, with follow-up visits from October 2019 until July 2021. Data were collected using several instruments: Brief COP E, the Source of Social Support Scale (SSSS), the Post-Traumatic Growth Inventory - Short Form (P T GI-SF), and a Malay version of the 34-Item Shortform Supportive Care Need Survey (SCNS-SF34).
RESULTS: The results indicated a significant change from T1 to T3 for all domains of the unmet needs (p-value < 0.001), except for the sexual domain. A lower SCNS-SF34 score resulted from more unfavorable social support. The P T GI-SF results indicated a trend toward meeting the unmet needs, and a higher SCNS-SF-34 score predicted a considerably higher P T GI-SF score.
CONCLUSIONS: Our study findings suggest that majority of the factors evaluated in terms of unmet needs among cancer patients have undergone considerable changes.
Fulltext Co-inheritance of compound heterozygous Hb Constant Spring and a single -alpha(3.7) gene deletion with heterozygous deltabeta thalassaemia: a diagnostic challenge

Azma RZ, Othman A, Azman N, Alauddin H, Ithnin A, Yusof N, et al.

Malays J Pathol, 2012 Jun;34(1):57-62.
PMID: 22870600

Haemoglobin Constant Spring (Hb CS) mutation and single gene deletions are common underlying genetic abnormalities for alpha thalassaemias. Co-inheritance of deletional and non-deletional alpha (alpha) thalassaemias may result in various thalassaemia syndromes. Concomitant co-inheritance with beta (beta) and delta (delta) gene abnormalities would result in improved clinical phenotype. We report here a 33-year-old male patient who was admitted with dengue haemorrhagic fever, with a background history of Grave's disease, incidentally noted to have mild hypochromic microcytic red cell indices. Physical examination revealed no thalassaemic features or hepatosplenomegaly. His full blood picture showed hypochromic microcytic red cells with normal haemoglobin (Hb) level. Quantitation of Hb using high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) revealed raised Hb F, normal Hb A2 and Hb A levels. There was also small peak of Hb CS noted in CE. H inclusions was negative. Kleihauer test was positive with heterocellular distribution of Hb F among the red cells. DNA analysis for alpha globin gene mutations showed a single -alpha(-3.7) deletion and Hb CS mutation. These findings were suggestive of compound heterozygosity of Hb CS and a single -alpha(-3.7) deletion with a concomitant heterozygous deltabeta thalassaemia. Co-inheritance of Hb CS and a single -alpha(-3.7) deletion is expected to result at the very least in a clinical phenotype similar to that of two alpha genes deletion. However we demonstrate here a phenotypic modification of alpha thalassemia presumptively as a result of co-inheritance with deltabeta chain abnormality as suggested by the high Hb F level.
Fulltext Early experience of endobronchial ultrasound-guided transbronchial nodal cryobiopsy: a case series from Sabah, Malaysia

Ramarmuty HY, Huan NC, Nyanti LE, Khoo TS, Renganathan T, Manoh AZ, et al.

Ther Adv Respir Dis, 2024;18:17534666241231122.
PMID: 38357899 DOI: 10.1177/17534666241231122

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established minimally invasive method for the diagnosis of benign and malignant conditions. Continuous efforts are underway to improve the material adequacy of EBUS-TBNA, including the introduction of a new technique called EBUS-guided transbronchial nodal cryobiopsy (EBUS-TBNC). This method allows for the retrieval of larger and well-preserved histologic samples from the mediastinum. We present a case series of four patients who underwent combined EBUS-TBNA and EBUS-TBNC procedures in our centre. All procedures were performed under general anaesthesia using a convex probe EBUS scope (Pentax EB-1970UK). Two patients were diagnosed with malignancy and two with benign disorders (silicosis and tuberculosis). In the malignant cases, both EBUS-TBNA/cell block and cryobiopsy provided a diagnosis but cryobiopsy yielded more material for ancillary tests in one patient. However, in the benign cases, there was discordance between EBUS-TBNA/cell block and cryobiopsy. Only cryobiopsy detected granuloma in the patient with TB (tuberculosis), and in the patient with silicosis, TBNC provided a better overall histological evaluation, leading to a definitive diagnosis. No complications were observed. This case series supports the potential diagnostic value of combining EBUS-TBNA and EBUS-TBNC, particularly in benign mediastinal lesions (granulomatous diseases), and in cases requiring additional molecular tests in cancer diagnosis.
Fulltext Health Anxiety and Its Correlations with Self-Perceived Risk and Attitude on COVID-19 among Malaysian Healthcare Workers during the Pandemic

Mohd Salleh Sahimi H, Azman N, Nik Jaafar NR, Mohd Daud TI, Baharudin A, Ismail AK, et al.

Int J Environ Res Public Health, 2021 May 03;18(9).
PMID: 34063714 DOI: 10.3390/ijerph18094879

Healthcare workers (HCW) are exposed to health-related anxiety in times of pandemic as they are considered to have a high risk of being infected whilst being the vital workforce to manage the outbreak. This study determined the factors that influence health anxiety and its extent in correlations with perceived risk, knowledge, attitude, and practice of HCW. A cross-sectional online survey was conducted on a total of 709 HCW from both public and private healthcare facilities who completed a set of questionnaires on sociodemographic data, knowledge, attitude, and practice of HCW on COVID-19, and health anxiety traits assessed using the short version Health Anxiety Inventory (HAI). Multiple linear regression (adjusted R2 = 0.06) revealed respondents with higher perceived risk for COVID-19 significantly predicted higher HAI scores (beta 1.281, p < 0.001, 95%, CI: 0.64, 1.92), and those with a higher cautious attitude towards COVID-19 significantly predicted higher HAI scores (beta 0.686, p < 0.001, 95%CI: 0.35, 1.02). Healthcare workers' perceived risk and cautious attitude towards COVID-19 might be potentially influenced by management of the sources and approaches to the dissemination of information of the pandemic. The implementation of certain measures that minimize the infection risk and its related anxiety is important to preserve both their physical and psychological wellbeing.

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