Displaying all 11 publications

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  1. Mohd Azman ZA, Kim SH
    PMID: 28138573 DOI: 10.21037/tgh.2016.03.16
    Robotic surgery has the upper hand when compared to the laparoscopic approach in terms of superior visualisation, flexibility in movement, steadiness and accessibility to confined anatomical spaces. Nevertheless, limitations still exist with regards to cost, reduced tactile sensation, time-consuming setup and a significant learning curve to achieve. Although studies have shown better or at least comparable outcomes between the robotic and laparoscopic approach, the limitations mentioned result in poor penetrance among centres and surgeons. Advancements in robotic surgery technology and attaining the acquired skillset will translate into better clinical outcomes for patients.
  2. George E, George R, Ariffin WA, Mokhtar AB, Azman ZA, Sivagengei K
    Med J Malaysia, 1993 Sep;48(3):325-9.
    PMID: 8183146
    The study concerned the identification of the beta-thalassaemia mutations that were present in 24 patients with beta-thalassaemia major who were transfusion dependent. The application of a modified polymerase chain reaction, the amplification refractory system (ARMS) was found to be an effective and rapid method for the identification of the beta-thalassaemia mutations. Six different mutations were detected. Seventy five percent of the patients were Chinese-Malaysians and showed the commonly occurring anomalies: 1. frameshift codon 41 and 42 (-TCTT); 2. the C to T substitution at position 654 of intron 2 (IVS-2); 3. the mutation at position -28(A to G); and the nonsense mutation A to T at codon 17. In the Malays, the common mutations seen were: 1. the G to C mutation at position 5 of IVS-1; 2. the G to T mutation at position 1 of intron 1 (IVS-1); and the A to T at codon 17. The delineation of the specific mutations present will enable effective prenatal diagnosis for beta-thalassaemia to be instituted.
  3. Zainal Abidin ZA, Azizan N, Hayati F, Mra A, Mohd Azman ZA
    Kathmandu Univ Med J (KUMJ), 2018 7 1;16(63):272-274.
    PMID: 31719321
    Inflammatory myofibroblastic tumour is rare but more common in children. It shows an immunophenotypic features of myofibroblastic differentiation, hence bearing neoplastic potential. The diagnosis is challenging especially if it involves rectum. Surgical resection is the mainstay of treatment if clinically obstructed. A 65-year-old gentleman presented with intestinal obstruction, which then followed by a hartmann's procedure. Final diagnosis is a rare case of inflammatory myofibroblastic tumour of the rectum. We discuss its genetic involvement with a literature review.
  4. George E, Mokhtar AB, Azman ZA, Hasnida K, Saripah S, Hwang CM
    Singapore Med J, 1996 Oct;37(5):501-4.
    PMID: 9046203
    Haemoglobin Bart's hydrops fetalis is the result of complete absence of functional alpha-globin genes where the fetus is homozygous for the alpha 0-thal gene. Prenatal diagnosis can be made by analysis of fetal DNA from chorionic villus, amniotic cells and fetal blood. Earlier studies for analysing genomic DNA needed digestion with restriction enzymes and hybridisation to radiolabelled probes which took 2 weeks. We have used the polymerase chain reaction (PCR) and non-radioactive primers to identify specific target sequences with results available within 1-3 days for the diagnosis of haemoglobin Bart's syndrome. With fetal blood samples, complete absence of alpha-chain synthesis is confirmed by globin chain electrophoresis on cellulose acetate pH 6.0.
  5. Nordin N, Zairul Azman ZA, Adnan NA, Majid SR
    Int J Biol Macromol, 2024 Aug;274(Pt 1):133383.
    PMID: 38914395 DOI: 10.1016/j.ijbiomac.2024.133383
    In this report, we present a dual crosslinking hydrogel fiber made from polyamine saccharides chitosan (CS), synthesized through UV polymerization. This process utilizes Irgacure 2959 and N,N'-Methylenebisacrylamide (MBAA) as initiators, followed by immersion in an aluminum chloride (AlCl3) solution. The resulting hydrogel incorporates a dual crosslinking mechanism, quantitatively studied via Nuclear Magnetic Resonance (NMR) spectroscopy. This mechanism involves chemical crosslinking through radical graft polymerization of acrylamide and acrylic acid onto CS in the presence of MBAA, and physical crosslinking through hydrogen bonding interactions between P(AAm-co-AA) and a metal coordination bond. The mechanical properties of the hydrogel fiber enable it to withstand stresses up to 656 kPa and strains exceeding 300 %. Additionally, the hydrogel fiber exhibits conductivity at 1.96 Scm-1. Serving as a multifunctional material, it acts as a strain sensor and finds utility in optics. Remarkably, it demonstrates the capability to detect human motions such as finger bending and minor deformations like vibrations of the vocal cords. Furthermore, its ability to guide dynamic light makes it promising for optical applications. Consequently, this multifunctional hydrogel fiber emerges as a highly promising candidate for diverse applications in fields such as bioengineering and electronics.
  6. Hayati F, Mohd Azman ZA, Nasuruddin DN, Mazlan L, Zakaria AD, Sagap I
    Asian Pac J Cancer Prev, 2017 07 27;18(7):1821-1825.
    PMID: 28749112
    Background: Anastomotic leaks in colorectal surgery results in a high morbidity and mortality rate. Serum procalcitonin levels is known as a sensitive and specific marker of sepsis and could be use as a marker for early detection of a leak allowing early intervention. It may help a clinician decide to perform a CT scan even earlier especially when the diagnosis of a leak is uncertain. The aim of this study is to determine whether serum procalcitonin is a good predictor of anastomotic leak in colorectal surgery. Methodology: Between July 2014 until October 2015, 70 patients undergoing colorectal surgery were prospectively analyzed in a single-center tertiary teaching hospital. Demographic and surgical data were obtained. Serum procalcitonin was taken before surgery and at day 3 (72 hours) postoperatively. During the postoperative period, the patients were observed in the ward for features of anastomotic leak and if present, it was managed accordingly. The primary outcome was to prospectively determine an association between serum procalcitonin levels and an anastomotic leak in patients who underwent colorectal surgery with a primary anastomosis. Result: The rate of anastomotic leak was 4.5% (3 patients) with a mortality rate of 4.3% (3 patients). A rise in serum procalcitonin was statistically significant among patients with anastomotic leak. The optimal procalcitonin cut-off level at postoperative day 3 was 5.27 ng/mL, resulting in 100% sensitivity, 85% specificity, 23% positive predictive value and 100% negative predictive value. Nevertheless, none of the variables showed statistical significance with an anastomotic leak. Conclusion: Procalcitonin is a reliable biochemical marker to help diagnose anastomotic leak in colorectal surgery. Our study has shown that a level of 5 times beyond normal is statistically significant and a value of more than 5.27 ng/mL is confirmatory of a leak.
  7. Nasir H, Mohammad Azmi N, Dualim DM, Azman ZA, Abdul Rahman NA
    Cureus, 2024 Apr;16(4):e57585.
    PMID: 38707052 DOI: 10.7759/cureus.57585
    Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory disorder affecting the terminal follicular epithelium within the apocrine skin glands. When these lesions develop in the genital and perianal regions, there is a potential risk of progression to squamous cell carcinoma or mucinous adenocarcinoma. The tumor may appear in the perianal area, perineum, or buttocks. Here, we present a rare case of long-standing perianal HS with associated fistula-related mucinous adenocarcinoma and the challenges we faced in managing this condition.
  8. Joan Gan CY, Chan KK, Tan JH, Tan Chor Lip H, Louis Ling LL, Mohd Azman ZA
    ANZ J Surg, 2021 06;91(6):E375-E381.
    PMID: 33876547 DOI: 10.1111/ans.16870
    BACKGROUND: Smartphone-controlled patch electro-acupuncture (SCEA) is a novel device which gives the same analgesic effect as with conventional acupuncture. There are no published articles in the English literature on the use of this device as a primary mode of pain relief during colonoscopy. Primary aims of this study were to investigate the efficacy of SCEA as a substitute for pain relief during colonoscopy.

    METHODS: Thirty-seven patients were randomized to receive SCEA (n = 19) or placebo (n = 18) during colonoscopy. Additional rescue sedation was administered to patients if they had pain or discomfort during the procedure. Visual analogue scale was used to quantify the intensity of pain from the beginning to end of the procedure. Other variables analysed were the amount of sedation used, duration from start to caecal intubation, length of time for completion of colonoscopy and recovery time to home discharge.

    RESULTS: Patients who received SCEA had a lower median pain score of 4.6 (interquartile range 5.7) compared to the placebo group of 6.0 (interquartile range 3.2). Statistical analysis comparing the groups revealed a non-significant P-value of 0.12, although more than 90% of the patients indicated willingness for SCEA as the primary analgesia if they were to repeat the procedure. Throughout the study, there were no adverse complications that occurred during the use of SCEA.

    CONCLUSIONS: Even though this study did not demonstrate, a significance in pain reduction, SCEA remains a safe modality which, more than 90% of patients favoured as a substitute for pain relief during colonoscopy.

  9. Abdul Razak N, Azhar ZI, Baharuddin IH, Ismail Z, Mohd Azman ZA, Abdul Manap SA, et al.
    Asian Pac J Cancer Prev, 2024 Feb 01;25(2):379-391.
    PMID: 38415522 DOI: 10.31557/APJCP.2024.25.2.379
    INTRODUCTION: Early diagnostic and treatment advances have resulted in prolonged cancer survivorship. Therefore, exercise intervention in survivorship management is essential for enhancing cancer survivors' health-related quality of life (HRQoL).

    OBJECTIVE: The systematic review and meta-analysis in this study aimed to explore the effect of exercise intervention on health-related quality of life of colorectal cancer survivors.

    METHODS: The current study followed guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) to identify relevant literature. Comprehensive searches were conducted using EBSCOhost, Web of Science (WOS), Scopus, Science Direct, and PubMed. The inclusion criteria included are randomised control trials studies written in English, with no restrictions for the time of publication that reported the effects of exercise intervention on health-related quality of live among colorectal cancer survivors. Meta-analysis was conducted by pooling the mean and standard deviation of post-intervention scores across randomised control trial studies using a random effects model.

    RESULT: A total of 467 articles were identified but only seven articles were randomised control trials (RCT) (n = 7) with PEDro scores ranging from 6 to 9 showing good internal validity were included in the review. The results of the meta-analysis of pooled data from six RCTs studies on HRQoL showed no significant effect of exercise intervention on HRQoL in the intervention group compared to control group [SMD = 0.25; 95% CI; -0.0, 0.51; Z = 1.88; p = 0.06; I2 = 30.8%].

    CONCLUSION: This meta-analysis provides key insights into the effect of exercise on the health-related quality of life (HRQoL) of colorectal cancer (CRC) survivors. Therefore, more experimental studies should be carried out with rigorous methodology to evaluate the effectiveness of exercise interventions before it is recommended as a routine activity in post-treatment management for CRC survivors.

  10. Abdul Razak N, Azhar ZI, Ismail Z, Mohd Azman ZA, Abdul Manap SA, Ramli N, et al.
    Asian Pac J Cancer Prev, 2024 Aug 01;25(8):2895-2904.
    PMID: 39205588 DOI: 10.31557/APJCP.2024.25.8.2895
    OBJECTIVE: This study aimed to investigate the effect of Pilates exercise on the quality of life, functional capacity, cancer-related fatigue, depression and salivary cortisol of colorectal cancer survivors.

    METHODS: This is a quasi-experimental study which was conducted at Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia (UKM), and Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), Malaysia. The intervention group performed Pilates exercises with a certified Pilates instructor for eight weeks via online streaming from the participants' homes. Meanwhile, the control group participants received the usual care as stipulated by their oncologists. The primary outcome was the quality of life. The secondary outcomes were functional capacity, cancer-related fatigue, depression and salivary cortisol. Data was collected at baseline and eight weeks after the exercise intervention. The effects of the intervention were analyzed using Repeated Measures Analysis of Covariance (ANCOVA) statistical test.

    RESULT: Thirty-six (36) colorectal cancer survivors were allocated into either a Pilates exercise intervention group (N= 18) or a control group (N= 18). Over eight weeks, the Pilates exercise group revealed significant group x time interactions in terms of quality of life (p = 0.003), role functioning (p = 0.012), functional capacity (p = 0.048), and stool frequency (p = 0.021). However, only the stool frequency symptom (p = 0.008) remained significant after controlling for the confounders of age, gender and stage of cancer. No significant changes in cancer-related fatigue, depression and salivary cortisol levels between the groups were observed after the intervention.

    CONCLUSION: Pilates exercise had positive impacts on role functioning, bowel function, and functional capacity among colorectal cancer survivors, ultimately contributing to an improvement in quality of life.

  11. Muhammad Nawawi KN, Mokhtar NM, Wong Z, Mohd Azman ZA, Hsin Chew DC, Rehir R, et al.
    PeerJ, 2021;9:e12425.
    PMID: 34820182 DOI: 10.7717/peerj.12425
    Background: The incidence rate of colorectal cancer (CRC) in Asian countries is increasing. Furthermore, recent studies have shown a concerning rise in the incidence of CRC among younger patients aged less than 50 years. This study aimed to analyze the incidence trends and clinicopathological features in patients with early-onset CRC (EOCRC) and later-onset CRC (at age ≥ 50 years).

    Methods: A retrospective analysis was performed on 946 patients with CRC diagnosed from 1997 to 2017 at Universiti Kebangsaan Malaysia Medical Centre. The time trend was assessed by dividing the two decades into four 5-year periods. The mean age-standardized and age-specific incidence rates were calculated by using the 5-year cumulative population of Kuala Lumpur and World Health Organization standard population. The mean incidence was expressed per 100,000 person-years.

    Results: After a stable (all age groups) CRC incidence rate during the first decade (3.00 per 100,000 and 3.85 per 100,000), it sharply increased to 6.12 per 100,000 in the 2008-2012 period before decreasing to 4.54 per 100,000 in the 2013-2017 period. The CRC incidence trend in later-onset CRC showed a decrease in the 2013-2017 period. Contrariwise, for age groups of 40-44 and 45-49 years, the trends showed an increase in the latter 15 years of the study period (40-44 years: 1.44 to 1.92 to 2.3 per 100,000; 45-49 years: 2.87 to 2.94 to 4.01 per 100,000). Malays' EOCRC incidence rate increased from 2008-2012 to 2013-2017 for both the age groups 40-44 years (1.46 to 2.89 per 100,000) and 45-49 years (2.73 to 6.51 per 100,000). Nearly one-fifth of EOCRC cases were diagnosed at an advanced stage (Dukes D: 19.9%), and the majority of them had rectal cancer (72.8%).

    Conclusion: The incidence of EOCRC increased over the period 1997-2017; the patients were predominantly Malays, diagnosed at a later stage, and with cancer commonly localized in the rectal region. All the relevant stakeholders need to work on the management and prevention of CRC in Malaysia.

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