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  1. Association between HER-2/neu over-expression and clinico-pathologic parameters of breast cancer in northern Malaysia
    Kamil M, Yusuf N, Khalid I, Islam R, Biswas M, Hashim H
    Ceylon Med J, 2010 Mar;55(1):9-13.
    PMID: 20446534
    BACKGROUND: Breast cancer is the commonest cancer affecting women world wide. Breast cancer is a leading cause of cancer related mortality in Asian countries. Management of breast cancer depends on several tumour-related and patient related factors. HER-2/neu over-expression has been associated with a poor prognosis in breast cancer. We assessed HER-2/neu over expression pattern in unselected breast cancer cases in terms of clinico-pathologic parameters to identify any associations between them.

    METHODS: Two hundred cases of breast cancer were evaluated at Advanced Medical and Dental Institute and Hospital Kepala Batas from 2002 to 2007. HER-2/neu status was confirmed in breast cancer tissues by immunohistochemistry. Immunohistochemical expression of HER-2/neu was evaluated according to the published scoring guidelines of the 'Hercep Test' (Dako, Carpinteria, CA). Data were analysed to identify any association between HER-2/neu and clinico-pathologic parameters.

    RESULTS: HER-2/neu over expression was found in 63 (31.5%) tumours out of 200. When assessed for various age groups no significant association was found. However, a high percentage (75%) of over-expression was noted in the 81-85 years age group. No association was found with different racial groups (Malay, Chinese and Indians), with lymph node status or with grade of tumour. However a positive association was observed with oestrogen receptor and progesterone receptor expression.

    CONCLUSION: There was no association between HER-2/neu over expression and age, race, lymph node status or tumor grade. However a positive association was found with oestrogen and progesterone receptor status.

  2. Fulltext Time series prediction of COVID-19 by mutation rate analysis using recurrent neural network-based LSTM model
    Pathan RK, Biswas M, Khandaker MU
    Chaos Solitons Fractals, 2020 Sep;138:110018.
    PMID: 32565626 DOI: 10.1016/j.chaos.2020.110018
    SARS-CoV-2, a novel coronavirus mostly known as COVID-19 has created a global pandemic. The world is now immobilized by this infectious RNA virus. As of June 15, already more than 7.9 million people have been infected and 432k people died. This RNA virus has the ability to do the mutation in the human body. Accurate determination of mutation rates is essential to comprehend the evolution of this virus and to determine the risk of emergent infectious disease. This study explores the mutation rate of the whole genomic sequence gathered from the patient's dataset of different countries. The collected dataset is processed to determine the nucleotide mutation and codon mutation separately. Furthermore, based on the size of the dataset, the determined mutation rate is categorized for four different regions: China, Australia, the United States, and the rest of the World. It has been found that a huge amount of Thymine (T) and Adenine (A) are mutated to other nucleotides for all regions, but codons are not frequently mutating like nucleotides. A recurrent neural network-based Long Short Term Memory (LSTM) model has been applied to predict the future mutation rate of this virus. The LSTM model gives Root Mean Square Error (RMSE) of 0.06 in testing and 0.04 in training, which is an optimized value. Using this train and testing process, the nucleotide mutation rate of 400th patient in future time has been predicted. About 0.1% increment in mutation rate is found for mutating of nucleotides from T to C and G, C to G and G to T. While a decrement of 0.1% is seen for mutating of T to A, and A to C. It is found that this model can be used to predict day basis mutation rates if more patient data is available in updated time.
  3. Fulltext Successful surgical resection of advanced gastrointestinal stromal tumor post neoadjuvent therapy
    Kamil S, Biswas M, Imran A, Islam R, Mukhtar A, Joshi S
    Libyan J Med, 2009 Jun 01;4(2):83-5.
    PMID: 21483516 DOI: 10.4176/081220
    We report a case of a 48-year-old Indian male who presented with swelling and firmness in his left upper part of the abdomen of one month duration with anorexia and weight loss. Initial examination revealed an intra abdominal mass of around 16.8x11.0x24.5cm with minimal left sided pleural effusion. A biopsy from the mass confirmed the diagnosis of gastrointestinal stromal tumour (GISTs) as supported by immmunohistochemistry results which showed strong positivity for c-kit while stains for smooth muscle actin, desmin, myoglobin, S100 Protein and cytokerstin remained negative. The patient was not suitable for surgical intervention in view of advanced tumor, and Imatinib Mesylate 400mg daily was started with the aim of making the tumor operable. Such therapy lasted for twenty months and was tolerated well by the patient. It then resulted in gradual tumor regression, following which the patient underwent successful tumor resection. Post surgical resection patient had no radiological evidence of intra abdominal tumor but mild left sided pleural effusion with left lower lobe atelectasis. The patient had uneventful post operative recovery and he is currently on Imatinib mesylate and tolerating treatment well with mild skin rash. The experience with preoperative imatinib on surgical resection rates and post operative outcomes is limited especially with primary locally advanced GISTs. In our case successful surgical resection was possible for a huge locally advanced GIST with unusually prolonged treatment of twenty months with imatinib preoperatively.
  4. Effects of the ABCB1 C3435T single nucleotide polymorphism on major adverse cardiovascular events in acute coronary syndrome or coronary artery disease patients undergoing percutaneous coronary intervention and treated with clopidogrel: A systematic review and meta-analysis
    Biswas M, Rahaman S, Biswas TK, Ibrahim B
    Expert Opin Drug Saf, 2020 Dec;19(12):1605-1616.
    PMID: 33040624 DOI: 10.1080/14740338.2020.1836152
    INTRODUCTION: The effects of the ABCB1 C3435T genetic polymorphism on clopidogrel responses are conflicting and inconclusive especially in patients undergoing percutaneous coronary intervention (PCI). This study examined the pooled risk of major adverse cardiovascular events (MACE) and bleeding events associated with the ABCB1 C3435T polymorphism in acute coronary syndrome or coronary artery disease patients undergoing PCI and treated with clopidogrel.

    AREAS COVERED: Literature was searched in different resources for eligible studies. The pooled risk ratio was measured using RevMan software, with p<0.05 (two-sided) set as statistically significant.

    EXPERT OPINION: The ABCB1 C3435T homozygous mutant (TT) was associated with significantly increased risk of MACE compared to either wild type genotype (CC) or the combination of wild type and heterozygous genotypes (TT vs. CC: RR 1.33; 95% CI 1.06-1.68; p=0.02; TT vs. CC+CT: RR 1.32; 95% CI 1.10-1.60; p=0.004). Safety outcomes, i.e. bleeding events were not significantly different between the genetic models investigated (TT vs. CC: RR 1.93; 95% CI 0.86-4.35; p=0.11; TT vs. CC+CT: RR 1.36; 95% CI 0.89-2.09; p=0.16; CT+TT vs. CC: RR 1.20; 95% CI 0.59-2.44; p=0.61). It is suggested that ABCB1 C3435T genotype should be tested for ACS/CAD patients undergoing PCI to ensure optimum therapy of clopidogrel.

  5. Risk of major adverse cardiovascular events for concomitant use of clopidogrel and proton pump inhibitors in patients inheriting CYP2C19 loss-of-function alleles: meta-analysis
    Biswas M, Rahaman S, Biswas TK, Ibrahim B
    Int J Clin Pharm, 2021 Oct;43(5):1360-1369.
    PMID: 33774763 DOI: 10.1007/s11096-021-01261-y
    Background Efficacy of clopidogrel may be diminished due to either co-administration of proton pump inhibitors or carrying CYP2C19 loss-of-function alleles. However, patients may be at greater risk of major adverse cardiovascular events if taking clopidogrel together with proton pump inhibitors and also inherited the CYP2C19 loss-of-function alleles which may cause further reduction of clopidogrel efficacy. This is due to the cumulative effects of drug-drug interactions and drug-gene interactions collectively referred to as multifactorial drug-gene interactions. Aim of the review The aim of this analysis was to estimate aggregated risk of major adverse cardiovascular events for either coronary heart disease or stroke patients with multifactorial drug-gene interactions versus clopidogrel alone with or without drug-gene interactions. Methods Literatures were searched using different resources based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analysis was performed using RevMan software following either fixed/random effects model based on the levels of heterogeneity. A p value 
  6. Risk of major adverse cardiovascular events of CYP2C19 loss-of-function genotype guided prasugrel/ticagrelor vs clopidogrel therapy for acute coronary syndrome patients undergoing percutaneous coronary intervention: a meta-analysis
    Biswas M, Kali MSK, Biswas TK, Ibrahim B
    Platelets, 2021 Jul 04;32(5):591-600.
    PMID: 32664772 DOI: 10.1080/09537104.2020.1792871
    The most effective antiplatelet treatments for acute coronary syndrome (ACS) patients carrying CYP2C19 loss-of-function (LoF) alleles undergoing percutaneous coronary intervention (PCI) is still debating and conflicting. It was aimed to compare the efficacy and safety endpoints for these patients treated with alternative P2Y12 receptor blockers (e.g. prasugrel or ticagrelor) against clopidogrel. Literature was searched in PubMed, Cochrane library, Synapse and 1000 Genomes databases following PRISMA guidelines for identifying relevant studies. Aggregated risk was estimated by RevMan software using either fixed/random-effects models where P values<0.05 (two-sided) were considered statistically significant. Nine studies comprising 16,132 ACS patients undergoing PCI were included in this analysis in which 2,746 and 2,640 patients were in the CYP2C19 LoF clopidogrel and alternatives treatment group, respectively. It was demonstrated that patients treated with prasugrel or ticagrelor significantly reduced the risk of MACEs (RR 0.58; 95% CI 0.45-0.76; P<0.0001) as compared to patients with clopidogrel where both groups carrying CYP2C19 LoF alleles. Subgroup analysis showed that prasugrel or ticagrelor significantly reduced the risk of cardiovascular death (RR 0.44; 95% CI: 0.25-0.74; P=0.002) and MI (RR 0.60; 95% CI: 0.44-0.81; P=0.0008) while other clinical outcomes were not found statistically significant between these two groups; stroke (RR 0.77; 95% CI: 0.43-1.38; P =0.39), stent thrombosis (RR 0.67; 95% CI: 0.38-1.18; P =0.17), unstable angina (RR 0.55; 95% CI: 0.13-2.33; P =0.42), revascularisation (RR 0.79; 95% CI: 0.28-2.24; P=0.66). Bleeding events were not found significantly different between these groups (RR 1.06; 95% CI: 0.88-1.28; P=0.55). Considering efficacy and safety, alternative antiplatelets (e.g. prasugrel or ticagrelor) may be regarded as better treatment option as compared to clopidogrel for ACS patients undergoing PCI.
  7. Effects of the CYP2C19 LoF allele on major adverse cardiovascular events associated with clopidogrel in acute coronary syndrome patients undergoing percutaneous coronary intervention: a meta-analysis
    Biswas M, Sukasem C, Khatun Kali MS, Ibrahim B
    Pharmacogenomics, 2022 02;23(3):207-220.
    PMID: 35042400 DOI: 10.2217/pgs-2021-0098
    The aggregated risk of major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS) patients inheriting CYP2C19 loss-of function (LoF) alleles who underwent percutaneous coronary intervention (PCI) and were treated with clopidogrel is controversial. In the current study, we searched the literature in different databases for eligible studies. The risk ratio (RR) was measured where p<0.05 was statistically significant. The ACS patients with either one or two CYP2C19 LoF alleles who underwent PCI, treated with clopidogrel were correlated with a significantly escalated risk of MACE compared with noncarriers (RR: 1.53, 95% CI: 1.39-1.69, p < 0.00001), driven by CV death (RR: 1.88, 95% CI: 1.18-3.01, p = 0.008), MI (RR: 1.67, 95% CI: 1.21-2.31, p = 0.002) and ST (RR: 1.90, 95% CI: 1.27-2.84, p = 0.002). Patients with two CYP2C19 LoF alleles were correlated with significantly greater risk of MACE compared with noncarriers (RR: 3.91, 95% CI: 2.78-5.50, p < 0.00001). Further analysis revealed that the risk of MACE was markedly significant in Asian patients (RR: 2.02, 95% CI: 1.67-2.44, p < 0.00001) and was comparatively low significance in western patients (RR: 1.35, 95% CI: 1.20-1.52, p < 0.00001). There was no significantly different bleeding events in patients with CYP2C19 LoF alleles compared with noncarriers (RR: 0.99, 95% CI: 0.85-1.15, p = 0.87). The ACS patients inheriting CYP2C19 LoF alleles, who underwent PCI and were treated with clopidogrel were correlated with significantly increased risk of MACE compared with noncarriers.
  8. Fulltext Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis
    Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B
    Intervirology, 2020 Dec 09.
    PMID: 33296901 DOI: 10.1159/000512592
    INTRODUCTION: Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients.

    METHODS: Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as p < 0.05.

    RESULTS: COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67-2.07; p < 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age <50 years (RR 15.44: 95% CI 13.02-18.31; p < 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04-7.88; p < 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39-6.76; p < 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20-4.25; p < 0.00001), respiratory disease (RR 2.74: 95% CI 2.04-3.67; p < 0.00001), diabetes (RR 1.97: 95% CI 1.48-2.64; p < 0.00001), hypertension (RR 1.95: 95% CI 1.58-2.40; p < 0.00001), and cancer (RR 1.89; 95% CI 1.25-2.84; p = 0.002) but not liver disease (RR 1.64: 95% CI 0.82-3.28; p= 0.16).

    CONCLUSION: Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

  9. Association of carcinoma breast: grade and estrogen progesterone receptor expression
    Kamil M, Khalid I, Hashim H, Biswas M, Kaur G, Islam R
    J Coll Physicians Surg Pak, 2010 Apr;20(4):250-2.
    PMID: 20392401 DOI: 04.2010/JCPSP.250252
    To determine the association between histological grade of tumour and estrogen progesterone receptors (ER/PR) expression in unselected invasive carcinoma of breast in Malaysian patients.
  10. Fulltext Development of a Robust Multi-Scale Featured Local Binary Pattern for Improved Facial Expression Recognition
    Yasmin S, Pathan RK, Biswas M, Khandaker MU, Faruque MRI
    Sensors (Basel), 2020 Sep 21;20(18).
    PMID: 32967087 DOI: 10.3390/s20185391
    Compelling facial expression recognition (FER) processes have been utilized in very successful fields like computer vision, robotics, artificial intelligence, and dynamic texture recognition. However, the FER's critical problem with traditional local binary pattern (LBP) is the loss of neighboring pixels related to different scales that can affect the texture of facial images. To overcome such limitations, this study describes a new extended LBP method to extract feature vectors from images, detecting each image from facial expressions. The proposed method is based on the bitwise AND operation of two rotational kernels applied on LBP(8,1) and LBP(8,2) and utilizes two accessible datasets. Firstly, the facial parts are detected and the essential components of a face are observed, such as eyes, nose, and lips. The portion of the face is then cropped to reduce the dimensions and an unsharp masking kernel is applied to sharpen the image. The filtered images then go through the feature extraction method and wait for the classification process. Four machine learning classifiers were used to verify the proposed method. This study shows that the proposed multi-scale featured local binary pattern (MSFLBP), together with Support Vector Machine (SVM), outperformed the recent LBP-based state-of-the-art approaches resulting in an accuracy of 99.12% for the Extended Cohn-Kanade (CK+) dataset and 89.08% for the Karolinska Directed Emotional Faces (KDEF) dataset.
  11. Fulltext Sign language recognition using the fusion of image and hand landmarks through multi-headed convolutional neural network
    Pathan RK, Biswas M, Yasmin S, Khandaker MU, Salman M, Youssef AAF
    Sci Rep, 2023 Oct 09;13(1):16975.
    PMID: 37813932 DOI: 10.1038/s41598-023-43852-x
    Sign Language Recognition is a breakthrough for communication among deaf-mute society and has been a critical research topic for years. Although some of the previous studies have successfully recognized sign language, it requires many costly instruments including sensors, devices, and high-end processing power. However, such drawbacks can be easily overcome by employing artificial intelligence-based techniques. Since, in this modern era of advanced mobile technology, using a camera to take video or images is much easier, this study demonstrates a cost-effective technique to detect American Sign Language (ASL) using an image dataset. Here, "Finger Spelling, A" dataset has been used, with 24 letters (except j and z as they contain motion). The main reason for using this dataset is that these images have a complex background with different environments and scene colors. Two layers of image processing have been used: in the first layer, images are processed as a whole for training, and in the second layer, the hand landmarks are extracted. A multi-headed convolutional neural network (CNN) model has been proposed and tested with 30% of the dataset to train these two layers. To avoid the overfitting problem, data augmentation and dynamic learning rate reduction have been used. With the proposed model, 98.981% test accuracy has been achieved. It is expected that this study may help to develop an efficient human-machine communication system for a deaf-mute society.
  12. Transcatheter vs Surgical Aortic Valve Replacement Outcomes Among Solid Organ Transplant Patients: A Systematic Review and Meta-Analysis
    Jaiswal V, Ang SP, Ishak A, Joshi A, Chia JE, Kalra K, et al.
    Curr Probl Cardiol, 2023 Aug;48(8):101685.
    PMID: 36931333 DOI: 10.1016/j.cpcardiol.2023.101685
    The safety and clinical outcomes of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) among patients with solid organ transplants is not well understood. This study aimed to evaluate the clinical outcomes of TAVR and SAVR among patients with a history of solid organ transplantation. We performed a systematic literature search of databases for relevant articles from inception until May 1st, 2022. Unadjusted odds ratios (OR) were pooled using a random-effect model, and a P-value of <0.05 was considered statistically significant. A total of 3240 studies were identified of which 3 studies with a total of 2960 patients were included in the final analysis. For solid organ transplants patients, the odds of in-hospital mortality (OR 0.37, 95% CI 0.20-0.71, P < 0.001), 30-day mortality (OR 0.51, 95% CI 0.35-0.74, P < 0.001), acute kidney injury (OR 0.45, 95% CI 0.35-0.59, P < 0.001), and bleeding (OR 0.35, 95% CI 0.27-0.46, P < 0.001) were significantly lower in patients undergoing TAVR compared to SAVR. In contrast, the odds of pacemaker implantation (OR 2.60, 95% CI 0.36-18.90, P = 0.34), postprocedural stroke (OR 0.36, 95% CI 0.13-1.03, P = 0.06) were similar between both groups of patients. Length of hospital stay was significantly lower in TAVR compared to SAVR patients (SMD -0.82, 95% CI -0.95 to -0.70, P < 0.001). In solid organ transplant patients, TAVR appeared to be a safe procedure with fewer postprocedure complications, shorter length of hospital stay, and lower in hospital mortality compared with SAVR.
  13. Fulltext Retraction notice to "Association between sarcoidosis and cardiovascular Outcomes: A systematic review and meta-analysis" [IJC Heart Vasculat. 41 (2022) 101073]
    Jaiswal V, Ang SP, Sarfraz Z, Butey S, Khandait HV, Song D, et al.
    Int J Cardiol Heart Vasc, 2022 Aug;41:101112.
    PMID: 36093509 DOI: 10.1016/j.ijcha.2022.101112
    [This corrects the article DOI: 10.1016/j.ijcha.2022.101073.].
  14. Fulltext Association between sarcoidosis and cardiovascular Outcomes: A systematic review and Meta-analysis
    Jaiswal V, Peng Ang S, Sarfraz Z, Butey S, Vinod Khandait H, Song D, et al.
    Int J Cardiol Heart Vasc, 2022 Aug;41:101073.
    PMID: 35800042 DOI: 10.1016/j.ijcha.2022.101073
    BACKGROUND: Sarcoidosis is a chronic inflammatory disorder of unknown etiology associated with high morbidity and mortality. Its association with cardiovascular outcomes is under-documented.

    AIM: The aim of this study was to assess the adverse cardiovascular outcomes in patients with sarcoidosis compared with that of non-sarcoidosis.

    METHODOLOGY: Online databases including PubMed, Embase and Scopus were queried from inception until March 2022. The outcomes assessed included all-cause mortality (ACM) and incidence of ventricular tachycardia (VT), heart failure (HF) and atrial arrhythmias (AA).

    RESULT: A total of 6 studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354 Non-Sarcoidosis) were included in this analysis. The pooled prevalence of sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47 years. The most common comorbidities were hypertension (12.7% vs 12.5%), and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17 to 3.08; p = 0.01) was significantly increased in sarcoidosis patients. The pooled analysis of secondary endpoints showed that the incidence of VT (RR, 15.3; 95% CI: 5.39 to 43.42); p 

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