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  1. Faizah, M. H., Anisah, N., Yusof, S., Noraina, A. R., Adibah, M. R.
    Medicine & Health, 2017;12(2):286-292.
    MyJurnal
    Acanthamoeba spp. merupakan ameba hidup bebas yang biasa ditemui
    di persekitaran. Ia merupakan agen penyebab keratitis Acanthamoeba (AK)
    dan ensefalitis ameba bergranuloma (GAE). Ameba ini juga mampu menjadi
    perumah kepada pelbagai bakteria termasuklah yang bersifat patogenik seperti
    Mycobacterium, Legionella dan Staphylococcus aureus rintang metisilin (MRSA).
    Berdasarkan maklumat ini, satu kajian dijalankan untuk mengesan kehadiran tiga
    bakteria endosimbion berkepentingan perubatan di dalam Acanthamoeba spp. yang
    telah dipencilkan dari bolong penghawa dingin yang terdapat di wad and dewan
    bedah di Pusat Perubatan Universiti Kebangsaan Malaysia. Kehadiran bakteria
    endosimbion ini disaring menggunakan pasangan primer khusus bagi setiap genus
    menggunakan reaksi rantai polimerase (PCR) konvensional dan disahkan dengan
    analisis penjujukan. Dua puluh sembilan (80.56%) pencilan Acanthamoeba spp.
    didapati mengandungi bakteria endosimbion patogenik yang disasarkan dengan
    sekurang-kurangnya satu genus bakteria bagi setiap pencilan. Mycobacterium
    (82.76 %) adalah bakteria yang paling banyak dikesan, diikuti dengan Legionella sp.
    (65.52 %) dan Pseudomonas spp. (62.07 %). Tiada bakteria MRSA dikesan daripada
    mana-mana pencilan dalam kajian ini. Dua endosimbion Mycobacterium yang
    dikenalpasti telah dikelompokkan ke dalam strain Mycobacterium tuberculosis.
    Kami membuat kesimpulan bahawa, kebanyakan Acanthamoeba berpotensi untuk
    menjadi perumah bagi pelbagai bakteria patogenik, namun implikasi interaksi ini
    terhadap patogenisiti kedua-dua organisma masih kurang jelas dan memerlukan
    penyelidikan yang lebih lanjut.
  2. Hoe HG, Zaki FM, Rashid AHA
    Sultan Qaboos Univ Med J, 2018 Feb;18(1):e93-e96.
    PMID: 29666688 DOI: 10.18295/squmj.2018.18.01.015
    Synovial haemangiomas are rare benign vascular proliferations arising in synovium-lined surfaces. While the knee is by far the joint most commonly involved, this condition can also occur in the elbow. We report an eight-year-old boy who presented to the National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia, in 2016 with a left elbow swelling of one year's duration. Magnetic resonance imaging showed a lobulated intra-articular mass with intermediate signal intensity on T1-weighted imaging and low signal punctate and linear structures within the hyperintense mass on T2-weighted imaging. In addition, there was heterogeneous yet avid contrast enhancement on post-gadolinium contrast images. The mass had juxta-articular extension and bony erosion to the coronoid process and the head of the radius. Synovial haemangiomas present a diagnostic dilemma. This report highlights certain imaging characteristics to distinguish this entity from other differential diagnoses.
  3. Faizah M, Kanaheswari Y, Thambidorai C, Zulfiqar M
    Biomed Imaging Interv J, 2011 Jan-Mar;7(1):e7.
    PMID: 21655116 MyJurnal DOI: 10.2349/biij.7.1.e7
    To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR).
  4. Nattabi HA, Sharif NM, Yahya N, Ahmad R, Mohamad M, Zaki FM, et al.
    Acad Radiol, 2017 Oct 18.
    PMID: 29054676 DOI: 10.1016/j.acra.2017.09.002
    RATIONALE AND OBJECTIVE: This study is a dedicated 2D-shear wave elastography (2D-SWE) review aimed at systematically eliciting up-to-date evidence of its clinical value in differential diagnosis of benign and malignant thyroid nodules.

    METHODS: PubMed, Web of Science, and Scopus databases were searched for studies assessing the diagnostic value of 2D-SWE for thyroid malignancy risk stratification published until December 2016. The retrieved titles and abstracts were screened and evaluated according to the predefined inclusion and exclusion criteria. Methodological quality of the studies was assessed using the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Review 2 (QUADAS-2) tool. Extracted 2D-SWE diagnostic performance data were meta-analyzed to assess the summary sensitivity, specificity, and area under the receiver operating characteristic curve.

    RESULTS: After stepwise review, 14 studies in which 2D-SWE was used to evaluate 2851 thyroid nodules (1092 malignant, 1759 benign) from 2139 patients were selected for the current study. Study quality on QUADAS-2 assessment was moderate to high. The summary sensitivity, specificity and area under the receiver operating characteristic curve of 2D-SWE for differential diagnosis of benign and malignant thyroid nodules were 0.66 (95% confidence interval [CI]: 0.64-0.69), 0.78 (CI: 0.76-0.80), and 0.851 (Q* = 0.85), respectively. The pooled diagnostic odds ratio, negative likelihood ratio, and positive likelihood ratio were 12.73 (CI: 8.80-18.43), 0.31 (CI: 0.22-0.44), and 3.87 (CI: 2.83-5.29), respectively.

    CONCLUSION: Diagnostic performance of quantitative 2D-SWE for malignancy risk stratification of thyroid nodules is suboptimal with mediocre sensitivity and specificity, contrary to earlier reports of excellence.

  5. Thay WY, Aisha Fadhilah AA, Faizah MJ, Zainudin Z
    Med J Malaysia, 2020 03;75(2):173-174.
    PMID: 32281603
    Umbilical artery catheterisation is considered the standard of care for arterial access in neonatal intensive care unit. It is routinely used for blood sampling and blood pressure monitoring. Unfortunately, an indwelling umbilical catheter have been associated with thrombotic complication which may result in either partial or complete occlusion of the aorta. We report here our experience in the diagnosis and treatment of a neonate with this condition.
  6. Nor Fauziah MH, Faizah MZ, Loh CK
    Med J Malaysia, 2017 10;72(5):324-326.
    PMID: 29197894
    A four-year-old Ibanese boy presented with subacute abdominal distension for two months duration. Ultrasound and computed tomography (CT) scan showed solid liver masses as well as bowel and intraperitoneal lesions. Initial diagnosis of intraperitoneal inflammatory process as in tuberculosis with non-liquefied liver abscess with differential diagnosis of neoplastic process was made. Liver biopsy and peritoneal fluid analysis revealed Burkitt's lymphoma (BL). We aim to highlight the diagnostic challenge of BL in this young age group emphasizing on the ultrasound and CT features of intraabdominal BL. We would also want to stress the importance of early diagnosis of BL as it is known to be the most aggressive tumour within 24 hours yet to have good survival if early diagnosis was made.
  7. Leow VM, Faizah MS, Mohd Sharifudin S, Letchumanan VP, Yang KF, Manisekar KS
    Med J Malaysia, 2014 Jun;69(3):129-32.
    PMID: 25326354 MyJurnal
    OBJECTIVE: Conventional laparoscopic cholecystectomy (LC) involves the use of four ports, but the number of ports has gradually been reduced to one for cosmetic reasons. however, single-incision LC is technically demanding, and there is a substantial learning curve associated with its successful application. The aim of this clinical study was to evaluate the safety and feasibility of a less demanding alternative LC technique with a faster learning curve.

    METHODS: This prospective descriptive study was performed from September 2009 to February 2011 at Sultanah Bahiyah hospital in Kedah, Malaysia. A total of 58 patients underwent two-incision threeport laparoscopic cholecystectomy (TILC), which was performed by the senior consultant hepato-pancreato-biliary surgeon and two hepato-pancreato-biliary trainees. Study end points included operative time, postoperative pain, length of hospital stay and early postoperative complications. The follow-up period was 4 weeks.

    RESULTS: The overall operative time taken was 44 ± 18 minutes. none of the patients had major complication or incisional hernia postoperatively. All but one of the patients were discharged within 24 h. nonsteroidal anti-inflammatory drugs were the main postoperative analgesic used.

    CONCLUSION: TILC is feasible and safe cholecystectomy technique.
  8. Chelliah KK, Faizah MZ, Dayang AA, Bilkis AA, Shareena I, Mazli M
    Case Rep Radiol, 2012;2012:564036.
    PMID: 22792503 DOI: 10.1155/2012/564036
    Conjoined twins are rare and present a unique challenge to pediatric surgeons and radiologists. An imaging strategy to accurately define anatomic fusion, vascular anomalies, and other associated abnormalities is important for surgical planning and prognostic information. A conjoined female twin with a combined weight of 2.8 kg was born by emergency caeserean. Hence, a computed tomography scan of the thorax and entire abdomen at 1.25 mm slice thickness was performed to delineate the internal structures of the twins. CT-angiography defined specific vascular supply which determined the distribution of shared structures between the twins. An echocardiogram showed four heart chambers with atrioventricular septal defect. To further evaluate the heart chambers, the twin was planned for gated cardiac magnetic resonance imaging. Unfortunately, they succumbed 6 hours apart due to complication of septicemia. Magnetic resonance imaging and CT scan provide excellent anatomic detail, demonstrating organ position, shared viscera, and limited vascular anatomy, whilst angiography defined specific vascular supply, useful in determining the distribution of shared structures between the twins in planning for surgery.
  9. Leow VM, Faizah MS, Mohd Sharifudin S, Vasu Pillai L, Yang KF, Manisekar KS
    Med J Malaysia, 2015 Oct;70(5):278-80.
    PMID: 26556115 MyJurnal
    OBJECTIVE: Various techniques and instruments have been developed to provide safe and secure closure of laparoscopic wounds. Herein we describe a simple method to close laparoscopic supraumbilical wounds with the aid of a laparoscopic port.
    METHOD: This was a retrospective review of prospective data, which were from 151 patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease from December 2009 to December 2010 in Sultanah Bahiyah Hospital. A senior consultant hepato-pancreato-biliary (HPB) surgeon and two HPB trainee surgeons performed the operations. Postoperatively, all patients were followed up at 4 weeks.
    RESULTS: All patients successfully underwent closure of the supraumbilical wound with the assistance of a 5mm laparoscopic port. None of the patients had incisional hernia on follow up.
    CONCLUSION: Port assisted closure of supraumbilical laparoscopic wounds is a feasible and safe technique.
    Study site: Sultanah Bahiyah Hospital, Kedah
  10. Faizah MZ, Hamzaini AH, Kanaheswari Y, Dayang A AA, Zulfiqar MA
    Med J Malaysia, 2015 Oct;70(5):269-72.
    PMID: 26556113 MyJurnal
    OBJECTIVE: Contrast-enhanced ultrasound has become increasingly utilised as an alternative imaging modality for the diagnosis of vesicoureteric reflux (VUR) in paediatric patients. The study objective is to evaluate the efficacy of contrast enhanced Voiding Urosonography (ce-VUS) compared with fluoroscopic micturating cystourethrography (MCU) in the detection of VUR.
    METHODS: This prospective study was carried out between July 2011 and January 2013 on paediatric patients who underwent MCU. All consented patients would undergo ce- VUS prior to MCU. We documented the epidemiology details, the number of Kidney-Ureter (K-U) unit studied, baseline renal and bladder sonogram, as well as presence of VUR on ce-VUR. The technique for ce-VUS was standardized using normal saline to fill the bladder prior to administration of SonoVue® (2.5 ml) to assess the kidney-ureter (K-U) unit. Dedicated contrast detection software was used to discern the presence of microbubbles in the pelvicaliceal system (PCS). The findings were then compared with MCU.
    RESULTS: 27 paediatric patients were involved in the study [17 males (63%) and 10 females (37%)] involving 55 K-U units (one patient had a complete duplex system). MCU detected VUR in 10 K-U units while ce-VUS detected VUR in 8 out of the 10 K-U units. There were 2 false negative cases (both Grade 1) with ce-VUS. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ce-VUS were 80%, 98%, 95%, 89% and 96%, respectively.
    CONCLUSION: ce-VUS is a sensitive and specific radiation-free alternative for the detection of VUR in the paediatric population.
  11. Nadzri M, Hing EY, Hamzaini AH, Faizah MZ, AbAziz A, Kanaheswari Y, et al.
    Med J Malaysia, 2015 Dec;70(6):346-50.
    PMID: 26988207 MyJurnal
    BACKGROUND: to determine the usefulness of Doppler ultrasound measurement of resistive index (RI) in differentiating obstructive from non-obstructive hydronephrosis in children.
    METHODS: From August 2011 to November 2012, renal Doppler assessments of the intra-renal renal arteries were performed on 16 children (19 kidneys) with congenital hydronephrosis. the independent t-test was used to assess for significant difference in RI values between those with obstructive hydronephrosis (6 kidneys) and those with non-obstructive hydronephrosis (13 kidneys) as determined by dynamic renal scintigraphy. the assessor was blinded to the clinical findings and scintigraphy results.
    RESULTS: RI was significantly different between obstructive and non-obstructive hydronephrosis. Obstructive hydronephrosis returned higher RI values, with mean RI of 0.78. Mean RI in non-obstructive hydronephrosis was 0.70, and the difference was significant (p <0.05). the sensitivity and specificity of Doppler ultrasound were 100% and 53% respectively.
    CONCLUSION: Doppler ultrasound measurement of resistive index is useful in differentiating obstructive from nonobstructive hydronephrosis and provides an alternative non-ionizing investigation.
    Study site: Universiti Kebangsaan Malaysia
    Medical Centre, Kuala Lumpur, Malaysia
  12. Leong YY, Kanaheswari Y, Faizah MZ, Hing EY, Nik Ismail NA, Nik Fuad NF, et al.
    Med J Malaysia, 2020 03;75(2):130-135.
    PMID: 32281593
    INTRODUCTION: A person's childhood is an important period of growth, and also one's most vulnerable, as one can be exposed to various pathologies, for example those that could affect the growth of one's kidney. Asians are physiologically different from Caucasians, and the nomogram renal size obtained from a Western population (mostly of Caucasians) is not be suitable for representing Asian children. As such a nomogram on paediatric renal size derived from Malaysia is needed.

    METHODS: A total of 109 (64 males and 45 females) aged 0-12 in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) took part in this study. They underwent ultrasonography of both kidneys, and their demographic and anthropometric data were collected. The mean and standard deviations of the renal length and renal volume according to their age groups was calculated, and the final data was compared to the ones reported by Rosenbaum et al. (1984).

    RESULT: Body weight and Body Surface Area (BSA) of the children reported the strongest correlation with renal size. Significant differences were found between local and the data from Rosenbaum et al (1984). A nomogram on paediatric renal size based on children in PPUKM was then created.

    DISCUSSION: Ultrasonography is regarded as the standard method for determining renal size. Body weight and BSA were both strongly correlated with renal size. It was shown that the widely used nomograms derived from data obtained from Caucasian was not suitable to represent the population of Malaysian children.

  13. Adli A, Wahab AA, Abdul Latiff AH, Ismail IH, Faizah MZ, Boekhren KB, et al.
    Med J Malaysia, 2022 Jan;77(1):95-97.
    PMID: 35087003
    We report a clinical and laboratory observation in a boy with X-linked agammaglobulinemia (XLA) who underwent an immunoglobulin replacement therapy (IRT) via the subcutaneous route (IGSC) seven years after his IRT via intravenous route (IGIV). He was free of invasive infections when on IGIV but not the troublesome coughs a week before the next infusion. A switch to a subcutaneous route resulted in significant improvement of symptoms with good weight gain. When on 2-weekly IGSC cycle, adjusting dose for weight resulted in an IgG trough level of > 600 mg/dl.
  14. Faizah M, Zuhanis A, Rahmah R, Raja A, Wu L, Dayang A, et al.
    Biomed Imaging Interv J, 2012 Jan;8(1):e6.
    PMID: 22970062 MyJurnal DOI: 10.2349/biij.8.1.e6
    This review was aimed at determining the imaging findings in patients with precocious puberty.
  15. Chong CY, Faizah MZ, Hing EY, Nik Fuad NF, Chai JN, Ng CF, et al.
    Med J Malaysia, 2022 Nov;77(6):661-668.
    PMID: 36448382
    INTRODUCTION: Diaphragmatic dysfunction is often underdiagnosed as clinical presentation is non-specific and reference values for normal diaphragmatic excursion are inadequate. The rationale of this study is to provide a normal reference value of diaphragmatic excursion and thickness in Malaysia's paediatric population using M-mode sonography, as no previous local data are available to our knowledge.

    MATERIALS AND METHODS: A total of 119 healthy infants and children fulfilling our inclusion and exclusion criteria were recruited. They were divided into three groups according to age - 0-2 years old in group 1; 2-6 years old in group 2; 6- 12 years old in group 3. Sonography B-mode was used to assess bilateral diaphragmatic thickness and M-mode to assess diaphragmatic excursion during quiet spontaneous respiration.

    RESULTS: In our paediatric population, the normal right and left diaphragmatic thickness were 2.0 mm ± 0.5 and 2.0 mm ± 0.5 for group 1; 2.5 mm ± 0.8 and 2.4 mm ± 0.6 for group 2; 2.7 mm ± 0.7 and 2.5 mm ± 0.5 for group 3, respectively. The normal right and left diaphragmatic excursion were 7.7 mm ± 2.5 and 7.3 mm ± 2.6 for group 1; 11.5 mm ± 3.8 and 10.6 mm ± 3.8 for group 2; 13.8 mm ± 3.9 and 12.9 mm ± 3.3 for group 3, respectively (data presented in mean ± standard deviation). There were no significant differences between two genders for each group. Significant positive correlation between age, weight, height, and body surface area with bilateral diaphragmatic thickness and excursion were detected in all studied population. The percentage difference between excursions of both hemidiaphragm was below 40%.

    CONCLUSIONS: M-mode sonography is the modality of choice for diaphragmatic kinetics especially in paediatric population. This study provides normal sonographic reference value of diaphragmatic excursion and thickness in the Malaysian paediatric population as well as percentile curves for right diaphragmatic excursion plotted against body weight. The availability of this data will aid in the diagnosis of diaphragmatic dysfunction and hence immediate intervention for better recovery.

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