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Fulltext Spontaneous haemothorax: a case report

Ho C, Ismail AR

Med J Malaysia, 2014 Oct;69(5):234-5.
PMID: 25638240 MyJurnal

Haemothorax is one of the less common presentations that requires hospital admission. Most cases are associated with underlying causes, but there is such an entity called spontaneous haemothorax. Spontaneous haemothorax is commonly associated with adhesions within the pleural cavity. Here, we reported two cases of young adults who presented with massive spontaneous haemothorax and required emergency thoracotomy for haemostasis purpose.
A comparative study of clonal selection algorithm for effluent removal forecasting in septic sludge treatment plant

Chun TS, Malek MA, Ismail AR

Water Sci Technol, 2015;71(4):524-8.
PMID: 25746643 DOI: 10.2166/wst.2014.451

The development of effluent removal prediction is crucial in providing a planning tool necessary for the future development and the construction of a septic sludge treatment plant (SSTP), especially in the developing countries. In order to investigate the expected functionality of the required standard, the prediction of the effluent quality, namely biological oxygen demand, chemical oxygen demand and total suspended solid of an SSTP was modelled using an artificial intelligence approach. In this paper, we adopt the clonal selection algorithm (CSA) to set up a prediction model, with a well-established method - namely the least-square support vector machine (LS-SVM) as a baseline model. The test results of the case study showed that the prediction of the CSA-based SSTP model worked well and provided model performance as satisfactory as the LS-SVM model. The CSA approach shows that fewer control and training parameters are required for model simulation as compared with the LS-SVM approach. The ability of a CSA approach in resolving limited data samples, non-linear sample function and multidimensional pattern recognition makes it a powerful tool in modelling the prediction of effluent removals in an SSTP.
Prediction analysis of effluent removal in a septic sludge treatment plant: a biomimetics engineering approach

Chun TS, Malek MA, Ismail AR

Environ Sci Process Impacts, 2014 Sep 20;16(9):2208-14.
PMID: 25005632 DOI: 10.1039/c4em00282b

Effluent discharge from septic tanks is affecting the environment in developing countries. The most challenging issue facing these countries is the cost of inadequate sanitation, which includes significant economic, social, and environmental burdens. Although most sanitation facilities are evaluated based on their immediate costs and benefits, their long-term performance should also be investigated. In this study, effluent quality-namely, the biological oxygen demand (BOD), chemical oxygen demand (COD), and total suspended solid (TSS)-was assessed using a biomimetics engineering approach. A novel immune network algorithm (INA) approach was applied to a septic sludge treatment plant (SSTP) for effluent-removal predictive modelling. The Matang SSTP in the city of Kuching, Sarawak, on the island of Borneo, was selected as a case study. Monthly effluent discharges from 2007 to 2011 were used for training, validating, and testing purposes using MATLAB 7.10. The results showed that the BOD effluent-discharge prediction was less than 50% of the specified standard after the 97(th) month of operation. The COD and TSS effluent removals were simulated at the 85(th) and the 121(st) months, respectively. The study proved that the proposed INA-based SSTP model could be used to achieve an effective SSTP assessment and management technique.
Development of effluent removal prediction model efficiency in septic sludge treatment plant through clonal selection algorithm

Ting SC, Ismail AR, Malek MA

J Environ Manage, 2013 Nov 15;129:260-5.
PMID: 23968912 DOI: 10.1016/j.jenvman.2013.07.022

This study aims at developing a novel effluent removal management tool for septic sludge treatment plants (SSTP) using a clonal selection algorithm (CSA). The proposed CSA articulates the idea of utilizing an artificial immune system (AIS) to identify the behaviour of the SSTP, that is, using a sequence batch reactor (SBR) technology for treatment processes. The novelty of this study is the development of a predictive SSTP model for effluent discharge adopting the human immune system. Septic sludge from the individual septic tanks and package plants will be desuldged and treated in SSTP before discharging the wastewater into a waterway. The Borneo Island of Sarawak is selected as the case study. Currently, there are only two SSTPs in Sarawak, namely the Matang SSTP and the Sibu SSTP, and they are both using SBR technology. Monthly effluent discharges from 2007 to 2011 in the Matang SSTP are used in this study. Cross-validation is performed using data from the Sibu SSTP from April 2011 to July 2012. Both chemical oxygen demand (COD) and total suspended solids (TSS) in the effluent were analysed in this study. The model was validated and tested before forecasting the future effluent performance. The CSA-based SSTP model was simulated using MATLAB 7.10. The root mean square error (RMSE), mean absolute percentage error (MAPE), and correction coefficient (R) were used as performance indexes. In this study, it was found that the proposed prediction model was successful up to 84 months for the COD and 109 months for the TSS. In conclusion, the proposed CSA-based SSTP prediction model is indeed beneficial as an engineering tool to forecast the long-run performance of the SSTP and in turn, prevents infringement of future environmental balance in other towns in Sarawak.
Orthodontic treatment need and demand among 12- and 16 year-old school children in Malaysia

Zreaqat M, Hassan R, Ismail AR, Ismail NM, Aziz FA

Oral Health Dent Manag, 2013 Dec;12(4):217-21.
PMID: 24390019

Assessment of orthodontic treatment need and demand helps in planning orthodontic services and estimating the required resources and man power. The aim of this study was to assess the orthodontic treatment need and demand and to assess the association between the orthodontic treatment demand and factors such as ITON, gender, and age.
Associated factors of tooth wear among Malaysian 16-year-olds: a case-control study in Kota Bharu, Kelantan

Saerah NB, Mastura N, bin Ismail AR, Sadiq MA

Community Dent Health, 2012 Mar;29(1):33-8.
PMID: 22482247

To determine the associated factors of tooth wear (TW) among 16-year-old school children.
Genotoxicity evaluation of locally produced dental porcelain--an in vitro study using the Ames and Comet assays

Noushad M, Kannan TP, Husein A, Abdullah H, Ismail AR

Toxicol In Vitro, 2009 Sep;23(6):1145-50.
PMID: 19505568 DOI: 10.1016/j.tiv.2009.05.025

The aim of this study was to determine the genotoxicity of a locally produced dental porcelain (Universiti Sains Malaysia, Malaysia) using the Ames and Comet assays. In the Ames assay, four genotypic variants of the Salmonella strains (TA98, TA100, TA1537 and TA1535) carrying mutations in several genes were used. The dental porcelain was incubated with these four strains in five different doses both in the presence and absence of metabolic activation (S9) and the result was assessed based on the number of revertant colonies. Concurrently, appropriate positive controls were used so as to validate the test. The average number of revertant colonies per plate treated with locally produced dental porcelain was less than double as compared to that of negative control. In the Comet assay, L929 (CCL-1 ATCC, USA) mouse fibroblast cells were treated with the dental porcelain in three different concentrations along with concurrent negative and positive controls. The tail moment which was used as a measurement of DNA damage was almost equal to that of the negative control, suggesting that the locally produced dental porcelain did not induce any DNA damage. The results indicated that the locally produced dental porcelain is non-genotoxic under the present test conditions.
Fulltext Upper gastrointestinal bleeding in Kuala Lumpur Hospital, Malaysia

Lakhwani MN, Ismail AR, Barras CDJ, Tan WJ

Med J Malaysia, 2000 Dec;55(4):498-505.
PMID: 11221164

Despite advancements in endoscopy and pharmacology in the treatment of peptic ulcer disease the overall mortality has remained constant at 10% for the past four decades. The aim of this study was to determine the age, gender, racial distribution, incidence and causes of endoscopically diagnosed cases of upper gastrointestinal (UGI) bleeding to summarise treatments undertaken and to report their outcome. A prospective study of UGI bleeding in 128 patients was performed in two surgical wards of Kuala Lumpur Hospital, involving both elective and emergency admissions. The study group comprised of 113 (88.2%) males and 15 (11.7%) females. The mean age was 51.9 years (range 14 to 85 years) and 37.5% (48 of 128 patients) were older than 60 years. The Indian race was over-represented in all disease categories. Smoking (50.1%), alcohol consumption (37.5%), non-steroidal anti-inflammatory drugs (NSAIDs) (17.2%), traditional remedies (5.5%), anti-coagulants (2.3%) and steroids (0.8%) were among the risk factors reported. Common presenting symptoms and signs included malaena (68.8%), haematemesis (59.4%) and fresh per rectal bleeding (33.6%). The commonest causes of UGI bleeding were duodenal ulcer (32%), gastric ulcer (29.7%), erosions (duodenal and gastric) (21.9%), oesophageal varices (10.9%) and malignancy (3.9%). UGI bleeding was treated non-surgically in 90.6% of cases. Blood transfusions were required in 62.6% (67/107) of peptic ulcer disease patients. Surgical intervention for bleeding peptic ulcer occurred in around 10% of cases and involved under-running of the bleeding vessel in most high risk duodenal and gastric ulcer patients. The overall mortality from bleeding peptic ulcer disease was 4.7%. Six patients died from torrential UGI haemorrhage soon after presentation, without the establishment of a cause. Active resuscitative protocols, early endoscopy, more aggressive interventional therapy, early surgery by more senior surgeons, increasing intensive care unit beds and more active participation of multidisciplinary teams in co-ordinating management are among remedial measures advocated. Broader educational preventive strategies should target the causes of UGI bleeding.
An immune-inspired swarm aggregation algorithm for self-healing swarm robotic systems

Timmis J, Ismail AR, Bjerknes JD, Winfield AF

Biosystems, 2016 Aug;146:60-76.
PMID: 27178784 DOI: 10.1016/j.biosystems.2016.04.001

Swarm robotics is concerned with the decentralised coordination of multiple robots having only limited communication and interaction abilities. Although fault tolerance and robustness to individual robot failures have often been used to justify the use of swarm robotic systems, recent studies have shown that swarm robotic systems are susceptible to certain types of failure. In this paper we propose an approach to self-healing swarm robotic systems and take inspiration from the process of granuloma formation, a process of containment and repair found in the immune system. We use a case study of a swarm performing team work where previous works have demonstrated that partially failed robots have the most detrimental effect on overall swarm behaviour. We have developed an immune inspired approach that permits the recovery from certain failure modes during operation of the swarm, overcoming issues that effect swarm behaviour associated with partially failed robots.
Tooth wear prevalence and sample size determination : a pilot study

Abd Karim NB, Ismail NM, Naing L, Ismail AR

Malays J Med Sci, 2008 Oct;15(4):35-40.
PMID: 22589636

Tooth wear is the non-carious loss of tooth tissue, which results from three processes namely attrition, erosion and abrasion. These can occur in isolation or simultaneously. Very mild tooth wear is a physiological effect of aging. This study aims to estimate the prevalence of tooth wear among 16-year old Malay school children and determine a feasible sample size for further study. Fifty-five subjects were examined clinically, followed by the completion of self-administered questionnaires. Questionnaires consisted of socio-demographic and associated variables for tooth wear obtained from the literature. The Smith and Knight tooth wear index was used to chart tooth wear. Other oral findings were recorded using the WHO criteria. A software programme was used to determine pathological tooth wear. About equal ratio of male to female were involved. It was found that 18.2% of subjects have no tooth wear, 63.6% had very mild tooth wear, 10.9% mild tooth wear, 5.5% moderate tooth wear and 1.8 % severe tooth wear. In conclusion 18.2% of subjects were deemed to have pathological tooth wear (mild, moderate & severe). Exploration with all associated variables gave a sample size ranging from 560 - 1715. The final sample size for further study greatly depends on available time and resources.
Fulltext Evaluation of a training programme for non-health professionals as oral health educators

Seman K, Yaacob H, Hamid AM, Ismail AR, Yusoff A

Malays J Med Sci, 2008 Apr;15(2):33-8.
PMID: 22589623

Involvement of oral health educators among non-health professionals in oral health promotion is important in the prevention of oral diseases. This study was carried out to compare the level of oral health knowledge among pre-school teachers before and after oral health seminar. Pre-test data was collected by distributing questionnaire to pre-school teachers in Pasir Mas, who attended the seminar on "Oral Health" (n=33) and they were required to fill anonymously before the seminar started. The questions consisted of information on general background, perceived oral health status, oral health knowledge and the environment where they work. After two weeks, post-test data was collected using the same structured questionnaire and identification code was used to match the pre and post data. SPSS 11.5 was use for statistical analysis. Two out of 33 eligible preschool teachers were considered non-respondents due to absenteeism during the post-test data collection. The response rate was 94.0% (n = 31). The study shows a significant improvement in oral health knowledge among pre-school teachers in Pasir Mas, after seminar (p < 0.001) as compared to controls. Thus, we can conclude that the oral health programme (seminar) appeared effective at influencing oral health educator's knowledge towards oral health.
A clonal selection algorithm model for daily rainfall data prediction

Noor Rodi NS, Malek MA, Ismail AR, Ting SC, Tang CW

Water Sci Technol, 2014;70(10):1641-7.
PMID: 25429452 DOI: 10.2166/wst.2014.420

This study applies the clonal selection algorithm (CSA) in an artificial immune system (AIS) as an alternative method to predicting future rainfall data. The stochastic and the artificial neural network techniques are commonly used in hydrology. However, in this study a novel technique for forecasting rainfall was established. Results from this study have proven that the theory of biological immune systems could be technically applied to time series data. Biological immune systems are nonlinear and chaotic in nature similar to the daily rainfall data. This study discovered that the proposed CSA was able to predict the daily rainfall data with an accuracy of 90% during the model training stage. In the testing stage, the results showed that an accuracy between the actual and the generated data was within the range of 75 to 92%. Thus, the CSA approach shows a new method in rainfall data prediction.
Fulltext Development of a decision support system for analysis and solutions of prolonged standing in the workplace

Halim I, Arep H, Kamat SR, Abdullah R, Omar AR, Ismail AR

Saf Health Work, 2014 Jun;5(2):97-105.
PMID: 25180141 DOI: 10.1016/j.shaw.2014.04.002

BACKGROUND: Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing.
METHODS: The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system.
RESULTS: Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results.
CONCLUSION: The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially.
Transplantation of human dental pulp stem cells: enhance bone consolidation in mandibular distraction osteogenesis

Alkaisi A, Ismail AR, Mutum SS, Ahmad ZA, Masudi S, Abd Razak NH

J Oral Maxillofac Surg, 2013 Oct;71(10):1758.e1-13.
PMID: 24040948 DOI: 10.1016/j.joms.2013.05.016

The main aim of the present study was to evaluate the capacity of stem cells from human exfoliated deciduous teeth (SHED) to enhance mandibular distraction osteogenesis (DO) in rabbits.
Oral mucosal lesions in non oral habit diabetic patients and association of diabetes mellitus with oral precancerous lesions

Saini R, Al-Maweri SA, Saini D, Ismail NM, Ismail AR

Diabetes Res Clin Pract, 2010 Sep;89(3):320-6.
PMID: 20488573 DOI: 10.1016/j.diabres.2010.04.016

AIMS: This study was aimed to determine the prevalence of oral mucosal lesions (OML) in patients with diabetes mellitus (DM) and non-diabetic subjects without any oral habits and to investigate the association of DM with oral precancerous lesions.
METHODS: This cross-sectional study involved 420 diabetic and 420 non-diabetic control subjects without any oral habits. Detailed oral examination was performed based on international criteria.
RESULTS: A significantly greater proportion of subjects with DM (45%) had one or more OML in comparison to non-diabetics (38.3%). Patients with DM showed a significantly greater prevalence of geographic tongue, denture stomatitis and angular cheilitis than non-diabetics (p<0.05). The results also showed an association between occurrence of one or more OML and metabolic control of diabetic patients (p<0.05). For precancerous lesions, lichen planus was found in two diabetic patients while none of controls had any precancerous lesion (p>0.05).
CONCLUSIONS: Prevalence of OML was significantly higher in diabetic patients than non-diabetics and this prevalence was associated with the metabolic control of the patients. However, no association was observed between DM and oral precancerous lesions.
Telescopium telescopium as potential biomonitors of Cu, Zn, and Pb for the tropical intertidal area

Yap CK, Noorhaidah A, Azlan A, Nor Azwady AA, Ismail A, Ismail AR, et al.

Ecotoxicol Environ Saf, 2009 Feb;72(2):496-506.
PMID: 18243309 DOI: 10.1016/j.ecoenv.2007.12.005

The distributions of Cu, Zn, and Pb concentrations in the selected soft tissues (foot, cephalic tentacle, mantle, muscle, gill, digestive caecum, and remaining soft tissues) and shells of the mud-flat snail Telescopium telescopium were determined in snails from eight geographical sites in the south-western intertidal area of Peninsular Malaysia. Generally, the digestive caecum compared with other selected soft tissues, accumulated higher concentration of Zn (214.35+/-14.56 microg/g dry weight), indicating that the digestive caecum has higher affinity for the essential Zn to bind to metallothionein. The shell demonstrated higher concentrations of Pb (41.23+/-1.20 microg/g dry weight) when compared to the selected soft tissues except gill from Kuala Sg. Ayam (95.76+/-5.32 microg/g dry weight). The use of different soft tissues also can solve the problem of defecation to reduce error in interpreting the bioavailability of heavy metals in the intertidal area.
Postural assessment in pen-and-paper-based observational methods and their associated health effects: a review

Sukadarin EH, Deros BM, Ghani JA, Mohd Nawi NS, Ismail AR

Int J Occup Saf Ergon, 2016 Sep;22(3):389-98.
PMID: 27173135 DOI: 10.1080/10803548.2016.1156924

INTRODUCTION: This review describes standardized ergonomics assessment based on pen-and-paper observational methods for assessing ergonomics risk factors.
OBJECTIVE: The three main objectives are to analyze published pen-and-paper observational methods, to extract and understand the risk levels of each method and to identify their associated health effects.
METHODOLOGY: The authors searched scientific databases and the Internet for materials from 1970 to 2013 using the following keywords: ergo, posture, method, observational, postural angle, health effects, pain and diseases. Postural assessments of upper arms, lower arms, wrists, neck, back and legs in six pen-and-paper-based observational methods are highlighted, extracted in groups and linked with associated adverse health effects.
RESULTS: The literature reviewed showed strengths and limitations of published pen-and-paper-based observational methods in determining the work activities, risk levels and related postural angles to adverse health effects. This provided a better understanding of unsafe work postures and how to improve these postures.
CONCLUSION: Many pen-and-paper-based observational methods have been developed. However, there are still many limitations of these methods. There is, therefore, a need to develop a new pen-and-paper-based observational method for assessing postural problems.
Interpopulation crosses, inheritance study, and genetic variability in the brown planthopper complex, Nilaparvata lugens (Homoptera: Delphacidae)

Latif MA, Omar MY, Tan SG, Siraj SS, Ismail AR

Biochem Genet, 2010 Apr;48(3-4):266-86.
PMID: 19967400 DOI: 10.1007/s10528-009-9316-5

Studies on hybridization, inheritance, and population genetics of brown planthoppers that infest rice and weeds were undertaken using starch gel electrophoresis to determine whether the weed-infesting population represents a biological race or a species. F(1) and F(2) generations were produced by crosses between parental insects from the two populations with little indication of hybrid sterility. Gpi, Mdh, and Idh loci were inherited in a simple Mendelian fashion in families of two sympatric populations. Sixteen populations of Nilaparvata spp. from eight locations were collected. The Mdh, Idh, Pgm, Gpi, 6Pgd, and Acp loci were polymorphic. The N. lugens of rice with high esterase activity were clustered into a group and characterized by the presence of alleles Gpi (110) and Gpi (120), whereas N. lugens from weeds with low esterase activity were clustered into another group and characterized by Gpi (100) and Gpi (90) . There was a lack of heterozygotes between the common alleles of the two populations. This means that the two groups of individuals belong to different gene pools.
In vitro cytotoxic evaluation of processed natural coral in human osteoblasts

Omar NS, Kannan TP, Ismail AR, Abdullah SF, Samsudin AR, Hamid SS

Int J Toxicol, 2011 Aug;30(4):443-51.
PMID: 21540334 DOI: 10.1177/1091581811399474

This study aimed to evaluate the in vitro cytotoxic effects of locally produced processed natural coral (PNC) using human osteoblasts (HOS). Cytotoxicity was not observed when HOS cells were cultured with PNC, as assessed by (3-(4,5-dimethylthiazol-2-yl)-2-5-diphenyl tetrazolium bromide; MTT) and Neutral Red (NR) assays at concentration up 200 mg/mL for up to 72 hours. Flow cytometry (FCM) analysis showed that PNC (200 mg/mL) did not decrease viability of HOS cells after 48 and 72 hours of treatment. In a cell attachment study, the HOS cells attached to the edge of the PNC disc, and later grew into the pores of the PNC disc. All results from these studies indicate that locally produced PNC material is noncytotoxic and favors the growth of HOS cells.
Fulltext ChatGPT for Academic Purposes: Survey Among Undergraduate Healthcare Students in Malaysia

George Pallivathukal R, Kyaw Soe HH, Donald PM, Samson RS, Hj Ismail AR

Cureus, 2024 Jan;16(1):e53032.
PMID: 38410331 DOI: 10.7759/cureus.53032

BACKGROUND: The impact of generative artificial intelligence-based Chatbots on medical education, particularly in Southeast Asia, is understudied regarding healthcare students' perceptions of its academic utility. Sociodemographic profiles and educational strategies influence prospective healthcare practitioners' attitudes toward AI tools.
AIM AND OBJECTIVES: This study aimed to assess healthcare university students' knowledge, attitude, and practice regarding ChatGPT for academic purposes. It explored chatbot usage frequency, purposes, satisfaction levels, and associations between age, gender, and ChatGPT variables.
METHODOLOGY: Four hundred forty-three undergraduate students at a Malaysian tertiary healthcare institute participated, revealing varying awareness levels of ChatGPT's academic utility. Despite concerns about accuracy, ethics, and dependency, participants generally held positive attitudes toward ChatGPT in academics.
RESULTS: Multiple logistic regression highlighted associations between demographics, knowledge, attitude, and academic ChatGPT use. MBBS students were significantly more likely to use ChatGPT for academics than BDS and FIS students. Final-year students exhibited the highest likelihood of academic ChatGPT use. Higher knowledge and positive attitudes correlated with increased academic usage. Most users (45.8%) employed ChatGPT to aid specific assignment sections while completing most work independently. Some did not use it (41.1%), while others heavily relied on it (9.3%). Users also employed it for various purposes, from generating questions to understanding concepts. Thematic analysis of responses showed students' concerns about data accuracy, plagiarism, ethical issues, and dependency on ChatGPT for academic tasks.
CONCLUSION: This study aids in creating guidelines for implementing GAI chatbots in healthcare education, emphasizing benefits, and risks, and informing AI developers and educators about ChatGPT's potential in academia.

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