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Fulltext Continuing professional development : roles of the individual lecturer and the institution

Jaafar R

Malays J Med Sci, 2006 Jan;13(1):1-2.
PMID: 22589583
Fulltext Hoarseness as the sole symptom of an impending thoracic aneurysm rupture?

Jaafar R, Mohamad I

Malays Fam Physician, 2014;9(1):25-7.
PMID: 25606294 MyJurnal

Unilateral vocal cord palsy secondary to thoracic aortic aneurysm is a rare occurrence. Direct compression of the enlarging thoracic aneurysm on the left recurrent laryngeal nerve causes neuronal injury of the nerve, which is manifested as hoarseness. We present a rare case of unilateral vocal cord palsy in a 60-year-old healthy gentleman caused by a large thoracic aortic aneurysm. This rare presentation, with a serious underlying pathology might be misdiagnosed or delayed. Therefore, it is important for us to have high index of suspicion in cases with a rare presentation such as this.
Fulltext An intravenous drug abuser with painless neck masses

Mohamad I, Jaafar R

Malays Fam Physician, 2014;9(3):49-50.
PMID: 26425306
Fulltext An elderly man with acute anterior neck pain and odynophagia after a meal

Mohamad I, Jaafar R

Malays Fam Physician, 2013;8(3):37-9.
PMID: 25893057 MyJurnal

The upper aerodigestive tract, specifically the cricopharyngeal area, is the most common site of foreign body impaction. Anatomically, this area is the first constriction of the oesophagus. Fish bones, one of the most common foreign bodies encountered in the throat, tend to get stuck in this area. The movement of this sharp-edged foreign body upon swallowing will induce odynophagia and an acute onset of neck pain. We report a case of a healthy elderly man who complained of sudden anterior neck pain and odynophagia after eating yellowtail scad fish.
Candida albicans--saprophyte or pathogen?

Jaafar R, Pettit JH

Int J Dermatol, 1992 Nov;31(11):783-5.
PMID: 1428429

Skin scrapings taken from toe spaces of 200 healthy volunteers and from toe webs and groins of 150 pediatric patients were cultured for Candida albicans using the serum germ-tube test. The results showed that Candida albicans can be isolated in about 15% of normal toe spaces and 14% of children with normal groins. Although Candida albicans can be found in various grades of athlete's foot and also in some abnormal groins, we believe that it is not necessarily responsible for these conditions and is often present at these sites only as a saprophyte.
Fulltext Career choices of physicians in Malaysia

Ahmad Z, Jaafar R

JUMMEC, 1999;4(1):47-50.

A survey of career choices was conducted for two batches of physicians applying for a medical speciality course in Malaysian medical schools. There were a total of 952 applications, with 477 males and 475 females. Surgery ranked highest, followed by obstetrics and gynaecology, fanlily medicine and orthopaedic surgery. The minor specialities of otorhinolaryngology, psychiatry and pathology were the least popular choices. Questionnaires were sent to a random sample of 250 physicians in each batch to note factors affecting their choices of speciality. A total of 359 physicians responded, giving a response rate of 71.8%. Fixed hours of work and the ability to have direct contact with patients were relatively important factors for choice of speciality. Working as a clinical consultant was the nlost popular nature of employment while worliing in the health office, service consultant in a public hospital, a non-clinical lecturer in a university hospital and working in a private clinic were less popular choices for these physicians. KEYWORDS: Career choice; medical speciality; doctors; Malaysia.
Atopic eczema in a multiracial country (Malaysia)

Jaafar RB, Pettit JH

Clin Exp Dermatol, 1993 Nov;18(6):496-9.
PMID: 8252784

A total of 14,342 patients with skin diseases who had attended either the National University of Malaysia skin clinic or a private dermatological office were analysed. Five hundred and thirty-four cases (3.7%) had atopic eczema, the prevalence being highest among the Malays (4.3%). The prevalence of atopic eczema among clinic attenders is lower in all three major Malaysian races when compared with studies from England.
Fulltext Developing and implementing a health educational package for preemie moms in the care of their baby after hospital discharge

Zakaria R, Sutan R, Jaafar R

J Educ Health Promot, 2020;9:113.
PMID: 32642469 DOI: 10.4103/jehp.jehp_497_19

INTRODUCTION: Educating a mother of a premature baby and providing a structured written educational information can enhance better understanding and practice. This article describes the development and implementation of a health educational package for preemie moms in the care of their premature baby after neonatal intensive care unit discharge.
SUBJECTS AND METHODS: The package known as "Preemie Mom: A Guide for You" was designed based on Stufflebeam's model and has four phases: (1) content evaluation from available sources of information, (2) input evaluation based on mothers' need related to premature baby care, (3) process evaluation for package designing and content drafting, and (4) product evaluation to determine its feasibility. The contents were extracted and collated for validation by consulting various specialists in related fields. A final draft was drawn based on comments given by experts. Comments from the mothers were taken for formatting, visual appearance, and content flow for easy understanding and usage.
RESULTS: All ten existing articles and eight relevant documents were gathered and critically appraised. The package was designed based on 11 main components related to the care of premature baby after discharge. The content validation was accepted at a minimum score of 0.85 for the item-level content validity index analysis. Both experts and mothers were agreed that the package is easy to use and well accepted as a guide after discharge. The agreement rate by the mothers was at 93.33% and greater for the front page, writing style, structure, presentation, and motives of the package.
CONCLUSIONS: "Preemie Mom: A Guide for You" is a validated health educational package and ready to be used to meet the needs of the mother for premature baby care at home.
Similarities and differences in cultural values between Iranian and Malaysian nursing students

Abdollahimohammad A, Jaafar R, Rahim AF

Iran J Nurs Midwifery Res, 2014 Sep;19(5):542-4.
PMID: 25400685

Cultural values are invisible and relatively constant in societies. The purpose of the present study is to find diversities in cultural values of Iranian and Malaysian nursing students.
Perception of students about the problem-based learning sessions conducted for medical and dental schools' students of Universiti Sains Malaysia

Barman A, Jaafar R, Naing NN

Educ Health (Abingdon), 2006 Nov;19(3):363-8.
PMID: 17178518
Fulltext Huge buccal angiomyolipoma: a rare entity

Cheah SC, Jaafar R, Jais MH

Braz J Otorhinolaryngol, 2020 Dec;86 Suppl 1:61-63.
PMID: 28918977 DOI: 10.1016/j.bjorl.2017.08.002
Fulltext Variable-Length Multiobjective Social Class Optimization for Trust-Aware Data Gathering in Wireless Sensor Networks

Saad MA, Jaafar R, Chellappan K

Sensors (Basel), 2023 Jun 12;23(12).
PMID: 37420692 DOI: 10.3390/s23125526

Data gathering in wireless sensor networks (WSNs) is vital for deploying and enabling WSNs with the Internet of Things (IoTs). In various applications, the network is deployed in a large-scale area, which affects the efficiency of the data collection, and the network is subject to multiple attacks that impact the reliability of the collected data. Hence, data collection should consider trust in sources and routing nodes. This makes trust an additional optimization objective of the data gathering in addition to energy consumption, traveling time, and cost. Joint optimization of the goals requires conducting multiobjective optimization. This article proposes a modified social class multiobjective particle swarm optimization (SC-MOPSO) method. The modified SC-MOPSO method is featured by application-dependent operators named interclass operators. In addition, it includes solution generation, adding and deleting rendezvous points, and moving to the upper and lower class. Considering that SC-MOPSO provides a set of nondominated solutions as a Pareto front, we employed one of the multicriteria decision-making (MCDM) methods, i.e., simple additive sum (SAW), for selecting one of the solutions from the Pareto front. The results show that both SC-MOPSO and SAW are superior in terms of domination. The set coverage of SC-MOPSO is 0.06 dominant over NSGA-II compared with only a mastery of 0.04 of NSGA-II over SC-MOPSO. At the same time, it showed competitive performance with NSGA-III.
Fulltext Problem-based learning as perceived by dental students in universiti sains malaysia

Barman A, Jaafar R, Ismail NM

Malays J Med Sci, 2006 Jan;13(1):63-7.
PMID: 22589593

The implementation of problem-based learning started in 1969 and has spread since then throughout different parts of the world with variations in its implementation. In spite of its growth and advantages, there is continuing debate about its effectiveness over the conventional teaching learning methods. In the School of Dental Sciences (SDS), Universiti Sains Malaysia (USM), the Doctor of Dental Sciences (DDS) program follows a 5-year integrated curriculum. Basically the curriculum is problem-based and community oriented. This study was to explore the perception of DDS students about PBL sessions. This questionnaires-based cross sectional descriptive study were carried out on all the 110 students of the SDS who completed their second year of the course and participated in PBL sessions. Ninety five (86%) students responded to the questionnaires. Dental students found PBL session interesting and wanted to maintain PBL from the beginning of year 2 up to the end of year 3. Most students reported their participation in discussion during PBL sessions but the level of participation varied. Some of them worked hard to prepare themselves for discussion while others were relatively passive. PBL helped them with in-depth understanding of certain topics and link their basic science knowledge to clinical classes. They felt that guidance from subject specialists and well-prepared facilitators of the sessions were beneficial. The students believed that repetition of triggers from year to year discouraged their active search for learning issues. Majority of the students were undecided or disagreed about the availability of adequate learning resources Most of the students were undecided or disagreed about the availability of adequate learning resources for their self-study. Reviewing and renewing the PBL triggers, providing guidelines for searching for resource materials and briefing the students and facilitators about the philosophy and principles of PBL may make the PBL sessions more beneficial.
Cervical lipoblastoma: An uncommon presentation

Jaafar R, Tang IP, Jong DE, Narihan MZ

Ear Nose Throat J, 2015 Jul;94(7):E8-10.
PMID: 26214680

Lipoblastoma is extremely rare and mainly occurs in children younger than 3 years old. It is predominantly found in the extremities and trunk. Head and neck region occurrences are rare; only 4 such cases involving patients who presented with stridor have been previously reported. We report the fifth case of lipoblastoma of the neck with stridor in a 9-year-old girl, which had gradually worsened over the previous year. Imaging showed a retrotracheal mass extending superiorly to the thyroid level and inferiorly to below the carina of the trachea. Total resection of the tumor was performed, and the histopathologic findings were consistent with lipoblastoma. Postoperatively, the patient was well with no complications.
Fulltext A halfway house for pregnant women

Ahmad Z, Jaafar R, Hassan MH, Awang CW

World Health Forum, 1998;19(2):133-5.
PMID: 9652210
Neonatal pain: Knowledge and perception among pediatric doctors in Malaysia

Ishak S, Nfe F, Zakaria Sz S, Adli A, Jaafar R

Pediatr Int, 2019 Jan;61(1):67-72.
PMID: 30484931 DOI: 10.1111/ped.13724

BACKGROUND: Inadequate pain management is linked to potential neurodevelopmental and behavioral problems. Sufficient knowledge in neonatal pain is required to facilitate optimal pain management. The aim of this study was therefore to assess the knowledge and perception of pain experienced by neonates requiring intensive care among pediatric doctors working in a level III neonatal intensive care unit in Malaysian hospitals.
METHODS: This was a cross-sectional study conducted over a period of 18 months. A self-administered questionnaire assessing knowledge and perception regarding neonatal pain was used.
RESULTS: Twenty-four hospitals participated in the study, with 423 respondents. The response rate was 85%. One hundred and ninety-seven respondents (47%) were aware of tools for neonatal pain assessment, but only 6% used them in daily practice. Doctors with >4 years of experience in neonatal care had better awareness of available pain assessment tools (59.4% vs 40.9%, P = 0.001). Sixteen statements regarding knowledge were assessed. Mean score obtained was 10.5 ± 2.5. Consultants/specialists obtained a higher mean score than medical officers (11.9 vs 10.4, P < 0.001). More than 80% of respondents were able to discriminate painful from non-painful procedures.
CONCLUSION: Clinicians involved in neonatal care, especially those with longer experience were knowledgeable about neonatal pain. Gaps between knowledge and its application, however, remain. Implementation of clinical guidelines to improve the quality of assessment and adequate pain management in neonates is recommended.
Fulltext The Principles of Hearable Photoplethysmography Analysis and Applications in Physiological Monitoring-A Review

Azudin K, Gan KB, Jaafar R, Ja'afar MH

Sensors (Basel), 2023 Jul 18;23(14).
PMID: 37514778 DOI: 10.3390/s23146484

Not long ago, hearables paved the way for biosensing, fitness, and healthcare monitoring. Smart earbuds today are not only producing sound but also monitoring vital signs. Reliable determination of cardiovascular and pulmonary system information can explore the use of hearables for physiological monitoring. Recent research shows that photoplethysmography (PPG) signals not only contain details on oxygen saturation level (SPO2) but also carry more physiological information including pulse rate, respiration rate, blood pressure, and arterial-related information. The analysis of the PPG signal from the ear has proven to be reliable and accurate in the research setting. (1) Background: The present integrative review explores the existing literature on an in-ear PPG signal and its application. This review aims to identify the current technology and usage of in-ear PPG and existing evidence on in-ear PPG in physiological monitoring. This review also analyzes in-ear (PPG) measurement configuration and principle, waveform characteristics, processing technology, and feature extraction characteristics. (2) Methods: We performed a comprehensive search to discover relevant in-ear PPG articles published until December 2022. The following electronic databases: Institute of Electrical and Electronics Engineers (IEEE), ScienceDirect, Scopus, Web of Science, and PubMed were utilized to conduct the studies addressing the evidence of in-ear PPG in physiological monitoring. (3) Results: Fourteen studies were identified but nine studies were finalized. Eight studies were on different principles and configurations of hearable PPG, and eight studies were on processing technology and feature extraction and its evidence in in-ear physiological monitoring. We also highlighted the limitations and challenges of using in-ear PPG in physiological monitoring. (4) Conclusions: The available evidence has revealed the future of in-ear PPG in physiological monitoring. We have also analyzed the potential limitation and challenges that in-ear PPG will face in processing the signal.
Fulltext Recent Advances in Non-Invasive Blood Pressure Monitoring and Prediction Using a Machine Learning Approach

Ismail SNA, Nayan NA, Jaafar R, May Z

Sensors (Basel), 2022 Aug 18;22(16).
PMID: 36015956 DOI: 10.3390/s22166195

Blood pressure (BP) monitoring can be performed either invasively via arterial catheterization or non-invasively through a cuff sphygmomanometer. However, for conscious individuals, traditional cuff-based BP monitoring devices are often uncomfortable, intermittent, and impractical for frequent measurements. Continuous and non-invasive BP (NIBP) monitoring is currently gaining attention in the human health monitoring area due to its promising potentials in assessing the health status of an individual, enabled by machine learning (ML), for various purposes such as early prediction of disease and intervention treatment. This review presents the development of a non-invasive BP measuring tool called sphygmomanometer in brief, summarizes state-of-the-art NIBP sensors, and identifies extended works on continuous NIBP monitoring using commercial devices. Moreover, the NIBP predictive techniques including pulse arrival time, pulse transit time, pulse wave velocity, and ML are elaborated on the basis of bio-signals acquisition from these sensors. Additionally, the different BP values (systolic BP, diastolic BP, mean arterial pressure) of the various ML models adopted in several reported studies are compared in terms of the international validation standards developed by the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS) for clinically-approved BP monitors. Finally, several challenges and possible solutions for the implementation and realization of continuous NIBP technology are addressed.
Community-acquired methicillin-resistant Staphylococcus aureus in a Malaysian tertiary centre

Rashid ZZ, Bahari N, Othman A, Jaafar R, Mohamed NA, Jabbari I, et al.

Southeast Asian J. Trop. Med. Public Health, 2013 Jan;44(1):104-8.
PMID: 23682444

Abstract. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a pathogen recognized to be distinct in both phenotype and genotype from hospital-acquired MRSA. We have identified CA-MRSA cases in Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, including their antibiotic susceptibility patterns and genotypic characteristics. Cases were identified during January to December 2009 from routine clinical specimens, where culture and antibiotic susceptibility results yielded pauci-resistant MRSA isolates suspected as being CA-MRSA. The patients' clinical data were collected and their specimens were sent for molecular confirmation and analysis. Five cases of CA-MRSA were identified, which had a multi-sensitive pattern on antibiotic susceptibility tests and were resistant to only penicillin and oxacillin. All cases were skin and soft-tissue infections, including diabetic foot with gangrene, infected scalp hematoma, philtrum abscess in a healthcare worker, thrombophlebitis complicated with abscess and infected bedsore. All five cases were confirmed MRSA by detection of mecA. SCCmec typing (ccr and mec complex) revealed SCCmec type IV for all cases except the infected bedsore case. Panton-Valentine leukocidin gene was positive in all isolates. As clinical features among methicillin-sensitive Staphylococcus aureus, CA-MRSA and "nosocomial CA-MRSA" are indistinct, early recognition is necessary in order to initiate appropriate antibiotics and infection control measures. Continual surveillance of pauci-resistant MRSA and molecular analysis are necessary in order to identify emerging strains as well as their epidemiology and transmission, both in the community and in healthcare setting.
Kiwi Omnicup versus Malmstrom metal cup in vacuum assisted delivery: a randomized comparative trial

Ismail NA, Saharan WS, Zaleha MA, Jaafar R, Muhammad JA, Razi ZR

J Obstet Gynaecol Res, 2008 Jun;34(3):350-3.
PMID: 18686348

AIM: To compare the success, clinical outcomes, and maternal and neonatal complications between the Kiwi Omnicup and the Malmstrom metal cup in vacuum assisted delivery.
METHODS: This was a prospective randomized comparative trial. Women who required vacuum assisted vaginal delivery were randomized into the Kiwi Omnicup (KO) group and the Malmstrom metal cup (MM) group. The vacuum assisted deliveries were conducted according to hospital protocol. Details of the procedure and delivery outcomes including success and complications were analyzed.
RESULTS: One hundred and sixty-four women were recruited - 85 were assigned to vacuum assisted delivery using the KO and 79 the MM. One hundred percent delivery success was achieved with no significant differences between the two instruments in terms of maternal morbidity (P = 0.66). Six women in the MM group sustained post delivery complications in comparison to five in the KO group. Three babies were diagnosed with birth asphyxia in each group. More babies in the MM group were admitted to the Neonatal Intensive Care Unit (NICU) (10 babies versus 5 babies) and suffered complications (14 versus 12 babies), compared to the KO group, although the difference was not statistically significant. There were no intrapartum or neonatal deaths and of those admitted to the NICU, all were discharged within a week without any serious consequences.
CONCLUSION: Kiwi Omnicup is an effective alternative to the currently available Malmstrom metal cup for vacuum assisted delivery with no increase in maternal or neonatal morbidity or mortality.

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