Displaying publications 1 - 20 of 43 in total

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  1. Jamal ARA
    Malays J Med Sci, 2021 Jun;28(3):1-4.
    PMID: 34285640 DOI: 10.21315/mjms2021.28.3.1
    Precision medicine is transforming healthcare worldwide and aims to improve the effectiveness of management of many diseases including cancers, other non-communicable diseases (NCDs) and also rare diseases. Precision medicine takes into account the individual patient's genetic, environment and lifestyle data. Developed nations are already embarking on precision medicine initiatives including the 100,000 Genomes England and the Precision Medicine Initiative in the United States (US). The Academy of Sciences Malaysia, the Ministry of Health and the Ministry of Higher Education are working together to put forward a precision medicine initiative for Malaysia. The key drivers that must be put in place include a strong policy agenda, a national large scale genome sequencing project and with it a national genome database, the implementation of the electronic medical record (EMR) system, a payment and reimbursement system to cover for the genetic testing and the targeted treatment, and putting in place an ecosystem that will support precision medicine. Relevant guidelines and Acts will also need to be developed especially with regard to privacy and confidentiality. The future of precision medicine is now and this will certainly bring better outcome and value to the patients.
  2. Dhillon KS, Jamal A, Bhupinderjeet S
    Med J Malaysia, 1993 Dec;48(4):427-35.
    PMID: 8183167
    From March 1986 to June 1992, 100 primary total knee arthroplasties were done in 69 patients. The demographic data and complications were analysed in these 69 patients. The first 50 knees with a minimal follow-up of one year (range 1-6 years) were analysed in more detail according to the International Knee Society Rating System. Detailed radiological evaluation was also carried out to assess positioning of the components. There were 79 knees with osteoarthritis, 20 knees with rheumatoid arthritis and one with Systemic Lupus Erythromatosus (SLE). The knee score was poor in all knees pre-operatively. Post-operatively 78% had good to excellent score and the other 22% had fair knee score. However the functional score remained poor in 50% of the knees. Ideal tibio-femoral alignment was obtained in 68% of the knees. Twenty four percent of the knees had 0.4 degrees of varus and eight percent had 10-12 degrees valgus. Complication rate was low with 1% of infection (one knee). Overall early results were satisfactory.
    Study site; University Hospital Kuala Lumpur (University Malaya Medical Centre)
  3. Zakaria N, Jamal A, Bisht S, Koppel C
    Med 2 0, 2013 Nov 27;2(2):e13.
    PMID: 25075236 DOI: 10.2196/med20.2735
    Public universities in Saudi Arabia today are making substantial investments in e-learning as part of their educational system, especially in the implementation of learning management systems (LMS). To our knowledge, this is the first study conducted in Saudi Arabia exploring medical students' experience with an LMS, particularly as part of a medical informatics course.
  4. Amalourde A, Vinayaga P, Naveed N, Jamal A, Looi LM, Sengupta S
    Med J Malaysia, 2004 Dec;59 Suppl F:60-2.
    PMID: 15941166 MyJurnal
    Although all types of tumour and tumour-like conditions have been described to occur in the clavicle, they only contribute to less then 0.5% of all skeletal tumours. The incidence of primary chondrosarcoma of the clavicle is extremely rare. To our knowledge it has not been reported in Malaysia. We would like to highlight the possibility of chondrosarcoma as a differential diagnosis for a clavicular lesion.
  5. George E, Jamal AR, Khalid F, Osman KA
    Malays J Med Sci, 2001 Jul;8(2):40-6.
    PMID: 22893759 MyJurnal
    Beta-thalassaemia is characterized by a decrease (β(+)) or absence (β(0)) in the synthesis of β-globin chains of human haemoglobin. The heterozygous state for β(+) or β(0) result in β-thalassaemia trait in which the hallmark is the presence of an elevated level of Haemoglobin (Hb) A(2) (α(2)δ(2)). In the past, the traditional methods such as cellulose acetate electrophoresis with elution and microcolumn chromatrography have been the techniques used by the majority of the laboratories in Malaysia for the estimation of (Hb) A(2) levels. The recommended method currently is high performance liquid chromatography which has only been introduced in a few laboratories in the country.
  6. Ho JPY, Merican AM, Hashim MS, Abbas AA, Chan CK, Mohamad JA
    J Arthroplasty, 2017 10;32(10):3176-3183.
    PMID: 28579444 DOI: 10.1016/j.arth.2017.04.060
    BACKGROUND: The posterior tibial slope (PTS) is an important consideration in knee arthroplasty. However, there is still no consensus for the optimal slope. The objectives of this study were (1) to reliably determine the native PTS in this population using 3-dimensional computed tomography scans and (2) to determine the normal reference range for PTS in this population.

    METHODS: One hundred computed tomography scans of disease-free knees were analyzed. A 3-dimensional reconstructed image of the tibia was generated and aligned to its anatomic axis in the coronal and sagittal planes. The tibia was then rotationally aligned to the tibial plateau (tibial centroid axis) and PTS was measured from best-fit planes on the surface of the proximal tibia and individually for the medial and lateral plateaus. This was then repeated with the tibia rotationally aligned to the ankle (transmalleolar axis).

    RESULTS: When rotationally aligned to the tibial plateau, the mean PTS, medial PTS, and lateral PTS were 11.2° ± 3.0 (range, 4.7°-17.7°), 11.3° ± 3.2 (range, 2.7°-19.7°), and 10.9° ± 3.7 (range, 3.5°-19.4°), respectively. When rotationally aligned to the ankle, the mean PTS, medial PTS, and lateral PTS were 11.4° ± 3.0 (range, 5.3°-19.3°), 13.9° ± 3.7 (range, 3.1°-24.4°), and 9.7° ± 3.6 (range, 0.8°-17.7°), respectively.

    CONCLUSION: The PTS in the normal Asian knee is on average 11° (mean) with a reference range of 5°-17° (mean ± 2 standard deviation). This has implications to surgery and implant design.

  7. Jamal A, Babazono A, Li Y, Yoshida S, Fujita T
    Medicine (Baltimore), 2020 May;99(18):e19871.
    PMID: 32358355 DOI: 10.1097/MD.0000000000019871
    The presence of comorbid conditions along with heterogeneity in terms of healthcare practices and service delivery could have a significant impact on the patient's outcomes. With a strong interest in social epidemiology to examine the impact of health services and variations on health outcomes, the current study was conducted to analyse the incidence of hemodialysis-associated infection (HAI) as well as its associated factors, and to quantify the extent to which the contextual effects of the care facility and regional variations influence the risk of HAI.A total of 6111 patients with end-stage renal disease who received hemodialysis treatment between 1 October 2015 and 31 March 2016 were identified from the insurance claim database as a population-based, close-cohort retrospective study. Patients were followed for one year from April 1, 2016 to March 31, 2017. A total of 200 HAI cases were observed during the follow-up and 12 patients died within 90 days of the onset of HAI. Increased risks for HAI were associated with moderate (HR 1.73, 95% confidence interval [CI] 1.00-2.98) and severe (HR 1.87, 95% CI 1.11-3.14) comorbid conditions as well as malignancy (HR 1.36, 95% CI 1.00-1.85). Increased risk was also seen among patients who received hemodialysis treatment from clinics (HR 2.49, 95% CI 1.1-5.33). However, these statistics were no longer significant when variations at the level of care facilities were statistically controlled. In univariate analyses, no statistically significant association was observed between 90-day mortality and baseline patients, and the characteristics of the care facility.The results of the multivariate, multilevel analyses indicated that HAI variations were only significant at the care facility level (σ 2.07, 95% CI 1.3-3.2) and were largely explained by the heterogeneity between care facilities. The results of this study highlight the need to look beyond the influence of patient-level characteristics when developing policies that aim at improving the quality of hemodialysis healthcare and service delivery in Japan.
  8. Jamal A, Hazim Alkawaz M, Rehman A, Saba T
    Microsc Res Tech, 2017 Jul;80(7):799-811.
    PMID: 28294460 DOI: 10.1002/jemt.22867
    With an increase in the advancement of digital imaging and computing power, computationally intelligent technologies are in high demand to be used in ophthalmology cure and treatment. In current research, Retina Image Analysis (RIA) is developed for optometrist at Eye Care Center in Management and Science University. This research aims to analyze the retina through vessel detection. The RIA assists in the analysis of the retinal images and specialists are served with various options like saving, processing and analyzing retinal images through its advanced interface layout. Additionally, RIA assists in the selection process of vessel segment; processing these vessels by calculating its diameter, standard deviation, length, and displaying detected vessel on the retina. The Agile Unified Process is adopted as the methodology in developing this research. To conclude, Retina Image Analysis might help the optometrist to get better understanding in analyzing the patient's retina. Finally, the Retina Image Analysis procedure is developed using MATLAB (R2011b). Promising results are attained that are comparable in the state of art.
  9. Li Y, Babazono A, Jamal A, Liu N, Yamao R
    Clin Epidemiol, 2021;13:883-892.
    PMID: 34616183 DOI: 10.2147/CLEP.S327404
    Background: Acute myocardial infarction (AMI) management strategies, involving treatment and post-care, are much more difficult for patients with dementia. This study investigated the factors influencing the use of invasive procedures and long-term care in the management strategies for AMI patients with dementia and the factors associated with these patients' survival.

    Methods: This multilevel study combined information from two databases, namely later-stage elderly healthcare insurance and long-term care insurance claims, from 2013 to 2019. Of 214,963 individuals with dementia, we identified 13,593 patients with AMI. The primary outcomes were the use of invasive procedures for treatment and long-term care for post-care management. Survival outcomes were also measured over a 6-year period, adjusting for individual- and regional-level characteristics in multilevel models.

    Results: A total of 1954 (14.38%) individuals received an invasive procedure during treatment, and 7850 (87.18%) used long-term care for post-care management after AMI. After multivariate adjustment, patients aged ≥ 85 years and women were less likely to receive invasive procedures and more likely to use long-term care. Patients undergoing invasive procedures had a lower use of long-term care. Better survival outcome was significantly associated with invasive management and long-term care, regardless of the type of care.

    Conclusion: Age and sex determine the use of invasive procedures and long-term care after AMI among patients with dementia. AMI patients with dementia receiving invasive procedures and long-term care had better survival outcomes.

  10. Abu Zaid Z, Shahar S, Jamal AR, Mohd Yusof NA
    Asia Pac J Clin Nutr, 2012;21(4):502-10.
    PMID: 23017308
    A randomised trial was carried out to determine the effect of supplementation of fish oil among 51 children with leukaemia aged 4 to 12 years on appetite level, caloric intake, body weight and lean body mass. They were randomly allocated into the trial group (TG) and the control group (CG). At baseline, 30.8% of TG subjects and 44.0% of CG subjects were malnourished and 7.7% of subject from TG and 28.0% from CG were classified as stunted. The majority of subjects from TG and CG were in the mild malnutrition category for mid upper arm muscle circumference (MUAMC)-for-age. The TG group showed significant increment in MUAMC (0.13 cm vs -0.09 cm) compared with CG at 8 weeks (p<0.001). There was a significant higher increase for appetite level (0.12±0.33) (p<0.05) and an increasing trend on energy and protein intake in the TG group (213±554 kcal; 3.64 ±26.8 g) than in the CG group. In conclusion, supplementation of fish oil has a positive effect on appetite level, caloric intake and MUAMC among children with leukaemia.
  11. Fujita T, Babazono A, Kim SA, Jamal A, Li Y
    BMC Geriatr, 2021 12 15;21(1):707.
    PMID: 34911495 DOI: 10.1186/s12877-021-02685-x
    BACKGROUND: The number of patients with Parkinson's disease among older adults is rapidly increasing. Such patients mostly take medication and require regular physician visits. However, the effect of physician visit frequency for the treatment for Parkinson's disease has not been evaluated. This study aimed to evaluate the impact of physician visit frequency for Parkinson's disease treatment on mortality, healthcare days, and healthcare and long-term care costs among older adults.

    METHODS: This study employed a retrospective cohort design utilizing claims data from the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare Insurance and Long-Term Care Insurance. Patients aged ≥75 years who were newly diagnosed with Parkinson's disease in 2014 were included in this study, following the onset of Parkinson's disease to March 31, 2019. We calculated the restricted mean survival time to evaluate mortality, focusing on the frequency of physician visits for Parkinson's disease treatment. Inpatient days, outpatient days, and healthcare and long-term care costs per month were calculated using a generalized linear model.

    RESULTS: There were 2224 participants, with 46.5% mortality among those with a higher frequency of physician visits and 56.4% among those with a lower frequency of physician visits. A higher frequency of physician visits was associated with a significant increase in survival time (1.57 months at 24 months and 5.00 months at 60 months) after the onset of Parkinson's disease and a decrease in inpatient days and healthcare costs compared to a lower frequency of physician visits.

    CONCLUSIONS: A higher frequency of physician visits was significantly associated with longer survival time, fewer inpatient days, and lower healthcare costs. Caregivers should support patients with Parkinson's disease to visit physicians regularly for their treatment.

  12. Fujita T, Babazono A, Jiang P, Jamal A, Li Y
    Pharmacoepidemiol Drug Saf, 2022 02;31(2):187-195.
    PMID: 34529297 DOI: 10.1002/pds.5359
    PURPOSE: Smoking is an important public health issue. Although measures to support smoking cessation have been implemented worldwide, smokers often fail to quit smoking after receiving pharmacotherapies for nicotine dependence. The present study evaluated the cost-effectiveness of varenicline for smoking cessation compared with no pharmacotherapy using actual paid medical cost data in Japan.

    METHODS: This was a retrospective cohort study of 3657 subjects who had quit smoking with varenicline or no pharmacotherapy. We extracted health examination and medical claim data from a health insurer database for the period 2012-2015. We calculated the incremental cost-effective ratio (ICER) of varenicline using actual paid medical costs for nicotine dependence and the number needed to treat to maintain smoking cessation compared with no pharmacotherapy, considering sex, age, income, and occupation.

    RESULTS: The 1- and 2-year smoking cessation maintenance rates were 69.7% and 62.4%, respectively. We found that 8.8% of subjects who quit smoking used varenicline for nicotine dependence and the cost per person was Japanese Yen (JPY) 52 177 (U.S. dollars [USD] 474; USD 1 = JPY 110). The ICER of varenicline was dominant when comparing 2-year cessation with 1-year cessation. Male, age <40 years, low income, and manufacturing workers were the most cost-effective variables.

    CONCLUSIONS: The cost-effective variables of varenicline in the real world were investigated. The results of this study strengthen the evidence regarding which type of people should be targeted for measures to support smoking cessation using varenicline.

  13. Kim SA, Babazono A, Jamal A, Li Y, Liu N
    BMJ Open, 2021 Apr 14;11(4):e041964.
    PMID: 33853793 DOI: 10.1136/bmjopen-2020-041964
    OBJECTIVES: We compared the care services use and medical institutional deaths among older adults across four home care facility types.

    DESIGN: This was a retrospective cohort study.

    SETTING: We used administrative claims data from April 2014 to March 2017.

    PARTICIPANTS: We included 18 347 residents of Fukuoka Prefecture, Japan, who received home care during the period, and aged ≥75 years with certified care needs of at least level 3. Participants were categorised based on home care facility use (ie, general clinics, Home Care Support Clinics/Hospitals (HCSCs), enhanced HCSCs with beds and enhanced HCSCs without beds).

    PRIMARY AND SECONDARY OUTCOME MEASURES: We used generalised linear models (GLMs) to estimate care utilisation and the incidence of medical institutional death, as well as the potential influence of sex, age, care needs level and Charlson comorbidity index as risk factors.

    RESULTS: The results of GLMs showed the inpatient days were 54.3, 69.9, 64.7 and 75.0 for users of enhanced HCSCs with beds, enhanced HCSCs without beds, HCSCs and general clinics, respectively. Correspondingly, the numbers of home care days were 63.8, 51.0, 57.8 and 29.0. Our multivariable logistic regression model estimated medical institutional death rate among participants who died during the study period (n=9919) was 2.32 times higher (p<0.001) for general clinic users than enhanced HCSCs with beds users (relative risks=1.69, p<0.001).

    CONCLUSIONS: Participants who used enhanced HCSCs with beds had a relatively low inpatient utilisation, medical institutional deaths, and a high utilisation of home care and home-based end-of-life care. Findings suggest enhanced HCSCs with beds could reduce hospitalisation days and medical institutional deaths. Our study warrants further investigations of home care as part of community-based integrated care.

  14. Ramelah M, Aminuddin A, Alfizah H, Isa MR, Jasmi AY, Tan HJ, et al.
    FEMS Immunol. Med. Microbiol., 2005 May 1;44(2):239-42.
    PMID: 15866222
    Helicobacter pylori infection of a distinct subtype of cagA may lead to different pathological manifestation. The aim of this study is to determine the presence of cagA gene and its variants in H. pylori infection among different ethnic groups and its effect on gastroduodenal diseases. Overall detection of cagA among the 205 clinical isolates of H. pylori was 94%. Variations in size of the 3' region of cagA gene were examined among 192 Malaysian H. pylori cagA-positive strains. Results showed that three cagA variants differing in fragment length of PCR products were detected and designated as type A (621-651bp), type B (732-735bp) and type C (525 bp). Although there was no association between any of the cagA subtypes with peptic ulcer disease (p>0.05), an association between cagA subtypes with a specific ethnic group was observed. Specific-cagA subtype A strains were predominantly isolated from Chinese compared to Malays and Indians (p<0.0005), and cagA subtype B strains were predominantly isolated from Malays and Indians compared to Chinese (p<0.05). The cagA type A strains of H. pylori is commonly found in the Chinese patients who have a higher risk of peptic ulcer disease, thus indicating that it could be used as an important clinical biomarker for a more severe infection.
  15. Abdul Rahman A, Jamal AR, Harun R, Mohd Mokhtar N, Wan Ngah WZ
    PMID: 24980711 DOI: 10.1186/1472-6882-14-213
    Gamma-tocotrienol (GTT), an isomer of vitamin E and hydroxy-chavicol (HC), a major bioactive compound in Piper betle, has been reported to possess anti-carcinogenic properties by modulating different cellular signaling events. One possible strategy to overcome multi-drug resistance and high toxic doses of treatment is by applying combinational therapy especially using natural bioactives in cancer treatment.
  16. Saghir FS, Rose IM, Dali AZ, Shamsuddin Z, Jamal AR, Mokhtar NM
    Int. J. Gynecol. Cancer, 2010 Jul;20(5):724-31.
    PMID: 20973258
    INTRODUCTION: Malignant transformation of type I endometrium involves alteration in gene expression with subsequent uncontrolled proliferation of altered cells.

    OBJECTIVE: The main objective of the present study was to identify the cancer-related genes and gene pathways in the endometrium of healthy and cancer patients.

    MATERIALS AND METHODS: Thirty endometrial tissues from healthy and type I EC patients were subjected to total RNA isolation. The RNA samples with good integrity number were hybridized to a new version of Affymetrix Human Genome GeneChip 1.0 ST array. We analyzed the results using the GeneSpring 9.0 GX and the Pathway Studio 6.1 software. For validation assay, quantitative real-time polymerase chain reaction was used to analyze 4 selected genes in normal and EC tissue.

    RESULTS: Of the 28,869 genes profiled, we identified 621 differentially expressed genes (2-fold) in the normal tissue and the tumor. Among these genes, 146 were up-regulated and 476 were down-regulated in the tumor as compared with the normal tissue (P < 0.001). Up-regulated genes included the v-erb-a erythroblastic leukemia viral oncogene homolog 3 (ErbB3), ErbB4, E74-like factor 3 (ELF3), and chemokine ligand 17 (CXCL17). The down-regulated genes included signal transducer and activator transcription 5B (STAT5b), transforming growth factor A receptor III (TGFA3), caveolin 1 (CAV1), and protein kinase C alpha (PKCA). The gene set enrichment analysis showed 10 significant gene sets with related genes (P < 0.05). The quantitative polymerase chain reaction of 4 selected genes using similar RNA confirmed the microarray results (P < 0.05).

    CONCLUSIONS: Identification of molecular pathways with their genes related to type I EC contribute to the understanding of pathophysiology of this cancer, probably leading to identifying potential biomarkers of the cancer.

  17. Nasri NW, Jamal AR, Abdullah NC, Razi ZR, Mokhtar NM
    Arch Med Res, 2009 Jan;40(1):1-9.
    PMID: 19064120 DOI: 10.1016/j.arcmed.2008.10.008
    Preimplantation genetic diagnosis (PGD) of monogenic autosomal hereditary disorders following assisted conception usually involves the removal of one or two blastomeres from preimplantation embryos. However, the amount of DNA from a single blastomere is insufficient to amplify the region of interest. Hence, the whole genome amplification (WGA) method is performed prior to amplifying the genes of interest before analysis of DNA material through polymerase chain reaction (PCR).
  18. Li Y, Babazono A, Jamal A, Fujita T, Yoshida S, Kim SA
    Int J Equity Health, 2021 03 16;20(1):80.
    PMID: 33726747 DOI: 10.1186/s12939-021-01415-4
    BACKGROUND: Variation in health care delivery among regions and hospitals has been observed worldwide and reported to have resulted in health inequalities. Regional variation of percutaneous coronary intervention (PCI) was previously reported in Japan. This study aimed to assess the small-area and hospital-level variations and to examine the influence of patient and hospital characteristics on the use of PCI.

    METHODS: Data provided by the Fukuoka Prefecture Latter-stage Elderly Insurance Association was used. There were 11,821 patients aged ≥65 years with acute coronary syndromes who were identified from 2015 to 2017. Three-level multilevel logistic regression analyses were performed to quantify the small-area and hospital variations, as well as, to identify the determinants of PCI use.

    RESULTS: The results showed significant variation (δ2 = 0.744) and increased PCI use (MOR = 2.425) at the hospital level. After controlling patient- and hospital-level characteristics, a large proportional change in cluster variance was found at the hospital level (PCV 14.7%). Fixed-effect estimation results showed that females, patients aged ≥80 years old, hypertension and dyslipidemia had significant association with the use of PCI. Hospitals with high physician density had a significantly positive relationship with PCI use.

    CONCLUSIONS: Patients receiving care in hospitals located in small areas have equitable access to PCI. Hospital-level variation might be originated from the oversupply of physicians. A balanced number of physicians and beds should be taken into consideration during healthcare allocation. A treatment process guideline on PCI targeting older patients is also needed to ensure a more equitable access for healthcare resources.

  19. Ahmed T, Moeinaddini M, Almoshaogeh M, Jamal A, Nawaz I, Alharbi F
    PMID: 34444563 DOI: 10.3390/ijerph18168813
    Crosswalks are critical locations in the urban transport network that need to be designed carefully as pedestrians are directly exposed to vehicular traffic. Although various methods are available to evaluate the level of service (LOS) at pedestrian crossings, pedestrian crossing facilities are frequently ignored in assessing crosswalk conditions. This study attempts to provide a comprehensive framework for evaluating crosswalks based on several essential indicators adopted from different guidelines. A new pedestrian crossing level of service (PCLOS) method is introduced in this research, with an aimto promote safe and sustainable operations at such locations. The new PCLOS employs an analytical point system to compare existing street crossing conditions to the guidelines' standards, taking into account the scores and coefficients of the indicators. The quantitative scores and coefficients of indicators are assigned based on field observations and respondent opinions. The method was tested to evaluate four pedestrian crosswalks in the city of Putrajaya, Malaysia. A total of 17 indicators were selected for the study after a comprehensive literature review. Survey results show that the provision of a zebra crossing was the most critical indicator at the pedestrian crossings, while drainage near crosswalks was regarded as the least important. Four indicators had a coefficient value above 4, indicating that these are very critical pedestrian crossing facilities and significantly impact the calculation of LOS for pedestrian crossings. Four crosswalks were evaluated using the proposed method in Putrajaya, Malaysia. The crosswalk at the Ministry of Domestic Trade Putrajaya got the "PCLOS A". In contrast, the midblock crossing in front of the Putrajaya Corporation was graded "PCLOS C". While the remaining two crosswalks were graded as "PCLOS B" crosswalks. Based on the assigned PCLOS grade, the proposed method could also assist in identifying current design and operation issues in existing pedestrian crossings and providing sound policy recommendations for improvements to ensure pedestrian safety.
  20. Loong TY, Chong DL, Jamal AR, Murad NA, Sabudin RZ, Fun LC
    EXCLI J, 2016;15:630-635.
    PMID: 28096792 DOI: 10.17179/excli2016-613
    Haemoglobin (Hb)-M Hyde Park, also known as Hb-M Akita is a rare type of hereditary Hb M due to autosomal dominant mutation of CAC>TAC on codon 92 of β globin gene resulting in the replacement of histidine by tyrosine on β globin chain. This variant Hb has a tendency to form methaemoglobin (metHb). The iron ion in metHb is oxidized to ferric (Fe3+) which is unable to carry oxygen and the patients manifest as cyanosis clinically. A 9-year-old Malay girl was incidentally found to be cyanotic when she presented to a health clinic. Laboratory investigations revealed raised methaemoglobin levels and Hb analysis findings were consistent with Hb-M Hyde Park. β gene sequencing confirmed a point mutation of CAC>TAC on codon 92 in one of the β genes. The family study done on the individuals with cyanosis showed similar findings. A diagnosis of heterozygous Hb-M Hyde Park was made. Patients with this variant Hb usually presented with cyanosis with mild haemolysis and maybe misdiagnosed as congenital heart disease. No further treatment is needed as patients are relatively asymptomatic. Although the disease is harmless in the heterozygous carriers but the offspring of the carriers may suffer severe haemolytic anaemia when the offspring also inherit other β haemoglobinopathies/thalassemia. This can happen due to high prevalence of β thalassemia carrier (3.5-4 %) found in Malaysia. At the time of writing, this is the first case of hereditary Hb-M Hyde Park diagnosed in a Malay family living in Malaysia.
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