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  1. Planned complex suicide: self-strangulation and fall from height
    Nor FM, Das S
    J Forensic Leg Med, 2011 Oct;18(7):336-9.
    PMID: 21907941 DOI: 10.1016/j.jflm.2011.06.013
    We hereby present a case of planned complex suicide. In this case study, we report a teen-aged girl who committed suicide by strangulating herself, and subsequently fell from the 13th floor of a housing apartment. The planned complex suicide was substantiated by the presence of a suicide note and a photograph captured in a mobile handset. To the best of our knowledge, it is the first case involving self-strangulation and fall from height, in which the photograph was stored in the handset. This is to further emphasize that objects like mobile handsets can be important in determining the cause and manner of death. The available evidence at the site of incident should be explored meticulously in order to arrive at a proper conclusion.
  2. Age at death estimation from bone histology in Malaysian males
    Nor FM, Pastor RF, Schutkowski H
    Med Sci Law, 2014 Oct;54(4):203-8.
    PMID: 24189643 DOI: 10.1177/0025802413506573
    Estimation of age from microscopic examination of human bone utilizes bone remodeling. This allows 2 regression equation to be determined in a specific population based on the variation in osteon turnover in different populations. The aim of this study was to provide age estimation for Malaysian males. Ground undecalcified cross sections were prepared from long limb bones of 50 deceased males aged between 21 and 78 years. Ten microstructural parameters were measured and subjected to multivariate regression analysis. Results showed that osteon count had the highest correlation with age (R = 0.43), and age was estimated to be within 10.94 years of the true value in 98% of males. Cross validation of the equation on 50 individuals showed close correspondence of true ages with estimated ages. Further studies are needed to validate and expand these results.
  3. Antioxidative properties of Murraya koenigii leaf extracts in accelerated oxidation and deep-frying studies
    Nor FM, Suhaila M, Aini IN, Razali I
    Int J Food Sci Nutr, 2009;60 Suppl 2:1-11.
    PMID: 19488917 DOI: 10.1080/09637480802158168
    Murraya koenigii leaf extract antioxidant potentials were evaluated in palm olein using accelerated oxidation storage and deep-frying studies at 180 degrees C for up to 40 h. The extracts (0.2%) retarded oil oxidation and deterioration significantly (P<0.05), slightly less effectively than 0.02% butylated hydroxytoluene in tests such as the peroxide value, anisidine value, iodine value, free fatty acid, Oxidative Stability Index, and polar and polymer compound content. Sensory evaluation on French fries indicated that the extract was useful in improving colour, flavour and overall acceptability and the quality of the fried product. All samples were more acceptable by panellists, especially after the 40th hour frying, compared with those similarly fried in the control oils and the oil containing butylated hydroxytoluene. M. koenigii leaf extract, had a polyphenol content of 109.5+/-0.3 mg gallic acid equivalents/g extract, and contain a heat-stable antioxidant that could be a natural alternative to synthetic antioxidants for the industry.
  4. Antioxidative properties of Pandanus amaryllifolius leaf extracts in accelerated oxidation and deep frying studies
    Nor FM, Mohamed S, Idris NA, Ismail R
    Food Chem, 2008 Sep 15;110(2):319-27.
    PMID: 26049222 DOI: 10.1016/j.foodchem.2008.02.004
    The potential uses of Pandanus amaryllifolius leaf extract as a natural antioxidant were evaluated in refined, bleached and deodorized (RBD) palm olein, using accelerated oxidation and deep frying studies at 180°C from 0 to 40h. The extracts (optimum concentration 0.2%) significantly retarded oil oxidation and deterioration (P<0.05), comparably to 0.02% BHT in tests such as peroxide value, anisidine value, iodine value, free fatty acid, oxidative stability index (OSI), polar and polymer compound contents. In sensory evaluation studies, different batches of French fries were not significantly different (P<0.05) from one another for oiliness, crispiness, taste and overall acceptability when the same oil was used for up to the 40th hour of frying. P. amaryllifolius leaf extract, which had a polyphenol content of 102mg/g, exhibited an excellent heat-stable antioxidant property and may be a good natural alternative to existing synthetic antioxidants in the food industry.
  5. Establishment of Reference Ranges for Normal Organ Weights in Malaysian Adults at Autopsy
    Jothee S, Shafie MS, Vijayaretnam SV, Nor FM
    Am J Forensic Med Pathol, 2020 Jun;41(2):110-114.
    PMID: 32205487 DOI: 10.1097/PAF.0000000000000539
    Organ weights are routinely measured during autopsies as a crude screening tool to detect possible organ pathology. In several centers, inclusion of major organ weights indicates whether an autopsy report has achieved its standard of practice, which in turn should be subjected to an audit. Previous studies show statistical variation in organ weights across different populations. Malaysian pathologists have relied on Western data and crude subjective determination in the interpretation of normal organ weights. Hence, the need for a reference range as a guide for pathologists is acute. Organ weights from traumatic deaths between 2004 and 2017 were analyzed in the UKM Medical Centre. Statistical analysis was performed to form reference ranges for normal weights of the brain, heart, lung, liver, spleen, and kidneys. In addition, the data were compared between sexes, races, and body mass index values to determine whether organ weights were affected by these parameters. In this study, reference ranges for organ weights are presented for Malaysian adult men and women.
  6. Fulltext Effects of Starter Defect on Energy Release Rate of Three-Point End-Notch Flexure Tested Unidirectional Carbon Fiber Reinforced Polymer Composite
    Nor FM, Lim JY, Tamin MN, Lee HY, Kurniawan D
    Polymers (Basel), 2020 Apr 14;12(4).
    PMID: 32295111 DOI: 10.3390/polym12040904
    The mechanics of damage and fracture process in unidirectional carbon fiber reinforced polymer (CFRP) composites subjected to shear loading (Mode II) were examined using the experimental method of the three-point end-notch flexure (3ENF) test. The CFRP composite consists of [0o]16 with an insert film in the middle plane for a starter defect. A 3ENF test sample with a span of 50 mm and interface delamination crack length of 12.5 mm was tested to yield the load vs. deformation response. A sudden load drop observed at maximum force value indicates the onset of delamination crack propagation. The results are used to extract the energy release rate, GIIC, of the laminates with an insert film starter defect. The effect of the starter defect on the magnitude of GIIC was examined using the CFRP composite sample with a Mode II delamination pre-crack. The higher magnitude of GIIC for the sample with insert film starter defect was attributed to the initial straight geometry of the notch/interface crack and the toughness of the resin at the notch front of the fabricated film insert. The fractured sample was examined using a micro-computerized tomography scanner to establish the shape of the internal delamination crack front. Results revealed that the interface delamination propagated in a non-uniform manner, leaving a curved-shaped crack profile.
  7. The Pattern of Injuries Among Motorcyclists in Fatal Road Traffic Accidents: An Autopsy-Based Study
    Mohd Saman SA, Jothee S, Nor FM, Shafie MS
    Am J Forensic Med Pathol, 2021 Jun 01;42(2):141-146.
    PMID: 33346978 DOI: 10.1097/PAF.0000000000000639
    INTRODUCTION: In recent years, there has been a significant increase in mortality among motorcyclists, which warrants a need to analyze the epidemiology and pattern of injuries among road users in Malaysia. Hence, prioritizing road safety in the government policy by implementing targeted actions is justified to reduce injury and fatality.

    MATERIALS AND METHODS: Cases of road accident deaths in motorcyclists received by UKM Medical Centre were studied over a period of 10 years, that is, between 2010 and 2019. This study was based on forensic autopsy records database and forensic autopsy.

    RESULTS: The most affected age group by road fatalities were young men. The most common injuries were intracranial hemorrhage (74%), thoracic hemorrhage (73%), and lung laceration (85.7%). About 39 (31%) fatally injured riders were positive for illicit drug and/or alcohol.

    CONCLUSIONS: This study showed that men in the third decade of life are the major victims of motorcycle fatalities. Hence, urgent measures are necessary to establish road safety policy to reduce such fatalities.

  8. Estimation of stature by using lower limb dimensions in the Malaysian population
    Nor FM, Abdullah N, Mustapa AM, Qi Wen L, Faisal NA, Ahmad Nazari DA
    J Forensic Leg Med, 2013 Nov;20(8):947-52.
    PMID: 24237796 DOI: 10.1016/j.jflm.2013.09.006
    Estimation of stature is an important step in developing a biological profile for human identification. It may provide a valuable indicator for an unknown individual in a population. The aim of this study was to analyse the relationship between stature and lower limb dimensions in the Malaysian population. The sample comprised 100 corpses, which included 69 males and 31 females between the age range of 20-90 years old. The parameters measured were stature, thigh length, lower leg length, leg length, foot length, foot height and foot breadth. Results showed that the mean values in males were significantly higher than those in females (p 
  9. Fulltext Efficacy of chitosan derivative films versus hydrocolloid dressing on superficial wounds
    Halim AS, Nor FM, Mat Saad AZ, Mohd Nasir NA, Norsa'adah B, Ujang Z
    J Taibah Univ Med Sci, 2018 Dec;13(6):512-520.
    PMID: 31435371 DOI: 10.1016/j.jtumed.2018.10.004
    Objectives: Chitosan, the N-deacetylated derivative of chitin, has useful biological properties that promote haemostasis, analgesia, wound healing, and scar reduction; chitosan is bacteriostatic, biocompatible, and biodegradable. This study determined the efficacy of chitosan derivative film as a superficial wound dressing.

    Methods: This multicentre randomised controlled trial included 244 patients, of whom 86 were treated with chitosan derivative film and 84 with hydrocolloid. The percentage of epithelisation, as well as patient comfort, clinical signs, and patient convenience in application and removal of the dressings were assessed.

    Results: The primary outcome of this study was the percentage of epithelisation. Except for race (p = 0.04), there were no significant differences between groups in sex, age, antibiotic usage, or initial wound size (p > 0.05). There was no significant difference in the mean epithelisation percentage between groups (p = 0.29). Patients using chitosan derivative film experienced more pain during removal of dressing than those in the hydrocolloid group (p = 0.007). The chitosan derivative film group showed less exudate (p = 0.036) and less odour (p = 0.024) than the control group. Furthermore, there were no significant differences between groups in terms of adherence, ease of removal, wound drainage, erythema, itchiness, pain, and tenderness. No oedema or localised warmth was observed during the study.

    Conclusion: This study concluded that chitosan derivative film is equivalent to hydrocolloid dressing and can be an option in the management of superficial and abrasion wounds.

    Clinical trial No: NMRR-11-948-10565.

  10. Accuracy and reliability of virtual femur measurement from CT scan
    Ismail NA, Abdullah N, Mohamad Noor MH, Lai PS, Shafie MS, Nor FM
    J Forensic Leg Med, 2019 Apr;63:11-17.
    PMID: 30825771 DOI: 10.1016/j.jflm.2019.02.010
    BACKGROUND: In the application of scientific human skeletal variation in medico-legal matters, virtual anthropology is the current technique performed to examine skeleton and its body parts. Hence, this study was conducted to assess the accuracy and reliability of virtual femur measurement through intra and inter-observer error analysis, and comparison was made between the virtual and conventional methods.

    METHODS: A total of 15 femora were examined with four parameters i.e. maximum length of femur (FeMl), diameter of femoral head (FeHd), transverse diameter of midshaft (FeMd) and condylar breadth (FeCb). Osteometric board and vernier calipers were employed for the conventional method, while CT reconstructed images and Osirix MD software was utilised for the virtual method.

    RESULTS: Results exhibited that there were no significant differences in the measurements by conventional and virtual methods. There were also no significant differences in the measurements by the intra or inter-observer error analyses. The intraclass correlation coefficients (ICC) were more than 0.95 by both intra and inter-observer error analyses. Technical error of measurement had displayed values within the acceptable ranges (rTEM <0.08 for intra-observer, <2.25 for inter-observer), and coefficient of reliability (R) indicated small measurement errors (R > 0.95 for intra-observer, R > 0.92 for inter-observer). By parameters, FeMl showed the highest R value (0.99) with the least error in different methods and observers (rTEM = 0.02-0.41%). Bland and Altman plots revealed points scattered close to zero indicating perfect agreement by both virtual and conventional methods. The mean differences for FeMl, FeHd, FeMd and FeCb measurements were 0.01 cm, -0.01 cm, 0.02 cm and 0.01 cm, respectively.

    CONCLUSION: This brought to suggest that bone measurement by virtual method was highly accurate and reliable as in the conventional method. It is recommended for implementation in the future anthropological studies especially in countries with limited skeletal collection.

  11. Fulltext Sex estimation using subpubic angle from reconstructed three-dimensional computed tomography pelvic model in a contemporary Malaysian population
    Mohd Ali SH, Omar N, Shafie MS, Nik Ismail NA, Hadi H, Nor FM
    Anat Cell Biol, 2020 Mar;53(1):27-35.
    PMID: 32274246 DOI: 10.5115/acb.19.135
    Research in forensic anthropology is recent in Malaysia due to limited access to documented skeletal collections. However, advanced imaging techniques provide virtual bone samples for use in morphometric studies to establish population-specific standards by virtual anthropology. This study examined sexual dimorphism in the subpubic angle using a three-dimensional computed tomography model of the pelvis, in a contemporary Malaysian population. The sample comprised multidetector computed tomography (MDCT) scans of 50 male and 50 female adults. Segmentation of the MDCT scans was performed using 3D Slicer, and four landmarks were acquired using Stratovan Checkpoint for the subpubic angle measurement. The technical error of measurement (TEM), relative TEM, and coefficient of reliability (R) exhibited high reliability in measurements. Results showed that the subpubic angle in males was 68.6°±7.6° and in females 87.4°±6.5°. The subpubic angle in females was significantly larger than in males (P<0.001). Inverse correlation was found between the subpubic angle and age, in both males (r=-0.449, P<0.01) and females (r=-0.385, P<0.01). The overall accuracy of sex estimation using the subpubic angle was 94% (P<0.001). The subpubic angle, with a demarcating point of 78.6°, showed a sensitivity and specificity of 94% in the classification of female individuals. In conclusion, sex estimation using the subpu bic angle is highly accurate, with a high degree of expected sensitivity and specificity in the Malaysian population.
  12. Fulltext Study of sexual dimorphism of Malaysian crania: an important step in identification of the skeletal remains
    Ibrahim A, Alias A, Nor FM, Swarhib M, Abu Bakar SN, Das S
    Anat Cell Biol, 2017 Jun;50(2):86-92.
    PMID: 28713610 DOI: 10.5115/acb.2017.50.2.86
    Sex determination is one of the main steps in the identification of human skeletal remains. It constitutes an initial step in personal identification from the skeletal remains. The aim of the present study was to provide the population-specific sex discriminating osteometric standards to aid human identification. The present study was conducted on 87 (174 sides) slices of crania using postmortem computed tomography in 45 males and 42 females, aged between 18 and 75 years. About 22 parameters of crania were measured using Osirix software 3-D Volume Rendering. Results showed that all parameters were significantly higher in males than in females except for orbital height of the left eye by independent t test (P<0.01). By discriminant analysis, the classification accuracy was 85.1%, and by regression, the classification accuracy ranged from 78.2% to 86.2%. In conclusion, cranium can be used to distinguish between males and females in the Malaysian population. The results of the present study can be used as a forensic tool for identification of unknown crania.
  13. Fulltext Erratum: Study of sexual dimorphism of Malaysian crania: an important step in identification of the skeletal remains
    Ibrahim A, Alias A, Nor FM, Swarhib M, Abu Bakar SN, Das S, et al.
    Anat Cell Biol, 2019 Jun;52(2):219.
    PMID: 31338243 DOI: 10.5115/acb.2019.52.2.219
    [This corrects the article on p. 86 in vol. 50, PMID: 28713610.].
  14. A Prospective Multicenter Randomized Controlled Trial to Evaluate the Efficacy of Chitosan Hydrogel Paste in Comparison to Commercial Hydroactive Gel as a Wound Bed Preparation
    Nasir NAM, Saad AZM, Bachok NS, Rashid AHA, Ujang Z, Noorsal K, et al.
    Indian J Plast Surg, 2023 Feb;56(1):44-52.
    PMID: 36998939 DOI: 10.1055/s-0042-1759503
    Background  This clinical trial aimed to evaluate the clinical efficacy of chitosan derivative hydrogel paste (CDHP) as a wound bed preparation for wounds with cavities. Methods  This study enrolled 287 patients, with 143 patients randomized into the CDHP group (treatment) and 144 patients randomized into the commercial hydroactive gel (CHG) group (control). The granulation tissue, necrotic tissue, patient comfort, clinical signs, symptoms, and patient convenience during the application and removal of the dressing were assessed. Results  The study was completed by 111 and 105 patients from the treatment and control groups, respectively. Both groups showed an increasing mean percentage of wound granulation over time when the initial wound size and comorbidity were adjusted (F(10,198) = 4.61; p  
  15. Fulltext Increased risks of cardiovascular diseases and insulin resistance among the Orang Asli in Peninsular Malaysia
    Tuan Abdul Aziz TA, Teh LK, Md Idris MH, Bannur Z, Ashari LS, Ismail AI, et al.
    BMC Public Health, 2016;16(1):284.
    PMID: 27009064 DOI: 10.1186/s12889-016-2848-9
    Despite the strategic development plan by the authorities for the Orang Asli, there are six subtribes of which their population numbers are small (less than 700). These minorities were not included in most of the health related studies published thus far. A comprehensive physiological and biomedical updates on these small subtribes in comparison to the larger subtribes and the urban Malay population is timely and important to help provide appropriate measures to prevent further reduction in the numbers of the Orang Asli.
  16. Fulltext Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction
    Rashidbenam Z, Jasman MH, Hafez P, Tan GH, Goh EH, Fam XI, et al.
    Tissue Eng Regen Med, 2019 08;16(4):365-384.
    PMID: 31413941 DOI: 10.1007/s13770-019-00193-z
    BACKGROUND: Urinary tract is subjected to a variety of disorders such as urethral stricture, which often develops as a result of scarring process. Urethral stricture can be treated by urethral dilation and urethrotomy; but in cases of long urethral strictures, substitution urethroplasty with genital skin and buccal mucosa grafts is the only option. However a number of complications such as infection as a result of hair growth in neo-urethra, and stone formation restrict the application of those grafts. Therefore, tissue engineering techniques recently emerged as an alternative approach, aiming to overcome those restrictions. The aim of this review is to provide a comprehensive coverage on the strategies employed and the translational status of urethral tissue engineering over the past years and to propose a combinatory strategy for the future of urethral tissue engineering.

    METHODs: Data collection was based on the key articles published in English language in years between 2006 and 2018 using the searching terms of urethral stricture and tissue engineering on PubMed database.

    RESULTS: Differentiation of mesenchymal stem cells into urothelial and smooth muscle cells to be used for urologic application does not offer any advantage over autologous urothelial and smooth muscle cells. Among studied scaffolds, synthetic scaffolds with proper porosity and mechanical strength is the best option to be used for urethral tissue engineering.

    CONCLUSION: Hypoxia-preconditioned mesenchymal stem cells in combination with autologous cells seeded on a pre-vascularized synthetic and biodegradable scaffold can be said to be the best combinatory strategy in engineering of human urethra.

  17. Fulltext Fabrication of Adipose-Derived Stem Cell-Based Self-Assembled Scaffold under Hypoxia and Mechanical Stimulation for Urethral Tissue Engineering
    Rashidbenam Z, Jasman MH, Tan GH, Goh EH, Fam XI, Ho CCK, et al.
    Int J Mol Sci, 2021 Mar 25;22(7).
    PMID: 33805910 DOI: 10.3390/ijms22073350
    Long urethral strictures are often treated with autologous genital skin and buccal mucosa grafts; however, risk of hair ingrowth and donor site morbidity, restrict their application. To overcome this, we introduced a tissue-engineered human urethra comprising adipose-derived stem cell (ASC)-based self-assembled scaffold, human urothelial cells (UCs) and smooth muscle cells (SMCs). ASCs were cultured with ascorbic acid to stimulate extracellular matrix (ECM) production. The scaffold (ECM) was stained with collagen type-I antibody and the thickness was measured under a confocal microscope. Results showed that the thickest scaffold (28.06 ± 0.59 μm) was achieved with 3 × 104 cells/cm2 seeding density, 100 μg/mL ascorbic acid concentration under hypoxic and dynamic culture condition. The biocompatibility assessment showed that UCs and SMCs seeded on the scaffold could proliferate and maintain the expression of their markers (CK7, CK20, UPIa, and UPII) and (α-SMA, MHC and Smootheline), respectively, after 14 days of in vitro culture. ECM gene expression analysis showed that the ASC and dermal fibroblast-based scaffolds (control) were comparable. The ASC-based scaffold can be handled and removed from the plate. This suggests that multiple layers of scaffold can be stacked to form the urothelium (seeded with UCs), submucosal layer (ASCs only), and smooth muscle layer (seeded with SMCs) and has the potential to be developed into a fully functional human urethra for urethral reconstructive surgeries.
  18. Differential positive selection of malaria resistance genes in three indigenous populations of Peninsular Malaysia
    Liu X, Yunus Y, Lu D, Aghakhanian F, Saw WY, Deng L, et al.
    Hum Genet, 2015 Apr;134(4):375-92.
    PMID: 25634076 DOI: 10.1007/s00439-014-1525-2
    The indigenous populations from Peninsular Malaysia, locally known as Orang Asli, continue to adopt an agro-subsistence nomadic lifestyle, residing primarily within natural jungle habitats. Leading a hunter-gatherer lifestyle in a tropical jungle environment, the Orang Asli are routinely exposed to malaria. Here we surveyed the genetic architecture of individuals from four Orang Asli tribes with high-density genotyping across more than 2.5 million polymorphisms. These tribes reside in different geographical locations in Peninsular Malaysia and belong to three main ethno-linguistic groups, where there is minimal interaction between the tribes. We first dissect the genetic diversity and admixture between the tribes and with neighboring urban populations. Later, by implementing five metrics, we investigated the genome-wide signatures for positive natural selection of these Orang Asli, respectively. Finally, we searched for evidence of genomic adaptation to the pressure of malaria infection. We observed that different evolutionary responses might have emerged in the different Orang Asli communities to mitigate malaria infection.
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