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  1. Songib NA, Nazri M, Yaakup NA, Nor HM, Sun Z
    Clin Imaging, 2013 Nov-Dec;37(6):1037-42.
    PMID: 24035803 DOI: 10.1016/j.clinimag.2013.08.005
    The aim of this study is to investigate the feasibility of eliminating the nephrographic phase from the four-phase renal computed tomography (CT) imaging to a three-phase protocol without affecting its diagnostic value. Thirty patients undergoing four-phase renal CT scans for assessment of renal lesions (>10 mm) were included in the study. A three-phase renal CT, without nephrographic phase, had similar diagnostic ability to a four-phase renal CT in the detection and characterization of renal lesions. A three-phase CT (plain, corticomedullary, and excretory phase) is therefore adequate in the clinical diagnosis of renal lesions.
  2. Chai CH, Yuki N, Nor HM, Goh KJ, Shahrizaila N
    Pract Neurol, 2012 Oct;12(5):328-31.
    PMID: 22976064 DOI: 10.1136/practneurol-2011-000205
  3. Zeimaran E, Kadir MR, Nor HM, Kamarul T, Djordjevic I
    Bioorg Med Chem Lett, 2013 Dec 15;23(24):6616-9.
    PMID: 24215893 DOI: 10.1016/j.bmcl.2013.10.053
    In this study aliphatic polyacids were synthesized using palm acid oil (PAO) and sunflower oil (SFO) via addition reaction technique. The synthesized materials were characterized using Fourier-transform infra-red (FTIR) spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-ToF-MS) and thermo-gravimetric analysis (TGA). Mixing formic acid and hydrogen peroxide with PAO or SFO at the ratio 3:10:1 produced the lowest iodine value of 10.57 and 9.24 respectively, indicating the increase in epoxidization of both oils. Adding adipic acid to the epoxidized oils at a ratio of 1:10 increases the acid values of SFO and PAO to 11.22 and 6.73 respectively. The existence of multi-acid groups present in synthesized polyacid was confirmed by MALD-ToF-MS. This feature indicates a possible value to the biomaterials development.
  4. Searan WM, Abdalqader MA, Al-Goshae HA, Nor HM, Al-Shubrumi HS, Badahdah H
    PMID: 38425229 DOI: 10.1177/15347346241233236
    BACKGROUND: Diabetic foot ulcer is a serious and common complication of diabetes that often leads to significant morbidity and even amputation if not properly treated. Current treatment options, such as wound dressing, have limitations in promoting efficient healing. There is a need for effective interventions that can expedite the healing process and enhance the time required for complete healing.

    METHODOLOGY: This prospective single-blinded randomized control trial studied diabetic mellitus type 2 patients with ulcer in their second-degree feet from February 2019 to February 2023 in the Diabetic Foot Center, King Fahad Specialist Hospital Al Qassim-KSA.

    RESULTS: This study involved 120 patients with a mean age of 59.64 ± 10.21. And 63% to 52.5% of them were males and 57% to 47.5% were females. The mean healing time was about 12.76 ± 4.08 days. Cases were divided into 4 equal groups with altered treatment procedures: honey alone, hydrogel alone, honey, and hydrogel combination alternately (3 intervention groups), and fucidin ointment or cream alone (1 control group), with 30 participants in each group. We revealed that the mean healing times for honey alone, hydrogel alone, and honey and hydrogel alternately were 12.20, 13.97, and 10.83 days, respectively. While it was 14.03 days in the control Fucidin ointment or cream [significantly P 

  5. Tai ML, Nor HM, Kadir KA, Viswanathan S, Rahmat K, Zain NR, et al.
    Medicine (Baltimore), 2016 Jan;95(1):e1997.
    PMID: 26735523 DOI: 10.1097/MD.0000000000001997
    Paradoxical manifestation is worsening of pre-existing tuberculous lesion or appearance of new lesions in patients whose condition initially improved with antituberculous treatment. Our hypothesis was that paradoxical manifestation in non-HIV tuberculous meningitis (TBM) patients was underestimated and this could contribute to patients' prognosis. This was the first systemic study of paradoxical manifestation in HIV-negative TBM patients. Between 2009 and 2014, TBM patients were studied prospectively in 2 hospitals. Clinical features, cerebrospinal fluid, and radiological findings were monitored. Paradoxical manifestation was divided into definite (4 weeks or more) and probable (between 14 and 27 d) after commencement of antituberculous treatment. Forty-one non-HIV TBM patients were recruited. Definite paradoxical manifestation occurred in 23/41 (56%) of the patients. Time to onset of paradoxical manifestation was between 28 days and 9 months, and majority was between 28 and 50 days. Neuroimaging manifestation in the brain (22/41 patients, 54%) and clinical manifestation (22/41 patients, 54%) were most commonly seen, followed by cerebrospinal fluid manifestation (7/41 patients, 17%). Neuroimaging changes most commonly seen were worsening of leptomeningeal enhancement, new infarcts, new tuberculomas, and enlargement of tuberculoma. Initial Computed Tomography Angiography/magnetic resonance angiography brain showed vasculitis in 14 patients, with 2 (12.5%) showing paradoxical vasculitis during follow-up. Recurrence of the paradoxical manifestation was seen in 7/23 (30%) of the patients. More than half (14/23, 61%) of the patients improved, 6 (26%) patients died, and 3 (13%) patients had persistent neurological deficit. Paradoxical manifestation was very common in non-HIV TBM patients. Neuroimaging paradoxical manifestation of 2-4 weeks may not be paradoxical manifestation but could be delayed treatment response.
  6. Rosnah I, Noor DIZA, Asnarulkhadi AS, Fathiah J, Nor HM, Abdul KO, et al.
    Med J Malaysia, 2024 Nov;79(6):708-714.
    PMID: 39614788
    INTRODUCTION: Cardiorespiratory fitness is crucial for safe and efficient performance in executing firefighting tasks. The study aims to assess the effects of Phase 1 of a newly designed 4-week physical training regimen on changes in cardiorespiratory fitness, health parameters and other physical fitness elements. Phase 1 was crafted to primarily focus on improving firefighter recruits' cardiorespiratory fitness to prime their body for the subsequent phase of exercise.

    MATERIALS AND METHODS: A quasi-experimental study employing a one-group pre- and post-intervention was carried out involving 142 male firefighter recruits from a Fire and Rescue Academy in Malaysia. Various aspects of physical fitness changes, including speed, agility, and coordination (SAC), muscle strength, endurance, and power, were evaluated at baseline (Week 1) and upon completion of the first phase (Week 5). Changes in health parameters, such as blood pressure, resting heart rate, body weight, muscle mass, body fat percentage, and body mass index, were also assessed. A paired sample t-test was conducted with the significance level set at 0.05. The magnitude of changes was assessed using the following criteria: values of 0.3 were considered a small effect size, 0.5 indicated a moderate effect size, and 0.8 signified a large effect size.

    RESULTS: Upon completion of the first phase of the physical training regimen, there was a statistically significant improvement in cardiorespiratory fitness, with a mean increment of VO2max was 9 mL/kg/min (95% CI: 8.33, 9.58, p<0.001, large effect size of 2.40). Both pre-and postintervention assessments of abdominal and upper body muscle strength and endurance showed statistically significant improvement with the mean difference of 11 situps (95%CI: 10.08, 12.01; p<0.001, large effect size of 1.89) and 1.5 pull-ups (95%CI: 1.07, 1.86; p<0.001, moderate effect size of 0.63), respectively. Health parameters showed similar, except for systolic BP (SBP). There was a small increment in recruits' SBP following the 4-week training period with a mean difference of 4.3 mmHg (95%CI: 2.37, 6.24; effect size = 0.37, p<0.001).

    CONCLUSION: The first phase of the newly introduced fourweek physical training regimen has proven effective in enhancing cardiorespiratory fitness, as well as abdominal and upper body muscle strength and endurance. Additionally, the regimen has positively influenced several health parameters, except for systolic blood pressure. The observed increase in average systolic blood pressure indicates a necessity for continuous monitoring at the academy to address this issue effectively. confirm our findings.

  7. Tai MS, Viswanathan S, Rahmat K, Nor HM, Kadir KA, Goh KJ, et al.
    Sci Rep, 2016 12 13;6:38802.
    PMID: 27958312 DOI: 10.1038/srep38802
    Tuberculous meningitis (TBM) causes significant morbidity and mortality. The primary objective was to re-examine the concept of "TB zone" and "ischaemic zone" in cerebral infarction in patients with tuberculous meningitis. The secondary objective was to evaluate cerebral infarction, vasculitis and vasospasm in tuberculous meningitis infections. Between 2009 and 2014, TBM patients were recruited. Neuroimaging was performed and findings of cerebral infarction, vasculitis and vasospasm were recorded. Infarcts were classified based on arterial supply and Hsieh's classification. Fifty-one TBM patients were recruited of whom 34 patients (67%) had cerebral infarction. Based on Hsieh's classification, 20 patients (59%) had infarcts in both "TB zone" and "ischaemic zones". 12 patients (35%) had infarcts in "ischaemic zone" and two (6%) patients had infarcts in "TB zone". In terms of vascular supply, almost all patients (35/36) had infarcts involving perforators and cortical branches. 25 patients (73%) and 14 patients (41%) had infarcts supplied by lateral lenticulostriate and medial lenticulostriate arteries respectively. 15 patients (37%) had vasculitis. Vasospasm was present in six patients (15%). 29 patients (85%) with cerebral infarction also had leptomeningeal enhancement (p = 0.002). In summary, infarcts involved mainly perforators and cortical branches, rather than "TB zone" versus "ischaemic zone".
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