MyMedR

3 Tesla magnetic resonance imaging noise in standard head and neck sequence does not cause temporary threshold shift in high frequency

Lim EY, Tang IP, Peyman M, Ramli N, Narayanan P, Rajagopalan R

Eur Arch Otorhinolaryngol, 2015 Nov;272(11):3109-13.

PMID: 25205300 DOI: 10.1007/s00405-014-3232-y

High acoustic noise level is one of the unavoidable side effects of 3 T magnetic resonance imaging (MRI). A case of hearing loss after 3 T MRI has been reported in this institution and hence this study. The objective of this study was to determine whether temporary threshold shift (TTS) in high frequency hearing occurs in patients undergoing 3 T MRI scans of the head and neck. A total of 35 patients undergoing head and neck 3 T MRI for various clinical indications were tested with pure tone audiometry in different frequencies including high frequencies, before and after the MRI scan. Any threshold change from the recorded baseline of 10 dB was considered significant. All patients were fitted with foamed 3 M earplugs before the procedure following the safety guidelines for 3 T MRI. The mean time for MRI procedure was 1,672 s (range 1,040-2,810). The noise dose received by each patient amounted to an average of 3,906.29% (1,415-9,170%). The noise dose was derived from a normograph used by Occupational Noise Surveys. This was calculated using the nomograph of L eq, L EX, noise dose and time. There was no statistically significant difference between the hearing threshold before and after the MRI procedures for all the frequencies (paired t test, P > 0.05). For patients using 3 M foamed earplugs, noise level generated by 3 T MRI during routine clinical sequence did not cause any TTS in high frequency hearing.

Fulltext A Case Report of Dengue-Associated Maculopathy With Literature Review

Govinda Raju D, Ramli N, Ramayaj R

Cureus, 2023 Mar;15(3):e35937.

PMID: 37038576 DOI: 10.7759/cureus.35937

We report a case of dengue-associated maculopathy in a healthy adult. A 31-year-old lady with dengue fever presented with both eye sudden, painless blurry vision in the left eye. On examination, the best-corrected visual acuity was 6/18 in her right eye and 2/60 in her left eye. Anterior segment examination was unremarkable. Fundi showed bilateral macula edema with cotton wool spots. Optical coherence tomography (OCT) macula scan was suggestive of bilateral macula edema, with higher severity in the left eye. She was started on intravenous methylprednisolone 500mg once daily for three days. Upon completion of steroids, her right eye visual acuity improved to 6/6 however her left eye vision worsened to 3/60 after six months. Her OCT six months later showed resolved macula edema on both eyes. Ocular manifestation associated with dengue fever is rare but may result in permanent visual impairment. The use of high-dose steroids helps in improving visual acuity.

Fulltext A Hot Cross Bun sign from diffusion tensor imaging and tractography perspective

Loh KB, Rahmat K, Lim SY, Ramli N

Neurol India, 2011 Mar-Apr;59(2):266-9.

PMID: 21483130 DOI: 10.4103/0028-3886.79143

A "Hot Cross Bun" sign on T2-weighted MRI was described as a result of selective loss of myelinated transverse pontocerebellar fibers and neurons in the pontine raphe with preservation of the pontine tegmentum and corticospinal tracts (CST). However, neuropathologic studies showed contradicting results with no sparing of the CST. This is a pictorial and quantitative demonstration of the sign on diffusion tensor imaging and tractography, which provides the imaging evidence that is consistent with neuropathologic findings.

Fulltext A Patient with Beta-Propeller Protein-Associated Neurodegeneration: Treatment with Iron Chelation Therapy

Lim SY, Tan AH, Ahmad-Annuar A, Schneider SA, Bee PC, Lim JL, et al.

J Mov Disord, 2018 May;11(2):89-92.

PMID: 29860786 DOI: 10.14802/jmd.17082

We present a case of beta-propeller protein-associated neurodegeneration, a form of neurodegeneration with brain iron accumulation. The patient harbored a novel mutation in the WDR45 gene. A detailed video and description of her clinical condition are provided. Her movement disorder phenomenology was characterized primarily by limb stereotypies and gait dyspraxia. The patient's disability was advanced by the time iron-chelating therapy with deferiprone was initiated, and no clinical response in terms of cognitive function, behavior, speech, or movements were observed after one year of treatment.

A Rare but Disabling Stroke

Lau KF, Tan KS, Goh KJ, Ramli N, Tai SM

Ann Acad Med Singap, 2019 Mar;48(3):109-111.

PMID: 30997481

Fulltext A child with atypical teratoid/rhabdoid tumour of the posterior cranial fossa

Rahmat K, Kua CH, Ramli N

Singapore Med J, 2008 Dec;49(12):e365-8.

PMID: 19122937

Primary central nervous system (CNS) atypical teratoid/rhabdoid tumours (ATRT) are highly malignant neoplasms which usually present in infancy or early childhood. Although ATRT may arise anywhere within the CNS, the majority (approximately two-thirds) arise in the cerebellum or posterior fossa, and the remainder in the cerebrum. We described the imaging characteristics of CNS ATRT in the posterior cranial fossa of a 14-month-old boy.

A decision tree for differentiating multiple system atrophy from Parkinson's disease using 3-T MR imaging

Nair SR, Tan LK, Mohd Ramli N, Lim SY, Rahmat K, Mohd Nor H

Eur Radiol, 2013 Jun;23(6):1459-66.

PMID: 23300042 DOI: 10.1007/s00330-012-2759-9

OBJECTIVE: To develop a decision tree based on standard magnetic resonance imaging (MRI) and diffusion tensor imaging to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD).

METHODS: 3-T brain MRI and DTI (diffusion tensor imaging) were performed on 26 PD and 13 MSA patients. Regions of interest (ROIs) were the putamen, substantia nigra, pons, middle cerebellar peduncles (MCP) and cerebellum. Linear, volumetry and DTI (fractional anisotropy and mean diffusivity) were measured. A three-node decision tree was formulated, with design goals being 100 % specificity at node 1, 100 % sensitivity at node 2 and highest combined sensitivity and specificity at node 3.

RESULTS: Nine parameters (mean width, fractional anisotropy (FA) and mean diffusivity (MD) of MCP; anteroposterior diameter of pons; cerebellar FA and volume; pons and mean putamen volume; mean FA substantia nigra compacta-rostral) showed statistically significant (P < 0.05) differences between MSA and PD with mean MCP width, anteroposterior diameter of pons and mean FA MCP chosen for the decision tree. Threshold values were 14.6 mm, 21.8 mm and 0.55, respectively. Overall performance of the decision tree was 92 % sensitivity, 96 % specificity, 92 % PPV and 96 % NPV. Twelve out of 13 MSA patients were accurately classified.

CONCLUSION: Formation of the decision tree using these parameters was both descriptive and predictive in differentiating between MSA and PD.

KEY POINTS: • Parkinson's disease and multiple system atrophy can be distinguished on MR imaging. • Combined conventional MRI and diffusion tensor imaging improves the accuracy of diagnosis. • A decision tree is descriptive and predictive in differentiating between clinical entities. • A decision tree can reliably differentiate Parkinson's disease from multiple system atrophy.

A one-step self-sustained low temperature carbonization of coconut shell biomass produced a high specific surface area biochar-derived nano-adsorbent

Samsudin MH, Hassan MA, Idris J, Ramli N, Mohd Yusoff MZ, Ibrahim I, et al.

Waste Manag Res, 2019 May;37(5):551-555.

PMID: 30727859 DOI: 10.1177/0734242X18823953

A one-step self-sustained carbonization of coconut shell biomass, carried out in a brick reactor at a relatively low temperature of 300-500°C, successfully produced a biochar-derived adsorbent with 308 m2/g surface area, 2 nm pore diameter, and 0.15 cm3/g total pore volume. The coconut shell biochar qualifies as a nano-adsorbent, supported by scanning electron microscope images, which showed well-developed nano-pores on the surface of the biochar structure, even though there was no separate activation process. This is the first report whereby coconut shell can be converted to biochar-derived nano-adsorbent at a low carbonization temperature, without the need of the activation process. This is superior to previous reports on biochar produced from oil palm empty fruit bunch.

Fulltext A psychologist-led educational intervention results in a sustained reduction in neonatal intensive care unit infections

Van Rostenberghe H, Short J, Ramli N, Geok TB, Subramaniam S, Che Yaakob CA, et al.

Front Pediatr, 2014;2:115.

PMID: 25478550 DOI: 10.3389/fped.2014.00115

Even though in the corporate world psychological science has been widely used, the formal use of evidence-based psychology in important areas of clinical medicine has been scanty at best. It was the aim of this study to determine the efficacy of a psychologist-led 2-week nurse educator training on the infection rate in the neonatal intensive care unit (NICU).

Fulltext A review of the discussions on cultivated meat from the Islamic perspective

Hamdan MN, Abdul Jalil R, Ramli MA, Ramli N, Ibrahim MNA, Ab Rahman MF, et al.

Heliyon, 2024 Apr 15;10(7):e28491.

PMID: 38601623 DOI: 10.1016/j.heliyon.2024.e28491

Since the introduction of the cultivated meat burger in 2013, numerous discussions have transpired between researchers and consumers, manifesting in various forms such as academic publications, opinions on personal websites and interactions on social platforms. For Muslim consumers, a primary concern revolves around the halal status of cultivated meat, given the pivotal role of adhering to a halal diet as a divine obligation in their lives. Therefore, this article seeks to systematically review the existing literature on cultivated meat from an Islamic perspective as articulated by Muslim scholars, whether these perspectives are issued by an established fatwa organisation or representations of personal views. The sources incorporated into this analysis span from academic publications, newspaper articles, fatwa bodies, personal websites and interviews. Employing thematic analysis, five principal themes were discerned within the discourse among Muslim scholars regarding cultivated meat: (i) the ontological status of cultivated meat, (ii) the status and source of stem cells used in the cultivation process, (iii) the theological implications of cultivated meat production on altering God's creation, (iv) foundational principles for halal cultivated meat production, and (v) the contemporary necessity of cultivated meat from the perspective of al-maqasid al-shariah. It is duly recommended that international fatwa organisations such as the International Islamic Fiqh Academy (IIFA) engage in discussions and deliberations on this matter of growing significance within the food industry. The fatwas and resolutions issued by IIFA are frequently cited as the most recognised authority in many Islamic countries.

A study on the age at menopause and menopausal symptoms among Malaysian women

Arshat H, Tey NP, Ramli N

Malays J Reprod Health, 1989 Jun;7(1):1-9.

PMID: 12342395

A viable secondary intra-abdominal pregnancy resulting from rupture of uterine scar: role of MRI

Teng HC, Kumar G, Ramli NM

Br J Radiol, 2007 Jul;80(955):e134-6.

PMID: 17704308

Pre-natal diagnosis of intra-abdominal pregnancy is difficult. Ultrasound has been the frontline modality to date; however, it gives a diagnostic error of 50-90% and its use is disappointing. In recent years, MRI has emerged as an appealing imaging modality. With its good soft tissue contrast and non-ionizing property, it acts as a means of definitive non-invasive assessment before surgical intervention when ultrasound is inconclusive.

Adult-onset neuronal intranuclear inclusion disease mimicking Fragile X-associated tremor-ataxia syndrome in ethnic Chinese patients

Lim SY, Ishiura H, Ramli N, Shibata S, Almansour MA, Tan AH, et al.

Parkinsonism Relat Disord, 2020 05;74:25-27.

PMID: 32289521 DOI: 10.1016/j.parkreldis.2020.03.025

Two ethnic Chinese men with clinico-radiologic features of Fragile X-associated tremor-ataxia syndrome (FXTAS) were found on genetic testing to have neuronal intranuclear inclusion disease (NIID), highlighting that NIID should be considered in the differential diagnosis of FXTAS. NIID may also be much more common than FXTAS in certain Asian populations.

Fulltext Alternating Hemiplegia of Childhood in a Person of Malay Ethnicity with Diffusion Tensor Imaging Abnormalities

Tan AH, Ong TL, Ramli N, Tan LK, Lim JL, Azhan MA, et al.

J Mov Disord, 2019 May;12(2):132-134.

PMID: 31158946 DOI: 10.14802/jmd.18063

Fulltext Antimalarial activity of Malaysian Plectranthus amboinicus against Plasmodium berghei

Ramli N, Ahamed PO, Elhady HM, Taher M

Pharmacognosy Res, 2014 Oct;6(4):280-4.

PMID: 25276063 DOI: 10.4103/0974-8490.138248

Malaria is a mosquito-borne disease caused by parasitic protozoa from the genus of Plasmodium. The protozoans have developed resistance against many of current drugs. It is urgent to find an alternative source of new antimalarial agent. In the effort to discover new antimalarial agents, this research has been conducted on Plectranthus amboinicus.

Fulltext Application of receptor models on water quality data in source apportionment in Kuantan River Basin

Nasir MF, Zali MA, Juahir H, Hussain H, Zain SM, Ramli N

Iranian J Environ Health Sci Eng, 2012 Dec 10;9(1):18.

PMID: 23369363 DOI: 10.1186/1735-2746-9-18

Recent techniques in the management of surface river water have been expanding the demand on the method that can provide more representative of multivariate data set. A proper technique of the architecture of artificial neural network (ANN) model and multiple linear regression (MLR) provides an advance tool for surface water modeling and forecasting. The development of receptor model was applied in order to determine the major sources of pollutants at Kuantan River Basin, Malaysia. Thirteen water quality parameters were used in principal component analysis (PCA) and new variables of fertilizer waste, surface runoff, anthropogenic input, chemical and mineral changes and erosion are successfully developed for modeling purposes. Two models were compared in terms of efficiency and goodness-of-fit for water quality index (WQI) prediction. The results show that APCS-ANN model gives better performance with high R2 value (0.9680) and small root mean square error (RMSE) value (2.6409) compared to APCS-MLR model. Meanwhile from the sensitivity analysis, fertilizer waste acts as the dominant pollutant contributor (59.82%) to the basin studied followed by anthropogenic input (22.48%), surface runoff (13.42%), erosion (2.33%) and lastly chemical and mineral changes (1.95%). Thus, this study concluded that receptor modeling of APCS-ANN can be used to solve various constraints in environmental problem that exist between water distribution variables toward appropriate water quality management.

Assessing changes in microstructural integrity of white matter tracts in children with leukaemia following exposure to chemotherapy

Ramli N, Lim CH, Rajagopal R, Tan LK, Seow P, Ariffin H

Pediatr Radiol, 2020 08;50(9):1277-1283.

PMID: 32591982 DOI: 10.1007/s00247-020-04717-x

BACKGROUND: Intrathecal and intravenous chemotherapy, specifically methotrexate, might contribute to neural microstructural damage.

OBJECTIVE: To assess, by diffusion tensor imaging, microstructural integrity of white matter in paediatric patients with acute lymphoblastic leukaemia (ALL) following intrathecal and intravenous chemotherapy.

MATERIALS AND METHODS: Eleven children diagnosed with de novo ALL underwent MRI scans of the brain with diffusion tensor imaging (DTI) prior to commencement of chemotherapy and at 12 months after diagnosis, using a 3-tesla (T) MRI scanner. We investigated the changes in DTI parameters in white matter tracts before and after chemotherapy using tract-based spatial statistics overlaid on the International Consortium of Brain Mapping DTI-81 atlas. All of the children underwent formal neurodevelopmental assessment at the two study time points.

RESULTS: Whole-brain DTI analysis showed significant changes between the two time points, affecting several white matter tracts. The tracts demonstrated longitudinal changes of decreasing mean and radial diffusivity. The neurodevelopment of the children was near compatible for age at the end of ALL treatment.

CONCLUSION: The quantification of white matter tracts changes in children undergoing chemotherapy showed improving longitudinal values in DTI metrics (stable fractional anisotropy, decreasing mean and radial diffusivity), which are incompatible with deterioration of microstructural integrity in these children.

Assessment of infectiousness of male Malaysian blood donors

So-Har T, Gladys LC, Ramli N

Vox Sang, 1983;45(5):389-91.

PMID: 6636661

HBeAg and anti-HBe were determined in the blood of 189 male blood donors. The incidence of HBsAg was 6.9% while that for HBeAg and anti-HBe was 1.6 and 18%, respectively. Of the 13 samples positive for HBsAg, two (15.4%) were positive for HBe while six (46.2%) were positive for anti-HBe. One specimen was negative for HBsAg but was positive for HBeAg and anti-HBe. The observations are discussed.

Fulltext Automatic COVID-19 Detection Using Exemplar Hybrid Deep Features with X-ray Images

Barua PD, Muhammad Gowdh NF, Rahmat K, Ramli N, Ng WL, Chan WY, et al.

Int J Environ Res Public Health, 2021 07 29;18(15).

PMID: 34360343 DOI: 10.3390/ijerph18158052

COVID-19 and pneumonia detection using medical images is a topic of immense interest in medical and healthcare research. Various advanced medical imaging and machine learning techniques have been presented to detect these respiratory disorders accurately. In this work, we have proposed a novel COVID-19 detection system using an exemplar and hybrid fused deep feature generator with X-ray images. The proposed Exemplar COVID-19FclNet9 comprises three basic steps: exemplar deep feature generation, iterative feature selection and classification. The novelty of this work is the feature extraction using three pre-trained convolutional neural networks (CNNs) in the presented feature extraction phase. The common aspects of these pre-trained CNNs are that they have three fully connected layers, and these networks are AlexNet, VGG16 and VGG19. The fully connected layer of these networks is used to generate deep features using an exemplar structure, and a nine-feature generation method is obtained. The loss values of these feature extractors are computed, and the best three extractors are selected. The features of the top three fully connected features are merged. An iterative selector is used to select the most informative features. The chosen features are classified using a support vector machine (SVM) classifier. The proposed COVID-19FclNet9 applied nine deep feature extraction methods by using three deep networks together. The most appropriate deep feature generation model selection and iterative feature selection have been employed to utilise their advantages together. By using these techniques, the image classification ability of the used three deep networks has been improved. The presented model is developed using four X-ray image corpora (DB1, DB2, DB3 and DB4) with two, three and four classes. The proposed Exemplar COVID-19FclNet9 achieved a classification accuracy of 97.60%, 89.96%, 98.84% and 99.64% using the SVM classifier with 10-fold cross-validation for four datasets, respectively. Our developed Exemplar COVID-19FclNet9 model has achieved high classification accuracy for all four databases and may be deployed for clinical application.

Fulltext Avoid haste in defining human muscular sarcocystosis

Italiano CM, Wong KT, AbuBakar S, Lau YL, Ramli N, Syed Omar SF, et al.

Clin Infect Dis, 2015 Apr 1;60(7):1134.

PMID: 25537869 DOI: 10.1093/cid/ciu1163

Displaying publications 1 - 20 of 161 in total