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Nonselective Laryngeal Reinnervation Versus Type 1 Thyroplasty in Patients With Unilateral Vocal Fold Paralysis: A Single Tertiary Centre Experience

Mat Baki M, Abdul Rani A

J Voice, 2022 Jul;36(4):581.
PMID: 32951955 DOI: 10.1016/j.jvoice.2020.08.007
Use of bovine xenograft in reconstruction of traumatic anterior cranial fossa bone defects involving the frontal sinus

Abdullah J, Rushdan A, Hamzah M, Ariff AR, Rani A

Ann. Transplant., 1999;4(3-4):28-31.
PMID: 10853777

Four patients underwent reconstruction of anterior cranial fossa of skull defects between November 1997 and January 1998. All of them had traumatic anterior cranial fossa defect and were reconstructed with lyophilised bovine cortical bone graft. There was no cerebrospinal fluid leakage, meningitis, extradural abscess or other infections. This study demonstrates that the use of bovine bone graft in the reconstruction of anterior base defects is safe.
Fulltext Matrix Metalloproteinase-9 Gene Polymorphism and Its Methylation in Stroke Patients

Choudhari OK, Rani A, Kampani G, Kaur C, Sengupta A

Malays J Med Sci, 2021 Dec;28(6):32-41.
PMID: 35002488 DOI: 10.21315/mjms2021.28.6.4

Background: Genetic and environmental factors, along with hypertension, diabetes mellitus and smoking cause accelerated atherosclerosis and, eventually, stroke. Matrix metalloproteinase-9 (MMP-9) are inflammatory mediators of the endoproteinase family, and their polymorphism and methylation are associated with the development of atherosclerosis and stroke. This study explores this association in the Indian population.
Objective: To study the association of MMP gene polymorphism and methylation with the risk of stroke.
Methods: A case-control study was conducted on 100 admitted patients (both genders) diagnosed with ischaemic stroke. Another 100 healthy subjects, not suffering from any chronic illness or stroke, were taken as controls. All participants were genotyped for rs3918242 (MMP-9) by polymerase chain reaction (PCR) and restriction fragment length polymorphism. Methylation of the MMP-9 gene-promoter region was assessed by methylation-specific PCR.
Results: The case (mean age = 61.3 ± 7.36 years old) and control (mean age = 60.68 ± 7.1 years old) groups were age-matched. Among cases, 61 patients were smokers, 55 were diabetic and 53 were hypertensive. A significant risk of ischaemic stroke was associated with the CT genotype (adjusted odds ratio [aOR] = 7.09; P < 0.001), TT genotype (aOR = 19.75; P < 0.001) and T allele (aOR = 10.71; P < 0.001). MMP-9 methylation decreased the risk of stroke (aOR = 0.23; P < 0.001).
Conclusion: MMP-9 gene-1562C/T polymorphism (SNP rs3918242) (single-nucleotide polymorphism [SNP] rs3918242) is a potential marker to predict ischaemic stroke and constitutes a significant proportion of the general population. Its polymorphism predisposes to ischaemic stroke, while its methylation is protective.
A scoping review on socioeconomic factors affecting tuberculosis loss to follow-up in Southeast Asia

Abd Rani AY, Ismail N, Zakaria Y, Isa MR

Med J Malaysia, 2024 Jul;79(4):470-476.
PMID: 39086346

INTRODUCTION: Tuberculosis (TB) is a global public health issue. The Southeast Asian region grapples with numerous challenges in TB management, with loss to follow-up (LTFU) emerging as a critical barrier to effective control of the disease. This review synthesised published articles to identify socioeconomic factors contributing to the burden of TB losses for follow-up in Southeast Asia.
MATERIALS AND METHODS: This scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework developed by the Joanna Briggs Institute (JBI). A total of 10 studies were identified as eligible from the title and abstract review. The mixed method quality appraisal tool (MMAT) version 2018 was used to assess the quality of the included quantitative studies.
RESULTS: The results showed that poverty, unemployment, low education levels, migrant status, community support, male gender, substance abuse, and regional disparities significantly impact the occurrence of TB LTFU in Southeast Asia.
CONCLUSION: The findings have significant implications for public health in Southeast Asia. Addressing these socioeconomic barriers through community-based strategies, educational initiatives, and policy reforms is vital for improving treatment outcomes and overall public health.
Nonselective Laryngeal Reinnervation versus Type 1 Thyroplasty in Patients with Unilateral Vocal Fold Paralysis: A Single Tertiary Centre Experience

Ab Rani A, Azman M, Ubaidah MA, Mohamad Yunus MR, Sani A, Mat Baki M

J Voice, 2021 May;35(3):487-492.
PMID: 31732294 DOI: 10.1016/j.jvoice.2019.09.017

OBJECTIVE: This study compared the voice outcomes of selected patients with unilateral vocal fold palsy (UVFP) who underwent either nonselective laryngeal reinnervation (LR) or Type 1 thyroplasty (thyroplasty) in a Malaysian tertiary centre using multidimensional voice assessments.
PARTICIPANTS: The study included 16 patients with UVFP who underwent either LR (9 patients) or thyroplasty (7 patients) between 2015 and 2018 who fulfilled the inclusion criteria.
MAIN OUTCOME MEASURES: The outcomes were measured subjectively and objectively with: (1) voice handicap index-10 (VHI-10- Malay version); (2) auditory perceptual evaluation using the breathiness component of Grade, Roughness, Breathiness, Asthenia, Strain scale; (3) maximum phonation time (MPT); and (4) acoustic analysis (jitter%, shimmer%, and NHR) using OperaVOXTM. The outcomes were measured at baseline, 6 and 12-months postoperative. The comparison of outcomes between pre and postoperative of each group was evaluated using one-way ANOVA test. Mann-Whitney test was used to compare the outcomes between the two groups.
RESULTS: Comparison of each group at different time points showed significant improvement of VHI-10 and MPT of LR group between baseline and 12 months (P ≤ 0.05) whereas, the improvement in thyroplasty group was observed at all time points (P ≤ 0.05). When comparing between the two groups at 12 months, the VHI-10 and MPT was significantly better in the LR group than thyroplasty group with P = 0.004 and P = 0.001 respectively. Other outcome measures did not reveal significant difference between the two groups.
CONCLUSION: This observational study showed that LR may be better than thyroplasty in improving VHI-10 and MPT in selected patients with UVFP.
Revitalizing plastic wastes employing bio-circular-green economy principles for carbon neutrality

Rani A, Negi S, Fan C, Lam SS, Kim H, Pan SY

J Hazard Mater, 2024 Jul 05;472:134394.
PMID: 38703690 DOI: 10.1016/j.jhazmat.2024.134394

The use of plastics has become deeply ingrained in our society, and there are no indications that its prevalence will decrease in the foreseeable future. This article provides a comprehensive overview of the global plastic waste disposal landscape, examining it through regional perspectives, various management technologies (dumping or landfilling, incineration, and reuse and recycling), and across different sectors including agriculture and food, textile, tourism, and healthcare. Notably, this study compiles the findings on life-cycle carbon footprints associated with various plastic waste management practices as documented in the literature. Employing the bio-circular-green economy model, we advocate for the adoption of streamlined and sustainable approaches to plastic management. Unique management measures are also discussed including the utilization of bioplastics combined with smart and efficient collection processes that facilitate recycling, industrial composting, or anaerobic digestion. Moreover, the integration of advanced recycling methods for conventional plastics with renewable energy, the establishment of plastic tax and credits, and the establishment of extended producer responsibility are reviewed. The success of these initiatives relies on collaboration and support from peers, industries, and consumers, ultimately contributing to informed decision-making and fostering sustainable practices in plastic waste management.
Screening of the LIX1 gene in Japanese and Malaysian patients with SMA and/or SMA-like disorder

Sasongko TH, Gunadi, Yusoff S, Atif AB, Fatemeh H, Rani A, et al.

Brain Dev, 2010 May;32(5):385-9.
PMID: 19664890 DOI: 10.1016/j.braindev.2009.06.008

The majority of spinal muscular atrophy (SMA) patients showed homozygous deletion or other mutations of SMN1. However, the genetic etiology of a significant number of SMA patients has not been clarified. Recently, mutation in the gene underlying cat SMA, limb expression 1 (LIX1), has been reported. Similarity in clinical and pathological features of cat and human SMA may give an insight into possible similarity of the genetic etiology.
Fulltext Association between hydrocarbon exposure and risk of stroke: a systematic literature review

Shabil M, Gaidhane AM, Vadia N, Menon SV, Chennakesavulu K, Panigrahi R, et al.

BMC Neurol, 2025 Feb 21;25(1):71.
PMID: 39984906 DOI: 10.1186/s12883-025-04083-x

BACKGROUND: Hydrocarbon exposure, including polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), is increasingly linked to vascular dysfunction and stroke, a leading cause of morbidity and mortality globally. Common in occupational and environmental contexts, hydrocarbons induce oxidative stress, systemic inflammation, and endothelial dysfunction, disrupting vascular health. This systematic review examines the association between hydrocarbon exposure and stroke, emphasizing specific metabolites and their cerebrovascular effects.
METHODS: A comprehensive search across PubMed, Embase, and Web of Science was conducted through December 10 2024, identifying observational studies exploring hydrocarbon exposure and stroke risk. Studies meeting predefined inclusion criteria, excluding those with major methodological flaws, were synthesized narratively. Variations in hydrocarbon types, population demographics, and stroke outcomes were considered.
RESULTS: Six studies, including five cross-sectional and one retrospective cohort, with sample sizes ranging from 5,537 to 283,666 participants, demonstrated significant associations between hydrocarbon exposure and stroke risk. Key findings revealed strong associations for metabolites like 1-hydroxynaphthalene (OR: 1.89; 95% CI: 1.62-2.20) and 2-hydroxyfluorene (OR: 1.94; 95% CI: 1.66-2.26). However, variability in findings was noted, attributed to differences in study design, exposure levels, and populations studied.
CONCLUSION: This review highlights a complex relationship between hydrocarbon exposure and stroke risk, with some studies indicating significant associations and others reporting inconsistencies. Standardized, large-scale research is essential to clarify this relationship, identify high-risk populations, and guide public health strategies to mitigate exposure and prevent stroke.
CLINICAL TRIAL NUMBER: Not applicable.
Maternal hypertensive disorders among Individuals of reproductive age (15-49 Years) in South Asia: A global Burden of Disease study (1990-2021) with future Projections

Shabil M, Gaidhane AM, Vadia N, Menon SV, Chennakesavulu K, Panigrahi R, et al.

Eur J Obstet Gynecol Reprod Biol, 2025 Mar 07;308:214-221.
PMID: 40086257 DOI: 10.1016/j.ejogrb.2025.03.012

BACKGROUND: Maternal hypertensive disorders (HDP) remain a major contributor to maternal and perinatal morbidity and mortality worldwide, particularly in South Asia, where healthcare disparities persist.
OBJECTIVE: This study aims to analyze trends in maternal hypertensive disorders across South Asia from 1990 to 2021, leveraging data from the Global Burden of Disease (GBD) study to evaluate the effectiveness of healthcare interventions and provide actionable recommendations.
METHODS: We conducted a retrospective analysis using GBD 2021 data for Bangladesh, Bhutan, India, Nepal, and Pakistan. Health trends such as prevalence, incidence, and maternal mortality ratios (MMR) were analyzed using descriptive statistics and Join point regression. This approach allowed us to identify significant changes and trends over the studied period.
RESULTS: The study revealed significant declines in the prevalence and MMR associated with maternal hypertensive disorders across the region. Notable reductions were observed in Bangladesh, Bhutan, India, and Nepal, while Pakistan showed minimal improvement, indicating ongoing healthcare challenges. The analysis underscores substantial regional disparities, particularly in Pakistan, which reported higher prevalence rates and MMR across all age groups.
CONCLUSIONS: The findings suggest that targeted healthcare interventions can effectively reduce the burden of maternal hypertensive disorders in South Asia. However, persistent disparities in Pakistan highlight the need for region-specific strategies to address gaps in healthcare access and quality. Strengthening healthcare policies and improving intervention coverage could further mitigate the burden of HDP in South Asia.
Helicobacter pylori management in ASEAN: The Bangkok consensus report

Mahachai V, Vilaichone RK, Pittayanon R, Rojborwonwitaya J, Leelakusolvong S, Maneerattanaporn M, et al.

J Gastroenterol Hepatol, 2018 Jan;33(1):37-56.
PMID: 28762251 DOI: 10.1111/jgh.13911

Helicobacter pylori (H. pylori) infection remains to be the major cause of important upper gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. H. pylori management in ASEAN: the Bangkok consensus report gathered key opinion leaders for the region to review and evaluate clinical aspects of H. pylori infection and to develop consensus statements, rationales, and grades of recommendation for the management of H. pylori infection in clinical practice in ASEAN countries. This ASEAN Consensus consisted of 34 international experts from 10 ASEAN countries, Japan, Taiwan, and the United States. The meeting mainly focused on four issues: (i) epidemiology and disease association; (ii) diagnostic tests; (iii) management; and (iv) follow-up after eradication. The final results of each workshop were presented for consensus voting by all participants. Statements, rationale, and recommendations were developed from the available current evidence to help clinicians in the diagnosis and treatment of H. pylori and its clinical diseases.