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Fulltext Characteristic differences in neuroimaging and physical findings between non-accidental and accidental traumatic brain injury in young children. A local experience in general hospital of Kuala Lumpur

Hafiz MZ, Saffari MH

Med J Malaysia, 2011 Jun;66(2):95-100.
PMID: 22106685 MyJurnal

OBJECTIVE: The objective of this study is to identify the characteristic neuroimaging (namely brain CT) as well as physical findings found in young children with nonaccidental traumatic brain injury (TBI) and to compare them with accident cases of the similar age group, in order to study the specific features of the former group more precisely.
MATERIALS AND METHODS: A cross sectional study was done involving 92 children aged 3 years old and below who were admitted to the Kuala Lumpur Hospital with diagnosis of moderate to severe traumatic brain injury from period of June 2007 to September 2009. These children were categorized into non-accidental and accidental TBI and their physical examination data, brain computed tomography and skeletal surveys were done within one week from the date of admission were compared.
RESULTS: There was a male predominance in both non-accidental and accidental TBI groups with male-to-female ratio of 2:1 and 3:1 respectively. The majority of the non-accidental TBI cases presented with no definite history of trauma (52.2%) while most of the accidental TBI cases were caused by motor vehicle accidents (69.9%). Subdural haematomas appeared to be significantly the most common brain haematomas among the nonaccidental TBI as compared to the accidental group while extradural haematomas were only present in the accidental TBI group. Cerebral edema was also significantly more common in the non-accidental group. Signs of pre-existing brain injury, including cerebral atrophy and subdural hygroma/effusion were present in 23.9% and 19.6% respectively among children with non-accidental TBI and in none of the children with accidental TBI. None of the children in the non-accidental group diagnosed to have shear injury while 6 (13.0%) of the children in the accidental group was diagnosed with diffuse axonal injury. In our series, retinal haemorrhage was significantly more common in the non-accidental TBI group (93.5%) as opposed to only 4(8.7%) children noted to have retinal haemorrhage in the accidental group. Seizures also occurred significantly more often in children with non-accidental TBI. Depressed skull fractures were only found in the accidental TBI group (19.6%), while other types of skull fractures occur more or less similar in both groups. Bodily fractures were also more predominant among the accidental group of TBI. Bodily lacerations/abrasions were only found in the accidental group while findings of bodily bruises were quite equal in both groups.
KEY WORDS: Traumatic brain injury, Non-accidental head injury (NAI), Young children
Fulltext Proptosis presenting as a delayed sign of frontal extradural haematoma

Saiful MN, Azmi A, Saffari MH

Med J Malaysia, 2007 Jun;62(2):156-7.
PMID: 18705451 MyJurnal

We report a case of a young man who presented with proptosis as a delayed manifestation of a frontal extradural haematoma (EDH) following a minor head injury. A computed tomography (CT) of the brain done 72 hours after trauma revealed a large extradural haematoma in the right anterior cranial fossa with orbital roof fracture and subperiosteal clot extension into the orbital cavity. Right frontal craniotomy with evacuation of haematoma was done and the proptosis completely resolved after surgery. The clinical course, possible mechanism and management of the patient are discussed.
Fulltext Prognostic factors of severe traumatic brain injury outcome in children aged 2-16 years at a major neurosurgical referral centre

Kan CH, Saffari M, Khoo TH

Malays J Med Sci, 2009 Oct;16(4):25-33.
PMID: 22135509 MyJurnal

Traumatic Brain Injury (TBI) in children has been poorly studied, and the literature is limited. We evaluated 146 children with severe TBI (coma score less than 8) in an attempt to establish the prognostic factors of severe TBI in children.
Fulltext Cerebellopontine angle medulloblastoma

Nyanaveelan M, Azmi A, Saffari M, Banu SK, Suryati MY, Jeyaledchumy M

Med J Malaysia, 2007 Jun;62(2):173-4.
PMID: 18705459 MyJurnal

An extremely rare case of a right cerebellopontine angle medulloblastoma in a five year old Malay girl which had eroded into the petrous bone and extended into the temporal fossa is reported. Combined subtemporal and retromastoid approach to achieve gross total surgical resection was achieved followed by radiotherapy and chemotherapy.
Fulltext Bilateral epidural extension of thoracic capillary vertebral (intraosseous) hemangioma mimicking spinal meningioma

Kan CH, Saw CB, Rozaini R, Fauziah K, Ng CM, Saffari MH

Med J Malaysia, 2008 Jun;63(2):154-6.
PMID: 18942307 MyJurnal

We describe a rare case of vertebra (intraosseous) hemangioma with bilateral and symmetrical epidural extension causing cord compression in a 24-year-old woman. The epidural component was isointense to cord on both T1 and T2 sequences, and enhanced markedly and homogenously following gadolinium administration. The gradual in onset and progressive nature with the typical enhancing pattern lead the neurosurgeon to the more common diagnosis of spinal meningioma. Epidural extension of vertebral hemangiomas causing cord compression is rarely reported. Review of literatures reveal that cases that have been reported are of unilateral extension into epidural space and of cavernous type. This is the first case report of capillary vertebral (intraossous) hemangioma with bilateral extension through both intervetebral foramen into the epidural space causing myelopathy.
Fulltext Characteristics and clinical predictors of minor head injury in children presenting to two Malaysian accident and emergency departments

Chan HC, Aasim WA, Abdullah NM, Naing NN, Abdullah JM, Saffari MH, et al.

Singapore Med J, 2005 May;46(5):219-23.
PMID: 15858690

Paediatric minor head injuries (MHI) are just as common in both bigger and smaller towns in Malaysia. Urban-based MHI are due more to motor vehicular injuries compared to rural-based MHI which are mainly due to non-motor vehicular injuries. The main objectives of this study were to compare incidence of admitted patients to accident and emergency departments of hospitals in two different settings in Malaysia, namely: Ipoh (urban-based) and Kota Bharu (rural-based); and to correlate to demographical characteristics, types of accident, clinical signs and symptoms, radiological and computed tomography (CT) findings, management; and finally, to determine clinical predictors of intracranial injury in MHI.
Psychometric Properties of the Spiritual Coping Strategies Scale-Chinese Version (SCSS-C) for Adults in Taiwan

Wang TY, Yap KY, Saffari M, Hsieh MT, Koenig HG, Lin CY

J Relig Health, 2023 Oct;62(5):3651-3663.
PMID: 37587304 DOI: 10.1007/s10943-023-01877-6

This study examined the psychometric properties of the Spiritual Coping Strategies Scale-Chinese version (SCSS-C) in Taiwanese adults. A convenience sample of 232 participants in Taiwan completed an online survey, and 45 of the 232 participants completed the SCSS-C again over a 2 week interval. The content validity index of the SCSS-C was 0.97. Parallel analysis and exploratory factor analysis results revealed two factors (religious coping and non-religious coping). The internal consistency of the SCSS-C was satisfactory (α = 0.88 to 0.92). Test-retest reliability was satisfactory (r = 0.68 to 0.89). The psychometric properties of the SCSS-C were found to be acceptable for use in Taiwanese adults.
Fulltext Yale Food Addiction Scale 2.0 (YFAS 2.0) and modified YFAS 2.0 (mYFAS 2.0): Rasch analysis and differential item functioning

Saffari M, Fan CW, Chang YL, Huang PC, Tung SEH, Poon WC, et al.

J Eat Disord, 2022 Nov 28;10(1):185.
PMID: 36443860 DOI: 10.1186/s40337-022-00708-5

BACKGROUND: Food addiction (FA) is a prevalent concern that may manifest as poorly controlled food consumption and promote overweight/obesity. Thus, having a well-established instrument for assessment may facilitate better prevention and treatment. The current study investigated the psychometric properties of two common measures of FA (i.e., the Yale Food Addiction Scale [YFAS] 2.0 and its modified version, mYFAS 2.0) using a robust statistical analysis (Rasch model).
METHODS: In this cross-sectional study, the scales were sent to 974 students studying in higher education (60% females) in Taiwan through online media including email and social networks. Rasch modeling was used to assess dimensionality, difficulty level, and item misfit and hierarchy. Differential item functioning (DIF) was performed to examine consistency of the items across gender and weight status.
RESULTS: Rasch analysis indicated 3 items of the 35 items belonging to the YFAS 2.0 (8.6%) and none belonging to the mYFAS 2.0 were misfit. Unidimensionality and construct validity of both scales were supported by appropriate goodness-of-fit for diagnostic criteria. The person separation was 3.14 (reliability = 0.91) for the YFAS 2.0 and 2.17 (reliability = 0.82) for mYFAS 2.0, indicating the scales could distinguish participants into more than 3 strata. Only one substantial DIF was found for diagnostic criteria of "Failure to fulfill major role obligation" in the YFAS 2.0 across gender.
CONCLUSION: According to Rasch modeling, both the YFAS 2.0 and mYFAS 2.0 have acceptable construct validity in Chinese-speaking youth. Scoring methods using either diagnostic criteria or symptom counts for both the YFAS 2.0 and mYFAS 2.0 are supported by the present Rasch findings.