MyMedR

An MLP neural network for ECG noise removal based on Kalman filter

Moein S

Adv Exp Med Biol, 2010;680:109-16.

PMID: 20865492 DOI: 10.1007/978-1-4419-5913-3_13

In this paper, application of Artificial Neural Network (ANN) for electrocardiogram (ECG) signal noise removal has been investigated. First, 100 number of ECG signals are selected from Physikalisch-Technische Bundesanstalt (PTB) database and Kalman filter is applied to remove their low pass noise. Then a suitable dataset based on denoised ECG signal is configured and used to a Multilayer Perceptron (MLP) neural network to be trained. Finally, results and experiences are discussed and the effect of changing different parameters for MLP training is shown.

Fulltext Mahmood Merican Award for Masters in Orthopaedic Surgery Trainees in Malaysia

Sara Ahmad, T.

Malays Orthop J, 2011;5(3):35-37.

MyJurnal

The Mahmood Merican Award is an annual award for the best original scientific or clinical study submitted by young trainees in orthopaedic surgery in Malaysia, for presentation during the annual scientific meeting of the Malaysian Orthopaedic Association (MOA). This award was initiated in 1997 to encourage high standard of research and scientific presentations among young trainees.A cash prize of RM 1,000 was donated by Dato Dr Mahmood Merican. All Award finalists will represent MOA as ambassadors to regional orthopaedic association meetings, a duty that will be fully sponsored by MOA.

Strategies of social and sexual control of Malaysian women in psychiatric institutional care

Crabtree SA

Health Care Women Int, 2004;25(6):581-95.

PMID: 15354623 DOI: 10.1080/07399330490444849

An ethnographic study of female psychiatric patients was undertaken in East Malaysia. Findings indicate that these service users were subject to a number of sexist and oppressive practices that militate against their freedom of movement on the wards as well as their social interaction in the wider context of the hospital. Stereotypic notions of female sexuality and morality act as forms of moral containment and are interpreted in the hospital context as requiring heavy custodial care by the hospital authorities.

Fulltext Comparison of nerve graft and artificial conduits for bridging nerve defects

Azhar MM, Sara TA

Med J Malaysia, 2004 Dec;59(5):578-84.

PMID: 15889558

A study of nerve regeneration through a 1cm defect in the peroneal component of the sciatic nerve was performed on sixteen rabbits. Either silicone or polytetrafluoroethylene (PTFE) tubes or nerve graft were used to bridge the defect and the opposite limb was not operated upon. The rabbits that underwent nerve grafting had favourable findings. In the PTFE group, a nerve-like structure was seen at the former gap site and histology confirmed viable axons within the tubes and distal to the repair site. In the silicone tube group, there were no myelinated axons demonstrated. The axonal count for the grafted nerves and the nerves repaired with PTFE tube are on average 80.4% and 38.2% of that of the unoperated nerve, respectively. On average, the percentage anterior compartment muscle weight (expressed as a percentage of the unoperated limb) for the silicone, PTFE and nerve graft groups are 42.3%, 42.1%, and 72.7% respectively. The results show that although, PTFE conduits can bridge a nerve defect of 1cm, nerve grafting provides a superior and more predictable outcome.

Fulltext Experience in snuffbox arteriovenous fistulae for hemodialysis

Lee JK, Sara TT

Med J Malaysia, 2000 Sep;55 Suppl C:35-8.

PMID: 11200042

Sixty-five patients with "Snuffbox" arteriovenous fistulae for hemodialysis were reviewed. The procedure was performed under local anaesthesia as an outpatient procedure. It was done as a "standby" procedure for 41.5% of patients with Chronic Ambulatory Peritoneal Dialysis. 58.5% of patients had the procedure done for primary hemodialysis. Patency was assessed as presence of an engorged vein and presence of thrill. This was assessed routinely at 4 to 6 weeks after the procedure. Patency rate was noted to be 83%. The commonest complication was thrombosis of the arteriovenous anastomosis. Some patients required repeated procedure at a more proximal site. Further study to determine the blood flow rate provided by the anastomosis, and comparison with other anatomical sites is necessary.

Fulltext Noise Exposure and Perceived Hearing Symptoms of Metal Fabrication Workers in Heating, Ventilating and Air Conditioning Manufacturing Industry

Siti Nur Sara Mamat, Faridah Naim

Malaysian Journal of Medicine and Health Sciences, 2020;16(111):135-143.

MyJurnal

Introduction: Rapid ongoing industrialisation particularly in developing countries has triggered an
increased risk of occupational noise-related disease occurrence. Machinery and work tasks in metal fabrication
processes may produce high noise levels that can be harmful to hearing. This study aimed to investigate the
workers’ exposure to noise at a fabrication plant and their perceptions toward hearing loss symptoms and its association.
Methods: This study was conducted at a Heating, Ventilating and Air Conditioning fabrication plant in Johor.
With a 31% response rate, 50 respondents who were selected using purposive sampling answered a
questionnaire regarding demographic background, noise exposure and perceived hearing loss symptoms. Noise
measurements were also conducted among 30 of them based on the concept of sampling the maximum
risky workers. The noise was measured using a sound level meter IEC 60651 Class 2. Minimum (Lmin)
and maximum (Lmax) sound pressure levels were measured for 5-minute and repeated for three exposure
periods (morning, afternoon, evening). Results: 68% and 32% of the workers were 20-30 years old and had
been employed for 3-5 years, respectively. Average noise exposure level observed was 63.3-101.5 dBA. 25%
of the workers reported that they were sometimes experienced the symptoms of hearing loss. These include
difficulty in understanding conversation and ringing in the ear. However, noise exposure and hearing loss
symptoms were not significantly associated. Conclusion: The study findings suggest that the workers have a risk
of developing hearing loss. Intervention programme and enforcement on hearing protection of the workforce
are highly recommended.

Fulltext Splinter Removal with the Aid of Ultrasonography:A Case Report

Lee, C.K., Sara Ahmad, T., Abdullah, B.J.J.

Malays Orthop J, 2008;2(2):47-49.

MyJurnal

Splinter or foreign body removal from the hand and foot is a common occurrence. Usually only the deep seated, broken or missed splinters are referred to the surgeon for removal. Unless the object is radio-opaque, plain radiograph will not give any useful information, hence removal can sometimes be very difficult and traumatic. We are reporting a case where a radiolucent splinter was removed with the aid of ultrasonography. This modality can help to localize a splinter at the pre and intra-operative period, minimizing amount of exploration and time of operation.

Fulltext Free radial forearm flap after partial glossectomy for squamous cell carcinoma of the tongue

Chuah, U.C., Kamarul, T., Sara, T.

JUMMEC, 2006;9(2):28-31.

MyJurnal

Squamous cell carcinoma of the tongue is a highly malignant condition and results in high mortality and morbidity in patients despite its early detection (1). Early surgical interventions have been found to reduce mortality but in many reports, tongue reconstructions using live grafts have been found to reduce normal tongue function of speech, swallow and taste. In contrast, our report using free radial forearm flap (FRFF) to reconstruct the defect left over after a radical tongue resection in a 38-year-old gentleman with oral cancer has shown promising results. This type of reconstruction has left the patient with a functional and cosmetically acceptable tongue with minimal alteration in recognizable speech.

Fulltext Endoscopic Carpal Tunnel Release - A Prospective Study of Functional Outcome

Ravindran, T., Sara, T., Loh, Y.C.

Malays Orthop J, 2009;3(1):46-52.

MyJurnal

To evaluate the functional outcome of patients who underwent endoscopic carpal tunnel release (ECTR). This was a prospective study in 24 patients with idiopathic carpal tunnel syndrome undergoing ECTR. Patient assessment entailing both subjective and objective tests at intervals of two and six weeks, three, six and nine months and finally at one year postoperatively. Our assessment results showed overall improvement in symptoms. As early as two weeks post-operatively, there was a low incidence of pillar pain and scar tenderness, allowing patients to return to work early. There were no serious complications. ECTR can be effectively performed with a low perioperative and late postoperative rate of complications. This minimally invasive method can be an option of surgical treatment for patients with carpal tunnel syndrome, who intend to return to work soon after surgery.

Fulltext Fibula Osteocutaneous Flap for Mandible Reconstruction after Ameloblastoma Resection: Amending Technique to Reduce Ischaemic Time

Chee, E.K., Sara Ahmad, T., Ng, E.S.

Malays Orthop J, 2007;1(1):39-41.

MyJurnal

A 27-year-old patient with ameloblastoma of the mandible
underwent anterior mandibulectomy and reconstruction with
left fibula osteocutaneous flap. The bone was shaped at the
lower limb before cutting the pedicle. Vascularised free fibula flap provides a good alternative to other bone grafts in mandible reconstruction as it is relatively easy to perform, carries a low complication rate, and mandibular shaping with intact pedicle cuts down on ischaemic as well as total operative time.

Diagnosis of pulmonary embolism: A comparison between ventilation/perfusion SPECT/CT and perfusion-only SPECT/CT

Thanuja M, Maimanah M, Sara U

Med J Malaysia, 2020 09;75(5):490-493.

PMID: 32918415

BACKGROUND: The role of nuclear medicine in diagnosing pulmonary embolism (PE) is continuously evolving owing to advancements in imaging methods. In recent years, ventilation/perfusion single photon emission computed tomography-computed tomography (V/Q SPECT/CT) has established a synergistic role over conventional V/Q planar scintigraphy and V/Q SPECT in diagnosing pulmonary embolism.

OBJECTIVES: In this study, we aimed to assess the incremental value of V/Q SPECT/CT over conventional V/Q planar scintigraphy and V/Q SPECT, and to determine if Q only-SPECT/CT without the conventional ventilation component could replace the current imaging protocol in diagnosing pulmonary embolism.

METHODS: We retrospectively assessed 73 patients with suspicion of pulmonary embolism who had undergone/Q planar scintigraphy, V/Q SPECT and V/Q SPECT/CT consecutively. Combination of clinical follow-up, laboratory test results and correlative imaging were used as reference standard. Q-only SPECT/CT datasets were then analysed separately without the V-planar, V-SPECT and V-SPECT/CT datasets.

RESULTS: A total of 66 patients fulfilled our initial inclusion and exclusion criteria, with 23 patients as positive for PE and 43 patients ruled out of having PE based on the reference standard. Sensitivity and specificity for V/P planar scintigraphy, V/Q SPECT, and V/Q SPECT-CT were 86.9% and 39.5%, 91.3% and 55.8%, and 100% and 97.6% respectively. Overall, SPECT/CT resulted in significantly higher diagnostic accuracy than planar and SPECT imaging respectively (p<0.05). Q-only SPECT/CT significantly over diagnosed pulmonary embolism in 12 patients (p<0.05).

CONCLUSION: Adding V/Q SPECT/CT to the algorithm of PE significantly improves the sensitivity and specificity. However, by eliminating the ventilation component, the diagnostic accuracy is significantly reduced.

Steroid injection versus NSAID injection for trigger finger: a comparative study of early outcomes

Shakeel H, Ahmad TS

J Hand Surg Am, 2012 Jul;37(7):1319-23.

PMID: 22721455 DOI: 10.1016/j.jhsa.2012.03.040

Stenosing tenosynovitis of the flexor tendon sheath of the digits of the hand results from a discrepancy between the diameter of the flexor tendon and its sheath at the A1 pulley. The treatment options for trigger digits include oral nonsteroidal anti-inflammatory drugs (NSAIDs) and local NSAID applications, splintage, steroid injection, and percutaneous and open release of the A1 pulley. Injectable NSAID is used intramuscularly and locally in other sites. The hypothesis is that an injectable NSAID is as effective as the traditionally used steroid injection in the treatment of trigger digit, based on Quinnell grading, and that the treatment works as well in patients with diabetes as in those without diabetes.

Fulltext Bacterial hand infections: an analysis of cases presenting at the University Hospital, Kuala Lumpur

Omar BMI, Sara BTA

Med J Malaysia, 1996 Mar;51(1):23-8.

PMID: 10967975

A significant number of hand infections were found to occur in college students, a group not associated with manual labour. Diabetics did not have a significant delay in recognising the symptoms but have a significant longer period of hospitalisation. The right hand was predominantly involved especially the thumb, index finger and the thenar region. Staphylococcus aureus was the commonest infecting organism.

Fulltext Dupuytren Contracture in a Patient with Congenital Camptodactyly and Incidental Carpal Tunnel Syndrome

Mahendran, S, Paisal, H., Ng, E.S., Sara, T.

Malays Orthop J, 2008;2(2):37-39.

MyJurnal

Dupuytren contracture is commonly seen in northern European populations but not in Asians. Even more rare is a presentation of flexion deformity of fingers involving two different pathologies with incidental carpal tunnel syndrome in the same patient. We report herein a case of Dupuytren contracture with congenital camptodactyly and unilateral carpal tunnel syndrome.

Fulltext The impact of government incentives on financial viability of selected aquaculture species in Malaysia

Sara, R.R., Ismail, M.M., Kamarulzaman, N.H., Mohamed, Z.A.

International Food Research Journal, 2014;21(4):1451-1456.

MyJurnal

Aquaculture businesses in Malaysia require careful and comprehensive financial analysis to be successful. Comprehensive financial analysis has three key components, namely financial position, profitability and liquidity/cash flow. This research focuses on using pro forma income statements to analyze financial positions and to evaluate the effect of government incentives on sustainability of Malaysian aquaculture farms. This paper is divided into two sections; the first section discusses and provides the finding and comparability of the financial analysis on freshwater and brackish water producers. In the first section, the discussion was based on financial viability criteria, namely net present value (NPV), internal rate of return (IRR) and benefit cost ratio (BCR)) for base study. The evaluation process was carried out using four different phases; base study and government incentives simulations, Pioneer Status (PS), Investment Tax Allowance (ITA), and Accelerated Capital Allowance (ACA) for effectiveness of government incentives and roles in increase of profitability and production. The results showed that in all brackish water farms, NPV after the ACA incentive showed a higher and positive value comparable to individual PS and ITA. The effect of Government Incentive on Penaeus vannamei and Grouper showed that IRR and NPV on ACA (based on PS) is 2% and 9%, respectively higher than ACA (based on ITA). Meanwhile, in Barramundi farming ACA (based on ITA) was 8% higher than ACA (based on PS). The results on freshwater showed that ACA (based on ITA) on Tilapia and Catfish was 8% and 6% higher than ACA (based on PS). This paper concludes that the aquaculture operators should choose to accept PS with ACA on Penaeus vannamei and Grouper and choose ACA based on ITA on Barramundi, Tilapia and Catfish in order to maximize private profitability.

Fulltext Hole on the palate, saliva in the nose: what is your diagnosis?

Irfan Mohamad, Shamina Sara Moses, Rose linda Abdul Rahman

Archives of Orofacial Sciences, 2013;8(1):44-45.

MyJurnal

A 69-year-old lady was diagnosed to have mucoepidermoid carcinoma of hard palate 3 years ago. She completed 20 cycles of external beam radiotherapy and 5 cycles of mould brachytherapy and remained asymptomatic until she again presented to us with the recurrence of a painless mass at the hard palate. The hard mass appeared as an ulcerated dimple measuring 2 x 1 cm located at the junction of the hard and soft palate, more towards the right. Excision biopsy of the mass was done with a 1cm circumferential margin deep to the periosteum, with the resulting exposed bony defect covered with a rotational flap from the soft palate. During follow-up, the patient complained that the saliva came up into the nose whenever she swallowed. Oral examination (Figure 1) and flexible nasopharyngolaryngoscopy (FNPLS) (Figure 2) were performed. What is your diagnosis?

Fulltext Stress and its associated factors amongst ward nurses in a public Hospital Kuala Lumpur

Sharifah Zainiyah, S.Y., Afiq, I.M., Chow, C.Y., Siti Sara, D.

Malaysian Journal of Public Health Medicine, 2011;11(1):78-85.

MyJurnal

Occupational stress exists in all professions, but the nursing profession appears to experience more stress at work compared to other health care workers. Stressful conditions at the workplace may cause the high turnover and burnout among nurses. This study objective was to determine the level of stress and its associated factors among in-patient ward nurses. A cross sectional study using the stratified random sampling method was carried out among 114 staff nurses from 5 different departments in a public hospital in Kuala Lumpur. Respondents were requested to complete a single set of validated and self-administered questionnaire, the Depression, Anxiety, Stress Scale (DASS) . Data was analysed using SPSS 17. In general, the prevalence of stress at the department of Medicine was found to be higher compared to other departments studied. There was also a statistical significant relationship between the prevalence of stress and types of department (p 0.05). In conclusion, stress had no significant association with sociodemographic factors (age, marital status and financial status) and working environment except for type of department nurses work in. There might be some other possible confounders that have a bigger potential in becoming stressors compared to those independent variables in this study.

Intralesional autologous blood injection compared to corticosteroid injection for treatment of chronic plantar fasciitis. A prospective, randomized, controlled trial

Lee TG, Ahmad TS

Foot Ankle Int, 2007 Sep;28(9):984-90.

PMID: 17880872

The response of chronic plantar fasciitis to any treatment is unpredictable. Autologous blood might provide cellular and humoral mediators to induce healing in areas of degeneration, the underlying pathology in plantar fasciitis. This study compared the efficacy of intralesional autologous blood with corticosteroid injection for plantar fasciitis present for more than 6 weeks.

Fulltext A modified Blatt dorsal capsulodesis in the treatment of dynamic scapholunate instability

Azura L, Ahmad TS, Kamarul T

Med J Malaysia, 2006 Dec;61 Suppl B:51-4.

PMID: 17600993

We report a case of scapholunate dissociation which was initially missed and presented late. A modification of Blatt dorsal capsulodesis performed using dorsal intercarpal ligament (DICL) and extra tunnel appears not only to add to dorsal stability but also address the volar problem as well. This modification may be a better alternative to the current technique of using a single flap.

Fulltext Automatic top loader washing machine related injury. A report of four cases with serious injury

Kwan MK, Saw A, Sara Ahmad T

Med J Malaysia, 2005 Mar;60(1):112-4.

PMID: 16250295 MyJurnal

We are reporting four cases of serious washing machine related injury that presented within a period of 5 months. All patients were young children with the mean age of 9 year-old and three had their dominant hand injured. The washing machines involved were the automatic top loader type and all injuries occurred during the spinning phase. Serious automatic washing machine injury is not uncommon in Malaysia. We feel that there is a need to improve the safety features especially during the spinning phase. The operating instructions and safety precautions on the washing machine should be displayed in different languages that can be understood well. Parents should also aware of the potential risks of this seemingly benign household appliance.

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