MyMedR

Adenoid mast cells and their role in the pathogenesis of otitis media with effusion

Abdullah B, Hassan S, Sidek D, Jaafar H

J Laryngol Otol, 2006 Jul;120(7):556-60.

INTRODUCTION: Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle-ear space while the tympanic membrane is intact. The association between adenoid inflammation and OME has long been noted but the exact mechanism is still much debated. We studied the role of adenoid mast cells in the causation of OME.
OBJECTIVE: To study the distribution and role of adenoid mast cells in the causation of OME.
METHODOLOGY: A cross-sectional, prospective study was carried out in the otorhinolaryngologic clinic, department of otorhinolaryngology (ORL), Science University of Malaysia, from June 1999 to September 2001. A total number of 50 cases were studied. Twenty-five of these patients underwent adenoidectomy, while another 25 patients underwent adenoidectomy and myringotomy with ventilation tube insertion. The adenoid specimens from all patients were examined for the number of adenoid mast cells present, using light microscopy and toluidine blue as the staining agent. The results were analysed using SPSS version 10.0 computer software.
RESULT: The population of adenoid mast cells in children with OME was significantly greater than that in children without OME (p=0.000).
CONCLUSION: The increased number of adenoid mast cells in patients with OME suggests that inflammation may play a role in this condition.

Pyopneumothorax--a rare sequelae of retropharyngeal abscess

Lokman S, Sani A, Sidek DS

J Laryngol Otol, 1993 May;107(5):460-2.

PMID: 8326234

A case of massive pyopneumothorax as a rare sequelae of retropharyngeal abscess following fish bone ingestion is reported. An initial attempt at removal of the fish bone in the oesophagus using the fibroptic oesophagoscope was unsuccessful, causing failure of its removal and the development of this rare and potentially fatal complication. The intercommunication of the retropharyngeal space with other spaces of the neck and thorax that allow this and most other complications to occur is described. Rigid endoscopes are the instrument of choice in retrieving sharp foreign bodies in the oesophagus.

Fulltext Extensive dural sinus thrombosis and bilateral lateral rectus palsy as an uncommon complication of chronic suppurative otitis media

Balasubramanian A, Mohamad I, Sidek D

BMJ Case Rep, 2013;2013.

PMID: 23355565 DOI: 10.1136/bcr-2012-007414

Dural venous sinus thrombosis, especially of the sigmoid sinus, is a known but uncommon intracranial extradural complication of chronic suppurative otitis media. Even rarer is the simultaneous occurrence of bilateral abducens palsy in the same patient. We report the case of an adolescent male who presented with signs of raised intracranial pressure, diplopia and bilateral lateral rectus palsy associated with a history of left ear discharge and neck swelling. Extensive dural sinus thrombosis extending right up to the left internal jugular vein was confirmed on CT imaging. The patient was successfully treated with thrombolytic agents and antibiotic therapy. The pathophysiology of the concurrent complications is discussed.

Tracheobronchial foreign bodies in relation to feeding practices in young children

Indudharan R, Ram SP, Sidek DS

J Accid Emerg Med, 1997 Sep;14(5):341-3.

PMID: 9315945

Tracheobronchial foreign bodies, which are common in children, are a leading cause of accidental deaths in children under four years of age. Three cases of tracheobronchial foreign bodies in children less than two years old are described. One of the foreign bodies was unsuspected; the other two were probably related to food habits. All three cases improved without sequelae following prompt bronchoscopic intervention. Young children should not be given food containing bones or hard chitinous shells.

Abnormal Auditory Brainstem Response (ABR) Findings in a Near-Normal Hearing Child with Noonan Syndrome

Jalaei B, Zakaria MN, Sidek D

Iran J Otorhinolaryngol, 2017 Jan;29(90):53-57.

PMID: 28229064

INTRODUCTION: Noonan syndrome (NS) is a heterogeneous genetic disease that affects many parts of the body. It was named after Dr. Jacqueline Anne Noonan, a paediatric cardiologist.

CASE REPORT: We report audiological tests and auditory brainstem response (ABR) findings in a 5-year old Malay boy with NS. Despite showing the marked signs of NS, the child could only produce a few meaningful words. Audiological tests found him to have bilateral mild conductive hearing loss at low frequencies. In ABR testing, despite having good waveform morphology, the results were atypical. Absolute latency of wave V was normal but interpeak latencies of wave's I-V, I-II, II-III were prolonged. Interestingly, interpeak latency of waves III-V was abnormally shorter.

CONCLUSION: Abnormal ABR results are possibly due to abnormal anatomical condition of brainstem and might contribute to speech delay.

Nasopharyngeal carcinoma: clinical trends

Indudharan R, Valuyeetham KA, Kannan T, Sidek DS

J Laryngol Otol, 1997 Aug;111(8):724-9.

PMID: 9327009 DOI: 10.1017/s0022215100138460

Nasopharyngeal carcinoma (NPC) is one of the most difficult diseases to diagnose at an early stage. The clinical presentation of 122 patients with confirmed NPC is described and the findings analysed. The common modes of presentation and cases where detailed nasopharyngeal examination need to be performed are highlighted. We emphasize the importance of health education and training for primary care physicians for early detection of these cases.

Fulltext Clinical and audiological profiles in children with chronic otitis media with effusion requiring surgical intervention

Abdullah B, Hassan S, Sidek D

Malays J Med Sci, 2007 Jul;14(2):22-7.

PMID: 22993488 MyJurnal

To determine the characteristic presenting symptoms, otoscopic findings, audiological profiles and the intraoperative findings of children with chronic otitis media with effusion who required surgical intervention. A prospective cross sectional study was undertaken in the otorhinolaryngology clinic of USM Hospital (HUSM) involving 25 cases (50 ears) of children with chronic otitis media with effusion requiring surgical intervention from June 1999 to September 2001. Their ages ranged from 3 to 12 years old. The gender distribution included males at 72 % and females at 28 %. The presenting symptoms noted were hearing impairment (52%), otalgia (18%), ear block (16%) and tinnitus (14%). The otoscopic findings were fluid in the middle ear (40%), dullness (32%) and retraction of the tympanic membrane (28%). On audiometry, 24 ears had moderate deafness (48%), 16 ears had mild deafness (32%) while 4 ears had severe deafness (8%). With tympanometry, 42 ears out of the total 50 had a flat type B curve (84%) while 6 ears had type As curve (12%). During myringotomy, middle ear secretion was seen in 38 ears (76%) out of the 50 ears; 22 ears had mucoid secretion while 16 ears had serous secretion. Clinically, the commonest presenting symptom was hearing impairment (52%) while the most common otoscopic finding was fluid in the middle ear (40%). Audiologically, most patients had moderate conductive hearing loss (48%) and a type B curve (84%) on tympanometry. On myringotomy middle ear fluid was found in 76 % of the ears.
Study site: otorhinolaryngology clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Fulltext Clinical use of Malay Version of Vertigo Symptom Scale (MWSS) in patients with peripheral vestibular disorder (PVD)

Zainun Z, Zakaria MN, Sidek D, Ismail Z

Med J Malaysia, 2012 Aug;67(4):386-9.

PMID: 23082446

The Vertigo symptom scale (VSS) is a well established tool for the evaluation of vestibular disorders and the associated symptoms of autonomic arousal and somatosensation. By using a validated Malay version of vertigo symptom scale (MVVSS) questionnaire, the severity of the vertigo from patients' perspective can be determined and rated. Before MVVSS can be applied clinically among Malaysians, it was of interest to determine its clinical value in identifying vestibular disorders.

Fulltext Underlay myringoplasty: comparison of human amniotic membrane to temporalis fascia graft

Harvinder S, Hassan S, Sidek DS, Hamzah M, Samsudin AR, Philip R

Med J Malaysia, 2005 Dec;60(5):585-9.

PMID: 16515109

Human amniotic membrane as a homograft material was compared to temporalis fascia to close tympanic membrane perforations in 50 patients with chronic otitis media. Human amniotic membrane was used in 20 patients while temporalis fascia was used in the remaining 30. Anatomical closure of the perforation and reduction of the air-bone gap was measured. The graft uptake showed a 65% success rate for the amniotic membrane and 56.7% for the temporalis fascia at 3 months post-operatively. Significant closure of air-bone gap was observed in the human amniotic group. These results indicate comparable outcomes between human amniotic membrane and the temporalis fascia graft.

Are speech-evoked auditory brainstem response (speech-ABR) outcomes influenced by ethnicity?

Zakaria MN, Jalaei B, Aw CL, Sidek D

Neurol Sci, 2016 Jun;37(6):943-8.

PMID: 26921173 DOI: 10.1007/s10072-016-2522-0

Due to its objective nature, auditory brainstem response (ABR) evoked by complex stimuli has been gaining attention lately. The present study aimed to compare the speech-evoked auditory brainstem response (speech-ABR) results between two ethnic groups: Malay and Chinese. In addition, it was also of interest to compare the speech-ABR outcomes obtained from the present study with the published Caucasian data. Thirty healthy male adults (15 Malay and 15 Chinese) were enrolled in this comparative study. Speech syllable/da/presented at 80 dBnHL was used to record speech-ABR waveforms from the right ear of each subject. Amplitudes and latencies of speech-ABR peaks (V, A, C, D, E, F and O), as well as composite onset measures (V/A duration, V/A amplitude and V/A slope) were computed and analyzed. When the two ethnic groups were compared, all speech-ABR results were not statistically different from each other (p > 0.05). When the data from the present study were compared with the published Caucasian data, most of the statistical analyses were significant (p

Fulltext Massive lingual teratoma in a neonate

Hassan S, Sidek DS, Shah Jihan WD, Phutane G, Mutum SS

Singapore Med J, 2007 Aug;48(8):e212-4.

PMID: 17657368

Teratoma of the tongue is a rare entity. We present a male newborn with massive lingual teratoma and cleft palate, which surprisingly did not cause immediate airway obstruction. This case illustrates a huge mass in the oral cavity, which was missed on antenatal ultrasonography because it did not present with polyhydramnios. The mass was excised under general anaesthesia. Histopathologically, it consisted of all three layers of embryonic elements with predominantly glial tissue. Postoperatively, the patient developed hypoglossal nerve palsy, and no recurrence was detected after four years.

Fulltext Outcome of a newborn hearing screening program in a tertiary hospital in Malaysia: the first five years

Ahmad A, Mohamad I, Mansor S, Daud MK, Sidek D

Ann Saudi Med, 2011 Jan-Feb;31(1):24-8.

PMID: 21245595 DOI: 10.4103/0256-4947.75774

Universal newborn hearing screening (UNHS) was started in the Hospital Universiti Sains Malaysia (HUSM) in January 2003. To comply with international standards, we determined the outcome of the newborn hearing screening program for the first 5 years of its implementation, from January 2003 to December 2007.

The performance of distortion product otoacoustic emissions and automated auditory brainstem response in the same ear of the babies in neonatal unit

Abdul Wahid SN, Md Daud MK, Sidek D, Abd Rahman N, Mansor S, Zakaria MN

Int J Pediatr Otorhinolaryngol, 2012 Sep;76(9):1366-9.

PMID: 22770594 DOI: 10.1016/j.ijporl.2012.06.008

OBJECTIVE: To identify the outcomes of hearing screening using different protocols of both Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR) tests in the same ear of the babies in a neonatal unit population.
METHODS: A cross-sectional study was carried out on babies who were admitted into a neonatal unit. By using a formula of single proportion and considering 20% drop out, the number of sample required was 114. The subjects were chosen by using a systematic random sampling. The infants selected were subjected to DPOAE followed by AABR tests screening at the same setting before discharge.
RESULTS: There were 73 newborns (61.6% male and 38.4% female) participated in this study with a total of 146 ears screened. Ototoxic medication was the most common risk factor followed by hyperbilirubinaemia and low birth weight. AABR had higher passing rate (82.9%) as compared to DPOAE (77.4%). The highest passing rate was achieved if the protocol of either passed DPOAE or AABR was used (90.4%). The rate was lower when auditory neuropathy spectrum disorder (ANSD) has been considered (82.9%). Hyperbilirubinaemia, prematurity, craniofacial malformation and ototoxic drugs seem to be the high risk factors for auditory neuropathy.
CONCLUSION: AABR has a higher passing rate as compared to DPOAE. However, the use of both instruments in the screening process especially in NICU will be useful to determine the infants with ANSD who may need different approach to management. Therefore, a protocol in which newborns are tested with AABR first and then followed by DPOAE on those who fail the AABR is recommended.

Screening of dental staff nurses for noise induced hearing loss

Daud MK, Noh NF, Sidek DS, Abd Rahman N, Abd Rani N, Zakaria MN

B-ENT, 2011;7(4):245-9.

PMID: 22338236

The effect of noise on employees of dental clinics is debatable. The purposes of this study were to determine the intensity and frequency components of dental instruments used by dental staff nurses and the prevalence of noise induced hearing loss.

Fulltext The Hyperactivity of Efferent Auditory System in Patients with Schizophrenia: A Transient Evoked Otoacoustic Emissions Study

Abdul Wahab NA, Wahab S, Abdul Rahman AH, Sidek D, Zakaria MN

Psychiatry Investig, 2016 Jan;13(1):82-8.

PMID: 26766950 DOI: 10.4306/pi.2016.13.1.82

Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia.

Evaluation of auditory hallucinations in patients with schizophrenia: A validation study of the Malay version of Psychotic Symptom Rating Scales (PSYRATS)

Wahab S, Zakaria MN, Sidek D, Abdul Rahman AH, Shah SA, Abdul Wahab NA

Psychiatry Res, 2015 Aug 30;228(3):462-7.

PMID: 26142835 DOI: 10.1016/j.psychres.2015.06.014

The Psychotic Symptom Rating Scales (PSYRATS) is the most widely used validated scale to measure the specific symptoms of auditory hallucination and delusion. The aim of this study was to validate and to examine the psychometric properties of the auditory hallucination component of the Malay PSYRATS (MyPSYRATS). The research was done in the Universiti Kebangsaan Malaysia Medical Center (UKMMC) among 51 schizophrenia inpatients and outpatients who had experienced or reported verbal auditory hallucination. The psychometric properties of MyPSYRATS (auditory hallucination) were studied and a comparison was made between the psychometric properties obtained and the Positive and Negative Syndrome Scale (PANSS). The internal consistency of MyPSYRATS was good as revealed by Cronbach's alpha value. Factor analysis replicated three components (emotional, cognitive, and physical) similar to the factorial structure of the original auditory hallucination scale. However, two items were regrouped under the emotional component. Spearman's rank-order correlation showed a significant positive relationship between the total score of auditory hallucinations and PANSS auditory hallucinations item (P3). In conclusion, the auditory hallucination domain of MyPSYRATS is a reliable and valid assessment tool for further clinical applications.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Gender Disparities in Speech-evoked Auditory Brainstem Response in Healthy Adults

Jalaei B, Zakaria MN, Mohd Azmi MH, Nik Othman NA, Sidek D

Ann Otol Rhinol Laryngol, 2017 Apr;126(4):290-295.

PMID: 28177264 DOI: 10.1177/0003489417690169

OBJECTIVES: Gender disparities in speech-evoked auditory brainstem response (speech-ABR) outcomes have been reported, but the literature is limited. The present study was performed to further verify this issue and determine the influence of head size on speech-ABR results between genders.

METHODS: Twenty-nine healthy Malaysian subjects (14 males and 15 females) aged 19 to 30 years participated in this study. After measuring the head circumference, speech-ABR was recorded by using synthesized syllable /da/ from the right ear of each participant. Speech-ABR peaks amplitudes, peaks latencies, and composite onset measures were computed and analyzed.

RESULTS: Significant gender disparities were noted in the transient component but not in the sustained component of speech-ABR. Statistically higher V/A amplitudes and less steeper V/A slopes were found in females. These gender differences were partially affected after controlling for the head size.

CONCLUSIONS: Head size is not the main contributing factor for gender disparities in speech-ABR outcomes. Gender-specific normative data can be useful when recording speech-ABR for clinical purposes.

Fulltext Listening to Sentences in Noise: Revealing Binaural Hearing Challenges in Patients with Schizophrenia

Abdul Wahab NA, Zakaria MN, Abdul Rahman AH, Sidek D, Wahab S

Psychiatry Investig, 2017 Nov;14(6):786-794.

PMID: 29209382 DOI: 10.4306/pi.2017.14.6.786

Objective: The present, case-control, study investigates binaural hearing performance in schizophrenia patients towards sentences presented in quiet and noise.

Methods: Participants were twenty-one healthy controls and sixteen schizophrenia patients with normal peripheral auditory functions. The binaural hearing was examined in four listening conditions by using the Malay version of hearing in noise test. The syntactically and semantically correct sentences were presented via headphones to the randomly selected subjects. In each condition, the adaptively obtained reception thresholds for speech (RTS) were used to determine RTS noise composite and spatial release from masking.

Results: Schizophrenia patients demonstrated significantly higher mean RTS value relative to healthy controls (p=0.018). The large effect size found in three listening conditions, i.e., in quiet (d=1.07), noise right (d=0.88) and noise composite (d=0.90) indicates statistically significant difference between the groups. However, noise front and noise left conditions show medium (d=0.61) and small (d=0.50) effect size respectively. No statistical difference between groups was noted in regards to spatial release from masking on right (p=0.305) and left (p=0.970) ear.

Conclusion: The present findings suggest an abnormal unilateral auditory processing in central auditory pathway in schizophrenia patients. Future studies to explore the role of binaural and spatial auditory processing were recommended.

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