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Pulmonary hypertension, cardiac disease and pregnancy

Tahir H

Int J Gynaecol Obstet, 1995 Nov;51(2):109-13.
PMID: 8635630

OBJECTIVE: To ascertain the significance of coexisting pulmonary hypertension in cardiac disease in pregnancy.
METHODS: Over a 3-year period a group of pregnant women with cardiac disease was followed until 6 weeks postpartum. Twenty women with pulmonary hypertension were compared with 20 controls without pulmonary hypertension with particular reference to maternal and fetal outcome. Analysis of data was carried out using Fisher's exact test and Student's t-test.
RESULTS: Except for Eisenmenger's syndrome, there were no differences in maternal morbidity and mortality between the two groups. There were more low birth weight babies but no significant differences in premature delivery rate, mode of delivery or perinatal mortality.
CONCLUSION: Except for Eisenmenger's syndrome, coexisting pulmonary hypertension complicating cardiac disease in pregnancy generally has a favorable outcome for both mother and fetus.
Fulltext Bilateral pure gonadoblastoma in a 46 XY individual--a case report

Siti Aishah MA, Chandran R, Tahir H

Med J Malaysia, 1991 Dec;46(4):384-7.
PMID: 1840451

We report here a rare case of bilateral pure gonadoblastoma which accounts for only 0.2% of all ovarian tumours seen at Universiti Kebangsaan Malaysia from 1980 to 1987. This tumour occurred in an 18 year old Chinese "female" who presented with primary amenorrhoea. Examination showed a phenotypic female with poorly developed external gentalia. Exploratory laparotomy revealed a hypoplastic uterus, rudimentary fallopian tubes and streak gonads. Histological examination of the gonads showed a mixed tumour comprising large germ cells and smaller sex cord derivatives arranged in characteristic nests or islands containing hyaline material.
Isolation of Moraxella catarrhalis from sputum specimens of Malaysian patients

Ahmad N, Cheong YM, Tahir HM

Malays J Pathol, 1994 Jun;16(1):63-7.
PMID: 16329578

Moraxella catarrhalis has gained reputation as a pathogen in the lower respiratory tract especially in patients with underlying chronic lung diseases. It is considered significant when isolated from sputum specimens of adults with respiratory tract infections. A study was carried out to determine the prevalence of Moraxella catarrhalis isolated in sputum specimens and beta-lactamase production of these isolates. Sputum specimens sent to the Bacteriology division, Institute for Medical Research from April 1990 until April 1993 were screened for Moraxella catarrhalis. A total of 1678 sputum specimens were processed and Moraxella catarrhalis was isolated from 15 (0.89%) of the sputum specimens. Six out of 15 (40%) were isolated from patients with chronic lung disease. Eight out of 15 (47%) were beta-lactamase producers. Moraxella catarrhalis isolated in good-quality sputum must not be disregarded and should be looked for especially in patients with chronic obstructive pulmonary disease. Beta-lactamase production should be tested on all isolates so that appropriate treatment can be given. All the isolates in this study were sensitive to cotrimoxazole.
Low birth weight in Kuala Lumpur

Tahir HM, Ismail NN, Gebbie DA

Asia Oceania J Obstet Gynaecol, 1991 Jun;17(2):135-42.
PMID: 1867582

Low birth weight babies are defined as those weighing under 2,500 g. They make 13.5% of all births at the Maternity Hospital, Kuala Lumpur but contribute to 74.8% of all deaths. They are most likely to be Indian babies and least likely to be Chinese. Among all 3 communities, the primigravidae tend to produce smaller babies than multiparae but this is also true for the Indian of parity more than 3. The Malay teenager is more likely to produce small babies than their older counterparts but not so with the Indian and Chinese. There are definite clinical factors associated with or causing the births of small babies and the lighter the baby, the more influential are these factors. Maternal hypertension, antepartum haemorrhage, multiple pregnancy and unexplained intrauterine death are the 4 outstanding associations with both low birth weight and perinatal death. Although the spontaneous (often premature) onset of labour was the commonest preceding factor, it was much less important in the lowest birth weight groups of babies and was a less important contributor to perinatal death.
A Pilot Study Evaluating the Stigma and Public Perception about the Causes of Depression and Schizophrenia

Khan T, Hassali M, Tahir H, Khan A

Iran J Public Health, 2011;40(1):50-6.
PMID: 23113054

To evaluate public perceptions towards the causes of depression and schizophrenia and identifications of factors resulting stigma towards mental ill.
Fulltext Evaluating the Performance of Proposed Switched Beam Antenna Systems in Dynamic V2V Communication Networks

Ahmed TH, Tiang JJ, Mahmud A, Gwo-Chin C, Do DT

Sensors (Basel), 2023 Jul 29;23(15).
PMID: 37571565 DOI: 10.3390/s23156782

This paper develops a novel approach for reliable vehicle-to-vehicle (V2V) communication in various environments. A switched beam antenna is deployed at the transmitting and receiving points, with a beam management system that concentrates the power in each beam using a low-computation algorithm and a potential mathematical model. The algorithm is designed to be flexible for various environments faced by vehicles. Additionally, an anti-failure system is proposed in case the intelligent transportation system (ITS) system fails to retrieve real-time Packet Delivery Ratio (PDR) values related to traffic density. Performance metrics include the time to collision in seconds, the bit error rate (BER), the packet error rate (PER), the average throughput (Mbps), the beam selection probability, and computational complexity factors. The proposed system is compared with traditional systems. Extensive experiments, simulations, and comparisons show that the proposed approach is excellent and reliable for vehicular systems. The proposed study demonstrates an average throughput of 1.7 Mbps, surpassing conventional methods' typical throughput of 1.35 Mbps. Moreover, the bit error rate (BER) of the proposed study is reduced by a factor of 0.1. Additionally, the proposed framework achieves a beam power efficiency of touching to 100% at computational factor of 34. These metrics indicate that the proposed method is both efficient and sufficiently robust.
The role of transvaginal sonography in the diagnosis of placenta praevia

Tan NH, Abu M, Woo JL, Tahir HM

Aust N Z J Obstet Gynaecol, 1995 Feb;35(1):42-5.
PMID: 7771998 DOI: 10.1111/j.1479-828x.1995.tb01828.x

Transvaginal sonography was performed in 70 patients diagnosed to have placenta praevia by transabdominal sonography. The diagnosis was confirmed either by digital examination in theatre at term or operative finding at delivery. Forty-nine cases (70%) were correctly diagnosed to have placenta praevia by both modes of sonography. Transvaginal sonography ruled out placenta praevia in 12 cases (17%) thought to be placenta praevia by transabdominal ultrasound. Both transabdominal and transvaginal sonography demonstrated 'placental migration' in 4 cases (6%) which were no longer praevia at delivery. Five patients (7%) were erroneously believed to have placenta praevia by both sonographic techniques. Overall, the diagnostic accuracy of transvaginal sonography was 92.8% compared with 75.7% for transabdominal sonography. None of the subjects experienced any exacerbation of bleeding or other complications. The results suggest that transvaginal sonographic localization of the placenta is safe and superior to the transabdominal route.
Fulltext Role of the husband's knowledge and behaviour in postnatal depression: a case study of an immigrant Pakistani woman

Khan TM, Arif NH, Tahir H, Anwar M

Ment Health Fam Med, 2009 Dec;6(4):195-201.
PMID: 22477910

Objective. This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.
Methods. A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.
Results. The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.
Conclusion. This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.
Clinical presentation of depression among Malaysian women in Penang Island

Khan TM, Sulaiman SA, Hassali MA, Tahir H

Ment Health Fam Med, 2011 Sep;8(3):205-8.
PMID: 22942902

Objectives To identify the aetiology and clinical presentation of depression among Malaysian women.Methods A cross-sectional study was conducted at the Psychiatry Clinic, Public Hospital, Pulau Penang, Malaysia. Retrospective evaluations of records were conducted between January 2002 and December 2007. The data were analysed using the statistical software, SPSS v. 131®.Results Ninety-six (56.8%) of the patients were Chinese, the mean (± SD) age of the patients was 45 ± 17.8 years, with a majority (72; 42.6%) aged over 50 years. The incidence of depression with comorbid hypertension and comorbid diabetes mellitus was significant among women aged over 50 (P < 0.001 (hypertension) P < 0.015 (diabetes mellitus)). Marital and relationship problems were found to significantly affect Chinese women aged 15-30 years (P = 0.019). In terms of the clinical presentation of depression among Malaysian women, suicidal ideation and somatic symptoms like reduced energy/being easily fatigued were more frequent among Chinese.Conclusion Symptoms of being short-tempered, crying, restless and doubtful/distracted should not be neglected in primary care because of the possibility of mental health disorders. The timely evaluation of diabetic and hypertensive patients is an ideal strategy to prevent mental health disorders.
Fulltext Attitude toward depression, its complications, prevention and barriers to seeking help among ethnic groups in Penang, Malaysia

Khan TM, Sulaiman SA, Hassali MA, Tahir H

Ment Health Fam Med, 2009 Dec;6(4):219-27.
PMID: 22477913

This study aims to explore attitudes towards, complications of and preventive measures for depression and the barriers that result in delays in seeking help among the various ethnic groups in Penang, Malaysia. In June 2007 a questionnaire-based survey was undertaken in Penang. Face-to-face interviews were conducted, and 1855 respondents were approached to participate in the study by adopting a cluster random sampling method. A 25-item questionnaire was used to explore public attitudes towards, complications of and preventive measures for depression and delays in seeking help. A total of 1149 (61.94%) showed willingness to participate in the survey. Ethnically, 490 (42.6%) of the respondents who participated in the survey were Malay, while 413 (35.9%) were Chinese, 149 (13%) Indian and 97 (8.4%) from other ethnic minorities. The mean age of the respondents was 30 years (SD ± 11.5). In evaluating public attitudes, the majority (n = 910, 79.2%) agreed with the statement that family and friends can enhance the depression recovery process by providing more care and attention to the patient and this was found to be statistically significant (P ≤0.001). More than one-third of the respondents (n = 437, 38.0%) perceived depression as a normal medical condition and believed that it subsides automatically. The majority (n = 830, 72.2%) stated that depression results in social problems, while some felt that it can lead to raised blood pressure (n = 518, 45.1%). In terms of prevention, most of the respondents indicated that one can prevent depression by maintaining a good social life. In evaluating the barriers to seeking professional help, the majority (n = 582, 50.7%) stated that they did not believe they were at risk, with the next largest group identifying a lack of awareness regarding the signs and symptoms. However, a positive attitude was observed towards the complications and prevention of depression. Initiatives to increase mental health literacy will prove fruitful in neutralising the negative public perceptions towards the treatment of depression and barriers to seeking professional help.
Fulltext Psychological Effects of COVID-19 Among Health Care Workers, and How They Are Coping: A Web-Based, Cross-Sectional Study During the First Wave of COVID-19 in Pakistan

Salman M, Mustafa ZU, Raza MH, Khan TM, Asif N, Tahir H, et al.

Disaster Med Public Health Prep, 2022 Jan 10;17:e104.
PMID: 35000668 DOI: 10.1017/dmp.2022.4

OBJECTIVE: The aim of this study is to ascertain the psychological impacts of coronavirus disease (COVID-19) among the Pakistani health care workers (HCWs) and their coping strategies.
METHODS: This web-based, cross-sectional study was conducted among HCWs (N = 398) from Punjab Province of Pakistan. The generalized anxiety scale (GAD-7), patient health questionnaire (PHQ-9), and Brief-COPE were used to assess anxiety, depression, and coping strategies, respectively.
RESULTS: The average age of respondents was 28.67 years (SD = 4.15), with the majority being medical doctors (52%). Prevalences of anxiety and depression were 21.4% and 21.9%, respectively. There was no significant difference in anxiety and depression scores among doctors, nurses, and pharmacists. Females had significantly higher anxiety (P = 0.003) and depression (P = 0.001) scores than males. Moreover, frontline HCWs had significantly higher depression scores (P = 0.010) than others. The depression, not anxiety, score was significantly higher among those who did not receive the infection prevention training (P = 0.004). The most frequently adopted coping strategies were religious coping (M = 5.98, SD = 1.73), acceptance (M = 5.59, SD = 1.55), and coping planning (M = 4.91, SD = 1.85).
CONCLUSION: A considerable proportion of HCWs are having generalized anxiety and depression during the ongoing COVID-19 pandemic. Our findings call for interventions to mitigate mental health risks in HCWs.
Challenges of having a child with thalassemia in Pakistan: A phenomenological study

Rehman IU, Khan TM, Bukhsh A, Munawar K, Suleiman AK, Ming LC, et al.

J Pediatr Nurs, 2023;72:e179-e186.
PMID: 37414623 DOI: 10.1016/j.pedn.2023.06.026

BACKGROUND: Thalassemia is a persistent hemolytic disease and has debilitating effects on patients and their parents. Parents of these children experience pain and suffer from additional emotional strain as they provide daily and lifetime care and are mostly concerned about the health and future of their children.
AIM: The study aimed to understand the experiences of parents of children with thalassemia related to their family, financial, social, treatment, and psychological issues in Pakistan.
METHODS: This descriptive phenomenological study recruited 21 parents of children with thalassemia through purposive sampling until data saturation was achieved. Analysis of transcribed interviews was performed through Colaizzi's method and themes and subthemes revolving around diagnosis, challenges, and treatment issues were extracted.
FINDINGS: A total of 21 Pakistani parents participated in this study. Most of the participants were females (n = 16, 76.19%), housewives/stay-at-home moms (n = 13 (61.90%), and were uneducated (n = 6, 28.57%). Regarding genetic traits, only three (14.28%) parents declared that they had genetic traits of thalassemia. The findings of our study revealed that thalassemia is enormously influenced by psychosocial and economic problems because of this disease in their families.
CONCLUSION: Our findings indicated that parents of these children face multi-faceted challenges, such as physical, socio-emotional, financial, and familial. These findings may lead to an adequate understanding of their individual needs and efficient utilization of supportive and care programs.
PRACTICE IMPLICATIONS: An understanding of such experiences, involving those distinctive to Pakistani culture, is especially vital to inform the care of these children and enhance their quality of life.

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