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Fulltext Revisiting asthma phenotype in children

Fahisham Taib

Malaysian Journal of Paediatrics and Child Health, 2011;17(1):0-0.
MyJurnal

Asthma is considered as heterogeneous multidimensional disorder due to variable phenotypic presentation. Phenotype is defined as a cluster of either clinical or pathologic features, which tends to be associated with the understanding the mechanisms of the disease. Asthma is typically characterized by airway inflammation, variable airway obstruction, bronchial hyper-reactivity, smooth muscle hypertrophy and apparent reversible airflow obstruction by bronchodilators. ‘Asthma syndrome’ is a term to describe complex pathophysiology of the condition which is not exclusive to allergen triggered episodes. Diagnosing childhood asthma is difficult, due to the similarity of symptoms and overlapping with other wheezing conditions. The precise mechanism for asthma exacerbation, for each individual phenotype is not fully understood. However, it is influenced by genetic interaction with variety of external environmental stimuli. The current understanding on asthma phenotypes were interpreted based on age of onset, associated triggers, clinical aspects, physiologic parameters and type of inflammation (Table 1). Due to the illdefined of the current phenotypic definition and disagreement among the respirologists, it is becoming a challenge to label specific phenotype with certainty. Accurate definition of each phenotype should therefore be helpful to provide better understanding of different mechanistic pathways and focusing on targeted therapy for individual phenotype. (Copied from article).
Fulltext Palliative care for disease with uncertain Disease trajectory: an ethical case learning

Fahisham Taib

Education in Medicine Journal, 2019;11(1):1-5.
MyJurnal

Disease trajectory in children can be difficult to determine. This is primarily, despite the life limiting condition, healthcare professionals are unable to pin the exact time when these children’s lives will end. We illustrate an unusual case of dicephalic parapagus, an inseparable conjoined twin which was complicated by anomalies, psychosocial and safeguarding issues. Such case posed a challenge even to paediatric palliative care team as the trajectory of the disease, in this case, is rather difficult to predict. Anticipatory symptoms management perhaps is the best way forward, despite having to face many ethical challenges and medical enigma.
Recognizing pitfalls in breast cancer follow-up: a necessity--reply

Taib NA

World J Surg, 2015 Feb;39(2):548-9.
PMID: 25446473 DOI: 10.1007/s00268-014-2872-9
Fulltext A case of pustular psoriasis in a young boy

Meera Kuppusamy, Tarita Taib

Journal of Clinical and Health Sciences, 2017;2:39-42.

We report a case of a 13-year-old boy who presented with acute onset of generalised erythematous skin and patchy areas of pustules for one week duration. He was well until one month ago when he started having small scaly plaques on his scalp and extensors of his legs. During the acute episode, he also had joint pain and bilateral conjunctivitis. Skin biopsy confirmed pustular psoriasis. He developed leucocytosis and transaminitis during the acute phase of the pustular eruption while on acitretin, which was then withheld. Subsequently, treatment with oral cyclosporine induced remission of his skin and joint disease. The case is hereby reported because of rarity of presentation and clinical features. Oral cyclosporine should be considered in patients with generalised pustular psoriasis complicated with transaminitis.
Fulltext A case of pustular psoriasis in a young boy

Meera Kuppusamy, Tarita Taib

Journal of Clinical and Health Sciences, 2017;2(1):39-42.
MyJurnal

We report a case of a 13-year-old boy who presented with acute onset of generalised erythematous skin and patchy areas of pustules for one week duration. He was well until one month ago when he started having small scaly plaques on his scalp and extensors of his legs. During the acute episode, he also had joint pain and bilateral conjunctivitis. Skin biopsy confirmed pustular psoriasis. He developed leucocytosis and transaminitis during the acute phase of the pustular eruption while on acitretin, which was then withheld. Subsequently, treatment with oral cyclosporine induced remission of his skin and joint disease. The case is hereby reported because of rarity of presentation and clinical features. Oral cyclosporine should be considered in patients with generalised pustular psoriasis complicated with transaminitis.
Fulltext A case report of unusual para-meningeal rhabdomyosarcoma

Jamilu Abdullahi Faruk, Fahisham Taib

Malaysian Journal of Paediatrics and Child Health, 2019;23(2):60-63.
MyJurnal

A Case Report Of Unusual Para-Meningeal RhabdomyosarcomaMalaysian Journal of Paediatrics and Child Health, Vol. 23 (2), December 2017: 60-63© 2017 MJPCH. All Rights Reserved.60CASE REPORTA CASE REPORT OF UNUSUAL PARA-MENINGEAL RHABDOMYOSARCOMAJamilu Abdullahi Faruk1, Fahisham Taib21.Department of Paediatrics, Ahmadu Bello University Teaching Hospital, PMB -06, Shika-Zaria, Kaduna State,Nigeria.2.Paediatric Department, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia.AbstractRhabdomyosarcomas arise from mesenchymal cells destined to form skeletal muscle, but they are often found at sites where skeletal muscle is typically not found. The parameningeal site has a poor prognostic risk, if it is associated with intra-cranial extensions and skull bone erosions.This is a case report of a five-year-old girl who presented with cranial nerve palsy, and later diagnosed as rhabdomyosarcoma of the mastoid and middle ear, with infiltration of the cerebellopontine angle of the brain. She did not respond to chemotherapyand rapidly deteriorated, succumbed to the disease within a short time following the diagnosis.
Fulltext Reversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report

Fahisham Taib, Laila Ab Mukmin

Malaysian Journal of Paediatrics and Child Health, 2020;26(2):56-59.
MyJurnal

Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.
Fulltext Psychosocial dimension of children with chronic disease: a case study in Malaysia

Lee, Chee Chan, Fahisham Taib

Education in Medicine Journal, 2016;8(1):79-83.
MyJurnal

Psychosocial issues have been seen as minor in medicine despite the importance for holistic medical
care involving emotional, spiritual and psychological domains. Most patients with chronic conditions
have complex and complicated psychosocial needs especially when dealing children with life limiting
conditions. These needs have a dynamic extension to patients’ care as their impact can also affect the
extended family members. Across the trajectory of the illnesses, the pattern of psychosocial needs
changes and, this demands attending physicians to perform accurate psychosocial assessment and
understanding issues from patients and caregivers perspective. Non-judgmental decision making
is essential to avoid friction and misunderstanding between the healthcare providers and caregivers
especially during the consultative process. Resolving psychosocial issue may involve various techniques
from moral support, bridging the services to helping the family, counseling on relationship issues and
many other areas. There is a need to equip healthcare workers with different skills in order to deliver a
better psychosocial care and input even after the bereavement period.
Fulltext Palliative care approach for preemie – an ethical case learning

Fahisham Taib, Lee, Chee Chan

Education in Medicine Journal, 2018;10(2):55-59.
MyJurnal

Palliative care for life limiting conditions usually starts at birth. In neonatal period, planning,
discussion and goal of care should focus towards improving the baby quality of life. It does not mean
palliative care in this age group mainly as end of life care. We illustrate a complex 30 weeks baby
who was born with genetic abnormality complicated with intracranial bleeding and acute myeloid
leukaemia. There were various ethical issues related to the approach of death and dying infant and
psychosocial challenges surrounding the case.
Changes on amino acids content in soybean, garbanzo bean and groundnut during pre-treatments and tempe making

Aishah Bujang, Nurul Akmal Taib

Sains Malaysiana, 2014;43:551-557.

Fermentation of legumes is a well-recognised preserving method that not only diversifies the sensory attributes of the legume-based foods but also enhances its nutritional value. This study aimed to evaluate the changes in amino acids content of soybean, garbanzo bean and groundnut upon pre-treatments (soaking and steaming) and fermentation times ( 18, 24 and 30 h). The amino acids analysis was performed with a HPLC system using AccQTag method. The results obtained showed that raw soybean contain the highest amount of essential and non-essential amino acids followed by raw garbanzo bean and groundnut. After the soaking process, the amount of amino acids obtained was significantly increased in all three legumes. However, the steaming process was found to cause significant decrease in the amino acids content. After the steaming process, the legumes were inoculated with Rhizopus oligosporus and incubated at 30°C and 65% RH. At 18 h of fermentation time, the amount of total amino acids were found to increase by 26% in fermented groundnut and 16% in both soybean and garbanzo bean compared to after steaming. Further fermentation time of 24 h shows further enhancement in the amino acids content in all three legumes. Groundnut shows the highest increased of 71% in total amino acids content followed by 63% increased in garbanzo bean and 53% increase in soybean. However, prolong fermentation time of 30 h shows a decrease in total amino acids content in all three legumes which indicates the slow process of mould degradation have occurred. Therefore, fermented legumes must be consumed at the appropriate time of fermentation in order to get the benefit from the highest accumulation of amino acids content.
Benign Disorders of the Breast in Pregnancy and Lactation

Taib NA, Rahmat K

Adv Exp Med Biol, 2020;1252:43-51.
PMID: 32816261 DOI: 10.1007/978-3-030-41596-9_6

Benign cystic or solid lumps frequently occur in the breasts of young women, and consequently can also be seen during pregnancy and lactation. Simple cysts do not increase the risk of malignancy. The current management is routine follow-up. Complex cysts are thick walled or contain a mass, and should be followed by a US-guided biopsy and then treated similar to any non-gravid, non-lactating patient.Galactoceles can be detected during the last trimester of pregnancy and during or after stopping lactation. Aspiration can be done to confirm the content. Co-existence of galactocele and malignancy is extremely rare, and the key is to follow up until it resolves.Fibroadenoma is the most frequent lesion found during pregnancy and lactation. Management is usually conservative after triple assessment. Surgery is usually not recommended in pregnant and lactating women unless rapid increase in size occurs or there is discordance in the triple assessment.Lactating adenomas are sometimes interpreted as a variant of fibroadenoma . They can naturally disappear at the end of pregnancy or lactation. Management is usually conservative, and an excisional biopsy is only mandated if it is rapidly enlarging or if there is discordance in the triple assessment.Gestational gigantomastia is a rare condition consisting of diffuse severe hypertrophy of both breasts during pregnancy . Mastectomy and reconstruction may rarely be required in such cases.
Fulltext A Dive into Delivery of Oral Hygiene Advice Based on the Personalized Oral Hygiene Advice Model

Nordin NS, Taib H

Cureus, 2024 Mar;16(3):e56606.
PMID: 38646217 DOI: 10.7759/cureus.56606

Oral health's impact on overall well-being highlights the importance of preventive measures through effective oral hygiene practices. Currently, there is growing recognition of the need for customized oral hygiene advice depending on the patient's unique needs and circumstances. This narrative review addresses the gap in understanding the significance of personalized guidance through the proposal of the Personalized Oral Hygiene Advice Model (POHAM) as a comprehensive guide for oral health professionals. This model was developed to adapt to evolving patient demographics and diverse challenges, promoting a patient-centric and effective oral health approach. The POHAM comprises a flow chart of strategies from establishing a good rapport with patients, conducting comprehensive assessment through history-taking, psychosocial and technology proficiency evaluation, tailored education modules, and customized oral care product recommendations until the reassessment. These strategies aim to enhance patient engagement and adherence, as well as act as a guide for oral health professionals to use in the clinical setting before and during the course of oral treatment. Nevertheless, continued research, education, and technological advancements are needed to realize the full potential of personalized oral hygiene strategies, ensuring a transformative and sustainable oral healthcare landscape.
Breast health in developing countries

Yip CH, Taib NA

Climacteric, 2014 Dec;17 Suppl 2:54-9.
PMID: 25131779 DOI: 10.3109/13697137.2014.947255

Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.
Follicular thyroid carcinoma with direct tumour extension into the great cervical veins and right atrium: is transcervical thrombectomy a safe option?

Taib NA, Hisham AN

Asian J Surg, 2007 Jul;30(3):216-9.
PMID: 17638642

Direct tumour extension into the internal jugular veins (IJV) and right atrium in thyroid cancer is extremely uncommon. We report three cases of advanced thyroid cancer invading into the IJV and right atrium. All three patients had well-differentiated thyroid cancer and presented with typical clinical picture of the superior cava syndrome coupled with significant compressive symptoms. Two patients had obvious tumour thrombus extending to the superior vena cava (SVC) and right atrium, whilst in one patient, the thrombus extended to the SVC close to the edge of the right atrium. In all three patients, the intraluminal tumour thrombus was clinically palpable. Involvement of the IJV, SVC and right atrium was confirmed with computed tomography (CT) scan and echocardiography. The decision to extract the thrombus transcervically was made on the basis of the positive "ring sign", which is a thin rim of contrast surrounding the tumour thrombus documented on CT. All three patients underwent total thyroidectomy with segmental resection and ligation of the IJV. The tumour thrombus was successfully extracted transcervically. The histopathology report confirmed follicular carcinoma in all three patients. Two patients had radioiodine ablation therapy postoperatively, and were well 18 months after operation. One patient who had lung metastases documented on chest CT succumbed to the disease due to massive haemoptysis 3 weeks after operation.
Challenges in the management of breast cancer in low- and middle-income countries

Yip CH, Taib NA

Future Oncol, 2012 Dec;8(12):1575-83.
PMID: 23231519 DOI: 10.2217/fon.12.141

The incidence of breast cancer is rising in low- and middle-income countries (LMICs) due to 'westernization' of risk factors for developing breast cancer. However, survival remains low because of barriers in early detection and optimal access to treatment, which are the two main determinants of breast cancer outcome. A multidisciplinary approach to treatment gives the best results. An accurate diagnosis is dependent on a reliable pathology service, which will provide an adequate pathology report with prognostic and predictor information to allow optimal oncological treatment. Stratification of clinical practice guidelines based on resource level will ensure that women will have access to treatment even in a low-resource setting. Advocacy and civil society play a role in galvanizing the political will required to meet the challenge of providing opportunities for breast cancer control in LMICs. Collaboration between high-income countries and LMICs could be a strategy in facing these challenges.
Detection of Bartonella sp. in ticks and their small mammal hosts in mangrove forests of Peninsular Malaysia

Asyikha R, Sulaiman N, Mohd-Taib FS

Trop Biomed, 2020 Dec 01;37(4):919-931.
PMID: 33612746 DOI: 10.47665/tb.37.4.919

Bacteria of the genus Bartonella have been known as emerging zoonotic pathogens for several human diseases including cat scratch disease, Carrion's disease and trench fever. Numerous species of small mammals have been reported to play a role as a suitable reservoir to many pathogenic Bartonella. These infections are thought to be transmitted through blood-feeding arthropod vectors such as ticks, fleas and lice. The purpose of this study is to detect the presence of Bartonella species from tick samples collected from small mammals in mangrove forests of Peninsular Malaysia. Herein, 38 individual ticks and their small mammals host were evaluated for the presence of Bartonella DNA by conventional PCR targeting the 16S rRNA intergenic spacer region (ITS) and partial sequencing of 460 bp from this locususing Bartonella genus-specific primers. Two tick individuals from Dermacentor auratus and Haemaphysalis hystricis collected from Rattus tiomanicus (host), were PCR-positive for Bartonella DNA amplification. No Bartonella amplification was possible in other tick species (Amblyomma sp.). Phylogenetic analysis of ITS fragments demonstrated that the sequences from ticks were closely related to Bartonella phoceensis, a species that has been reported from black rats (Rattus rattus) in Australia. This is the first report of a Bartonella bacteria detected in ticks from small mammals in Malaysia. Further research should be warranted to investigate the transmission of Bartonella and the potential impact of this zoonotic pathogen in animals and humans as this mangrove ecosystem is significant for local economy and tourism.
Fulltext MPTP-induced mouse model of Parkinson's disease: A promising direction of therapeutic strategies

Mustapha M, Mat Taib CN

Bosn J Basic Med Sci, 2021 Aug 01;21(4):422-433.
PMID: 33357211 DOI: 10.17305/bjbms.2020.5181

Among the popular animal models of Parkinson's disease (PD) commonly used in research are those that employ neurotoxins, especially 1-methyl- 4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP). This neurotoxin exerts it neurotoxicity by causing a barrage of insults, such as oxidative stress, mitochondrial apoptosis, inflammation, excitotoxicity, and formation of inclusion bodies acting singly and in concert, ultimately leading to dopaminergic neuronal damage in the substantia nigra pars compacta and striatum. The selective neurotoxicity induced by MPTP in the nigrostriatal dopaminergic neurons of the mouse brain has led to new perspectives on PD. For decades, the MPTP-induced mouse model of PD has been the gold standard in PD research even though it does not fully recapitulate PD symptomatology, but it does have the advantages of simplicity, practicability, affordability, and fewer ethical considerations and greater clinical correlation than those of other toxin models of PD. The model has rejuvenated PD research and opened new frontiers in the quest for more novel therapeutic and adjuvant agents for PD. Hence, this review summarizes the role of MPTP in producing Parkinson-like symptoms in mice and the experimental role of the MPTP-induced mouse model. We discussed recent developments of more promising PD therapeutics to enrich our existing knowledge about this neurotoxin using this model.
Fulltext On the integration and standardization of medication error data: taxonomies, terminologies, causes and contributing factors

Taib IA, McIntosh AS

Ther Adv Drug Saf, 2010 Dec;1(2):53-63.
PMID: 25083195 DOI: 10.1177/2042098610389850

OBJECTIVE: A reliable database on the causes and contributing factors of medication errors can inform strategies for their prevention. To form a single database from multiple databases requires a process of integration that both maximizes the utility of the new data and minimizes the loss of information. Unfortunately, the terminologies used by different studies and databases may limit integration; therefore, terminologies must be standardized prior to integration.
METHODS: The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Taxonomy of Medication Errors was applied to standardize the different terminologies in 11 studies that reported the causes or contributing factors of medication errors.
RESULTS: After standardization, 57% of the reported causes and contributing factors were integrated to form a database while 43% were not integrated because the terminologies could not be standardized or were not similar to the taxonomy.
CONCLUSIONS: This study highlights the challenges to standardizing and integrating databases and the importance of adopting and applying a standardized terminology to record medical errors.
Fulltext Neuro-enteric dysfunction in children with severe neurological impairment

Fahisham Taib, Nik Zainal Abidin Nik Ismail

Malaysian Journal of Paediatrics and Child Health, 2019;25(1):1-5.
MyJurnal

Visceral hyperalgesia, intestinal dysfunction and unexplained irritability in neurological impaired children is a medical enigma for many healthcare professionals. The neuro-medical management can be challenging and difficult, due to poor understanding of the underlying aetiology and pathophysiology of the condition. Neuro-enteric axis has been proposed as emerging physiologic mechanism in the pathogenesis of many gastrointestinal diseases. The bidirectional connection between enteric and central nervous system may represent a direct relationship between neurological system and gut physiology. Insult to the brain indirectly contribute to the ongoing gut and brain axis sequalae. Microbiota has been an important modulator in the brain-gut axis. Irritability episodes in severe neurological impairment children has been commonly associated with pain originated from gastrointestinal pathology. Management of such condition requires a holistic approach to tackle multidimensional factors that has contributed to the ‘totality’ of the symptoms.
Fulltext Unresolved tachypnoea: a presentation of congenital cor-triatriatum

Fahisham Taib, Nur Atiqah Abdul Rahman

Malaysian Journal of Paediatrics and Child Health, 2019;25(2):23-27.
MyJurnal

Cor-triatriatum is a rare cardiac anomaly. In literature, majority case reports on the condition focused on its late presentation in adulthood. It can be easily corrected by surgical intervention to avoid pulmonary congestion and subsequent pulmonary hypertension. We report a rare case of cor-triatriatum with severe pulmonary hypertension in a 7-week-old baby who presented with persistent tachypnoea.

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