MyMedR

Fulltext Tuberculous aortic pseudoaneurysm treated with in situ silver-impregnated vascular inlay graft

Hussein H, Azizi ZA

Asian J Surg, 2008 Apr;31(2):87-9.

PMID: 18490221 DOI: 10.1016/S1015-9584(08)60064-0

A 62-year-old man presented with continuous, persistent backache shortly after completion of antituberculosis medication for tuberculosis (TB) of the spine. Computed tomography scan revealed a pseudoaneurysm involving the infrarenal aorta. He was restarted on anti-TB medication and underwent repair of the pseudoaneurysm with an in situ silver-coated bifurcated Dacron graft. His postoperative recovery was uneventful and he remained well up to 12 months of follow up. To our knowledge, this is the first case in the literature where an in situ silver-impregnated vascular graft has been successfully used in treating a tuberculous pseudoaneurysm.

Fulltext Heat treatment effect with the electrode contact of CaCu3Ti4O12

Muhammad Azwadi Sulaiman, Hutagalung, Sabar D., Zainal A. Ahmad

Journal of Nuclear and Related Technologies, 2013;2013(2):43-52.

MyJurnal

CaCu3Ti4O12 (CCTO) has attracted a great attention for electronic devices miniaturization due to its
very high dielectric constant properties at a wide range of frequency and nearly constant over broad temperature range. The origins of the giant dielectric constant have been speculated from electrical heterogeneous of interior elements of the CCTO ceramics. Four origins were suggested contributed to the electrical heterogeneous. In this study heat treatment were done with the electrode contact in Argon gas environment and the electrical properties over very wide frequency of CCTO ceramics were investigated. Cylindrical CCTO pellets samples were prepared by solid state reaction method and single phase of XRD pattern was obtained after sintering processes. Electrical impedance responds were measured at frequency from 100 Hz to 1 GHz for the samples for untreated and heat treated at 200ºC, 250ºC, 300ºC, 350ºC and 400ºC of CCTO. Improvement to the dielectric constant can be seen for 350ºC and 400ºC samples and dielectric loss were improved for 200ºC and 300ºC samples for overall frequency. The variations were discussed based on oxygen deficiency content and resistivity of the elements inside of CCTO structure.

Prospective study to determine the effect of intermittent pneumatic foot and calf compression on popliteal artery peak systolic blood flow

Mokhtar S, Azizi ZA, Govindarajanthran N

Asian J Surg, 2008 Jul;31(3):124-9.

PMID: 18658010

OBJECTIVE: This study investigated the effects of posture and also intermittent foot and calf compression on peak systolic flow of the popliteal artery in a normal population.

METHODS: This was a prospective study carried out in normal subjects at the Vascular Laboratory, Department of Surgery, Hospital Kuala Lumpur, from March 2006 to September 2006. The study compared the popliteal artery blood flow during change of posture from the horizontal (supine) to the sitting position and the effect of intermittent pneumatic compression (IPC) of the foot and calf on popliteal artery blood flow immediately and 10 minutes after cessation of compression.

RESULTS: A total of 15 subjects involving 30 limbs were examined in this study. On comparing flows between the horizontal and sitting position, there was a mean reduction in blood flow of 23% (p < 0.005). Immediately after compression of the foot and calf, there was an increase in blood flow of between 4% and 35% with a mean of 15% (p < 0.05). Peak systolic flows at 10 minutes postcompression were 536 +/- 95 mL/min, which was still significantly higher than precompression measurements.

CONCLUSION: There is a significant reduction in popliteal artery blood flow on changing from the supine to the sitting position. Popliteal artery blood flow is higher than baseline after 15 minutes of intermittent pneumatic foot and calf compression. The increase in popliteal artery blood flow is still present 10 minutes after cessation of IPC.

Fulltext Abdominal aortic aneurysm in a renal transplant patient

Naresh G, Zainal AA

Med J Malaysia, 2008 Mar;63(1):73-4.

PMID: 18935743 MyJurnal

Repair of an abdominal aortic aneurysm in a renal transplant recipient poses many different problems due to warm ischaemia to the grafted kidney. This is a case of 50-year-old gentleman who had a pervious renal transplant with abdominal aortic aneurysm. To reduce the effects of warm ischaemia on the transplanted kidney, an axillo unifemoral bypass was done prior to aneurysm repair. This ensured continued perfusion to the transplanted kidney. The post operative period was complicated by Methicillin Resistant Staphyloccus Aureus infection of the graft.

Fulltext Rare cause of Horner's syndrome: pseudoaneurysm of right subclavian artery in an intravenous drug user

Lee SK, Zainal A

Med J Malaysia, 2004 Mar;59(1):115-7.

PMID: 15535347

Pseudoaneurysms of the subclavian artery are extremely rare lesions despite the overall increase in the frequency of septic pseudoaneurysms caused by illicit parenteral drug abuse. A case of subclavian artery pseudoaneurysm presenting with Horner's syndrome in an intravenous drug user is discussed.

Study on changing the coefficient of thermal expansion (CTE) of dental porcelain

Jamaluddin O, Zainal AA

Med J Malaysia, 2004 May;59 Suppl B:143-4.

PMID: 15468859

Raising the thermal expansion coefficient (CTE) of dental porcelains is important to match the CTE of the ceramic material with the higher CTE of the metal inlay in dental restorations. The higher thermal expansion of the leucite phase increases the overall thermal expansion coefficient of the dental porcelain. Potassium nitrate (KNO3) additions in controlled percentages to the base dental porcelain formulation help in the formation of a leucite phase. The percentage added was 5,10 and 20 weight percent of leucite, respectively, to the total base frit composition. The change in CTE values was then investigated using a Linseis Dilatometer. A 20wt% KNO3 addition resulted in a CTE of 9.0 microm/m-K compared to the 7.7 microm/m-K CTE of the base composition. The microstructures observed under the scanning electron microscope (SEM) show a multiphase material with the leucite phases dispersed within a glassy matrix. The results suggest that higher CTEs in the dental porcelain are possible by increasing the KNO3- additions within the limits tested.

Fulltext An uncommon cause of duodenal obstruction

Dharmendran R, Zainal AA

Med J Malaysia, 2003 Mar;58(1):135-8.

PMID: 14556341

This is a case report of an elderly male, who presented with duodenal obstruction caused by abdominal aortic aneurysm. An axillo-bifemoral shunting with an infra renal straight inlay graft together with a feeding jejunostomy was performed. This is rare presentation with only a few cases reported.

Fulltext Learning parts of speech using poems

Syed,A,B,S,S,, Rahim,M, I,, Zainal,A,Dz,

Jurnal Inovasi Malaysia, 2019;1(1):33-42.

MyJurnal

ABSTRACT
Many language learners face difficulties in applying and using the parts
of speech in a given situation. It has become a challenge for teachers to
navigate a grammar lesson in a creative way that can help learners to
understand and apply the concepts most appropriately. Thus, POS-UP
designed as a supplementary teaching tool to allow language learners to
practice using the most suitable parts of speech in a sentence. Targeted at
English language learners, POS-UP is a game which provides players with
the opportunity to learn details of a lesson using poems written by local
poets. In this game, language learners must complete a poem by using
words with the correct parts of speech. In making sure that this game reaches
its objectives and fulfils the needs of the students, a survey was carried out
to find out the perceptions of English language learners towards POS-UP.
The result shows that learners who play this game find it enjoyable and
helpful in enhancing their understanding of parts of speech. It is hoped
that POS-UP will be a useful supplementary teaching tool for teachers in
the classroom. It is also expected that students will build an appreciation
towards poems written by local poets.

Fulltext From zinc selenate to zinc selenide nanostructures synthesized by reduction process

Hutagalung, Sabar D., Eng, Siew T., Zainal A. Ahmad, Ishak Mat, Yussof Wahab

Journal of Nuclear and Related Technologies, 2009;2009(1):147-154.

MyJurnal

One-dimensional nanostructure materials are very attractive because of their electronic and optical properties depending on their size. It is well known that properties of material can be tuned by reducing size to nanoscale because at the small sizes, that they behave differently with its bulk materials and the band gap will control by the size. The tunability of the band gap makes nanostructured materials useful for many applications. As one of the wide band gaps semiconductor compounds, zinc selenide (ZnSe) nanostructures (nanoparticles, nanowires, nanorods) have received much attention for the application in optoelectronic devices, such as blue laser diode, light emitting diodes, solar cells and IR optical windows. In this study, ZnSe nanostructures have been synthesized by reduction process of zinc selenate using hydrazine hydrate (N2H4.2H2O). The reductive agent of hydrazine hydrate was added to the starting materials of zinc selenate were heat treated at 500 o C for 1 hour under argon flow to form onedimensional nanostructures. The SEM and TEM images show the formation of nanocompositelike structures, which some small nanobars and nanopellets stick to the rod. The x-ray diffraction and elemental composition analysis confirm the formation of mixture zinc oxide and zinc selenide phases.

Fulltext Endovascular stent graft repair of aorto-iliac pseudoaneurysms - Hospital Kuala Lumpur experience

Khang NC, Zainal AA

Med J Malaysia, 2016 02;71(1):17-22.

PMID: 27130738

BACKGROUND: This is a single institutional review of aortoiliac pseudoaneurysm of various aetiologies managed with endovascular stent graft repair.

METHODS: From 2009 to 2014, 16 patients had endovascular stent graft inserted for pseudoaneurysm of the thoracic aorta, abdominal aorta and iliac arteries in Hospital Kuala Lumpur. Co-morbidity, causative agents, in-hospital mortality, complications and outcomes were examined.

RESULTS: The average age was 59.1 years (range 36-77). Comorbidities include hypertension, diabetes mellitus, tuberculosis, prior infection and previous open aneurysmal repair. All patients had raised WBC (>10.0x10(9) /L), ESR or Creactive protein on admission while 50% of patients had fever. Blood cultures were positive in 4 patients. All patients were given antibiotics. Only one in-hospital mortality was noted at day-47 post-procedure. Two patients died of aortoenteric fistula at district hospital eight and 16 months later. One patient died of chronic graft infection two years later. One died of unrelated cause. One patient developed type IB endoleak from internal iliac artery two years later and surgical ligation was performed. The average follow up was 15.8 months.

CONCLUSION: Endovascular stent graft repair for pseudoaneurysm is a viable option compared to open surgery. It is less invasive, has lower operative morbidity and fair outcomes. However, some cases may be due to inflammatory aortitis instead of infective pseudoaneurysm, given the frequent culture-negative results. In order to obtain high yield of bacteria culture for infected pseudoaneurysm, open repair with tissue culture is still the main mode of treatment especially for patients with low comorbidity.

Fulltext Bleeding jejunal GIST: An uncommon cause of gastrointestinal bleeding

Mohanaraj T, Hanif H, Zainal AA

Med J Malaysia, 2015 Feb;70(1):31-2.

PMID: 26032526 MyJurnal

Gastrointestinal stromal tumours (GIST) are rare gastrointestinal tumours and are one of the causes of obscure gastrointestinal bleeding. We report a case of massive gastrointestinal bleeding secondary to bleeding jejunal GIST in a 43 years old gentleman. Endoscopic intervention failed to identify the source of bleeding and CT Angiography (CTA) showed a jejunal mass and patient underwent laparotomy and resection of the bleeding jejunal GIST. This article highlights the rare cause of the massive GI bleeding and also emphasise the role of CTA in obscure GI bleeding.

Fulltext Laboratory evaluation of lambda-cyhalothrin a microencapsulated formulation on mosquito nets for control of vector mosquitos

Vythilingam I, Zainal AR, Hamidah T

Southeast Asian J. Trop. Med. Public Health, 1999 Mar;30(1):177-83.

PMID: 10695808

Two formulations of lambda-cyhalothrin (EC-Emulsion concentrate and MC-Microencapsulated) were impregnated into bednets made of polyethylene and polyester. The nets were treated at a dosage of 15 mg/m2. For bioassay of insecticidal efficacy, female Anopheles maculatus and Aedes aegypti were exposed to the nets for two minutes and mortality was scored 24 hours later. The nets were also tested after repeated washings with water and with soap and water. Microencapsulated (2.5CS) formulation was more effective than emulsion concentrate (2.5EC) formulation on both net materials--polyethylene and polyester. Repeated washing with water and soap reduces the efficacy of all bednet treatment combinations. Microencapsulated formulation on polyethylene gave best results; it could sustain up to five washes with water and two with soap and water.

Fulltext Profile of patients with abdominal aortic aneurysm referred to the Vascular Unit, Hospital Kuala Lumpur

Zainal AA, Yusha AW

Med J Malaysia, 1998 Dec;53(4):423-7.

PMID: 10971988

A prospective collection of patients referred with a diagnosis of abdominal aortic aneurysm (AAA) to the Vascular Unit, Hospital Kuala Lumpur (HKL) between February 1993 to July 1995 were analysed. There were a total of 124 patients, with a 85 per cent (%) male preponderance. Malays formed the largest ethnic group contributing about 60%. The median age of the patients was 69 years (range 49-84). Emergency referrals and admission accounted for 46.8% of patients. Hypertension and ischaemic heart disease were the two most common co-morbid medical conditions. The number of patients who underwent surgery was only 56 (45.2%). Of this total, 34 were done electively with an operative mortality of 8.8% (3 pts). The operative mortality for emergency surgery was 59.1%. AAA is relatively common in the older age group, especially in men and it should be actively looked for, as elective surgery can be offered with acceptable morbidity and mortality.

Fulltext A 3 year audit of infected pseudoaneurysms in intravenous drug users managed surgically in the Vascular Unit, Hospital Kuala Lumpur

Zainal AA, Yusha AW

Med J Malaysia, 1998 Dec;53(4):372-5.

PMID: 10971980

This is a study of 54 intravenous drug user's (IVDUs) with infected pseudoaneurysms undergoing ligation and debridement at the Vascular Unit, Hospital Kuala Lumpur (HKL) from February 1993 to February 1996. The median age was 37 years with a male preponderance (53:1). Chinese form the largest ethnic group with 57.4% of the cases. Staphylococcus aureus was the most common organism cultured. Human immunodeficiency virus (HIV) positive cases numbered 21 (38.9%). Four of the patients had to have an above-knee amputation after surgery. Simple ligation and debridement of all necrotic tissue is an acceptable mode of therapy in these patients with low amputation rates.

Rare complication of appendix: small bowel gangrene caused by the appendicular knot

Mohana RT, Zainal AA

Med J Malaysia, 2017 12;72(6):370-371.

PMID: 29308777 MyJurnal

Intestinal knot formation was first described by Riverius in 16th century and later by Rokitansky in 1836. We report a very rare cause of small bowel gangrene caused by appendiceal knotting on to the ileum in a previously healthy mid aged lady. Patient underwent laparatomy and right hemicolectomy and primary anastomosis. The intra operative findings were the appendix was twisting (knotting) the small bowel about 40cm from the terminal ileum and causing gangrene to the segment of small bowel. Appendicitis is a common condition and management is usually straightforward. However we must be aware of rare complications which may arise that require a change from the standard treatment of acute appendicitis.

Extra-anatomical veno-venous surgical bypass for central vein occlusion in patients with ipsilateral arterio-venous fistula (AVF) for haemodialysis - A single centre experience

Saravana KS, Zainal AA

Med J Malaysia, 2017 02;72(1):3-6.

PMID: 28255132 MyJurnal

OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face.

MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention. They underwent extra-anatomical vein to vein surgical bypass. The axillary and iliac or femoral veins were approached via infraclavicular and extraperitoneal groin incisions respectively. In all the patients, an externally supported 6 or 8 mm polytetrafluoroethylene (PTFE) graft was used as a conduit and was tunnelled extra-anatomical. All patients had double antiplatelet (Aspirin and Clopidogrel) therapy post-operatively.

RESULTS: Substantial improvement in the facial, neck and upper limb swelling was noticed following this diversion surgery. The vein to vein bypass was patent at 12 months in 10 out of 20 patients. Graft infection occurred in two (10%) cases. Re-thrombectomy or assisted patency procedure (stent/plasty) was done in four (20%) cases. The patients with preoperative fistula flow rate of more than 1500 ml/min and post-operative graft flow rate of more than a 1000 ml/min were patent at 12 months (P=0.025 and p=0.034 respectively).

CONCLUSION: Axillary to iliac/femoral vein bypass can salvage functioning ipsilateral fistula threatened by occluded upper central vein.

Fulltext Advancements of data anomaly detection research in wireless sensor networks: a survey and open issues

Rassam MA, Zainal A, Maarof MA

Sensors (Basel), 2013;13(8):10087-122.

PMID: 23966182 DOI: 10.3390/s130810087

Wireless Sensor Networks (WSNs) are important and necessary platforms for the future as the concept "Internet of Things" has emerged lately. They are used for monitoring, tracking, or controlling of many applications in industry, health care, habitat, and military. However, the quality of data collected by sensor nodes is affected by anomalies that occur due to various reasons, such as node failures, reading errors, unusual events, and malicious attacks. Therefore, anomaly detection is a necessary process to ensure the quality of sensor data before it is utilized for making decisions. In this review, we present the challenges of anomaly detection in WSNs and state the requirements to design efficient and effective anomaly detection models. We then review the latest advancements of data anomaly detection research in WSNs and classify current detection approaches in five main classes based on the detection methods used to design these approaches. Varieties of the state-of-the-art models for each class are covered and their limitations are highlighted to provide ideas for potential future works. Furthermore, the reviewed approaches are compared and evaluated based on how well they meet the stated requirements. Finally, the general limitations of current approaches are mentioned and further research opportunities are suggested and discussed.

Fulltext Endovascular Aneurysm Repair (EVAR) for Infra-renal Abdominal Aortic Aneurysm (AAA) under Local Anaesthesia - Initial Experience in Hospital Kuala Lumpur

Syed A, Zainal AA, Hanif H, Naresh G

Med J Malaysia, 2012 Dec;67(6):610-2.

PMID: 23770955 MyJurnal

This is our initial report on the first 4 cases of infra-renal abdominal aortic aneurysm undergoing Endovascular Aneurysm Repair (EVAR) with local anaesthesia, controlled sedation and monitoring by an anaesthetist. All four patients were males with a mean age of 66.7 years. Only one required ICU stay of two days for cardiac monitoring due to bradycardia and transient hypotension post procedure. No mortality or major post operative morbidity was recorded and the mean hospital stay post procedure was 3.5 days (range 2-5 days).

Fulltext Coeliac artery thrombosis: an uncommon cause of an acute abdomen

Saravana K, Zainal AA, Lee SK

Med J Malaysia, 2011 Aug;66(3):273-5.

PMID: 22111460 MyJurnal

Coeliac artery thrombosis with ischaemia is a rare condition, which usually presents with severe peptic ulcer disease symptoms. It is usually associated with risk factors for thrombosis or embolism. The manifestation is rare because of large number of collaterals between the coeliac and superior mesentery artery. Early detection and intervention is required to prevent the progression of its complications that includes gastric ischaemic necrosis.

Fulltext Supraglottoplasty for laryngomalacia: who will benefit?

Zainal A, Goh BS, Mohamed AS

Asian J Surg, 2011 Apr;34(2):92-6.

PMID: 21723473 DOI: 10.1016/S1015-9584(11)60026-2

Laryngomalacia is the most common cause of neonatal and infantile stridor. The aim of this study was to assess the outcome of surgical intervention in children with laryngomalacia.

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