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  1. Zanial AZ, Hamzah F
    MyJurnal
    Thyroid disorders could be broadly categorised into benign and malignant diseases. Approaches for the
    management of benign and malignant thyroid disorders have been well documented including the treatment
    using radioactive iodine (RAI). RAI has long been used to treat hyperthyroidism and well differentiated
    thyroid cancer. Nevertheless, there are various factors that may influence the outcome of RAI treatment
    including matters related to patient preparations. Thus, healthcare personnel play an important role in
    assisting patients to make the necessary preparations. This article aims to give nurses and clinicians of
    various specialities an insight into the overview of RAI treatment for thyroid disorders particularly in
    Malaysia and further discusses the issues related to preparations of patients.
  2. Kumar V, Li AK, Zanial AZ, Lee DA, Salleh SA
    J Clin Forensic Med, 2005 Oct;12(5):254-7.
    PMID: 16198967
    The main aim of this study was to determine the causes and epidemiological aspects of homicidal deaths. Data were collected on 217 homicidal victims from the total number of 2762 autopsies performed in UMMC, Kuala Lumpur over a five-year period, from year 1999 to 2003. There were 194 male victims and 23 female victims. The largest number of victims (63.6%) were in the age group of 20-39 years. Indians comprised the maximum proportion of victims (28.1%). Approximately 71.9% of victims came from the semiskilled and unskilled group. A majority of victims were married (47%). Injuries caused by sharp weapons (41%) were the most common cause of death, followed by blunt trauma and firearm injuries.
  3. Rohani MFM, Zanial AZ, Nagaratnam P, Gew LT, Mutalib NAA, Hassan SZA
    Med J Malaysia, 2021 07;76(4):518-525.
    PMID: 34305113
    INTRODUCTION: Gastroparesis is a medical condition that can cause significant morbidity. Its prevalence in Malaysia is not known and is often under diagnosed. The gold standard in the assessment of gastroparesis is radionuclide gastric emptying scintigraphy (GES). The aim of this study was to evaluate the added benefit of performing GES in patients with suspected gastroparesis in Hospital Kuala Lumpur (HKL).

    METHODS: The clinical data and scintigraphic findings of consecutive patients referred to the Department of Nuclear Medicine, HKL for GES from July 2020 to December 2020 were retrospectively reviewed.

    RESULTS: Thirteen patients underwent the study (6 males and 7 females) with a mean age of 47.9 years (age range of 25 to 72 years). The majority of patients (n=11) were diagnosed with either type I or type II diabetes mellitus. Ten patients reported abnormal scan findings with only 3 patients had normal GES findings. Scintigraphic findings from our patients, association of symptoms with abnormal GES as well as the challenges in implementing GES in Malaysia is discussed.

    CONCLUSION: GES provides valuable information to the referring physician in the diagnosis and management of patients with gastric motility disorders. However, its use is limited because of limited availability, cost restriction, lack of familiarity among clinicians, and lack of understanding of the test. Further effort is thus needed to enhance the availability and usage of GES in Malaysia.

  4. Mohd Rohani MF, Zanial AZ, Suppiah S, Phay Phay K, Mohamed Aslum Khan F, Mohamad Najib FH, et al.
    Nucl Med Commun, 2021 Jan;42(1):9-20.
    PMID: 33165258 DOI: 10.1097/MNM.0000000000001306
    Skeletal whole-body scintigraphy (WBS), although widely used as a sensitive tool for detecting metastatic bone disease in oncology cases, has relatively low specificity. Indeterminate bone lesions (IBLs) detected by WBS cause a diagnostic dilemma, which hampers further management plans. In the advent of hybrid imaging, single-photon emission computed tomography/computed tomography (SPECT/CT) has been gaining popularity as a tool to improve the characterisation of IBLs detected by WBS. As yet, there has not been a systematic review to objectively evaluate the diagnostic capabilities of SPECT/CT in this area. We conducted a systematic review of relevant electronic databases up to 30 August 2020. The outcomes of interest were the reporting of SPECT/CT to identify benign and malignant IBLs and the calculation of the sensitivity and specificity of the index test, based on histopathological examination or clinical and imaging follow-up as the reference standard. After the risk of bias and eligibility assessment, 12 articles were identified and synthesised in the meta-analysis. The pooled sensitivity and specificity of SPECT/CT for diagnosing IBLs are 93.0% [95% confidence interval (CI) 0.91-0.95] and 96.0% (95% CI 0.94-0.97), respectively. There was heterogeneity of the articles due to variable imaging protocols, duration of follow-up and scoring methods for interpreting the SPECT/CT results. The heterogeneity poses a challenge for accurate interpretation of the true diagnostic capability of SPECT/CT. In conclusion, targeted SPECT/CT improves the specificity of diagnosing bone metastases, but efforts need to be made to standardise the thresholds for SPECT/CT, methodology, as well as harmonising the reporting and interpretation criteria. We also make some recommendations for future works.
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