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  1. Meftahuddin, T., Anisah, A.B., Mohd Faizal, A.
    MyJurnal
    An outbreak of dengue and dengue haemorrhagic fever was studied in Bandar Baru Bangi, Hulu Langat District which started from epidemiological week 51 of December 2001 until ]anuary 2002. Altogether, 53 cases were reported to the Hulu Langat District Health Office with 24 cases detected in Section I and Section 6, and 5 cases in Section 4 of Bandar Baru Bangi respectively. Two cases were confirmed as dengue haernorrhagic fever (DHF). The majority of the cases were female Malays. The age of the cases ranged from 3 to 60 years with a mean of 29.17 : 13.18 years old. The majority of patients were mainly private sector workers from factories or companies with 29 cases (54.7%) and university students with 14 cases (26.4%). No deaths were reported in this outbreak. On the average, the duration taken for a patient to be admitted from the date of onset was about 4.4 - 2.0 days and the duration taken for notification from the date of admission was about 2.0 - 1.7 days. The majority of cases reported were based on classical clinical features of dengue fever. Only 18 cases (34%) were IgM positive for dengue. The statistical analysis showed that the majority were male (P>0.05), Malays (P>0.05) , age group of 21»30 years (P>0.05), platelets level < 100,000 per mm3 (p>0.05) and the serological specimens obtained 5 days after the date of onset (p2.0%) within residential premises in this locality with 46 Aedes mosquito breeding places identified and a total amount of RM 6500 of fines imposed.
  2. Mohd Faizal, A., Vijayan, V., Sandhya, M.M., Noor Shahieddah, F., Vinod, S., Tan, L.K., et al.
    MyJurnal
    The EXIT (Ex utero intrapartum treatment) procedures have been, with a high degree of success, employed to treat a myriad types of fetal airway obstruction most commonly neck masses such as cystic hygroma and lymphangioma with ample plan including prenatal diagnosis by ultrasound scan or MRI. Before the advent of EXIT, formal documentations had been published with descriptions of intubation during intrapartum period and fetal airway protection either during normal or operative delivery. We report a 28-year-old gravida 2 para 1 who was referred to our Maternal Fetal Medicine (MFM) unit at 26 weeks and 3 days gestation with a foetal neck mass. We present a case of an successful EXIT procedure performed in the Lloyd Davies position with the hips abducted and flexed at 15 degrees as is employed during gynecologic laparoscopy surgery minus the Trendelenburg tilt. Both mother and baby are well. The benefits of this position are discussed.
  3. Mohd Faizal, A., Dianie, D.J.K., Suguna, S., Soon, R., Moharzudi, M.
    MyJurnal
    A pure ovarian choriocarcinoma is a very rare disease which can be either pregnancy related (gestational), may not be related (non-gestational), or commonly correlated with different type of germ cell; teratocarcinoma, dysgerminoma or undifferentiated carcinoma. A pure non-gestational primary ovarian choriocarcinoma is astronomically uncommon and we recorded such condition in 14-year-old teenage girl’s ovary. An abdominal operative procedure with the help of a careful histopathology examination revealed choriocarcinoma in absence of other type of germ cell element. Multiple courses of Etoposide/Methotrexate/Actinomycin-D (EMA) regime of chemotherapy were shown to be effective in this case.
  4. Manaf FA, Peiffer JJ, Maker GL, Fairchild TJ
    J Sci Med Sport, 2021 Apr;24(4):412-417.
    PMID: 33162329 DOI: 10.1016/j.jsams.2020.10.014
    OBJECTIVES: To investigate the effects of acute branched-chain amino acid (BCAA) supplementation on cycling performance and neuromuscular fatigue during a prolonged, self-paced cycling time-trial.

    DESIGN: Randomised double-blind counterbalanced crossover.

    METHODS: Eighteen recreationally active men (mean±SD; age: 24.7±4.8 years old; body-weight, BW: 67.1±6.1kg; height: 171.7±4.9cm) performed a cycling time-trial on an electromagnetically-braked cycle ergometer. Participants were instructed to complete the individualised total work in the shortest time possible, while ingesting either BCAAs (pre-exercise: 0.084gkg-1 BW; during exercise: 0.056gkg-1h-1) or a non-caloric placebo solution. Rating of perceived exertion, power, cadence and heart rate were recorded throughout, while maximal voluntary contraction, muscle voluntary activation level and electrically evoked torque using single and doublet stimulations were assessed at baseline, immediately post-exercise and 20-min post-exercise.

    RESULTS: Supplementation with BCAA reduced (287.9±549.7s; p=0.04) time-to-completion and ratings of perceived exertion (p≤0.01), while concomitantly increasing heart rate (p=0.02). There were no between-group differences (BCAA vs placebo) in any of the neuromuscular parameters, but significant decreases (All p≤0.01) in maximal voluntary contraction, muscle voluntary activation level and electrically evoked torque (single and doublet stimulations) were recorded immediately following the trial, and these did not recover to pre-exercise values by the 20min recovery time-point.

    CONCLUSIONS: Compared to a non-caloric placebo, acute BCAA supplementation significantly improved performance in cycling time-trial among recreationally active individuals without any notable changes in either central or peripheral factors. This improved performance with acute BCAA supplementation was associated with a reduced rating of perceived exertion.

  5. Ho JP, Ahmad Faizal A, Sivapathasundaram N
    Malays Orthop J, 2013 Nov;7(3):30-2.
    PMID: 25674306 MyJurnal DOI: 10.5704/MOJ.1311.012
    We present a case of chronic acromioclavicular joint dislocation (Rockwood type 5) in which the choice of acromioclavicular reconstruction using autogenous semitendinosus tendon graft was made due to its superiority in anatomical reconstruction of the coracoclavicular ligaments, and the impact of postoperative rehabilitation on the recovery of this patient. We also discuss the rationale behind this.
  6. Munusamy T, Karuppiah R, Bahuri NFA, Sockalingam S, Cham CY, Waran V
    World Neurosurg, 2021 01;145:e53-e60.
    PMID: 32956888 DOI: 10.1016/j.wneu.2020.09.076
    OBJECTIVE: The coronavirus disease 2019 pandemic poses major risks to health care workers in neurocritical care. Recommendations are in place to limit medical personnel attending to the neurosurgical patient as a protective measure and to conserve personal protective equipment. However, the complexity of the neurosurgical patient proves to be a challenge and an opportunity for innovation. The goal of our study was to determine if telemedicine delivered through smart glasses was feasible and effective in an alternative method of conducting ward round on neurocritical care patients during the pandemic.

    METHODS: A random pair of neurosurgery resident and specialist conducted consecutive virtual and physical ward rounds on neurocritical patients. A virtual ward round was first conducted remotely by a specialist who received real-time audiovisual information from a resident wearing smart glasses integrated with telemedicine. Subsequently, a physical ward round was performed together by the resident and specialist on the same patient. The management plans of both ward rounds were compared, and the intrarater reliability was measured. On study completion a qualitative survey was performed.

    RESULTS: Ten paired ward rounds were performed on 103 neurocritical care patients with excellent overall intrarater reliability. Nine out of 10 showed good to excellent internal consistency, and 1 showed acceptable internal consistency. Qualitative analysis indicated wide user acceptance and high satisfaction rate with the alternative method.

    CONCLUSIONS: Virtual ward rounds using telemedicine via smart glasses on neurosurgical patients in critical care were feasible, effective, and widely accepted as an alternative to physical ward rounds during the coronavirus disease 2019 pandemic.

  7. Manaf FA, Lawler NG, Peiffer JJ, Maker GL, Boyce MC, Fairchild TJ, et al.
    J Appl Physiol (1985), 2018 Oct 01;125(4):1193-1203.
    PMID: 30070608 DOI: 10.1152/japplphysiol.00499.2018
    Although complex in nature, a number of metabolites have been implicated in the onset of exercise-induced fatigue. The purpose of this study was to identify changes in the plasma metabolome and specifically, to identify candidate metabolites associated with the onset of fatigue during prolonged cycling. Eighteen healthy and recreationally active men (mean ± SD; age: 24.7 ± 4.8 yr; mass 67.1 ± 6.1 kg; body mass index: 22.8 ± 2.2; peak oxygen uptake: 40.9 ± 6.1 ml·kg-1·min-1) were recruited to this study. Participants performed a prolonged cycling time-to-exhaustion (TTE) test at an intensity corresponding to a fixed blood lactate concentration (3 mmol/l). Plasma samples collected at 10 min of exercise, before fatigue (last sample before fatigue <10 min before fatigue), immediately after fatigue (point of exhaustion), and 20 min after fatigue were assessed using a liquid chromatography-mass spectrometry-based metabolomic approach. Eighty metabolites were putatively identified, with 68 metabolites demonstrating a significant change during the cycling task (duration: ~80.9 ± 13.6 min). A clear multivariate structure in the data was revealed, with the first principal component (36% total variance) describing a continuous increase in metabolite concentration throughout the TTE trial and recovery, whereas the second principal component (14% total variance) showed an increase in metabolite concentration followed by a recovery trajectory, peaking at the point of fatigue. Six clusters of correlated metabolites demonstrating unique metabolite trajectories were identified, including significant separation in the metabolome between prefatigue and postfatigue time points. In accordance with our hypothesis, free-fatty acids and tryptophan contributed to differences in the plasma metabolome at fatigue.NEW & NOTEWORTHY Metabolites have long been implicated in the onset of fatigue. This study applied a metabolomic approach to track 80 plasma-borne metabolites during a cycle to fatigue task. Of these, 68 metabolites demonstrated significant change, with the plasma metabolome at fatigue being clearly distinguishable from other time points. Six unique clusters of metabolites were identified, and free fatty acids were strongly associated with fatigue onset therein lending support to the central fatigue hypothesis.
  8. Saiboon IM, Qamruddin RM, Jaafar JM, Bakar AA, Hamzah FA, Eng HS, et al.
    Saudi Med J, 2016 Apr;37(4):429-35.
    PMID: 27052286 DOI: 10.15537/smj.2016.4.14833
    To evaluate the effectiveness and retention of learning automated external defibrillator (AED) usage taught through a traditional classroom instruction (TCI) method versus a novel self instructed video (SIV) technique in non-critical care nurses (NCCN).
  9. Faizal A, Bujang Safawi E, Sundram M, Kueh NS, Normala B
    Urol Int, 2011;87(1):117-9.
    PMID: 21709396 DOI: 10.1159/000324543
    Surgical wound infection after a renal transplant procedure can lead to graft loss in the presence of host immunosuppression and graft exposure to the environment. Early cover of the wound with well-vascularized tissue will facilitate early wound healing and preservation of the graft. The pedicle anterolateral thigh perforator flap is a popular flap used for soft tissue reconstruction in the groin and perineum. We present a case of an anterolateral thigh flap used to cover an exposed transplanted kidney after surgical wound breakdown.
  10. Saiboon IM, Singmamae N, Jaafar MJ, Muniandy BK, Sengmamae K, Hamzah FA, et al.
    Saudi Med J, 2014 Jul;35(7):718-23.
    PMID: 25028229
    To evaluate the effectiveness of a new patient flow system, `The Red Box` on the quality of patient care in respect of the time taken for the care to be delivered to the patient.
  11. Fariz MM, Tarmizi MN, Ainaini MH, Khairil AM, Faizal A, Sagap I
    Clin Ter, 2011;162(6):543-5.
    PMID: 22262325
    BACKGROUND AND OBJECTIVES: Ritual circumcision is one of the most common surgical procedures performed in the developing world. Various technique for circumcision has been described to increase patient's safety and to decrease operating time. This study will look at comparing the conventional method of circumcision using scissors and ligatures with bipolar diathermy. To compare the incidence of bleeding and infection in patients who underwent circumcision between using the bipolar diathermy technique with conventional surgery (dorsal slit) technique for circumcision. The operative time between the two techniques were also recorded.
    MATERIALS AND METHODS: A prospective, randomized study was conducted in all children undergoing ritual circumcision at Raja Perempuan Zainab II Hospital, Malaysia over a 1-year period. Data analysed were the operation time,postoperative bleeding rates and infection rates.
    RESULTS: A total of 341 patients were included in the study. Randomization resulted in 183 patients in conventional surgery group and 158 patients in bipolar group. The incidence of bleeding were significantly better in the bipolar group compared to conventional group (3.1% vs 19.7%), (p<0.001). There was no significant difference in the infection rate (1.3% vs 2.7%) (p=0.457). Operative times were shorter in the bipolar diathermy group (Mean 8.2 minutes) compared to conventional group (Mean 15.3 minutes) (p<0.01).
    CONCLUSION: Bipolar diathermy technique for circumcision is safe and quicker than the dorsal slit technique.
  12. Mat Jin N, Ahmad SM, Mohd Faizal A, Abdul Karim AKB, Abu MA
    Horm Mol Biol Clin Investig, 2022 Dec 01;43(4):469-474.
    PMID: 35545610 DOI: 10.1515/hmbci-2021-0096
    OBJECTIVES: We aim to discuss the hematological cancer cases that opted for ovarian tissue cryopreservation (OTC) as fertility preservation before the gonadotoxic chemotherapy agent.

    CASE PRESENTATION: The ovarian tissue cryopreservation (OTC) was started in August 2020 in our center. Up to now, there were four cases have been performed and included in this report. The ovarian tissue cortex was cryopreserved with cryoprotectant using Kitazato™ (Tokyo, Japan) media and fit in the closed system devices. A total of four post-OTC patients were included. The mean age was 24 years old, whereas the mean serum AMH level was 30.43 pmol/L. Most of them were diagnosed with lymphoma, except one was leukemia. All of them received additional GnRH analog following OTC as a chemoprotective agent before cancer treatment. Currently, they are recovering well and on regular follow-up with the hematological department.

    CONCLUSIONS: Although The OTC is an ultimate option for prepubertal girls, it can be proposed as a good strategy for adult cancer women who could not delay cancer therapy.

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