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Fulltext Anticoagulation with Warfarin: Roles of Adherence, Social Support and Illness Perception

Mohamed Koya SNMV

Innov Pharm, 2019;10(4).
PMID: 34007579 DOI: 10.24926/iip.v10i4.1966

OBJECTIVES: This study was aimed to determine (1) the associations between adherence to warfarin, social support, perception of illness, and demographic factors on the quality of international normalized ratios (INRs); as well as (2) the relationship between the patients' scores in the Malaysian medication adherence scale (MALMAS) and their current INRs.
METHOD: This cross-sectional survey was conducted from November 2017 to January 2018 at the warfarin clinic of Jerantut Hospital, Malaysia.
RESULTS: Some 58 participants were recruited, of whom 70.7% were diagnosed with atrial fibrillation (AF). Overall, 87.9% of the participants claimed adherence to their warfarin regimens. Patients with good-quality INR therapy were significantly older, had a higher median income and longer appointment durations. In terms of illness perception (IP), participants with good-quality INR therapyhad significantly lower scores in the identity, personal control, and consequence domains. Overall, the total scores for IP were significantly lower in the good-quality INR therapy. Meanwhile, the MALMAS scores were significantly lower in patients with sub-therapeutic current INR. However, there were no associations between warfarin adherence and perceived social support with current TTR.
CONCLUSION: Monitoring of demographic factors and IP's domains is vital since they were associated with quality of INR therapy. Meanwhile, the occurrence of sub-therapeutic current INR should raise suspicion of poor adherence in these patients. Overall, IP and MALMAS are useful tools that should be integrated into the patient care protocols.
Fulltext Associations between phosphate binders prescription, illness perception, and depression in hemodialysis patients

Mohamed Koya SNMV, Zulkepli NA

Saudi J Kidney Dis Transpl, 2018 8 29;29(4):828-836.
PMID: 30152419 DOI: 10.4103/1319-2442.239656

Studies among hemodialysis (HD) patients have looked into relationships between illness perception (IP), depression, and adherence yet rarely looked further into medication factors. Those studies were also conducted at urban HD centers leaving out those from a smaller town. Our objective is to determine phosphate binders (PBs) influences on IP and depression among HD population in smaller town. One hundred and thirteen patients from three Central Pahang Cluster Hospitals, Malaysia on HD were interviewed using Malay version of the Brief IP Questionnaire and Beck Depression Inventory II (BDI-II). This study found a significant positive correlation between PBs daily dose frequency with consequence, timeline, and illness concern. Type of PBs used influenced personal control significantly. History of PBs side effects resulted in significantly lower treatment control and lower emotional representation. There was a significant negative relationship between dialysis vintage with both identity and IP score. Depressed patients had significantly higher emotional representation compared to healthy controls. Meanwhile, there was a positive correlation between BDI-II score with coherence, consequence, and emotional representation. Around 23.9% of the patients reported symptoms of depression. Depressed patients had significantly shorter dialysis vintage compared to healthy controls. They tended to report a significant history of hospital admission in the past six months that peaked among those on HD between four to six years. The current study showed the effect of PBs therapy on IP while depression was associated with HD duration and hospital admission. This information can be used to formulate a better treatment approach by health-care practitioners toward better patients treatment hence outcomes.
Fulltext Stress among parents with acutely ill children

Nizam M, Norzila MZ

Med J Malaysia, 2001 Dec;56(4):428-34.
PMID: 12014761

Objectives: A child's admission into intensive care is a major cause of stress for parents. However among Malaysian parents, data concerning the perception of stress are virtually absent. Therefore we conducted a study to measure the reliability of the Malay version of Parental Stressor Scale: Pediatric Intensive Care Unit (PSS: PICU) in identifying sources of stress and to study factors that might influence their stress response.
Methods: Over a six-month period, one hundred and twelve parents were requested to answer the questionnaires twice either in Malay or English, a week apart. Spearman's correlation and Cronbach's alpha coefficient was used to assess the repeatability and internal consistency of the questionnaires.
Results: Ninety-four (83.9%) and seventy-one (75.3%) parents responded to the first and second administration of questionnaire respectively. All answered in the Malay language except for three. The correlation ranged from 0.50 to 0.71 with a total score of 0.76. The Cronbach's alpha coefficient ranged from 0.75 to 0.93, with total a score of 0.95.
Alteration in parental roles was the most stressful source of stress. Fathers, parents of children with higher PRISM score and parents with no previous admission into intensive care unit scored significantly higher in staff’s communication.
Conclusion: The Malay version of PSS: PICU is reliable in identifying sources of stress. Alteration in parental roles was the most stressful source of stress. Parents' gender, previous experience and severity of the child illness may influence their stress responses.
Fulltext Perinatal management of cardiac tumors: a case series

Amelia A, Mohd Nizam MB

Med J Malaysia, 2013 Aug;68(4):374-5.
PMID: 24145275 MyJurnal

Primary cardiac tumours in the foetuses and neonates are uncommon. Foetuses with cardiac tumour have risk for heart failure and hydrops fetalis. Therefore, an early decision for delivery should be made in the evidence of foetal compromise. Early neonatal care varies on tumour size, type, location and obstructive features. Antenatal detection of foetal cardiac tumours ensures better prenatal and postnatal management. We describe our 5- year experience in managing 5 cases of primary cardiac tumours from 1st January 2006 to 31st December 2010.
Fulltext Development of a randomised contrast detail digital phantom for observer detectability study

Nizam M, Ng Kh, Abdullah B

Biomed Imaging Interv J, 2006 Jul;2(3):e38.
PMID: 21614246 MyJurnal DOI: 10.2349/biij.2.3.e38

The accuracy and the efficacy of radiological diagnosis depend, to a large extent, on the conditions under which radiographs and images are viewed. This mainly involves the luminance of the display devices and the ambient room illumination. We report a perceptual study to investigate the relationship between detectability and monitor luminance as well as ambient illuminance. A statistical test pattern was used in this study, and the test pattern was developed using Microsoft® Visual Basic 6. The test pattern contained a set of randomised contrast detail objects, that is, disks of different diameters (0.7, 1.0, 1.4, and 2.0 mm) and contrasts against a black background (2.7, 3.9, 5.5, and 7.8%), simulating lesions in digital images. The receiver operating characteristic (ROC) analysis was used in this study. The results indicated that a set of optimal viewing conditions exists and that it has a significant effect on detectability performance.
Status fiziko-kimia tanih tapak Pusat Penyelidikan UKM Tasik Chini, Pahang, Malaysia

Sahibin Abd. Rahim, Wan Mohd. Razi Idris, Zulfahmi Ali Rahman, Tukimat Lihan, Gasim MB, Mohd Nizam M. Said, et al.

Sains Malaysiana, 2011;40:1123-1127.

Kajian ini dilakukan untuk menentukan ciri fiziko-kimia, kandungan nutrien dan logam berat dalam tanih di tapak Pusat Penyelidikan UKM Tasik Chini. Sampel tanih-atas diambil dari tiga transek pensampelan iaitu T1, T2 dan T3. Dua profil tanih telah dicerap di transek 1 (T1S1 & T1S3) dan sampel tanih telah diambil daripada profil dan juga tanih atas untuk penentuan ciri fiziko-kimia, kandungan nutrien dan logam berat. Bagi sampel tanih-atas, sebanyak empat stesen pensampelan (S1, S2, S3, S4) telah dipilih di transek 1 (T1), dua stesen pensampelan (S1, S2) di transek 2 (T2) dan tiga stesen pensampelan (S1, S2, S3) di transek 3 (T3) telah dipilih. Ciri fiziko-kimia yang ditentukan adalah pH, kekonduksian elektrik (KE), kapasiti pertukatan kation (KPK), fosforus, kalium dan magnesium tersedia dan nutrien terlarut, dan logam berat terpilih. Semua penentuan fiziko-kimia tanih, nutrien tersedia dan terlarut serta logam berat dilakukan mengikut kaedah penentuan yang piawai. Hasil uji kaji menunjukkan tekstur tanih didominasi oleh zarahan bersaiz lempung. Kandungan bahan organik tinggi pada tanih-atas dan berkurangan mengikut kedalaman. Purata nilai pH tanih di dalam profil dan tanih-atas adalah di antara 3.66 hingga 4.73 dan ia adalah sangat berasid. Sela purata bagi kekonduksian elektrik dalam profil dan tanih-atas adalah antara 2412 μScm-1 dan 2742 μScm-1. Purata nilai KPK adalah rendah iaitu antara 4.86 dan 12.58 meq/100g tanih. Kepekatan fosforus, magnesium dan kalium tersedia masing-masing mempunyai sela antara 1.76 – 3.32 μg/g, 16.80 – 122.23 μg/g dan 20.09 – 30.50 μg/g. Kepekatan nutrien terlarut bagi sulfat, nitrat-nitrogen, ammonium-nitrogen dan fosforus masing-masing adalah 37.50 – 1350 μg/g, 12.17 dan 90.00 μg/g, 12.17 to 53.17 μg/g dan 0.05 dan 0.62 μg/g. Kepekatan ferum dan Pb sangat tinggi di T1S1 dan di horizon bawah profil T1S3. Secara amnya tanih di tapak PPTC adalah sangat berasid dan mempunyai kandungan nutrien yang rendah. Terdapat bukti menunjukkan berlaku pengayaan Pb dalam tanih yang menerima pengaruh pasang surut jasad air tasik.
An indicator device for monitoring of room illuminance level in the radiological image viewing environment

Azlan CA, Ng KH, Anandan S, Nizam MS

Australas Phys Eng Sci Med, 2006 Sep;29(3):278-80.
PMID: 17058591

Illuminance level in the softcopy image viewing room is a very important factor to optimize productivity in radiological diagnosis. In today's radiological environment, the illuminance measurements are normally done during the quality control procedure and performed annually. Although the room is equipped with dimmer switches, radiologists are not able to decide the level of illuminance according to the standards. The aim of this study is to develop a simple real-time illuminance detector system to assist the radiologists in deciding an adequate illuminance level during radiological image viewing. The system indicates illuminance in a very simple visual form by using light emitting diodes. By employing the device in the viewing room, illuminance level can be monitored and adjusted effectively.
Ex vivo growth of rabbit bulbar, fornix and palpebral conjunctival epithelia in a serum-free and feeder layer-free culture system

Nizam MH, Ruszymah BH, Chua KH, Ghafar NA, Hamzah JC

Med J Malaysia, 2008 Jul;63 Suppl A:111-2.
PMID: 19025010

This study was conducted to explore the feasibility of culturing conjunctiva epithelial cells in serum-free and feeder layer-free culture system with regard to the cell morphology and immunocytochemistry of the rabbit bulbar, fornix and palpebral conjunctiva epithelia. The results showed that epithelium cells from all the three conjunctiva regions can be cultured in a serum-free and feeder layer-free environment. We obtained highest epithelial growth from fornix region with minimum invasion of fibroblast cells compared to other area. All cultured cells were stained positive for cytokeratin 19 and MUC5AC and negative for cytokeratin 3. These findings suggested that fornix was a better source of cells for the development of tissue engineered conjunctiva for future clinical application.
An improved rapid genotyping method for the study of beta-2 adrenergic receptor gene polymorphisms using single tube allele specific multiplex PCR

Zilfalil BA, Hoh BP, Nizam MZ, Liza-Sharmini AT, Teh LK, Ismail R

J Clin Pharm Ther, 2006 Dec;31(6):637-40.
PMID: 17176369

Seventeen single nucleotide polymorphisms (SNPs) have been identified so far, within the beta-2 receptor (beta(2) AR) gene. The presence of so many SNPs within the beta(2) AR gene causes a problem, for those studying beta(2) AR pharmacogenetics, in relation to which SNPs to choose. Most of the work has focused on the three common SNPs within the coding block (alleles 16, 27 and 164) and the techniques developed have been for these three functionally important alleles.
Bioaccumulation of heavy metals in maricultured fish, Lates calcarifer (Barramudi), Lutjanus campechanus (red snapper) and Lutjanus griseus (grey snapper)

Nasyitah Sobihah N, Ahmad Zaharin A, Khairul Nizam M, Ley Juen L, Kyoung-Woong K

Chemosphere, 2018 Apr;197:318-324.
PMID: 29360594 DOI: 10.1016/j.chemosphere.2017.12.187

Mariculture fish contains a rich source of protein, but some species may bioaccumulate high levels of heavy metals, making them unsafe for consumption. This study aims to identify heavy metal concentration in Lates calcarifer (Barramudi), Lutjanus campechanus (Red snapper) and Lutjanus griseus (Grey snapper). Three species of mariculture fish, namely, L. calcarifer, L. campechanus and L. griseus were collected for analyses of heavy metals. The concentration of heavy metal (As, Cd, Cu, Cr, Fe, Pb, Mn, Ni, Se, and Zn) was determined using inductive coupled plasma mass spectrometry (ICP-MS). The distribution of heavy metals mean concentration in muscle is Zn > Fe > As > Se > Cr > Cu > Mn > Pb > Ni > Cd for L. calcarifer, Fe > Zn > Cr > As > Ni > Mn > Se > Cu > Pb > Cd for L. campechanus and Fe > Zn > Cr > Ni > Se > Cu > As > Mn > Pb > Cd for L. griseus. Among all of the species under investigation, the highest concentration of Fe was found in the muscle tissue of L. campechanus (19.985 ± 1.773 mg kg-1) and liver tissue of L. griseus (58.248 ± 8.736 mg kg-1). Meanwhile, L. calcarifer has the lowest concentration of Cd in both muscle (0.007 ± 0.004 mg kg-1) and liver tissue (0.027 ± 0.016 mg kg-1). The heavy metal concentration in muscle tissue is below the permissible limit guidelines stipulated by the Food & Agriculture Organization, 1983 and Malaysia Food Act, 1983. The concentration of heavy metals varies significantly among fish species and tissues. L. campechanus was found to have a higher ability to accumulate heavy metals as compared to the other two species (p 
The use of autologous fibrin as a scaffold for cultivating autologous conjunctiva in the treatment of conjunctival defect

Safinaz MK, Norzana AG, Hairul Nizam MH, Ropilah AR, Faridah HA, Chua KH, et al.

Cell Tissue Bank, 2014 Dec;15(4):619-26.
PMID: 24633432 DOI: 10.1007/s10561-014-9436-y

The purpose of this study was to compare the use of autologous fibrin to human amniotic membrane (HAM) as a scaffold in cultivating autologous conjunctiva for transplantation in treatment of conjunctival defect. An experimental study was performed using 18 adult New Zealand white strain rabbits which were divided into 3 groups. Each group consists of 6 rabbits. The conjunctiva on the temporal site was excised to create a conjunctival epithelial defect. The excised area in the Group 1 was transplanted with autologous conjunctiva cultivated on autologous fibrin; Group 2 was transplanted with autologous conjunctiva cultivated on HAM and Group 3 was left bare. The rabbits were followed up at regular intervals until 6 weeks. The mean period of complete conjunctival epithelization was 11.50 ± 8.22 days for the autologous fibrin group, 15.33 ± 11.80 days for the HAM group and 25.33 ± 5.32 days in the bare sclera group. The epithelization rate for the autologous fibrin group was faster compared to the other two groups. However all the results were not statistically significant (p value >0.05). There were no postoperative complications noted during the follow up. Autologous fibrin is comparable to HAM as a scaffold for cultivation of conjunctiva in the treatment of conjunctival defect.
Fulltext Detection of beta-globin gene mutations among Kelantan Malay thalassaemia patients by polymerase chain reaction restriction fragment length polymorphism

Rozitah R, Nizam MZ, Nur Shafawati AR, Nor Atifah MA, Dewi M, Kannan TP, et al.

Singapore Med J, 2008 Dec;49(12):1046-9.
PMID: 19122960

Beta-thalassaemia major is an autosomal recessive disorder that results in severe microcytic, hypochromic, haemolytic anaemia among affected patients. Beta-thalassaemia has emerged as one of the most common public health problems in Malaysia, particularly among Malaysian Chinese and Malays. This study aimed to observe the spectrum of mutations found in Kelantan Malay beta-thalassaemia major patients who attended the Paediatrics Daycare Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, the data of which was being used in establishing the prenatal diagnosis in this Human Genome Centre.
Fulltext Safety and Efficacy of Human Wharton's Jelly-Derived Mesenchymal Stem Cells Therapy for Retinal Degeneration

Leow SN, Luu CD, Hairul Nizam MH, Mok PL, Ruhaslizan R, Wong HS, et al.

PLoS One, 2015;10(6):e0128973.
PMID: 26107378 DOI: 10.1371/journal.pone.0128973

To investigate the safety and efficacy of subretinal injection of human Wharton's Jelly-derived mesenchymal stem cells (hWJ-MSCs) on retinal structure and function in Royal College of Surgeons (RCS) rats.

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