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Fulltext Spinal cord stimulation for treatment of failed back surgery syndrome--two case reports

Vijayan R, Ahmad TS

Med J Malaysia, 1999 Dec;54(4):509-13.
PMID: 11072471

Severe, persistent back pain following back surgery is often referred to as Failed Back Surgery Syndrome (FBSS). Conservative measures such as physiotherapy, back strengthening exercises, transcutaneous electrical nerve stimulation and epidural steroids may be inadequate to alleviate pain. Spinal Cord Stimulators were implanted into two patients suffering from FBSS. Both patients responded successfully to spinal cord stimulation with reduction of pain and disability.
Fulltext Clinical significance of Mantoux test in Malaysian patients

Yaacob I, Ahmad Z

Med J Malaysia, 1990 Sep;45(3):231-4.
PMID: 2152084

The value of tuberculin skin testing in the diagnosis of active tuberculosis remains uncertain. Interpretation of tuberculin tests would be easier if the tuberculin test profiles in different communities were accurately known. We reviewed 468 Mantoux test reactions in patients coming to Hospital Universiti Sains Malaysia with suspected tuberculosis. Eighty six percent of patients with active tuberculosis had a positive Mantoux test. Forty two percent of the cases of positive Mantoux test did not have evidence of active tuberculosis. Most of these cases had evidence of past infection with tuberculosis. We conclude that Mantoux test is a sensitive but a non-specific test in the diagnosis of active tuberculosis.
Study site: outpatients, inpatients; Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
Fulltext Acute retrograde jejunogastric intussusception 20 years after Bilroth II gastrectomy: a case report

Sakijan AS, Ahmad I

Med J Malaysia, 1987 Jun;42(2):134-6.
PMID: 3503189

A 50-year-old male had an acute jejunogastric intussusception complicating a Bilroth 11 gastrectomy done 20 years previously for peptic ulcer. Preoperatively, the diagnosis was suspected from the plain abdominal radiograph which was subsequently confirmed by barium meal. The patient had an uneventful recovery following resection of the intussuscepted segment and an end-to-end anastomosis. Although rare, the condition is serious and should be recognised promptly and treated surgically. The diagnosis should always be considered in a patient who has had a previous gastrojejunostomy presented with a sudden onset of epigastric pain, bloody vomitus and epigastric mass.
Fulltext Complex Chemical Data Classification and Discrimination Using Locality Preserving Partial Least Squares Discriminant Analysis

Aminu M, Ahmad NA

ACS Omega, 2020 Oct 20;5(41):26601-26610.
PMID: 33110988 DOI: 10.1021/acsomega.0c03362

Partial least squares discriminant analysis (PLS-DA) is a well-known technique for feature extraction and discriminant analysis in chemometrics. Despite its popularity, it has been observed that PLS-DA does not automatically lead to extraction of relevant features. Feature learning and extraction depends on how well the discriminant subspace is captured. In this paper, discriminant subspace learning of chemical data is discussed from the perspective of PLS-DA and a recent extension of PLS-DA, which is known as the locality preserving partial least squares discriminant analysis (LPPLS-DA). The objective is twofold: (a) to introduce the LPPLS-DA algorithm to the chemometrics community and (b) to demonstrate the superior discrimination capabilities of LPPLS-DA and how it can be a powerful alternative to PLS-DA. Four chemical data sets are used: three spectroscopic data sets and one that contains compositional data. Comparative performances are measured based on discrimination and classification of these data sets. To compare the classification performances, the data samples are projected onto the PLS-DA and LPPLS-DA subspaces, and classification of the projected samples into one of the different groups (classes) is done using the nearest-neighbor classifier. We also compare the two techniques in data visualization (discrimination) task. The ability of LPPLS-DA to group samples from the same class while at the same time maximizing the between-class separation is clearly shown in our results. In comparison with PLS-DA, separation of data in the projected LPPLS-DA subspace is more well defined.
Fulltext Ventilation flow evaluation system for sustainable housing development

Nur Azfahani Ahmad, Zuraihana Ahmad Zawawi, Nazhatulzalkis Jamaludin, Khairulliza Ahmad Salleh

Jurnal Inovasi Malaysia, 2019;2(2):55-70.
MyJurnal

A 1984 World Health Organization (WHO) Committee report highlighted that up to 30 per cent of buildings may have to face problems related to Indoor Air Quality (IAQ). Insufficient ventilation will lead to stagnant air and can cause stuffiness in buildings. This will then leads to a bigger problem, known as the Sick Building Syndrome (SBS). It is important to note that sick building syndrome may cause various illnesses including allergies, acute respiration problem, feeling of discomfort and other psychological impacts. The “Ventilation Flow Evaluation System for Sustainable Housing Development” is a PC-based database tool developed to access and measure ventilation flow in a new or remodelled building in order to prevent or mitigate this problem. The purpose of the system is to provide resources for building designers in solving Indoor Air Quality (IAQ) issues especially related to ventilation flow based on regulations provided in Malaysian Standard (MS 1525). The system will allow readily building plan to be measured and analysed based on ventilation data collected at site, in order to allow buildings to obtain healthy and sufficient air for breathing and comfort purposes. The system will also recommend suitable layout plan in the building to meet the ventilation purposes, namely cross-ventilation and stack-effect ventilation.
The early phase of acute myocardial infarction - a study of 100 cases

Ng WH, Goh TH, Ahmad Z

Family Practitioner, 1979;3(5):24-7.
Oral Health Messiers: Diabetes Mellitus Relevance

Ahmad R, Haque M

Diabetes Metab Syndr Obes, 2021;14:3001-3015.
PMID: 34234496 DOI: 10.2147/DMSO.S318972

This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for "diabetes mellitus and oral complications" was done. The search was also carried out for "diabetes mellitus" and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45-88% in patients with type 2 diabetes compared to 38.3-45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.
Fulltext Occurrence of virulent genes among environmental isolates of Legionella pneumophila serogroup 1 strains from various parts of peninsular Malaysia

Arushothy R, Ahmad N

Trop Biomed, 2008 Dec;25(3):259-61.
PMID: 19287368

Legionella pneumophila are intracellular pathogens, associated with human disease, attributed to the presence and absence of certain virulent genes. In this study, virulent gene loci (lvh and rtxA regions) associated with human disease were determined. Thirty-three cooling tower water isolates, isolated between 2004 to 2006, were analyzed for the presence of these genes by PCR method. Results showed that 19 of 33 (57.5%) of the L. pneumophila serogroup 1 isolates have both the genes. Six (18.2%) of the isolates have only the lvh gene and 2 (6.1%) of the isolates have only the rtxA gene. However, both genes were absent in 6 (18.2%) of the L. pneumophila isolates. The result of our study provides some insight into the presence of the disease causing L. pneumophila serogroup 1 in the environment. Molecular epidemiological studies will provide better understanding of the prevalence of the disease in Malaysia.
Fulltext The prevalence of undernutrition upon hospitalization in children in a developing country: A single hospital study from Malaysia

Lee WS, Ahmad Z

Pediatr Neonatol, 2017 10;58(5):415-420.
PMID: 28330630 DOI: 10.1016/j.pedneo.2016.08.010

BACKGROUND: Undernourished children who require hospital care have a longer duration of hospitalization and respond poorly to modern medical therapy. The objective of the present study was to ascertain the nutritional status of children admitted to a pediatric tertiary center in Malaysia and the risk factors leading to undernutrition upon admission.
METHODS: In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) < -2 standard deviation (S.D.), respectively. Underweight was defined as weight-for-age < -2 S.D. For children aged between 1 and 5 years of age, World Health Organization definition for acute undernutrition (HFA
Population dynamics, antibiotics resistance and biofilm formation of Aeromonas and Vibrio species isolated from aquatic sources in Northern Malaysia

Odeyemi OA, Ahmad A

Microb Pathog, 2017 Feb;103:178-185.
PMID: 28062284 DOI: 10.1016/j.micpath.2017.01.007

This study aimed to compare population dynamics, antibiotic resistance and biofilm formation of Aeromonas and Vibrio species from seawater and sediment collected from Northern Malaysia. Isolates with different colony morphology were characterized using both biochemical and molecular methods before testing for antibiotic resistance and biofilm formation. Results obtained from this study showed that in Kedah, the population of Aeromonas isolated from sediment was highest in Pantai Merdeka (8.22 log CFU/ml), Pulau Bunting recorded the highest population of Aeromonas from sediment (8.43 log CFU/g). It was observed that Vibrio species isolated from seawater and sediment were highest in Kuala Sanglang (9.21 log CFU/ml). In Kuala Perlis, the population of Aeromonas isolated from seawater was highest in Jeti (7.94 log CFU/ml). Highest population of Aeromonas from sediment was recorded in Kampong Tanah Baru (7.99 log CFU/g). It was observed that Vibrio species isolated from seawater was highest in Padang Benta (8.42 log CFU/g) while Jeti Kuala Perlis had highest population of Vibrio isolated from sediment. It was observed that location does not influence population of Aeromonas. The results of the independent t - test revealed that there was no significant relationship between location and population of Vibrio (df = 10, t = 1.144, p > 0.05). The occurrence of biofilm formation and prevalence of antibiotic resistant Aeromonas and Vibrio species in seawater and sediment pose danger to human and aquatic animals' health.
Fulltext The effects of CR2O3 addition on microstructure and fracture toughness of ZTA ceramic composite

Ahmad Zahirani Ahmad Azhar, Hasmaliza Mohamed, Mani Maran Ratnam, Zainal Arifin Ahmad

Journal of Nuclear and Related Technologies, 2013;2013(2):9-15.
MyJurnal

The microstructure and mechanical properties of ceramic composites produced from alumina, yttria stabilized zirconia and chromia oxide system was investigated. The Cr2O3 weight percent was varied from 0 wt% to 1.0 wt%. Each batch of composition was mixed, uniaxially pressed to 13mm diameter and sintered at 1600 ◦C for 4 h in pressureless conditions. Studies on the effects of the sample microstructures on their mechanical and physical properties such as fracture toughness and bulk density were carried out. Results show that an addition of 0.6 wt% of Cr2O3 produces the best mechanical properties. Furthermore, microstructural observations show that the Al2O3 grain size is significantly dependent on the amount of Cr2O3 additives used. Maximum value obtained with 0.6 wt % Cr2O3 for the fracture toughness is 5.36 MPa.m1/2.
Effectiveness of adjunct psychotherapy for cancer treatment: a review

Chen Y, Ahmad M

Future Oncol, 2018 Jun;14(15):1487-1496.
PMID: 29767550 DOI: 10.2217/fon-2017-0671

Psychotherapies were offered to alleviate psychological and physical symptoms; however, most psychological interventions were only delivered after cancer treatment. Newly diagnosed cancer patients experienced psychological distress while waiting for treatments. This review paper focused on randomized control trial studies, aimed to investigate the effectiveness of psychological intervention among newly diagnosed cancer patients. Eight randomized control trial papers were found in recent 10 year period through electronic database. A moderate to large effect size was detected on the outcomes, ranging from 0.43 to 0.89. This indicated that psychological-based prehabilitation with standard care yielded better outcomes than standard care alone. Psychological-based prehabilitation provides evidence in its effectiveness to reduce psychological distress, functional impairment, recurrence of cancer, numbers of immune reactivity and sleeping quality; however, inconsistent with longer survival result among cancer patients. In conclusion, psychological-based prehabilitation before cancer treatment is necessary for better treatment outcome, and future research is needed to investigate more directly the outcome.
Fulltext Affordability of essential medicine prices in Malaysia's private health sector

Ahmad NS, Islahudin F

Patient Prefer Adherence, 2018;12:1231-1237.
PMID: 30038489 DOI: 10.2147/PPA.S151603

Background: The lack of price control in Malaysia has led to increased market competition, resulting in high medicine prices, notably in the private sector. This largely affects patients' out-of-pocket expenses in the private sector. Although generic medicines are preferred due to affordability, the prices are still notably high.
Methods: This study compares innovator and generic medicine prices to estimate treatment affordability in the private sector. Private hospitals and community retail pharmacies were examined from 2011 to 2015. Data were collected on the basis of recommendations by the World Health Organization's Health Action International.
Results: The markup of generic medicines was significantly higher than that of innovator medicines during the study period (p<0.001). While the markup of generic medicine was 31%-402% (36%-171% and 31%-402% for core and supplementary list items), that of innovator medicine was 24%-86% (28%-86% and 24%-80% for core and supplementary list items). There was no significant increase in the median price ratio for 11 selected generic medicines (from 1.8±3.9 to 2.9±8.2) (p>0.05). However, the median price ratio of the 11 innovator medicines significantly increased (from 4.9±6.1 to 11.2±20.3) (p=0.045). Affordability of all generic medicines was below the 2-day wage for treatment, with captopril (25 mg tablet) reporting the highest cost (1.1-1.7-day wages). Among innovator medicines, omeprazole (20 mg capsule; 6.2-7.0 days' wages) reported the highest median treatment cost.
Conclusion: There is a need for policies to control national drug prices, to ensure medicine prices are monitored. This can help keep out-of-pocket expenses, especially in middle-income countries such as Malaysia, at a minimal in the private sector.
Availability and affordability of life-saving vaccines

Khan MU, Ahmad A

Lancet Infect Dis, 2017 02;17(2):136-137.
PMID: 28134107 DOI: 10.1016/S1473-3099(17)30014-2
Fulltext Synergistic Effect of Hybridized Cellulose Nanocrystals and Organically Modified Montmorillonite on κ-Carrageenan Bionanocomposites

Zakuwan SZ, Ahmad I

Nanomaterials (Basel), 2018 Oct 24;8(11).
PMID: 30352971 DOI: 10.3390/nano8110874

The synergistic effect of using κ-carrageenan bionanocomposites with the hybridization of cellulose nanocrystals (CNCs) and organically modified montmorillonite (OMMT) reinforcements was studied. The effects of different reinforcements and filler contents were evaluated through mechanical testing, and morphological and water uptake properties. The tensile strength and Young's modulus of both bionanocomposites increased with filler loading and optimized at 4%. OMMT incorporation into the κ-carrageenan/CNCs bionanocomposites resulted in further mechanical property improvement with an optimum ratio of 1:1 (CNCs:OMMT) while maintaining high film transparency. X-ray diffraction and morphological analyses revealed that intercalation occurred between the κ-carrageenan bionanocomposite matrix and OMMT. The water uptake of the κ-carrageenan bionanocomposites was significantly reduced by the addition of both CNCs and OMMT. The enhancements in the mechanical properties and performance of the hybrid bionanocomposite indicate compatibility among the reinforcement, biopolymer, and well-dispersed nanoparticles. This renders the hybrid CNC/OMMT/κ-carrageenan nanocomposites extremely promising for food packaging applications.
Fulltext Premature ejaculation and quality of life among men attending Klinik Kesihatan Jaya Gading, Kuantan

Harun Z, Ahmad S

Int J Public Health Res, 2018;8(1):878-874.
MyJurnal

Introduction: Premature ejaculation (PE) is an important sexual problem among men attending health clinic. Impacts of this condition towards quality of life still require further exploration. Aims of the study is to determine the proportion and determinants for PE and its impact on Quality of Life (QOL) among men attending a public health clinic in Kuantan
Methods: A cross-sectional study involving 290 respondents was conducted at a public health clinic over the period of five months (Nov 2015-March 2016). A validated self-administrated questionnaire that consisted of sociodemographic questionnaire, clinical characteristics, premature ejaculation diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were used.
Results: The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE 15.8% (43/271). Multivariate analysis showed that level of education (p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR 1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after controlling self-reported erectile dysfunction, pulmonary and neurological disorder. PE patients had lower median scores QOL in all four domain namely physical health, psychological, social relationship, environment (all domains with p<0.001).
Conclusions: The proportion of men diagnosed with premature ejaculation in this study is high and possibly associated with level of education and hypertension. Men with PE had lower quality of life in domains of physical health, psychological, social relationship and environment. Hence, it is
recommended for PE screening among male attendees to primary health clinic especially those with hypertension and moderate level of education.
Keywords Premature ejaculation - Quality of life - Sexual dysfunction.
Study site: Klinik Kesihatan Jaya Gading, Kuantan, Pahang, Malaysia
Fulltext Effects of Hybridized Organically Modified Montmorillonite and Cellulose Nanocrystals on Rheological Properties and Thermal Stability of K-Carrageenan Bio-Nanocomposite

Zakuwan SZ, Ahmad I

Nanomaterials (Basel), 2019 Oct 31;9(11).
PMID: 31683602 DOI: 10.3390/nano9111547

Herein, hybrid k-carrageenan bio-nanocomposite films were fabricated by using two types of nanofillers, organically modified montmorillonite (OMMT), and cellulose nanocrystals (CNCs). Hybrid bio-nanocomposite films were made by casting techniques employing 4 wt% of CNCs, OMMT, and hybridized CNCs/OMMT in a 1:1 ratio. The rheological and morphological properties and thermal stability of all composites were investigated using rotational rheometry, thermogravimetry analysis, differential scanning calorimetry, field emission scanning electron microscopy, and transmission electron microscopy (TEM). The results showed that the hybrid CNC/OMMT bio-nanocomposite exhibited significantly improved properties as compared to those for the bio-nanocomposites with single fillers due to the nanosize and homogenous nanofiller dispersion in the matrix. Rheological analysis of the hybrid bio-nanocomposite showed higher dynamic shear storage modulus and complex viscosity values when compared to those for the bio-nanocomposite with individual fillers. The TEM analysis of the hybridized CNC/OMMT bio-nanocomposite revealed that more particles were packed together in the CNC network, which restricted the matrix mobility. The heat resistance and thermal stability bio-nanocomposite k-carrageenan film enhanced rapidly with the addition of hybridized CNCs/OMMT to 275 °C. The hybridized CNCs/OMMT exhibited synergistic effects due to the good affinity through interfacial interactions, resulting in the improvement of the material properties.
Electromagnetic and absorption properties of some TPNR/Fe3O4/YIG microwave absorbers as revealed by a microwave vector network analyser and specular absorber method

Ahmad Nazlim Yusoff, Junaidah Mat Sani, Mustaffa Abdullah, Sahrim Ahmad, Nazree Ahmad

Sains Malaysiana, 2007;36:65-67.

The complex scattering parameters (S11* and S21*), relative dielectric permittivity (er* = er' - jer"), relative magnetic permeability (mr* = mr' - jmr") and absorption characteristics of some thermoplastic natural rubber (TPNR) – Fe3O4/YIG composites were investigated by means of a microwave vector network analyser and specular absorber method. The measurements were performed in the frequency range of 1 – 13 GHz with and without the presence of a transverse external magnetic field with magnitude of 1 T. The specular absorber method is used in determining the reflection loss (RL) of the composites and its dependence on material properties, thickness and the external magnetic field. In toroidal form, the composites under study seem to transmit more (Pt > 60%) but absorb and reflect less (Pa + Pr < 30%) microwave power in the frequency range used in this study and in both unmagnetised and magnetised states. The external magnetic field is seen to have the effects of reducing S11*, S21*, er', er", mr' and mr". The suppression of the relaxation and resonance behaviours on the mr' and mr" plots for all samples are observed for measurements performed in the presence of the external field. The composites, as revealed by the specular absorber method, show conditions of minimal reflection on RL versus frequency plot for all sample thickness where more than 95% of the microwave power is not reflected back. The location of the dips of minimal reflection on the frequency domain depend on the thickness, the dielectric and magnetic properties of the materials. The conditions of minimal reflection was found to occur when the thickness (t) of the sample equals the odd number multiple of a quarter wavelength in the material (lm), t = nlm/4 (n = 1, 3, 5, 7 …), where a geometrical cancellation took place at the surface of the absorber between the reflected waves, resembling a thin filem inteference phenomenon. The dips are suppressed and shifted to a higher frequency in the presence of the external magnetic field. With the knowledge of the dielectric permittivity and magnetic permeability of a material, the specular absorber method may provides a simple theoretical graphic aids in determining the absorption characteristics and location of the matching condition in the frequency domain.
Fulltext The Conserved Molecular Determinants of Virulence in Dengue Virus

Ahmad Z, Poh CL

Int J Med Sci, 2019;16(3):355-365.
PMID: 30911269 DOI: 10.7150/ijms.29938

Dengue virus belongs to the Flaviviridae family which also includes viruses such as the Zika, West Nile and yellow fever virus. Dengue virus generally causes mild disease, however, more severe forms of the dengue virus infection, dengue haemorrhagic fever (DHF) and dengue haemorrhagic fever with shock syndrome (DSS) can also occur, resulting in multiple organ failure and even death, especially in children. The only dengue vaccine available in the market, CYD-TDV offers limited coverage for vaccinees from 9-45 years of age and is only recommended for individuals with prior dengue exposure. A number of mutations that were shown to attenuate virulence of dengue virus in vitro and/or in vivo have been identified in the literature. The mutations which fall within the conserved regions of all four dengue serotypes are discussed. This review hopes to provide information leading to the construction of a live attenuated dengue vaccine that is suitable for all ages, irrespective of the infecting dengue serotype and prior dengue exposure.
Fulltext Career choices of physicians in Malaysia

Ahmad Z, Jaafar R

JUMMEC, 1999;4(1):47-50.

A survey of career choices was conducted for two batches of physicians applying for a medical speciality course in Malaysian medical schools. There were a total of 952 applications, with 477 males and 475 females. Surgery ranked highest, followed by obstetrics and gynaecology, fanlily medicine and orthopaedic surgery. The minor specialities of otorhinolaryngology, psychiatry and pathology were the least popular choices. Questionnaires were sent to a random sample of 250 physicians in each batch to note factors affecting their choices of speciality. A total of 359 physicians responded, giving a response rate of 71.8%. Fixed hours of work and the ability to have direct contact with patients were relatively important factors for choice of speciality. Working as a clinical consultant was the nlost popular nature of employment while worliing in the health office, service consultant in a public hospital, a non-clinical lecturer in a university hospital and working in a private clinic were less popular choices for these physicians. KEYWORDS: Career choice; medical speciality; doctors; Malaysia.

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