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Fulltext Community eye service program: factors associated with delayed presentation to a tertiary centre post community screening

Nor Hafiza I., Lathalakshmi, T., Ab Hamid Siti-Azrin, Liza-Sharmini A.T.

Journal of Biomedical and Clinical Sciences, 2017;2(2):42-47.
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Early detection and prompt treatment of eye diseases can prevent visual disability. To our knowledge, there is no published data on factors associated with delayed presentation of eye diseases in Malaysia. Our objective is to determine the proportion of patients with eye disease who had a delayed presentation to an ophthalmologist after an initial screening, as well as the factors associated with delay in seeking treatment. This was a retrospective cohort study of patients with eye diseases detected during a Community Eye Survey (CES) program from September 2004 to December 2012 who were referred to the ophthalmologist in Hospital Universiti Sains Malaysia (USM). Delayed presentation of eye disease was defined as patients who came to the eye clinic more than six months after eye screening. Multiple logistic regression was used for analyses. A total of 434 patients who were referred to Hospital USM, Kubang Kerian were included in the study. Their mean (standard deviation) age was 55.65 (21.62) years. The majority of patients (76%) had delayed presentation of eye disease post screening. Type of ocular diseases was not associated with delayed presentation. The factors associated with delayed presentation were unemployment (adjusted odds ratio (OR): 2.51, 95% CI (1.36, 4.64), p

Study site: Hospital Universiti Sains Malaysia (HUSM)
Fulltext Factors affecting health-related quality of life among paediatric patients with thalassemia: a review of literature

Wan Adnan Wan-Nor-Asyikeen, Ab Hamid Siti-Azrin, Maryam Mohd Zulkifli, Alwi Zilfalil

Malaysian Journal of Paediatrics and Child Health, 2017;23(1):0-0.
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Thalassaemia is a hereditary blood disorder that is becoming a major health problem all over the world. This chronic illness harms the quality of life of the sufferers by interrupting their physical activities, school performance and social life. Hence, this review takes aim to assess the factors affecting the quality of life of thalassaemia among paediatrics patients. A comprehensive electronic search was conducted by using PubMed, Google Scholar and Science Direct. The search was limited to those articles written in English language and by using Pediatrics Quality of Life Inventory (PedsQLTM) 4.0 generic core scale questionnaire only. This review notifies emerging knowledge regarding the factors affecting the quality of life among thalassaemia patients and its implications in the essential core domains for paediatrics health-related quality of life measurements: physical, emotional, social and school functioning. It also empowers a better understanding regarding thalassaemia and assists as a foundation for the development of the effective preventive strategies for it.
Evaluation of Optic Nerve Head Parameters, Retinal Nerve Fiber Layer Thickness, and Ocular Perfusion Pressure in Migraine Patients

Michael NDB, Hussein A, Abd Halim S, Ab Hamid SA

Cureus, 2019 May 04;11(5):e4599.
PMID: 31309023 DOI: 10.7759/cureus.4599

Background Neurovascular changes occur during the migraine is believed to cause alteration in cerebral and retinal circulation that possible result in damage to the brain and even retina or optic nerve. Retinal nerve fiber layer (RNFL) thickness measurement can be used as an index to assess ganglion cell and retinal nerve fiber damages. The aim of this study was to evaluate the optic nerve head (ONH) parameters, RNFL thickness, and ocular perfusion pressure (OPP) in migraine patients. Methods This was a cross-sectional study, conducted in Hospital Universiti Sains Malaysia, Kelantan from July 2016 to November 2018, involving patients with a confirmed diagnosis of migraine and controls. Ninety-four eyes of 47 migraine patients and 94 eyes of 47 healthy subjects were included in this study. Blood pressure and intraocular pressure were measured and OPP was calculated. ONH parameters and RNFL thickness were measured using optical coherence tomography (OCT) after pupillary dilatation. Statistical analysis was done using Statistical Package for the Social Science (SPSS Inc Version 24). Results With respect to all means values of ONH parameters, there was no statistically significant difference between migraine patients and controls. For RNFL, there were significant reductions in average and superior RNFL thickness on both eyes with adjustment of age and gender (P-value: right eye (RE) average = 0.027; RE superior = 0.034; left eye (LE) average = 0.037; LE superior = 0.031). In view of OPP, there was no significant difference between migraine patients and controls (P-value = 0.172). Weak correlations were found between the ONH parameters and RNFL thickness with OPP, respectively, in migraine patients. Conclusion This study showed no difference in ONH parameters between migraine patients and healthy subjects. There was significant thinning in average and superior RNFL for migraine patients. No difference found in OPP between both groups. ONH parameters and RNFL thickness had a weak correlation with OPP in migraine patients.
Fulltext Antioxidant enzymes in tears among Malay age-related macular degeneration patients

Yi Ni Koh, Embong Zunaina, Ahmad Tajudin Liza-Sharmini, Che Badariah Abd-Aziz, Che Hussin Che-Maraina, Mei Fong Chong, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):149-156.
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Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glu- tathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and gluta- thione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P
Fulltext Cytogenetic abnormalities at diagnosis and during follow up in multiple myeloma patients and their prognostic implications - a preliminary report

Eva Foong, Ismail Siti-Mariam, Ramli Norhidayah, Abu Bakar Zulaikha, Mat Zin Nik-Mohd-Zulfikri, Mohd Nawi Nurul-Alia, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(4):108-117.
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Introduction: Multiple myeloma (MM) is characterized by genomic instability and cytogenetic abnormalities (CAs). The variation in rates of treatment response and overall survival is thought to arise from multiple genomic events that result in tumour development and progression. This study investigated CAs among the newly diagnosed MM (NDMM) patients at diagnosis and during follow-up and subsequently to assess their prognostic significance. Meth- ods: This is a prospective cohort study where bone marrow (BM) samples of 16 NDMM patients were collected at diagnosis and during follow up and subjected to conventional cytogenetic analysis (CCA) and interphase fluores- cence in situ hybridization (iFISH) analyses using standard procedures. Spectral karyotyping was performed on a selected patient who showed complex karyotype (CK) pattern on CCA. Results: Clonal abnormalities were identified in 56.3% of analysis by karyotyping and 68.8% by combination of karyotyping and iFISH. CCA showed normal diploid, hypodiploid and hyperdiploid karyotypes, whereas iFISH analysis could detect various IGH translocations involving 14q32 region, del(13q14) and del(17p13). Significant associations were observed between patients with complex karyotypes and abnormal karyotypes. Patients who had a CK or showed an abnormal CCA and iFISH results were associated with worse survival (p=0.011 and p=0.034 respectively). Structural abnormalities were found to be more common among hyperdiploid MM patients (p=0.001). Cytogenetic evolution was seen in the follow-up of BM cytogenetics. Conclusion: Karyotyping and iFISH are valuable assets in detecting prognostically relevant genomic abnormalities. The presence of cytogenetic evolution demonstrated the value of cytogenetics in monitoring treatment response and in management of MM.
Fulltext Evaluation of vascular endothelial growth factor levels in tears and serum among diabetic patients

Ang WJ, Zunaina E, Norfadzillah AJ, Raja-Norliza RO, Julieana M, Ab-Hamid SA, et al.

PLoS One, 2019;14(8):e0221481.
PMID: 31437234 DOI: 10.1371/journal.pone.0221481

OBJECTIVE: Detection of vascular endothelial growth factor (VEGF) levels in ocular tissue may perhaps provide insight into the role of VEGF in the pathogenesis and progression of diabetic retinopathy (DR). The aim of this study was to evaluate the levels of VEGF in tears and serum amongst type 2 diabetes mellitus (DM) patients.
METHODS: A comparative cross-sectional study was conducted between August 2016 and May 2018 involving type 2 DM patients with no DR, non-proliferative DR (NPDR), and proliferative DR (PDR). Tear samples were collected using no.41 Whatman filter paper (Schirmer strips) and 5 mL blood samples were drawn by venous puncture. VEGF levels in tears and serum were measured by enzyme-linked immunosorbent assay.
RESULTS: A total of 88 type 2 DM patients (no DR: 30 patients, NPDR: 28 patients, PDR: 30 patients) were included in the study. Mean tear VEGF levels were significantly higher in the NPDR and PDR groups (114.4 SD 52.5 pg/mL and 150.8 SD 49.7 pg/mL, respectively) compared to the no DR group (40.4 SD 26.5 pg/mL, p < 0.001). There was no significant difference in the mean serum VEGF levels between the three groups. There was a fair correlation between serum and tear VEGF levels (p = 0.015, r = 0.263).
CONCLUSION: VEGF levels in tears were significantly higher amongst diabetic patients with DR compared to those without DR and were significantly associated with the severity of DR. There was a fair correlation between serum and tear VEGF levels. Detection of VEGF in tears is a good non-invasive predictor test for the severity of DR. A large cohort study is needed for further evaluation.
Fulltext Prevalence of low-back pain among public ambulance workers in Kelantan, Malaysia

Tuan Lonik EA, Tuan Kamauzaman TH, Abdullah AA, Nor J, Ab Hamid SA

Malaysian Journal of Public Health Medicine, 2017;17(1):126-135.
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This study is to determine the prevalence and the associated factors of low-back pain (LBP), which has multifactorial causes, among ambulance workers in Kelantan, Malaysia. The cross-sectional study involved ambulance workers in the emergency department in all government hospitals in Kelantan. Those who did not consent, complete or return the questionnaire as well as having rheumatic diseases were excluded from the study. The participants were asked to answer a self-administered questionnaire in English. Descriptive analyses and Chi-square test were used. A total of 168 respondents had completed the questionnaires with a response rate of 85.0%. Questionnaires with more than 95.0% items completed were included in the analysis (n=143). The respondents had a higher proportion of male than female (63.6% versus 36.4%). Assistant Medical Officer comprised of 60.0% of all respondents and the rest were nurses. The respondents’ age ranged between 23 to 58 years old with a mean age of 38.27 and standard deviation (SD) of 7.27. The mean duration of involvement in ambulance service was 9.68 years (SD 6.97). The majority (98.5%) of the respondents were Malay. Gender, smoking status and hobbies were the associated factors of LBP among ambulance workers. The modifiable risk factors should be emphasized to the ambulance workers as a measure to prevent the development of LBP.
Fulltext Supradiaphragmatic central venous catheter malposition detection using the parasternal long-axis echocardiographic view and dextrose 50% contrast solution: A pilot study

Che Rahim MJ, Abdull Wahab SF, Fauzi MH, Nadarajan C, Ab Hamid SA

Ultrasound, 2022 Nov;30(4):292-298.
PMID: 36969538 DOI: 10.1177/1742271X211051767

BACKGROUND: Contrast-enhanced ultrasonography (CEUS) using saline was studied to detect supradiaphragmatic central venous catheter malposition. Commonly used echocardiographic views are apical 4-chamber (A4c) and subcostal views. However, this standard method is not feasible in certain situations. We explored the feasibility of the right ventricle inflow parasternal long axis (RVI-PLAX) echocardiographic view and dextrose 50% (D50%) contrast solution for detecting supradiaphragmatic central venous catheter malposition.
METHOD: This pilot study screened 60 patients who underwent ultrasound-guided supradiaphragmatic central venous catheter insertion. We compared the investigators' guidewire's J-tip detection, D50% rapid atrial swirl sign (RASS) findings on the RVI-PLAX view and the central venous catheter tip on chest radiograph. We also compared the mean capillary blood sugar level before and after the 5 ml D50% flush.
RESULTS: No guidewire J-tips were detected from the RVI-PLAX view. The first and second investigators' diagnosis of central venous catheter malposition detected on RVI-PLAX CEUS achieved an almost perfect agreement (κ = 1.0 (95% confidence interval (CI): 0.90 to 1.0), p
Fulltext Master of Science in Medical Statistics Programme at Universiti Sains Malaysia: 20 Years Ongoing

Norsa'adah B, Yaacob NM, Abdullah S, Kueh Yee C, Ab Hamid SA, Ghazali AK, et al.

Malays J Med Sci, 2023 Feb;30(1):1-6.
PMID: 36875186 DOI: 10.21315/mjms2023.30.1.1

Health and medical research are important parts of the curriculum of medical and health programmes in universities and play an important role in the functioning of organisations related to health care. There is a shortage of well-trained health and medical research statisticians. This article describes the courses and structure of the Master of Science in Medical Statistics programme at Universiti Sains Malaysia (USM), as well as the graduates' achievements. It is a 2-year programme that prepares qualified and competent graduates in statistical methods and data analysis for research in health and medical sciences. The Biostatistics and Research Methodology Unit, School of Medical Sciences, USM has been running the programme since 2003. It is currently the only medical statistics programme available in Malaysia. There have been 97 graduates since 2005, with an employment rate of 96.7% and a successful subsequent doctorate rate of 21.1%. Most of the students returned to their previous employments, mainly with the Ministry of Health of Malaysia and several others became lecturers, statisticians or research officers. The employability of graduates from this programme is very high and their professional future is bright. We hope our graduates will impart their knowledge and skills to the nation.
Foetal and maternal outcomes in hyperuricaemia pre-eclampsia patients in Hospital Universiti Sains Malaysia

Jummaat F, Adnan AS, Ab Hamid SA, Hor JN, Nik Mustofar NN, Muhammad Asri NA, et al.

J Obstet Gynaecol, 2021 Jan;41(1):38-43.
PMID: 33124936 DOI: 10.1080/01443615.2019.1679731

Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance (rs = -0.338, p = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statementWhat is already known on this subject? Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes.What the results of this study add? There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients.What the implications are of these findings for clinical practice and/or further research? Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.

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