Displaying all 16 publications

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  1. Nasir F, Asha'ari ZA
    Malays Fam Physician, 2017;12(2):26-28.
    PMID: 29423127
    Otitis media is a common disease encountered in the primary practice. Most cases are successfully treated with antibiotics without any sequelae. Because of these, potential serious complications of otitis media may be overlooked. We report a rare case of Bezold's abscess, as a complication of otitis media and discuss its pathophysiology and management.
  2. Asha'ari ZA, Islah W, Ahmad R, Suzina SA
    Med J Malaysia, 2010 Jun;65(2):157-9.
    PMID: 23756806 MyJurnal
    We studied two similar cases of severe subglottic stenosis secondary to trauma with different treatment modalities. One had laryngotracheal reconstruction with cartilage augmentation and the other had laryngotracheal resection anastomosis. We wish to compare the two popular choices of surgery for laryngotracheal stenosis from two cases with similar nature and severity thus highlighting the complexity of managing severe subglottic stenosis in adult.
  3. Asha'ari ZA, Mat Zain N, Razali A
    Malays J Med Sci, 2010 Jan;17(1):49-51.
    PMID: 22135526 MyJurnal
    Phonophobia and hyperacusis are two separate but closely related symptoms that are often mistakenly used in clinical practice as the same entity. Here we present a case report to highlight the distinguishing features of both and discuss the steps of management in these conditions. It is vital for the attending doctors to recognise hyperacusis and phonophobia as different entities to manage them successfully.
  4. Asha'Ari ZA, Ahmad R, Rahman J, Kamarudin N, Ishlah LW
    J Laryngol Otol, 2011 Aug;125(8):781-5.
    PMID: 21524330 DOI: 10.1017/S0022215111000545
    To study the prevalence and patterns of contrecoup injury in traumatic temporal bone fracture cases.
  5. Asha'ari ZA, Suhaimi Y, Yusof RA, Rushdan I, Maraina CH
    Med J Malaysia, 2011 Aug;66(3):202-6.
    PMID: 22111441 MyJurnal
    We compared a newer serum specific IgE (SSIgE) test with skin prick testing (SPT) in the diagnosis of allergy in Malaysia. Ninety newly diagnosed allergic patients were enrolled for both tests. Using SPT as a clinical gold standard, the sensitivity, specificity, positive, and negative predictive values (PPV, NPV) were calculated for SSIgE for each of the common allergens tested. The highest positive results for both SPT and SSIgE were for house dust mite and cat. Compared to SPT, SSIgE showed better sensitivity but poorer specificity, low PPV and good NPV in all the allergens tested. Significant positive correlation was seen between the diameter of wheal and flare of SPT and the SSIgE results.
  6. Asha'ari ZA, Ahmad R, Rahman J, Yusof RA, Kamarudin N
    Auris Nasus Larynx, 2012 Apr;39(2):151-5.
    PMID: 21592698 DOI: 10.1016/j.anl.2011.02.010
    To study the relationship pattern of intracranial hemorrhage in cases of traumatic petrous temporal bone fracture.
  7. Asha'ari ZA, Yusof S, Ismail R, Che Hussin CM
    Ann Acad Med Singap, 2010 Aug;39(8):619-24.
    PMID: 20838703
    INTRODUCTION: Allergic rhinitis (AR) is a prevalent disease worldwide but is still underdiagnosed in many parts of Asia. We studied the clinical profiles of AR patients in our community based on the new ARIA classification and investigated the aetiological allergens using a skin prick test.

    MATERIALS AND METHODS: In 2008, 142 newly diagnosed patients with AR were seen and underwent skin prick testing with 90 patients completing the study.

    RESULTS: Intermittent mild and moderate/severe AR were evident in 10% and 21.1% of the patients, while persistent mild and moderate/severe were seen in 20% and 48.9%, respectively. Rhinitis and asthma co-morbidity occurred in 28.8% with asthma incidence significantly higher in persistent AR (P = 0.002). There was no significant association between AR severity, city living and asthma co-morbidity. Nasal itchiness and sneezing were the main presenting complaints and were more common in intermittent AR (P <0.05). Sleep disturbance was associated with moderate-severe AR (P <0.05). Polypoidal mucosa was associated with asthma co-morbidity (P <0.05). Monosensitivity reaction occurred in 12.2% of patients and was associated with fungi sensitivity (P <0.05). Majority of patients were oligosensitive (52.8%) and polysensitive (34.4%) and were significantly associated with moderate-severe persistent AR (P <0.01). The highest positive skin prick reaction and the largest average wheal diameter were for the house dust mites and cat allergen (P <0.05).

    CONCLUSION: Our results reflected the AR profiles in our country, which was comparable with typical profiles of the neighbouring country and other Mediterranean countries with a similar temperate climate.

  8. Banabilh SM, Asha'ari ZA, Hamid SS
    Sleep Breath, 2008 Aug;12(3):269-74.
    PMID: 17978839 DOI: 10.1007/s11325-007-0154-6
    Snoring is considered as the most common clinical symptom of obstructive sleep apnea-hypopnea syndrome. However, many snoring studies were done in western population, and data from around Asia is scarce. Therefore, the purposes of this study were to determine the prevalence of snoring among Malaysian children from hospital-based medical clinic population setting and to compare the craniofacial features of children with and without snoring using cephalometric analysis. A cross-sectional study among children aged 7-15 years were carried out in Hospital Kuala Terengganu. Sleep behavior questionnaire (Berlin questionnaire) was given to 500 children. The respondents were divided into snoring and non-snoring groups. Thirty children from each group were randomly selected to undergo a cephalometric X-ray. For each lateral cephalometric radiograph, 17 parameters consisting bony, soft tissue, and angular measurements were recorded using computer software VixWin2000. Independent t test was used to analyze the data. The results indicated that the whole questionnaire respondents were 317 (46 snoring and 271 non-snoring), hence, the prevalence of snoring in our survey population was 14.51%. The cephalometric X-ray showed that the snoring children manifested a significant different craniofacial features, such as narrow airway at the level of the soft palate and oropharynx (p < 0.05), more inferiorly positioned hyoid bone (p < 0.05), longer vertical airway length from posterior nasal spine to the base of epiglottis (p < 0.05), more protruding maxilla, and anterior-posterior discrepancy of maxilla and mandible (p < 0.05). In conclusion, our snorer children exhibit significant craniofacial differences compared to non-snorer groups.

    Study site: ACC at Hospital Kuala Terengganu, MalaysiaThe ACC is a daycare center consisting of
    various specialty clinics such as Pediatrics, Orthopedics,
    Otorhinolaryngology, Dental, Oral-maxillofacial, General
    Surgery, General Medical, Ophthalmology, Psychiatry, and
    Obstetrics and Gynecology clinics.
  9. Asha'ari ZA, Razali MS, Leman WI, Ahmad A
    Malays J Med Sci, 2014 Jan;21(1):72-4.
    PMID: 24639617
    Post-traumatic parotid sialocoele is a subcutaneous extravasation of saliva from the parotid gland secondary to traumatic disruption of its duct or parenchyma. Currently, there is no consensus regarding the best therapy for parotid sialocoele, as it is resistant to conservative management. The present paper puts forward a relatively simple, safe and effective technique for the treatment of parotid sialocoele, specifically a peroral drainage technique. The results justify our recommendation to use this approach for the treatment of sialocoele.
  10. Asha'ari ZA, Suhaimi Y, Fadzil A, Zihni M
    Malays J Med Sci, 2012 Oct;19(4):84-7.
    PMID: 23613654 MyJurnal
    Acquired subglottic cyst in infancy is almost always associated with episodes of early life intubation. Most cases typically presented late, usually days to months after extubation. We report a case of a subglottic cyst with different presentation than the norm. This case highlights that subglottic cyst can present acutely, and rapidly enlarging soon after the airway extubation. As the management of a large subglottic cyst can be challenging, a close observation for early diagnosis and intervention are recommended post extubation in the high-risk cases, such as in the premature infant.
  11. Asha'ari ZA, Razali MS, Ahmad RA
    Malays J Med Sci, 2010 Apr;17(2):56-60.
    PMID: 22135539
    Bilateral vocal cord palsy is almost always caused by neck surgery, particularly surgery of the thyroid. We report a case of bilateral vocal cord palsy requiring emergency surgery to relieve the airway obstruction as the sole presentation of acquired syphilis. As the incidence of syphilis worldwide is rising, this unusual presentation may give clinicians a different perspective on the disease.
  12. Asha'ari ZA, Hasmoni MH, Ab Rahman J, Yusof RA, Ahmad RA
    Laryngoscope, 2012 Oct;122(10):2337-42.
    PMID: 22753136 DOI: 10.1002/lary.23379
    To study the association between sleep apnea and hypertension in a younger age group than previously studied, adding upper airway sizes at endoscopy as important compounding variables not often included in the past.
  13. Asha'ari ZA, Rahman JA, Mohamed AH, Abdullah K, Leman WI
    JAMA Otolaryngol Head Neck Surg, 2017 03 01;143(3):239-246.
    PMID: 27893073 DOI: 10.1001/jamaoto.2016.3268
    Importance: In patients with obstructive sleep apnea (OSA), operative risks depend on the severity of the underlying OSA and the invasiveness of the surgical procedure.

    Objective: To investigate the nature of the associations between the severity of OSA and the number and anatomical sites of upper airway operations with operative complications.

    Design, Setting, and Participants: This retrospective study included adult patients diagnosed with OSA (apnea-hypopnea index [AHI], >5) who underwent upper airway surgery at a single tertiary referral hospital between October 1, 2008, and October 1, 2015.

    Interventions: All patients underwent single or combination surgery on the nose, palatopharyngeal (tonsils, adenoids, and soft palate), and tongue base as a treatment of OSA.

    Main Outcomes and Measures: Pulmonary, surgical, and cardiovascular complications within the first 30 postoperative days were analyzed according to OSA severity and types of upper airway surgery. Logistic regression was used to assess the multivariable association of OSA, age, sex, body mass index, medical comorbidities, and types of upper airway surgery with short-term operative complications.

    Results: The study included 95 patients (87 males [91.6%]; 83 were Malay [87.4%]; mean [SD] age, 37.7 [1.6] years) with complete data and follow-up who underwent upper airway surgery to treat OSA. Patients with more severe OSA had greater body mass index (Cohen d, 0.27; 95% CI, -0.28 to 0.82), longer surgical time (Cohen d, 1.57; 95% CI, 0.95-2.15), and older age (Cohen d, 3.06; 95% CI, 2.29-3.77). At least 1 operative complication occurred in 48 of 95 patients (51%). In a multivariable model, the overall complication rate was increased with age and body mass index. Complication rates were not associated with AHI severity, type of procedure performed, and whether the surgery was single or combination surgery. Lowest oxygen desaturation (odds ratio, 1.03; 95% CI, 0.96-1.45; P = .04) and longest apnea duration (odds ratio, 1.03; 95% CI, 0.99-1.08; P = .02) were polysomnographic variables that predict the short-term operative complications.

    Conclusions and Relevance: In patients with OSA undergoing upper airway surgery, the severity of OSA as assessed by AHI, and the sites and numbers of concurrent operations performed were not associated with the rate of short-term operative complications.

  14. Asha'ari ZA, Ahmad MZ, Jihan WS, Che CM, Leman I
    Ann Saudi Med, 2013;33(5):469-75.
    PMID: 24188941 DOI: 10.5144/0256-4947.2013.469
    BACKGROUND AND OBJECTIVES: The role of honey in the treatment of allergic rhinitis (AR) is controversial. We studied the complementary effect of ingestion of a high dose of honey, in addition to standard medications, on AR.

    DESIGN AND SETTINGS: Prospective randomized placebo-controlled study. Subjects were recruited from an otolaryngology clinic in 2 tertiary referral centers in the East coast of Peninsular Malaysia. The study period ranged from April 2010-April 2011.

    METHODS: Forty AR patients were divided equally into a case group and a control group. All the subjects received a daily dose of 10 mg of loratadine for 4 weeks. The case group ingested 1 g/kg body weight of honey daily in separate doses for the 4-week period. The control group ingested the same dose of honey-flavored corn syrup as placebo. AR symptoms were scored at the start, week 4, and week 8 of the study.

    RESULTS: There were no significant differences between the mean total symptom score of the case and the control groups at the start of the study. At week 4, both groups showed progressive improvement in the symptoms; at week 8, only the case group showed a continuous improvement in the symptom score. Only the group that ingested honey showed a significant improvement in individual AR symptoms. The improvement persisted for a month after the cessation of the treatment.

    CONCLUSION: Honey ingestion at a high dose improves the overall and individual symptoms of AR, and it could serve as a complementary therapy for AR.

  15. Abdullah K, Raja Lope Ahmad RA, Asha'ari ZA, Razali MS, Leman WI
    Malays J Med Sci, 2014 Jul;21(4):28-36.
    PMID: 25977619 MyJurnal
    Surgical management of head and neck cancer is undoubtedly challenging, and we would like to see the outcome of managing such cases at one of the tertiary referral center in the East Coast of Malaysia.
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