MyMedR

Fulltext Beyond medical school - time to re-look?

Hussin ZA

Malays J Med Sci, 2000 Jul;7(2):1-2.

PMID: 22977382

Pediatric resident training in Malaysia

Hussin ZA

Southeast Asian J Trop Med Public Health, 2014;45 Suppl 1:12-5.

PMID: 25507502

Fulltext Challenges in clinical research in Malaysia

Zabidi-Hussin ZA

Med J Malaysia, 2007 Oct;62(4):275-7.

PMID: 18551927 MyJurnal

Fulltext Practical way of creating differential diagnoses through an expanded VITAMINSABCDEK mnemonic

Zabidi-Hussin ZA

Adv Med Educ Pract, 2016;7:247-8.

PMID: 27217805 DOI: 10.2147/AMEP.S106507

Having an organized, structured thinking process is critical in medicine. It is through this thinking process that enables one to go through the method of history-taking, which will eventually lead to making a definitive diagnosis and all other processes that follow. The use of mnemonic has been found to be useful for this purpose. The mnemonic VITAMINSABCDEK, is a convenient and practical way to assist in expanding the differential diagnoses and covers all possible causes of an illness. It is also easy to remember, as the vitamins whose letters are represented in this mnemonic cover the entire range of vitamins known.

Does nondisclosure of genetic paternity status constitute a breach of ethics?: Commentary on "The dilemma of revealing sensitive information on paternity status in Arabian social and cultural contexts" by Abdallah A. Adlan and Henk A. M. J. ten Have

Zabidi-Hussin ZA

J Bioeth Inq, 2012 Dec;9(4):413-4.

PMID: 23188398 DOI: 10.1007/s11673-012-9401-z

Fulltext Histone deacetylase inhibitors as potential treatment for spinal muscular atrophy

Mohseni J, Zabidi-Hussin ZA, Sasongko TH

Genet Mol Biol, 2013 Sep;36(3):299-307.

PMID: 24130434 DOI: 10.1590/S1415-47572013000300001

Histone acetylation plays an important role in regulation of transcription in eukaryotic cells by promoting a more relaxed chromatin structure necessary for transcriptional activation. Histone deacetylases (HDACs) remove acetyl groups and suppress gene expression. HDAC inhibitors (HDACIs) are a group of small molecules that promote gene transcription by chromatin remodeling and have been extensively studied as potential drugs for treating of spinal muscular atrophy. Various drugs in this class have been studied with regard to their efficacy in increasing the expression of survival of motor neuron (SMN) protein. In this review, we discuss the current literature on this topic and summarize the findings of the main studies in this field.

Curricular trends in Malaysian medical schools: innovations within

Azila NM, Rogayah J, Zabidi-Hussin ZA

Ann Acad Med Singap, 2006 Sep;35(9):647-54.

PMID: 17051282

INTRODUCTION: Various curricular innovations were adopted by medical schools worldwide in an attempt to produce medical graduates that could meet future healthcare needs of society locally and globally. This paper presents findings on curricular approaches implemented in Malaysian medical schools, in trying to meet those needs.

METHODS: Information was obtained from published records, responses from various questionnaires, personal communication and involvement with curricular development.

RESULTS: Curricular innovations tended to be implemented in new medical schools upon their establishment. Established medical schools seemed to implement these innovations much later. Curricular trends appear to move towards integration, student-centred and problem-based learning as well as community-oriented medical education, with the Student-centred learning, Problem-based learning, Integrated teaching, Community-based education, Electives and Systematic programme (SPICES) model used as a reference. The focus is based on the premise that although the short-term aim of undergraduate medical education in Malaysia is to prepare graduates for the pre-registration house officer year, they must be able to practise and make decisions independently and be sensitive to the needs of the country's multiracial, multi-religious, and often remote communities.

CONCLUSION: In most cases, curricular planning starts with a prescriptive model where planners focus on several intended outcomes. However, as the plan is implemented and evaluated it becomes descriptive as the planners reassess the internal and external factors that affect outcomes. A common trend in community-oriented educational activities is evident, with the introduction of interesting variations, to ensure that the curriculum can be implemented, sustained and the intended outcomes achieved.

Fulltext Tuberous sclerosis complex: a review with a study of eight cases

Malik AS, Hussin ZA, Shriwas SR, Kasim ZM

Med J Malaysia, 1994 Dec;49(4):375-84.

PMID: 7674974

This paper reviews the subject of tuberous sclerosis complex and presents data in eight cases of this condition, admitted to Hospital Universiti Sains Malaysia over a period of 8.5 years. The average age at presentation was 53 months. Seizures were the most common presenting feature. Male to female ratio was 3:1. Family history was present in four patients. All of the patients had one or more skin lesions. Six of them had retinal in six patients. Two patients had renal angiomyolipomas. A high index of hamartomas. Cardiac tumours were found in two patients. Multiple subependymal hamartomas were detected in six patients. Two patients had renal angiomyolipomas. A high index of suspicion and a detailed physical examination is required to diagnose this rare disorder.

Transcript, methylation and molecular docking analyses of the effects of HDAC inhibitors, SAHA and Dacinostat, on SMN2 expression in fibroblasts of SMA patients

Mohseni J, Al-Najjar BO, Wahab HA, Zabidi-Hussin ZA, Sasongko TH

J Hum Genet, 2016 Sep;61(9):823-30.

PMID: 27251006 DOI: 10.1038/jhg.2016.61

Several histone deacetylase inhibitors (HDACis) are known to increase Survival Motor Neuron 2 (SMN2) expression for the therapy of spinal muscular atrophy (SMA). We aimed to compare the effects of suberoylanilide hydroxamic acid (SAHA) and Dacinostat, a novel HDACi, on SMN2 expression and to elucidate their acetylation effects on the methylation of the SMN2. Cell-based assays using type I and type II SMA fibroblasts examined changes in transcript expressions, methylation levels and protein expressions. In silico methods analyzed the intermolecular interactions between each compound and HDAC2/HDAC7. SMN2 mRNA transcript levels and SMN protein levels showed notable increases in both cell types, except for Dacinostat exposure on type II cells. However, combined compound exposures showed less pronounced increase in SMN2 transcript and SMN protein level. Acetylation effects of SAHA and Dacinostat promoted demethylation of the SMN2 promoter. The in silico analyses revealed identical binding sites for both compounds in HDACs, which could explain the limited effects of the combined exposure. With the exception on the effect of Dacinostat in Type II cells, we have shown that SAHA and Dacinostat increased SMN2 transcript and protein levels and promoted demethylation of the SMN2 gene.

Fulltext Macrodactyly and poliosis in tuberous sclerosis complex

Sasongko TH, Ismail NF, Nik Mohd Ariff NA, Zabidi-Hussin ZA

Jpn J Clin Oncol, 2014 Nov;44(11):1130.

PMID: 25320338 DOI: 10.1093/jjco/hyu157

Factors associated with undernutrition among children in a rural district of Kelantan, Malaysia

Cheah WL, Wan Muda WA, Mohd Hussin ZA, Thon CC

Asia Pac J Public Health, 2012 Mar;24(2):330-42.

PMID: 20833668 DOI: 10.1177/1010539510380737

The aim of the study was to identify the factors associated with undernutrition indicators in children 5 years and younger in a rural community in Malaysia. A total of 295 children and their carers were selected from community clinics based on a multistage sampling method. Pretested questionnaire, anthropometric measurement, and dietary assessment were used for data collection. There was 69% stunting, 63.4% underweight, 40% wasting, and 26.8% with mid-upper-arm circumference (MUAC) for age below a z score of -2 among children. In all, 10 factors were found to be associated with different indicators of undernutrition. Age was the only factor that had association with all the undernutrition indicators. Total household income and total expenditure showed significant association with underweight. Birth weight was reported to have significant association with underweight, stunting, and low MUAC-for-age. The findings suggest that the factors of undernutrition were different for different indicators of undernutrition and thus give a more comprehensive picture on factors contributing to acute and chronic malnutrition.

The BigSib students' peer group mentoring programme

Yusoff MS, Rahim AF, Noor AR, Yaacob NA, Hussin ZA

Med Educ, 2009 Nov;43(11):1106.

PMID: 19874517 DOI: 10.1111/j.1365-2923.2009.03459.x

Piloting a psycho-education program for parents of pediatric cancer patients in Malaysia

Othman A, Blunden S, Mohamad N, Mohd Hussin ZA, Jamil Osman Z

Psychooncology, 2010 Mar;19(3):326-31.

PMID: 19462470 DOI: 10.1002/pon.1584

To evaluate a psycho-educational program (PeP) for parents of children with cancer (PoCwC) in Malaysia.

Fulltext Rapamycin and its analogues (rapalogs) for Tuberous Sclerosis Complex-associated tumors: a systematic review on non-randomized studies using meta-analysis

Sasongko TH, Ismail NF, Nik Abdul Malik NM, Zabidi-Hussin ZA

Orphanet J Rare Dis, 2015;10:95.

PMID: 26259610 DOI: 10.1186/s13023-015-0317-7

Rapamycin has gained significant attention for its potential activity in reducing the size of TSC-associated tumors, thus providing alternative to surgery. This study aimed at determining the efficacy of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with Tuberous Sclerosis Complex (TSC).

Fulltext A qualitative study on malnutrition in children from the perspectives of health workers in Tumpat, Kelantan

Cheah WL, Wan Manan WM, Zabidi-Hussin ZM, Chang KH

Malays J Nutr, 2007 Mar;13(1):19-28.

PMID: 22692186 MyJurnal

Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Study site: Klinik kesihatan, Tumpat, Kelantan, Malaysia

Fulltext Permissibility of prenatal diagnosis and abortion for fetuses with severe genetic disorder: type 1 spinal muscular atrophy

Sasongko TH, Salmi AR, Zilfalil BA, Albar MA, Mohd Hussin ZA

Ann Saudi Med, 2010 Nov-Dec;30(6):427-31.

PMID: 21060155 DOI: 10.4103/0256-4947.72259

Abortion has been largely avoided in Muslim communities. However, Islamic jurists have established rigorous parameters enabling abortion of fetuses with severe congenital abnormalities. This decision-making process has been hindered by an inability to predict the severity of such prenatally-diagnosed conditions, especially in genetic disorders with clinical heterogeneity, such as spinal muscular atrophy (SMA). Heterogeneous phenotypes of SMA range from extremely severe type 1 to very mild type 4. Advances in molecular genetics have made it possible to perform prenatal diagnosis and to predict the types of SMA with its potential subsequent severity. Such techniques will make it possible for clinicians working in predominantly Muslim countries to counsel their patients accurately and in harmony with their religious beliefs. In this paper, we discuss and postulate that with our current knowledge of determining SMA types and severity with great accuracy, abortion is legally applicable for type 1 SMA.

Mutation spectrum of dystrophin gene in malaysian patients with Duchenne/Becker muscular dystrophy

Rani AQ, Sasongko TH, Sulong S, Bunyan D, Salmi AR, Zilfalil BA, et al.

J. Neurogenet., 2013 Jun;27(1-2):11-5.

PMID: 23438214 DOI: 10.3109/01677063.2012.762580

We undertook the clinical feature examination and dystrophin analysis using multiplex ligation-dependent probe amplification (MLPA) and direct DNA sequencing of selected exons in a cohort of 35 Malaysian Duchenne/Becker muscular dystrophy (DMD/BMD) patients. We found 27 patients with deletions of one or more exons, 2 patients with one exon duplication, 2 patients with nucleotide deletion, and 4 patients with nonsense mutations (including 1 patient with two nonsense mutations in the same exon). Although most cases showed compliance to the reading frame rule, we found two unrelated DMD patients with an in-frame deletion of the gene. Two novel mutations have been detected in the Dystrophin gene and our results were compatible with other studies where the majority of the mutations (62.8%) are located in the distal hotspot. However, the frequency of the mutations in our patient varied as compared with those found in other populations.

Allele-specific PCR for a cost-effective & time-efficient diagnostic screening of spinal muscular atrophy

Marini M, Sasongko TH, Watihayati MS, Atif AB, Hayati F, Gunadi, et al.

Indian J Med Res, 2012;135:31-5.

PMID: 22382180

Genetic diagnosis of spinal muscular atrophy (SMA) is complicated by the presence of SMN2 gene as majority of SMA patients show absence or deletion of SMN1 gene. PCR may amplify both the genes non selectively in presence of high amount of DNA. We evaluated whether allele-specific PCR for diagnostic screening of SMA is reliable in the presence of high amount of genomic DNA, which is commonly used when performing diagnostic screening using restriction enzymes.

National response to neurological diseases in Malaysia: planning for the future

Abdullah JM, Hussin AM, Tharakan J, Abdullah MR, Saad R, Kamari Z, et al.

Southeast Asian J Trop Med Public Health, 2006 Jul;37(4):798-805.

PMID: 17121309

The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.

Two closely spaced nonsense mutations in the DMD gene in a Malaysian family

Rani AQ, Malueka RG, Sasongko TH, Awano H, Lee T, Yagi M, et al.

Mol Genet Metab, 2011 Jul;103(3):303-4.

PMID: 21514860 DOI: 10.1016/j.ymgme.2011.04.002

In Duchenne muscular dystrophy (DMD), identification of one nonsense mutation in the DMD gene has been considered an endpoint of genetic diagnosis. Here, we identified two closely spaced nonsense mutations in the DMD gene. In a Malaysian DMD patient two nonsense mutations (p.234S>X and p.249Q>X, respectively) were identified within exon 8. The proband's mother carried both mutations on one allele. Multiple mutations may explain the occasional discrepancies between genotype and phenotype in dystrophinopathy.

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