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Pulmonologist-led ultrasound guided lung biopsy safety and efficacy: a 4-year experience from a tertiary centre in Northern Malaysia

Ismail IN, Alaga A

Med J Malaysia, 2023 Nov;78(6):751-755.
PMID: 38031216

INTRODUCTION: Ultrasound guided lung biopsy (USLB) is a minimally invasive diagnostic tool with short examination time and real-time monitoring conducted bedside for accurate diagnosis in order to provide the best treatment. However, it is not widely performed by pulmonologists. We aim to explicate the efficacy and safety of USLB led by pulmonologists. The objective of this study is to assess safety and efficacy of USLB performed by pulmonologists in an outpatient setting.
MATERIALS AND METHODS: We retrospectively enrolled patients who underwent the procedure from January 2018 to April 2022. Under real time ultrasound (Hitachi Medical ProSound F37), thoracic lesions adjacent to the chest wall were sampled with a full-core biopsy needle (CT Core Single Action Biopsy Device, 18G × 15 cm, Vigeo, Italy). Chest x-ray was performed 30 minutes post procedure ruling out pneumothorax. Patients were discharged home 1-2 hours post biopsy. Data was analysed using Microsoft Excel 2010 and Statistical Package for Social Science (SPSS) Version 26.
RESULTS: A total of 18 patients (14 males, 4 females) underwent USLB for lung tumours. Biopsies were histologically deemed adequate with an overall diagnostic yield of 77.8% (14/18). A total of 57% were positive for thoracic malignancy (21% squamous cell carcinoma, 21% adenocarcinoma, 15% small cell carcinoma) and another 43% were positive for extra thoracic malignancy (1 hepatocellular carcinoma, 2 DLBCL, 1 Hodgkin's lymphoma, 1 seminoma, 1 thymoma). Four patients had inconclusive results but managed to get positive results from surgical or lymph node biopsy (thymoma and adenocarcinoma). Statistical analysis showed more than two passes are needed to achieve a positive HPE yield (p value<0.05). There were nil complications to all the cases done.
CONCLUSIONS: USLB can safely and effectively be performed by trained pulmonologists with excellent accuracy and low complication rate in outpatients.
Solvent and pH Effects of Coumarin-Terminated Monolayer on Silver Particles

Ismail IN, Asri NI, Tajuddin HA, Abdullah Z

J Fluoresc, 2015 Jul;25(4):777-85.
PMID: 26054802 DOI: 10.1007/s10895-015-1587-0

A coumarin-terminated self-assembled monolayer on silver particles (C-SAM) from the reduction of silver ions in the presence of compound 3 was successfully prepared by utilizing phase transfer method, and analyzed by FTIR, SEM-EDS, UV-Visible and a particle sizer. The fluorescence behavior of coumarin termini was carried out in ethanol and chloroform with emission wavelength determined at 386 nm, suggesting an interaction between the carbonyl group and the solvent media. The dispersion was then investigated in acidic and basic conditions, showing a direct proportional correlation between the emission and the pH of the aqueous. These results were consistent for interpreting hydrogen bonds, particularly between the carbonyl group with either proton of the alcohol (C=O----H-O-R) or positive species in acidic conditions (C=O----H(+)). The interactions were possible only when the coumarin terminal rearranged in the monolayer and the carbonyl exerted towards the solvent media, while the rest of the molecules were separated from the solvents.
Bone regeneration at the distal aspect of the adjacent second molar after lower third molar coronectomy: a long-term analysis

Leung YY, Yeung AWK, Ismail IN, Wong NSM

Int J Oral Maxillofac Surg, 2020 Oct;49(10):1360-1366.
PMID: 32340909 DOI: 10.1016/j.ijom.2020.03.016

A residual bone defect at the distal aspect of the adjacent second molar may occur after total removal of the lower third molar. Lower third molar coronectomy has been proved to be a safe alternative to total removal, but the extent of bone regeneration at the adjacent tooth after coronectomy is not well reported. The aim of this prospective study was to investigate the long-term bone regeneration at the distal aspect of the adjacent second molar after lower third molar coronectomy. Preoperative and postoperative cone beam computed tomography scans were measured to assess bone regeneration at the distobuccal (DB), mid-distal (MD), and distolingual (DL) aspects of the lower second molar. Forty-eight coronectomies in 37 patients (23 female) with a mean±standard deviation age of 29.1±7.2 years were assessed. The mean follow-up was 93.2±8.7 months. The mean bone level increase at DB, MD, and DL aspects was 3.2±1.6mm, 3.5±1.5mm, and 3.2±1.6mm, respectively; the bone levels were significantly higher than the preoperative measurements (P<0.001). Age and impaction patterns were not factors affecting bone regeneration. Based on this study, it appears that coronectomy of the lower third molar brings favourable bone regeneration at the distal aspect of the adjacent second molar.
Does facial appearance of dentofacial deformity influence the need for orthognathic surgery: The Malaysian perception

Abdul Halim Chong FH, Md Salleh SN, Abu Bakar N, Ismail IN

Singapore Dent J, 2019 12;39(1):41-52.
PMID: 32910746 DOI: 10.1142/S2214607519500044

Aim: This study evaluates perception toward facial appearance in dentofacial deformity and the need for orthognathic surgery among the public with and without dental backgrounds. Materials and Methods: A questionnaire consisting of 12 facial photographs of cases with dentofacial deformity or malocclusion in varying severity was used. A hundred individuals were selected to answer the questionnaire. The perception of facial appearance (FAS), treatment need score (TNS), and knowledge regarding dentofacial deformity were used for the evaluation. Results: Significant differences were found between dental and non-dental when the respondents' knowledge in all the questionnaire items ([Formula: see text].05) was assessed. However, no significant difference was found in the mean of FAS and TNS in all the presented cases (normal, borderline, severe). Pearson correlation between perceived FAS and TNS was statistically negative for severe and normal cases, whereby a decrease in FAS for severe cases showed an increase in TNS, and an increase in FAS for normal cases showed a decrease in TNS. Conclusion: Respondents with dental background had sound knowledge of dentofacial deformity. A poorly attractive respondent with dentofacial deformity showed a greater need for orthognathic surgery.
Anammox process for aquaculture wastewater treatment: operational condition, mechanism, and future prospective

Ismail IN, Taufik M, Umor NA, Norulhuda MR, Zulkarnaini Z, Ismail S

Water Sci Technol, 2022 Dec;86(12):3093-3112.
PMID: 36579872 DOI: 10.2166/wst.2022.403

Treatment of ammonia- and nitrate-rich wastewater, such as that generated in the aquaculture industry, is important to prevent environmental pollution. The anaerobic ammonium oxidation (anammox) process has been reported as a great alternative in reducing ammoniacal nitrogen concentration in aquaculture wastewater treatment compared to conventional treatment systems. This paper will highlight the impact of the anammox process on aquaculture wastewater, particularly in the regulation of ammonia and nitrogen compounds. The state of the art for anammox treatment systems is discussed in comparison to other available treatment methods. While the anammox process is viable for the treatment of aquaculture wastewater, the efficiency of nitrogen removal could be further improved through the proper use of anammox bacteria, operating conditions, and microbial diversity. In conclusion, a new model of the anammox process is proposed in this review.