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Vincristine-induced vocal cord palsy: case report and review of the literature

Latiff ZA, Kamal NA, Jahendran J, Alias H, Goh BS, Syed Zakaria SZ, et al.

J Pediatr Hematol Oncol, 2010 Jul;32(5):407-10.
PMID: 20505534 DOI: 10.1097/MPH.0b013e3181e01584

Vincristine-induced vocal cord paralysis is a rare but serious complication. We report 2 patients with acute lymphoblastic leukemia who developed progressive stridor during induction chemotherapy. There were no clinical features of peripheral or autonomic neuropathy. Flexible laryngoscopy confirmed the diagnosis of bilateral vocal cord palsy; interestingly, the nerve conduction test revealed axonal motor neuropathy involving the median and common peroneal nerves in both patients. The first patient required prolonged ventilatory support necessitating unilateral cordectomy before extubation, whereas the second only required supplemental oxygen therapy. There was resolution of stridor in the first patient after cordectomy and gradual clinical improvement in the second. These cases illustrate that a high index of suspicion of vincristine-induced vocal cord palsy with prompt otolaryngology consultation for laryngoscopy is required in the diagnostic evaluation of a patient who has received vincristine.
Fulltext Estimation of soil erodibility in Peninsular Malaysia: A case study using multiple linear regression and artificial neural networks

Rehman MA, Abd Rahman N, Ibrahim ANH, Kamal NA, Ahmad A

Heliyon, 2024 Apr 15;10(7):e28854.
PMID: 38576554 DOI: 10.1016/j.heliyon.2024.e28854

Soil erodibility (K) is an essential component in estimating soil loss indicating the soil's susceptibility to detach and transport. Data Computing and processing methods, such as artificial neural networks (ANNs) and multiple linear regression (MLR), have proven to be helpful in the development of predictive models for natural hazards. The present case study aims to assess the efficiency of MLR and ANN models to forecast soil erodibility in Peninsular Malaysia. A total of 103 samples were collected from various sites and K values were calculated using the Tew equation developed for Malaysian soil. From several extracted parameters, the outcomes of correlation and principal component analysis (PCA) revealed the influencing factors to be used in the development of ANN and MLR models. Based on the correlation and PCA results, two sets of influencing factors were employed to develop predictive models. Two MLR (MLR-1 and MLR-2) models and four neural networks (NN-1, NN-2, NN-3, and NN-4) optimized using Levenberg-Marquardt (LM) and scaled conjugate gradient (SCG) were developed and evaluated. The model performance validation was conducted using the coefficient of determination (R2), mean squared error (MSE), root mean squared error (RMSE), and Nash-Sutcliffe efficiency coefficient (NSE). The analysis showed that ANN models outperformed MLR models. The R2 values of 0.446 (MLR-1), 0.430 (MLR-2), 0.894 (NN-1), 0.855 (NN-2), 0.940 (NN-3), and 0.826 (NN-4); MSE values of 0.0000306 (MLR-1), 0.0000315 (MLR-2), 0.0000158 (NN-1), 0.0000261 (NN-2), 0.0000318 (NN-3), and 0.0000216 (NN-4) suggested the higher accuracy and lower modelling error of ANN models as compared with MLR. This study could provide an empirical basis and methodological support for K factor estimation in the region.
Externalizing and internalizing syndromes in relation to school truancy among adolescents in high-risk urban schools

Nik Jaafar NR, Tuti Iryani MD, Wan Salwina WI, Fairuz Nazri AR, Kamal NA, Prakash RJ, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:27-34.
PMID: 23857834 DOI: 10.1111/appy.12072

To examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending "high-risk" schools in Kuala Lumpur.
Fulltext An elderly patient with depression and a suicide attempt during the COVID-19 pandemic: a case report

Mohd Salleh Sahimi H, Midin M, Lim JTY, Anwar MWA, Abdul Samad FD, Mohamad Kamal NA

Front Psychiatry, 2023;14:1151482.
PMID: 37840789 DOI: 10.3389/fpsyt.2023.1151482

OBJECTIVE: Elderly individuals are among the age groups with the highest risk of suicide. The coronavirus (COVID-19) pandemic forced isolation and resulted in an increased risk of depression, hopelessness, and perceived burdensomeness among the elderly, thereby increasing the risk of suicide.
METHODS: This is a case report of an elderly single retired school principal with obsessive-compulsive personality traits who developed depression with psychotic symptoms after being isolated following the movement control order (MCO) during the COVID-19 pandemic. The social isolation led to feelings of loneliness and hopelessness. The patient's depressive symptoms worsened after he developed physical illnesses, such as eye floaters, that affected his daily activities. This caused him to have suicidal ideation to the extent that he attempted suicide by ingesting 90 mL of pesticide. Two weeks prior to the attempt, he updated his will and asked his friend to keep it. After the suicide attempt, he vomited and had diarrhea and epigastric pain. He called his friend, who brought him to the hospital emergency room (ER). He was resuscitated and subsequently admitted to the intensive care unit (ICU). After being medically stabilized, he was transferred to the psychiatric ward, where further treatment was administered for his depression. His depressive symptoms and suicidal ideation improved after he was administered antidepressants and psychotherapy.
RESULTS: The impact of the COVID pandemic has led to a surge in mental health issues such as anxiety and depression. The elderly are among the highest-risk groups of individuals to contract or die of COVID-19 infection, and they are also the most likely to develop mental health issues related to the pandemic. Furthermore, the risk of death by suicide is highest in this age group due to physical illness, social isolation, and the lack of a support system. This case also highlights the need for awareness of suicidal ideation screening among non-medical healthcare professionals and religious organizations to avoid the treatment gap.
CONCLUSION: It is essential to enhance suicide risk assessment and management among the elderly after the COVID-19 pandemic.
Fulltext Stigma, Sociodemographic Factors, and Clinical Factors Associated with Psychological Distress among COVID-19 Survivors during the Convalescence Period: A Multi-Centre Study in Malaysia

Abdul Taib NI, Nik Jaafar NR, Azman N, Leong Bin Abdullah MFI, Mohamad Kamal NA, Baharudin A, et al.

Int J Environ Res Public Health, 2023 Feb 21;20(5).
PMID: 36900807 DOI: 10.3390/ijerph20053795

High rates of psychological distress among COVID-19 survivors and stigmatisation have been reported in both early and late convalescence. This study aimed to compare the severity of psychological distress and to determine the associations among sociodemographic and clinical characteristics, stigma, and psychological distress among COVID-19 survivors across two different cohorts at two different time points. Data were collected cross-sectionally in two groups at one month and six months post-hospitalisation among COVID-19 patient from three hospitals in Malaysia. This study assessed psychological distress and the level of stigma using the Kessler Screening Scale for Psychological Distress (K6) and the Explanatory Model Interview Catalogue (EMIC) stigma scale, respectively. At one month after discharge, significantly lower psychological distress was found among retirees (B = -2.207, 95% confidence interval [95% CI] = -4.139 to -0.068, p = 0.034), those who received up to primary education (B = -2.474, 95% CI = -4.500 to -0.521, p = 0.014), and those who had an income of more than RM 10,000 per month (B = -1.576, 95% CI = -2.714 to -0.505, p = 0.006). Moreover, those with a history of psychiatric illness [one month: (B = 6.363, 95% CI = 2.599 to 9.676, p = 0.002), six months: (B = 2.887, CI = 0.469-6.437, p = 0.038)] and sought counselling services [one month: (B = 1.737, 95% CI = 0.385 to 3.117, p = 0.016), six months: (B = 1.480, CI = 0.173-2.618, p = 0.032)] had a significantly higher severity of psychological distress at one month and six months after discharge from the hospital. The perceived stigma of being infected with COVID-19 contributed to greater severity of psychological distress. (B = 0.197, CI = 0.089-0.300, p = 0.002). Different factors may affect psychological distress at different periods of convalescence after a COVID-19 infection. A persistent stigma contributed to psychological distress later in the convalescence period.
Fulltext The Role of Oxidative Stress in Suicidal Behaviour Among Bipolar Patients: A Cross-Sectional Study in a Malaysian Sample

Loo JL, Mohamad Kamal NA, Goon JA, Ahmad Damanhuri H, Tan JAC, Abdul Murad NA, et al.

Front Psychiatry, 2021;12:698911.
PMID: 34916966 DOI: 10.3389/fpsyt.2021.698911

Background: Oxidative stress markers are found to be linked with depression and suicide attempts in bipolar disorder (BD), although the role of DNA damage as a marker of suicidal ideation and attempt has yet to be determined. We aim to investigate the association between DNA damage and suicidal behaviour, i.e., suicidal ideation and suicide attempt, among suicidal ideators in BD patients while accounting for clinical and psychosocial risk factors. Methods: A cross-sectional study was conducted in the Universiti Kebangsaan Malaysia Medical Centre on 62 consecutive BD patients diagnosed using the M.I.N.I. Neuropsychiatric Interview and 26 healthy control participants. Socio-demographic and clinical assessments were performed using the Columbia Suicide Severity Rating Scale (C-SSRS) for lifetime suicidal ideation and attempt, Quick Inventory of Depressive Symptomatology (QIDS) for depression severity, Clinical Global Impression for Bipolar Disorder (CGI-BD) for illness severity [both mania (CGI-Mania) and major depressive episode (CGI-MDE)], Social Readjustment Rating Scale (SRRS) for change in life events, and Barratt Impulsiveness Scale (BIS) for behavioural impulsivity. The degree of DNA damage in peripheral blood samples was determined using a standard protocol of comet assay. Results: Multivariable logistic regression revealed higher scores of CGI-MDE as the sole significant factor for lifetime suicidal ideation (OR = 1.937, 95% CI = 1.799-2.076). Although initial bivariate analysis showed a significant association between DNA damage, malondialdehyde (MDA), catalase (CAT), and suicidal behaviour, the findings were not seen in multivariable logistic regression. Bivariate subgroup analysis showed that moderate and severe DNA damage (p = 0.032 and p = 0.047, respectively) was significantly associated with lifetime suicide attempts among lifetime suicidal ideators. The study is the first to look at the connexion between DNA damage and suicidal risk in bipolar patients. It is limited by the small sample size and lack of information on illicit substance use. Conclusions: More severe DNA damage was significantly associated with lifetime suicide attempts among lifetime suicidal ideators in BD. However, the severity of depression was found to be independently associated with lifetime suicidal ideation per se rather than DNA damage in BD. Larger prospective studies are required to ascertain the potential of DNA damage as a biomarker for the transition from suicidal ideation to a suicide attempt.