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Association between HER-2/neu over-expression and clinico-pathologic parameters of breast cancer in northern Malaysia

Kamil M, Yusuf N, Khalid I, Islam R, Biswas M, Hashim H

Ceylon Med J, 2010 Mar;55(1):9-13.
PMID: 20446534

BACKGROUND: Breast cancer is the commonest cancer affecting women world wide. Breast cancer is a leading cause of cancer related mortality in Asian countries. Management of breast cancer depends on several tumour-related and patient related factors. HER-2/neu over-expression has been associated with a poor prognosis in breast cancer. We assessed HER-2/neu over expression pattern in unselected breast cancer cases in terms of clinico-pathologic parameters to identify any associations between them.
METHODS: Two hundred cases of breast cancer were evaluated at Advanced Medical and Dental Institute and Hospital Kepala Batas from 2002 to 2007. HER-2/neu status was confirmed in breast cancer tissues by immunohistochemistry. Immunohistochemical expression of HER-2/neu was evaluated according to the published scoring guidelines of the 'Hercep Test' (Dako, Carpinteria, CA). Data were analysed to identify any association between HER-2/neu and clinico-pathologic parameters.
RESULTS: HER-2/neu over expression was found in 63 (31.5%) tumours out of 200. When assessed for various age groups no significant association was found. However, a high percentage (75%) of over-expression was noted in the 81-85 years age group. No association was found with different racial groups (Malay, Chinese and Indians), with lymph node status or with grade of tumour. However a positive association was observed with oestrogen receptor and progesterone receptor expression.
CONCLUSION: There was no association between HER-2/neu over expression and age, race, lymph node status or tumor grade. However a positive association was found with oestrogen and progesterone receptor status.
High frequency of hand foot syndrome with capecitabine

Kamil M, Haron M, Yosuff N, Khalid I, Azman N

J Coll Physicians Surg Pak, 2010 Jun;20(6):421-2.
PMID: 20642979 DOI: 06.2010/JCPSP.421422

A hospital based cross-sectional retrospective study was conducted to determine the frequency of hand foot syndrome (HFS) with Capecitabine as a single agent and in combination with Oxaliplatin. The study included 43 consecutive cases of colorectal carcinoma and conducted from June till December 2008. Patients on palliative care were excluded. SPSS was used for the application of chi-square test, by keeping the level of significance as p < 0.05. Fifteen (34.9%) patients developed HFS, 10 in the single-agent and 5 in the combination group. No significant association of HFS with either regimens was noted (p=0.876).
Impact of Ramadan Focused Education Program on medications adjustment for patients with type 2 diabetes in a primary health care institution in Saudi Arabia

Tourkmani AM, Alharbi TJ, Bin Rsheed AM, AlRasheed AN, AlBattal SM, Abdelhay O, et al.

Diabetes Metab Syndr, 2018 08 02;13(1):161-165.
PMID: 30641690 DOI: 10.1016/j.dsx.2018.07.012

AIMS: To examine the impact of Ramadan Focused Education Program (RFEP) on medications adjustment in type 2 diabetes patients in Ramadan.
METHODS: This is a controlled, intervention based study. It was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n = 140) received RFEP on medications doses & timing adjustment before and after Ramadan, while the control group (n = 122) received standard care.
RESULTS: The dose of insulin glargine was reduced from 42.51 ± 22.16 at the baseline to 40.11 ± 18.51-units during Ramadan (p = 0.002) in the intervention group while it remained the same in the control group before Ramadan and during Ramadan (38.51 ± 18.63 and 38.14 ± 18.46, P = 0.428, respectively). The hypoglycemia score was 14.2 ± (8.5) pre-Ramadan in the intervention and reduced to 6.36 ± 6.17 during Ramadan (p 
Development of an inhibitive assay using commercial Electrophorus electricus acetylcholinesterase for heavy metal detection

Shukor MY, Tham LG, Halmi MI, Khalid I, Begum G, Syed MA

J Environ Biol, 2013 Sep;34(5):967-70.
PMID: 24558814

Near-real-ime assay is anassay method that the whole process from sampling until results could be obtained in approximately Iess than one hour. The ElIman assay for acetyl cholinesterase (AChE) has near real-time potential due to its simplicity and fast assay time. The commercial acetylcholinesterase from Electrophorus electricus is well known for its uses in insecticides detection. A lesser known fact is AChE is also sensitive to heavy metals. A near real-time inhibitive assay for heavy metals using AChE from this source showed promising results. Several heavy metals such as copper, silver and mercury could be etected with IC50 values of1.212, 0.1185 and 0.097 mg I-1, respectively. The Limits of Detection (LOD) for copper, silver and mercury were 0.01, 0.015 and 0.01 mg I-1, respectively. TheLimits of quantitation (LOQ) or copper, silver and mercury were 0.196, 0.112 and 0.025 mg I-1, respectively. The LOQvalues for copper, silver and mercury were well below the maximum permissible limit for these metal ions as outlined by Malaysian Department of Environment. A polluted location demonstrated near real-time applicability of the assay with variation oftemporal levels of heavy metals detected. The results show that AChE from Electrophorus electricus has the potential to be used as a near real-time biomonitoring tool for heavy
Association of carcinoma breast: grade and estrogen progesterone receptor expression

Kamil M, Khalid I, Hashim H, Biswas M, Kaur G, Islam R

J Coll Physicians Surg Pak, 2010 Apr;20(4):250-2.
PMID: 20392401 DOI: 04.2010/JCPSP.250252

To determine the association between histological grade of tumour and estrogen progesterone receptors (ER/PR) expression in unselected invasive carcinoma of breast in Malaysian patients.
Bilateral External Oblique Intercostal Catheter for Post-operative Analgesia After Open Pancreaticoduodenectomy: A Case Report

Chan WK, Tan KW, Chong KP, Lim ACC, Khalid I

Cureus, 2023 Oct;15(10):e47189.
PMID: 38021569 DOI: 10.7759/cureus.47189

Open pancreaticoduodenectomy, also known as Whipple surgery, is a complex and painful procedure that requires a multi-modal analgesic approach for successful post-operative rehabilitation and recovery. While thoracic epidural analgesia (TEA) remains the gold standard for pain relief after open upper abdominal surgery, it carries many risks that may outweigh the potential benefits of the technique. Furthermore, in laparoscopic converted to open pancreaticoduodenectomy cases, post-operative placement of a thoracic epidural catheter is inconvenient to the patient due to pain and positioning. The external oblique intercostal (EOI) block is a novel method that provides somatic analgesia to the upper abdomen. We present a case of bilateral EOI block with catheter insertion for post-operative analgesia in a patient who underwent laparoscopic converted to open Whipple surgery.
Fulltext Effect of Hydrophilic Polymers on Complexation Efficiency of Cyclodextrins in Enhancing Solubility and Release of Diflunisal

Bashir M, Syed HK, Asghar S, Irfan M, Almalki WH, Menshawi SA, et al.

Polymers (Basel), 2020 Jul 15;12(7).
PMID: 32679660 DOI: 10.3390/polym12071564

The effects of three hydrophilic polymers, namely, carboxymethyl cellulose sodium (CMC-Na), polyvinyl alcohol (PVA) and poloxamer-188 (PXM-188) on the solubility and dissolution of diflunisal (DIF) in complexation with β-cyclodextrin (βCD) or hydroxypropyl β-cyclodextrin (HPβCD), were investigated. The kneading method was used at different drug to cyclodextrin weight ratios. Increases in solubility and drug release were observed with the DIF/βCD and DIF/HPβCD complexes. The addition of hydrophilic polymers at 2.5, 5.0 and 10.0% w/w markedly improved the complexation and solubilizing efficiency of βCD and HPβCD. Fourier-transform infrared (FTIR) showed that DIF was successfully included into the cyclodextrin cavity. Differential scanning calorimetry (DSC) and X-ray diffractometry (XRD) confirmed stronger drug amorphization and entrapment in the molecular cage of cyclodextrins. The addition of PVA, CMC-Na or PXM-188 reduced further the intensity of the DIF endothermic peak. Most of the sharp and intense peaks of DIF disappeared with the addition of hydrophilic polymers. In conclusion, PXM-188 at a weight ratio of 10.0% w/w was the best candidate in enhancing the solubility, stability and release of DIF.
Fulltext Comparison of NeedleTrainer™ and ultrasound tissue simulator in a simulated environment among novice regional anaesthesia practitioners

Mokhtar MN, Suhaini SA, Chan WK, Khalid I, Tan KW, Lim ACC, et al.

BMC Med Educ, 2024 Nov 22;24(1):1350.
PMID: 39578873 DOI: 10.1186/s12909-024-06361-7

BACKGROUND: Utilising ultrasound technology has resulted in higher success and lower complication rates during regional anaesthesia (RA) procedures. Proper training is necessary to accurately identify structures, optimise images, and improve hand-eye coordination. Simulation training using immersive virtual environments and simulation models has enabled this competency training to be conducted safely before performing on patients. We conducted a study to compare the simulator performance and users' feedback on a Blue Phantom Regional Anaesthesia Ultrasound Training Block and NeedleTrainer™.
METHODS: Forty-seven participants were recruited via convenient sampling during a RA workshop for novice practitioners. They were divided into the N or B group and then crossover to experience using both Blue Phantom and NeedleTrainer model. Time-to-reach-target, first-pass success rate, and complication rate were assessed, while the learning and confidence scores were rated using six-item and three-item questionnaires, respectively, via a 5-point Likert scale.
RESULTS: Blue Phantom model has a longer time-to-target as compared to the NeedleTrainer model (16 ± 8 vs 8 ± 3 s, p