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Fulltext Transobsturator tape (TOT) procedure: the Ipoh experience

Nusee, Z., Naidu, A., Ranjudham, S.N., Ismail, H.

JUMMEC, 2011;14(1):10-20.
MyJurnal

The use of transobturator tape (TOT) for the treatment of stress urinary incontinence (SUI) has gained popularity since it was introduced in 2001. Only few studies have reported that TOT is superior in safety and efficacy when compared to tension free vaginal tape (TVT). This case-series study was conducted to investigate the safety and efficacy of the TOT procedure in patients at Ipoh Hospital. A cross sectional study on patients who underwent TOT procedures from Jan 2006 to Jun 2008 was conducted. Patients were followed-up 1 month, 3 month, 12 month and annually thereafter. Data were retrieved from patients‟ records based on the standard pre-operative assessment sheet and follow up record. Interviews were then made via telecommunication to assess the patients‟ progression and satisfaction using a validated questionnaire. Fifty-two subjects (n=52) were recruited. The mean age was 54.2 ± 10.6 years with the median follow up time of 19 months. Majority of cases (n=46; 88.5%) had concomitant pelvic organ prolapse (POP), while only 2 (3.8%) had an isolated stress urinary incontinence (SUI). Pre-operatively, only 16 patients (30.8%) were diagnosed with mixed urinary incontinence (MUI) and 24 patients (46.2%) had over active bladder symptoms (OAB) which include increased frequency and urgency. The objective cure rate for SUI was 42 (80.7%), 3 (5.8%) failed while 7 (13.5%) improved. Complications were limited to minor conditions and was only observed in four patients: one case (1.9%) of acute urinary retention, three (5.7%) had prolonged indwelling catheter more than 3 days and one (1.9%) each for mesh erosion, hematoma, urinary tract infection (UTI) and wound infection. Cure rate for MUI, frequency and urgency were 37.4%, 70.8% and 54.2% respectively. De novo urgency was noted in three (n=3: 5.7%) cases while (n=3: 5.7%) required revision of the tape. Forty-nine women (n=49: 94.2%) were satisfied with the procedure. TOT procedures significantly improve OAB symptoms with high patient‟s acceptance rate and no serious operative complication.
Rare postpartum ruptured degenerated fibroid: a case report

Tan YL, Naidu A

J Obstet Gynaecol Res, 2014 May;40(5):1423-5.
PMID: 24689652 DOI: 10.1111/jog.12334

Spontaneous rupture of uterine fibroid is rarely encountered. We present a case of a 31-year-old who presented with acute abdominal pain at 9 weeks postpartum. On examination, the abdomen had diffuse tenderness, with rebound tenderness in the suprapubic area and in both iliac fossae. On ultrasonography, a 12.7 × 8.6 × 8.9-cm sized hyperechoic mass was visible on the posterior wall of the uterus. A large amount of fluid was visible in the paracolic gutters and the Pouch of Douglas (POD). The patient underwent an exploratory laparotomy. A ruptured, cystic degenerated uterine fibroid with active bleeding was found, as well as approximately half a liter of free, bloodstained peritoneal fluid and pus. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra-abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.
Diaphragmatic hernia: an unusual cause of postpartum collapse

Sharifah H, Naidu A, Vimal K

BJOG, 2003 Jul;110(7):701-3.
PMID: 12842063
Influence of iron, growth temperature and plasmids on siderophore production in Aeromonas hydrophila

Naidu AJ, Yadav M

J Med Microbiol, 1997 Oct;46(10):833-8.
PMID: 9364139

Aeromonas hydrophila strains obtained from diarrhoeal samples of human patients (19 isolates) and freshwater ponds (11 isolates) were analysed for siderophore production. Both clinical and environmental isolates showed significantly increased siderophore production under iron-limiting conditions both at 28 degrees C and at 37 degrees C. Clinical isolates consistently produced higher levels of siderophores than did the environmental isolates. The role of plasmids in moderating siderophore production was studied after curing with acridine orange. Treatment with acridine orange for 24 h removed the larger plasmids but the smaller plasmids (< 5 MDa), more common in the environmental isolates, were resistant to curing. As found in the untreated isolates, the cured clinical isolates produced higher mean levels of siderophores than the cured environmental isolates. Siderophore production in A. hydrophila was significantly influenced by iron-limiting cultural conditions and the source of isolates, but plasmid content and growth temperature at 28 degrees C or 37 degrees C had little effect on production. The basis for the greater production of siderophores in clinical isolates than in environmental isolates needs further study.
The modern implementation of patient blood management (PBM) in Malaysia: the use of intravenous iron in severe anaemia with iron deficiency - A Case Report

Krishnamoorthy A, Hadi FA, Naidu A, Sathar J

Med J Malaysia, 2017 02;72(1):53-54.
PMID: 28255141

Anaemia is a common condition in Malaysia, and is mostly due to iron deficiency. In many cases, allogeneic blood transfusion (ABT) is administered unnecessarily to treat anaemia. Patient blood management (PBM) is a concept whereby a patient becomes his or her "own blood bank", instead of receiving ABT. The concept encompasses three pillars namely optimising erythropoiesis, minimising blood loss and harnessing human physiological reserve. We present a safe and fruitful outcome of managing severe anaemia without utilising any ABT, made possible with the PBM approach including administration of intravenous iron.
Fulltext Heartbeat sound classification using a hybrid adaptive neuro-fuzzy inferences system (ANFIS) and artificial bee colony

Keikhosrokiani P, Naidu A/P Anathan AB, Iryanti Fadilah S, Manickam S, Li Z

Digit Health, 2023;9:20552076221150741.
PMID: 36655183 DOI: 10.1177/20552076221150741

Cardiovascular disease is one of the main causes of death worldwide which can be easily diagnosed by listening to the murmur sound of heartbeat sounds using a stethoscope. The murmur sound happens at the Lub-Dub, which indicates there are abnormalities in the heart. However, using the stethoscope for listening to the heartbeat sound requires a long time of training then only the physician can detect the murmuring sound. The existing studies show that young physicians face difficulties in this heart sound detection. Use of computerized methods and data analytics for detection and classification of heartbeat sounds will improve the overall quality of sound detection. Many studies have been worked on classifying the heartbeat sound; however, they lack the method with high accuracy. Therefore, this research aims to classify the heartbeat sound using a novel optimized Adaptive Neuro-Fuzzy Inferences System (ANFIS) by artificial bee colony (ABC). The data is cleaned, pre-processed, and MFCC is extracted from the heartbeat sounds. Then the proposed ABC-ANFIS is used to run the pre-processed heartbeat sound, and accuracy is calculated for the model. The results indicate that the proposed ABC-ANFIS model achieved 93% accuracy for the murmur class. The proposed ABC-ANFIS has higher accuracy in compared to ANFIS, PSO ANFIS, SVM, KSTM, KNN, and other existing studies. Thus, this study can assist physicians to classify heartbeat sounds for detecting cardiovascular disease in the early stages.
Uterine inversion with massive uterovaginal prolapse and multiple bladder stones

Naidu A, Nusee Z, Tayib S

J Obstet Gynaecol Res, 2011 Jun;37(6):633-5.
PMID: 21349130 DOI: 10.1111/j.1447-0756.2010.01401.x

A non-puerperal uterine inversion in advanced uterovaginal prolapse is a rare occurrence. Even more unusual is the presence of bladder calculi in these two conditions, which has not been documented before. We report a case of acute urinary retention secondary to severe uterovaginal prolapse associated with uterine inversion and multiple bladder calculi.
Fulltext Genitourinary tuberculosis: an atypical clinical presentation

Lim PS, Atan IK, Naidu A

Case Rep Obstet Gynecol, 2012;2012:727146.
PMID: 23320216 DOI: 10.1155/2012/727146

Genitourinary tuberculosis is one of the common forms of extrapulmonary tuberculosis. We report a case of atypical genitourinary tuberculosis: massive uterovaginal prolapse with cervical lesion mimicking cervical carcinoma. This particular case highlights the problem of healthcare in most of the developing countries. Lack of patient education, awareness, and access to a healthcare system resulted in a complicated situation. In an endemic area or in an immunocompromised individual, a higher index of suspicion would allow early recognition and treatment institution to minimise its late consequences as well as spreading of the disease. Though anti-TB is the mainstay of treatment, surgical intervention might be needed in selected cases.
Modeling and simulation of an enzymatic reactor for hydrolysis of palm oil

Bhatia S, Naidu AD, Kamaruddin AH

Artif Cells Blood Substit Immobil Biotechnol, 1999 Sep-Nov;27(5-6):435-40.
PMID: 10595445

Hydrolysis of palm oil has become an important process in Oleochemical industries. Therefore, an investigation was carried out for hydrolysis of palm oil to fatty acid and glycerol using immobilized lipase in packed bed reactor. The conversion vs. residence time data were used in Michaelis-Menten rate equation to evaluate the kinetic parameters. A mathematical model for the rate of palm oil hydrolysis was proposed incorporating role of external mass transfer and pore diffusion. The model was simulated for steady-state isothermal operation of immobilized lipase packed bed reactor. The experimental data were compared with the simulated results. External mass transfer was found to affect the rate of palm oil hydrolysis at higher residence time.
Fetoscopic laser ablation for twin-to-twin transfusion syndrome in Malaysia: A 15-month retrospective cohort review from an emerging centre in South East Asia

Tan LN, Gardener GJ, R Jeganathan JR, Naidu A, Hassan G, Ahmad Zainuddin R, et al.

Med J Malaysia, 2023 Jan;78(1):68-73.
PMID: 36715194

INTRODUCTION: The authors aim to review the early outcomes of fetostopic laser ablation (FLA) to improve outcomes for twin-to-twin transfusion syndrome (TTTS) in an emerging national centre in Malaysia.
MATERIALS AND METHODS: This is a retrospective cohort study of 17 monochorionic diamniotic (MCDA) twin pregnancies with severe TTTS treated by FLA over 15 months in a single centre by a single operator after performing simulations.
RESULT: The overall survival rate at day 28 after birth for at least one twin was 76% while the dual-twin survival was 64%. The survival rates at day 28 after birth for at least one twin for stages II, III and IV were 90% vs 40% vs 100% (p=0.054) while dual survival rates were 80% vs 0% vs 100% (p=0.05), respectively. The rate of miscarriage was higher with anterior placentation compared to posterior placentation (33% vs 18%, p=0.660). There was one case of recurrent TTTS and no twin anaemia-polycythaemia sequence post-FLA. The fetal medicine unit in Ipoh is the national centre in Malaysia which covers the whole country, including the western coast of the Borneo Island (Sabah, Sarawak and Labuan) accessible only by air travel. All three cases from Borneo Island had resolved TTTS after FLA and dual neonatal survival at day 28 after birth.
CONCLUSION: This data from an emerging new fetoscopic laser centre in Malaysia indicates results consistent with the published international learning curve and within the limits of good clinical governance.