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Lethal hemorrhage from a ureteric-arterial-enteric fistula diagnosed by postmortem CT angiography

Rashid SN, Bouwer H, O'Donnell C

Forensic Sci Med Pathol, 2012 Dec;8(4):430-5.
PMID: 22477359 DOI: 10.1007/s12024-012-9332-3

Fistula formation following pelvic surgery and radiotherapy, including ureteric-arterial fistulas (UAF), is well documented, however, ureteric-arterial-enteric fistula is extremely rare. Conventional autopsy is usually required for the definitive diagnosis of pelvic vascular fistulas although an accurate diagnosis can still be complicated and challenging. The role of post-mortem computed tomography (PMCT) as an adjunct to conventional autopsy is well documented in the literature. One of the limitations of PMCT is the diagnosis of vascular conditions. Post-mortem computed tomography angiography (PMCTA) is a recently introduced technique that can assist in detecting such pathology. We present a case of post-radiotherapy ureteric-arterial-enteric fistula presenting as massive rectal and vaginal bleeding diagnosed prior to autopsy on PMCTA. The role of PMCTA in the diagnosis of such a UAF has not previously been reported in the literature.
Fulltext A rare case of an appendiceal mass masquerading as a pelvic tumour and causing bilateral hydronephrosis

Abdul Rashid S, Ab Hamid S, Mohamad Saini S, Muridan R

Biomed Imaging Interv J, 2012 Apr;8(2):e11.
PMID: 22970067 MyJurnal DOI: 10.2349/biij.8.2.e11

Diagnosing acute appendicitis in children can be difficult due to atypical presenting symptoms. While there are reported cases of acute appendicitis or appendiceal masses causing unilateral hydronephrosis, bilateral hydronephrosis as a complication of appendiceal mass is very rare. We report a case of a child who presented with cardinal symptomatology associated with the urogenital tract. Ultrasound (US) investigation showed a pelvic mass causing bilateral hydronephrosis. An initial diagnosis of a pelvic teratoma was made based on the US and computed tomography (CT) scan findings. The final diagnosis of an appendiceal mass causing bilateral hydronephrosis was established intraoperatively.
Fulltext Medullary carcinoma of the breast: Role of contrast-enhanced MRI in the diagnosis of multiple breast lesions

Abdul Rashid S, Rahmat K, Jayaprasagam K, Alli K, Moosa F

Biomed Imaging Interv J, 2009 Oct;5(4):e27.
PMID: 21610994 MyJurnal DOI: 10.2349/biij.5.4.e27

Medullary carcinoma is a rare breast carcinoma with a syncytial growth pattern and high-grade cytology. It can be difficult to diagnose and may be missed on conventional imaging as the findings may overlap with benign lesions i.e. fibroadenomas. The authors report a case of a 25-year-old female who presented with multifocal breast lumps diagnosed with medullary carcinoma and fibroadenomas. Imaging and pathological correlation with contrast-enhanced MRI are presented in the diagnosis of these lesions.
Characteristic imaging features of body packers: a pictorial essay

Ab Hamid S, Abd Rashid SN, Mohd Saini S

Jpn J Radiol, 2012 Jun;30(5):386-92.
PMID: 22415809 DOI: 10.1007/s11604-012-0069-4

The drug-trafficking business has risen tremendously because of the current increased demand for illegal narcotics. The smugglers conceal the drugs in their bodies (body packers) in order to bypass the tight security at international borders. A suspected body packer will normally be sent to the hospital for imaging investigations to confirm the presence of drugs in the body. Radiologists, therefore, need to be familiar with and able to identify drug packets within the human body because they shoulder the legal responsibilities. This pictorial essay describes the characteristic imaging features of drug packets within the gastrointestinal tract.
Decoding death by unknown causes using post mortem image-guided virtopsy: A review of recent literature and the Malaysian experience

Tawfiq Zyoud TY, Abdul Rashid SN, Suppiah S, Abdul Rahim E, Mahmud R

Med J Malaysia, 2020 07;75(4):411-418.
PMID: 32724006

INTRODUCTION: Autopsy is one of the most important approaches to identify clearly the exact cause of death, whether it was due to natural causes, sudden death, or traumatic. Various studies have been done in different countries regarding ways to improve the diagnosis during autopsy. The imaging approach is one of the methods that has been used to complement autopsy findings and to enhance the diagnosis for achieving the most accurate post-mortem diagnosis. The aim of this study is to identify the role of imaging modalities that complement routine autopsy and correlate the findings of diagnostic imaging that can help improve the accuracy of diagnosing the cause of death.
METHODS: We sourced articles from Scopus, Ovid and PubMed databases for journal publications related to post-mortem diagnostic imaging. We highlight the most relevant full articles in English that explain the type of modality that was utilised and the added value it provided for diagnosing the cause of death.
RESULTS: Minimally invasive autopsies assisted by imaging modalities added a great benefit to forensic medicine, and supported conventional autopsy. In particular the role of post mortem computed tomography (PMCT), post mortem computed tomography angiography (PMMR) and positron emission tomography computed tomography (PMCTA) that have incremental benefits in diagnosing traumatic death, fractures, tissue injuries, as well as the assessment of body height or weight for corpse identification.
CONCLUSION: PMCT and PMMR, with particular emphasis on PMCTA, can provide higher accuracy than the other modalities. They can be regarded as indispensable methods that should be applied to the routine autopsy protocol, thus improving the findings and accuracy of diagnosing the cause of death.
Fulltext Walking on thin ice! Identifying methamphetamine "drug mules" on digital plain radiography

Abdul Rashid SN, Mohamad Saini SB, Abdul Hamid S, Muhammad SJ, Mahmud R, Thali MJ, et al.

Br J Radiol, 2014 Apr;87(1036):20130472.
PMID: 24472728 DOI: 10.1259/bjr.20130472

The purpose of this study was to retrospectively evaluate the sensitivity, specificity and accuracy of identifying methamphetamine (MA) internal payloads in "drug mules" by plain abdominal digital radiography (DR).
Death by 'ice': fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy

Bin Abdul Rashid SN, Rahim AS, Thali MJ, Flach PM

Forensic Sci Med Pathol, 2013 Mar;9(1):82-7.
PMID: 23404531 DOI: 10.1007/s12024-012-9395-1

Fatal acute methamphetamine (MA) poisoning in cases of internal drug trafficking is rarely described in the literature. This case study reports an MA 'body packer' who died from fatal methamphetamine intoxication due to leaking drug packages in the alimentary tract. The deceased was examined by postmortem computed tomography (PMCT), and the results were correlated to subsequent autopsy and toxicological findings. The deceased was arrested by the police when he was found disoriented in the city of Kuala Lumpur. He was transferred to the emergency department on suspicion of drug abuse. The initial drug screening was reactive for amphetamines. Shortly after admission to the hospital, he died despite rigorous resuscitation attempts. The postmortem plain chest and abdominal radiographs revealed multiple suspicious opacities in the gastrointestinal tract attributable to body packages. An unenhanced whole body PMCT revealed twenty-five drug packages, twenty-four in the stomach and one in the transverse colon. At least two were disintegrating, and therefore leaking. The autopsy findings were consistent with the PMCT results. Toxicology confirmed the diagnosis of fatal methamphetamine intoxication.
Development of a valid measurement instrument to understand self-regulatory driving practices among older drivers in Malaysia

Yeoh SF, Ibrahim R, Oxley J, Hamid TA, Rashid SN

Accid Anal Prev, 2016 Jul;92:1-8.
PMID: 27022713 DOI: 10.1016/j.aap.2016.03.009

Self-regulatory driving is a term used to describe a strategy used by older drivers to preserve mobility and safety, through the adjustment of driving behaviors to match declining physical functions. It can be regarded as a way to prolong driving, or as a process leading to the cessation of driving. Previous studies have striven to explore and understand how older drivers self-regulate their driving. This paper aims to provide an overview of the relevant theories, to explicate the factors that contribute to the adoption of self-regulated driving and the scales used to measure self-regulatory behaviors. This paper also reports on the development and psychometric testing of a Self-Regulatory Driving Practices (SRDP) scale in the Malaysian context. Based on the reviewed theories, adoption of self-regulatory driving practices is a process and involves cognitive thinking that reflects a set of actions. Existing instruments to measure self-regulatory driving practices have been developed and used to identify the behavioral components of self-regulation. Based on literature reviews and a thematic analysis from focus group discussions, a SRDP scale was developed, accommodating the Malaysian context. There were 498 surveys completed by older drivers for further psychometric testing purposes. Results revealed that the final 12-item SRDP scale (α=0.81) consists of four subscales that are planning, avoidance, reduction and alternatives. Suggestions for future research are also recommended.
Estimation of body height from spinal length measurements using post-mortem computed tomographic images

Zyoud TYT, Abdul Rashid SN, Suppiah S, Mahmud R, Kabeer A, Abd Manaf R, et al.

Malays J Pathol, 2020 Dec;42(3):423-431.
PMID: 33361724

INTRODUCTION: Post-mortem computed tomography (PMCT) provides information that helps in the determination of the cause of death and corpse identification of disaster victims. One of the methods for corpse identification includes assessment of the body stature. There is a lack of post-mortem imaging studies that focus on the anthropometric assessment of corpses. Our aim was to identify the relationship between cadaveric spine length and autopsy length (AL) among and autopsy length (AL) among a Malaysian population and derive a regression formula for the estimation of corpse body height using PMCT.
MATERIALS AND METHODS: We retrospectively assessed 107 cadavers that had undergone conventional autopsy and PMCT. We made 5 measurements from the PMCT that included cervical length (CL), thoracic length (TL), lumbosacral length (LS), total column length of the spine, excluding the sacrum and coccyx (TCL), and ellipse line measurement of the whole spine, excluding the sacrum and coccyx (EL). We compared these anthropometric PMCT measurements with AL and correlated them using linear regression analysis.
RESULTS: The results showed a significant linear relationship existed between TL and LS with AL, which was higher in comparison with the other parameters than the rest of the spine parameters. The linear regression formula derived was: 48.163 + 2.458 (TL) + 2.246 (LS).
CONCLUSIONS: The linear regression formula derived from PMCT spine length parameters particularly thoracic and lumbar spine gave a finer correlation with autopsy body length and can be used for accurate estimation of cadaveric height. To the best of our knowledge, this is the first ever linear regression formula for cadaveric height assessment using only post mortem CT spine length measurements.
Fulltext Protective Effects of Nigella sativa on Metabolic Syndrome in Menopausal Women

Ibrahim RM, Hamdan NS, Ismail M, Saini SM, Abd Rashid SN, Abd Latiff L, et al.

Adv Pharm Bull, 2014;4(1):29-33.
PMID: 24409406 DOI: 10.5681/apb.2014.005

PURPOSE: This study was conducted in menopausal women to determine the metabolic impact of Nigella sativa.
METHODS: Thirty subjects who were menopausal women within the age limit of 45-60 were participated in this study and randomly allotted into two experimental groups. The treatment group was orally administered with N. sativa seeds powder in the form of capsules at a dose of 1g per day after breakfast for period of two months and compared to control group given placebo. Anthropometric and biochemical parameters were measured at baseline, 1st month, 2nd month and a month after treatment completed to determine their body weight, serum lipid profile and fasting blood glucose (FBG).
RESULTS: The treatment group showed slight reduction with no significant difference in body weight changes of the respondents. However, significant (p<0.05) improvement was observed in total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and blood glucose (p<0.05).
CONCLUSION: These results suggested that treatment with N. sativa exert a protective effect by improving lipid profile and blood glucose which are in higher risk to be elevated during menopausal period.
Fulltext A randomised controlled trial on hypolipidemic effects of Nigella Sativa seeds powder in menopausal women

Ibrahim RM, Hamdan NS, Mahmud R, Imam MU, Saini SM, Rashid SN, et al.

J Transl Med, 2014;12:82.
PMID: 24685020 DOI: 10.1186/1479-5876-12-82

The risk of cardiovascular diseases (CVD) is increased tremendously among menopausal women, and there is an increasing demand for alternative therapies for managing factors like dyslipidemia that contribute to CVD development.
Fulltext Recurrent glomangiomas of the ankle: a case report

Saini SM, Hamid SA, Abdul Rashid SN, Bahari N, Fakhrizzaki AA, Abu Hassan H, et al.

Med J Malaysia, 2013 Aug;68(4):356-7.
PMID: 24145267 MyJurnal
Correlation and assessment of coronary artery luminal stenosis: Post-mortem computed tomography angiogram versus histopathology

Chainchel Singh MK, Abdul Rashid SN, Abdul Hamid S, Mahmood MS, Feng SS, Mohd Nawawi H, et al.

Forensic Sci Int, 2020 Mar;308:110171.
PMID: 32032870 DOI: 10.1016/j.forsciint.2020.110171

BACKGROUND: Post-mortem Computed Tomography (PMCT) allows non-invasive or minimally invasive detection of findings that may or may not be visible during conventional autopsy, however, it does not allow the investigator to draw any conclusions regarding patency of the vessel's lumen. To address this deficiency, Post-mortem Computed Tomography Angiography (PMCTA) utilizing different contrast media and techniques have been introduced with various studies looking at the correlation between PMCTA, autopsy (gross) findings and coronary artery histology in diagnosing coronary artery disease.
OBJECTIVES: The aim of this study is to investigate the sensitivity and specificity of PMCTA in diagnosing coronary artery stenosis using water-based contrast media introduced though the vessels of the neck, compared to the gold standard of diagnosis i.e. gross and histological evaluation of the coronary artery.
METHOD: This was a cross sectional study of 158 arterial sections involving 37 subjects recruited from the National Institute of Forensic Medicine (IPFN), Hospital Kuala Lumpur (HKL). An unenhanced PMCT was performed followed by PMCTA using water-based contrast media introduced though the vessels of the neck. Coronary artery stenosis was determined using multiplanar reconstructionD while the degree of stenosis was determined by calculating the percentage of luminal diameter divided by the diameter of the vessel internal elastic.
RESULTS: The analysis of PMCTA and histopathology examinations revealed a sensitivity of 61.5%, specificity of 91.7%; positive predictive value (PPV) of 40.0% and negative predictive value (NPV) of 96.4%.
CONCLUSION: PMCTA utilizing water-based contrast introduced though the vessels of the neck yielded similar results as other methods and techniques of PMCTA. We would therefore conclude that PMCTA utilizing this technique could be used to assess the degree of calcification and the presence of significant stenosis.
A kinetic study of ex-situ soil remediation by nickel extraction using natural deep eutectic solvent

Rashid SN, Hizaddin HF, Hayyan A, Chan SE, Hasikin K, Razak SA, et al.

Environ Technol, 2024 Sep;45(23):4820-4833.
PMID: 37953730 DOI: 10.1080/09593330.2023.2283093

Using natural deep eutectic solvents (NADESs) as a green reagent is a step toward producing environmentally friendly and sustainable technology. This study screened three natural DESs developed using quaternary ammonium salt and organic acid to analyse their capability to extract nickel ions from contaminated mangrove soil, which are ChCl: Acetic Acid (ChCl-AceA), ChCl: Levulinic Acid (ChCl-LevA), and ChCl: Ethylene Glycol(ChCl-Eg) at molar ratio 1:2. The impact of various operating parameters such as washing agent concentration, pH solution, and contact time on the NADES performance in the dissolution of Ni ions batch experiments were performed. The optimal soil washing conditions for metal removal were 30% and 15% concentration, a 1:5 soil-liquid ratio, and pH 2 of ChCl-LevA and ChCl-AceA, respectively. A single removal washing may remove 70.8% and 70.0% Ni ions from the contaminated soil. The dissolution kinetic of Ni ions extraction onto NADES was explained using the linear kinetic pseudo and intraparticle mass transfer diffusion models. The kinetic validation demonstrates a good fit between the experimental and pseudo-second-order Lagergren data. The model's maximum Ni dissolution capacity, Qe are 51.56 mg g-1 and 52.00 mg g-1 of ChCl-LevA and ChCl-AceA, respectively. The synthesised natural-based DES has the potential to be a cost-effective, efficient, green alternative extractant to conventional solvent extraction of heavy metals.

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