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Fulltext Proteomic profiles of young adults with acute myocardial infarction.

Mohamed Bakrim N, Mohd Shah AS, Mohd. Shah ANS, A. Talib N, A.Rahman J, Muhamad Bunnori N, et al.

IIUM Medical Journal Malaysia, 2019;18(3):112-119.
MyJurnal

Proteomic profiling is essential in understanding the pathophysiological process of multifactorial diseases such as acute myocardial infarction (AMI). Despite the increasing incidence of AMI in young adults, proteomic-based study focusing on young AMI remains limited. This study aimed to examine the plasma proteomic profiles of young adults with AMI compared to control subjects. We also hope to identify disease-specific protein biomarkers that contribute to the development of AMI in the young. Methods:Pooled plasma protein from 10 AMI patients aged 18 to 45 years and 10 age, gender and race-matched volunteers were separated using two-dimensional electrophoresis (2-DE). The spots proteins were analysed using the PD Quest analysis software. The spots proteins that were found to have been expressed differently between the two groups were identified by Matrix Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry. Results:There were three differently expressed proteins namely Apolipoprotein AI (Apo AI), Apolipoprotein AIV (Apo AIV) and Haptoglobin (p < 0.05). The expressions of these proteins were found to be increased in young patients with AMI compared to control subjects. Conclusion: The up regulation of Apo AI, Apo AIV and Haptoglobin in AMI patients indicate their important roles in the development of atherosclerotic disease. Thus, Apo AI, Apo AIV and Haptoglobin are potential disease biomarkers for young AMI.
Fulltext Pattern of herbal and dietary supplement usage and conventional medication adherence among patients with chronic kidney disease: a survey finding.

Sowtali SN, Mohd Rasani AA, Mohd. Shah AS, Mohd. Yusoff D, Harith S, Zainol NAJ, et al.

IIUM Medical Journal Malaysia, 2019;18(3):154-164.
MyJurnal

There is widespread use of herbal and dietary supplements worldwide among patients despite robust clinical evidence of its efficacy. This may lead to adverse effects, such as diabetes, hypertension, stroke, cardiovascular risk and kidney problems due to inappropriate self-prescription. This study was performed to determine the prevalence of herbal and dietary supplements usage among patients with chronic kidney disease and its association with the socio-demographic background and the conventional medication adherence. Materials and methods: A survey was conducted among 78 chronic kidney disease patients attending the Nephrology Clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Data were collected using a questionnaire and analyzed using descriptive statistics, Chi Square Test and Fisher’s Exact Test. The p-valuewas set to be less 0.05 for its level of significance. Results: Most of the patients aged more than 50 years (89.7%), female (53.8%), unemployed (41%) and from lower socio-economic earners (75.6%). Only 5.2% of respondents reported using herbal and dietary supplements. There was no association between socio-demographic background with the herbal and dietary supplements usage. Similarly, there was no association between herbal and dietary supplements usage and the conventional medication adherence. Conclusion: This study provides a good baseline on the usage of herbal and dietary supplements use among chronic disease patients. It can be concluded that the level of awareness among the patients is good. Nevertheless, a larger study shall be performed in the future to explore the pattern of association.
Fulltext Freshwater fishes of gunung jerai, kedah darul aman: a preliminary study

Shah AS, Hashim ZH, Sah SA

Trop Life Sci Res, 2009 Dec;20(2):59-70.
PMID: 24575179 MyJurnal

A total of 37 fish species from 14 families were observed during surveys conducted from January to March 2005 at 8 selected streams near the Gunung Jerai Forest Reserve. The list includes two species (Rasbora trilineata and Systomus partipentazona) that were visually identified at the lower part of the Sungai Teroi stream. Single specimens of Leiocassis micropogon, Clarias macrocephalus and Hampala macrolepidota were also obtained at certain sampling stations. Devario regina and Systomus binotatus were the most abundant species at all sampling stations. However, the list is still incomplete as the study was carried out over a short time period and there are large areas that have not yet been surveyed. The presence of exotic species (Carassius auratus) at Sungai Badak indicates anthropogenic influences. Therefore, a long-term monitoring program for Gunung Jerai Forest Reserve streams should be planned and carried out to assess the impacts of future development on fish biodiversity and water quality.
Fulltext Short term energy consumption forecasting using neural basis expansion analysis for interpretable time series

Shaikh AK, Nazir A, Khan I, Shah AS

Sci Rep, 2022 Dec 29;12(1):22562.
PMID: 36581655 DOI: 10.1038/s41598-022-26499-y

Smart grids and smart homes are getting people's attention in the modern era of smart cities. The advancements of smart technologies and smart grids have created challenges related to energy efficiency and production according to the future demand of clients. Machine learning, specifically neural network-based methods, remained successful in energy consumption prediction, but still, there are gaps due to uncertainty in the data and limitations of the algorithms. Research published in the literature has used small datasets and profiles of primarily single users; therefore, models have difficulties when applied to large datasets with profiles of different customers. Thus, a smart grid environment requires a model that handles consumption data from thousands of customers. The proposed model enhances the newly introduced method of Neural Basis Expansion Analysis for interpretable Time Series (N-BEATS) with a big dataset of energy consumption of 169 customers. Further, to validate the results of the proposed model, a performance comparison has been carried out with the Long Short Term Memory (LSTM), Blocked LSTM, Gated Recurrent Units (GRU), Blocked GRU and Temporal Convolutional Network (TCN). The proposed interpretable model improves the prediction accuracy on the big dataset containing energy consumption profiles of multiple customers. Incorporating covariates into the model improved accuracy by learning past and future energy consumption patterns. Based on a large dataset, the proposed model performed better for daily, weekly, and monthly energy consumption predictions. The forecasting accuracy of the N-BEATS interpretable model for 1-day-ahead energy consumption with "day as covariates" remained better than the 1, 2, 3, and 4-week scenarios.
Fulltext Disseminated histoplasmosis presenting with chronic ulcerative tongue lesions in a patient with diabetes

Hasmoni MH, Shah AS, Ayoub S, Hin LS, Abd Rashid MA

BMJ Case Rep, 2010;2010.
PMID: 22791841 DOI: 10.1136/bcr.06.2010.3120
Fulltext The identification of copy number variation of CNV ESV27061 among young adults with hypertension: preliminary findings. [Abstract]

Shaik Alaudeen SR, Mohd Shah AS, Abdul Talib N, Abdullah A

International Medical Journal Malaysia, 2017;16(11):31.
MyJurnal

Introduction: Hypertension related morbidities and mortalities around the world show a gradual increase and early detection and prevention are advocated. The Database of Genomic Variants (DGV) has associated variation in DNA sequences called copy number variation (CNV) with susceptibility to common diseases. However, little is known about CNV role in essential hypertension. Thus, this study aimed to characterize the CNV esv27061 among prehypertensive and hypertensive young adults in Malaysia. Materials and method: In this comparative cross-sectional study, 104 subjects living in Kuantan who gave voluntary consent to participate are recruited and divided into three groups; control (43 subjects), prehypertensive (38 subjects) and mild hypertensive (23 subjects). An optimized droplet digital polymerase chain reaction (ddPCR) was used in the determination of CNV esv27061 in this study. Results: All subjects in the control (n=38; 88.4% gain), prehypertensive (n=33; 86.8% gain) and mild hypertensive (n=21; 91.3% gain) groups had CNV gain (copy number > 2) while 11.6% of control, 13.2% of prehypertensive and 8.7% of mild hypertensive subjects exhibited normal copies (copy number = 2). Conclusion: The present preliminary finding was consistent with the Database of Genomic Variants (DGV) which stated that CNV esv27061 showed more gain than loss.
Fulltext Attitudes toward euthanasia and related issues among physicians and patients in a multi-cultural society of Malaysia

Rathor MY, Abdul Rani MF, Shahar MA, Jamalludin AR, Che Abdullah ST, Omar AM, et al.

J Family Med Prim Care, 2014 Jul;3(3):230-7.
PMID: 25374860 DOI: 10.4103/2249-4863.141616

INTRODUCTION: Due to globalization and changes in the health care delivery system, there has been a gradual change in the attitude of the medical community as well as the lay public toward greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As euthanasia has gained world-wide prominence, the objectives of our study therefore were to explore the attitude of physicians and chronically ill patients toward euthanasia and related issues. Concomitantly, we wanted to ascertain the frequency of requests for assistance in active euthanasia.
MATERIALS AND METHODS: Questionnaire based survey among consenting patients and physicians.
RESULTS: The majority of our physicians and patients did not support active euthanasia or physician-assisted suicide (EAS), no matter what the circumstances may be P < 0.001. Both opposed to its legalization P < 0.001. Just 15% of physicians reported that they were asked by patients for assistance in dying. Both physicians 29.2% and patients 61.5% were in favor of withdrawing or withholding life-sustaining treatment to a patient with no chances of survival. Among patients no significant differences were observed for age, marital status, or underlying health status.
CONCLUSIONS: A significant percentage of surveyed respondents were against EAS or its legalization. Patient views were primarily determined by religious beliefs rather than the disease severity. More debates on the matter are crucial in the ever-evolving world of clinical medicine.
KEYWORDS: Attitude; euthanasia; legalization; multi-cultural; physician-assisted suicide
Fulltext Educational needs of chronic kidney disease patients who presented to Tengku Ampuan Afzan Hospital: Preliminary findings

Sowtali SN, Harith S, Mohd Shah AS, Ishak NA, Yusoff DM, Draman CR, et al.

Saudi J Kidney Dis Transpl, 2020 3 5;31(1):118-128.
PMID: 32129204 DOI: 10.4103/1319-2442.279931

Knowledge limitation is a major cause of the increasing number of chronic kidney disease (CKD) patients in Malaysia and the world. Nurses are responsible for identifying the patients' needs to come up with appropriate discharge plans which might include educational activities. The objective of this study was to determine the baseline information (socio- demographic background, as well as medical and lifestyle histories), along with educational needs of CKD patients. A total of 116 CKD patients who attended the Nephrology Clinic of Hospital Tengku Ampuan Afzan were recruited. Patients who fulfilled the inclusion criteria were selected between April and May 2017. Data were obtained via semi-guided questionnaires; the patients were given enough time to complete the required items. The CKD educational needs' assessment consisted of seven domains: general information, chronic illness management, complications, self-management, medications, treatment, and financial status. Majority of the patients were men (53.4%), aged 54.65 ± 16.49 years, secondary school-finishers (49.1%), and jobless (48.3%). In terms of medical and life-style histories, most patients were diagnosed with end-stage renal disease (51.7%), hypertension (96.6%), diabetes (51.7%), and anemia (25.9%). The patients were interested to know the complications of kidney disease (57.8%), management of diseases like hypertension (58.6%), complications like edema (55.2%), indications for medication (73.3%), self-management or fluid control (37.9%), hemodialysis (37.1%), and financial status (21.6%). Thus, strengthening patient education strategies in the clinics, hospitals, and community settings should be given due attention by relevant healthcare professionals.
Fulltext External quality assessment of dengue and chikungunya diagnostics in the Asia Pacific region, 2015

Soh LT, Squires RC, Tan LK, Pok KY, Yang H, Liew C, et al.

Western Pac Surveill Response J, 2016 04 22;7(2):26-34.
PMID: 27508088 DOI: 10.5365/WPSAR.2016.7.1.002

OBJECTIVE: To conduct an external quality assessment (EQA) of dengue and chikungunya diagnostics among national-level public health laboratories in the Asia Pacific region following the first round of EQA for dengue diagnostics in 2013.
METHODS: Twenty-four national-level public health laboratories performed routine diagnostic assays on a proficiency testing panel consisting of two modules. Module A contained serum samples spiked with cultured dengue virus (DENV) or chikungunya virus (CHIKV) for the detection of nucleic acid and DENV non-structural protein 1 (NS1) antigen. Module B contained human serum samples for the detection of anti-DENV antibodies.
RESULTS: Among 20 laboratories testing Module A, 17 (85%) correctly detected DENV RNA by reverse transcription polymerase chain reaction (RT-PCR), 18 (90%) correctly determined serotype and 19 (95%) correctly identified CHIKV by RT-PCR. Ten of 15 (66.7%) laboratories performing NS1 antigen assays obtained the correct results. In Module B, 18/23 (78.3%) and 20/20 (100%) of laboratories correctly detected anti-DENV IgM and IgG, respectively. Detection of acute/recent DENV infection by both molecular (RT-PCR) and serological methods (IgM) was available in 19/24 (79.2%) participating laboratories.
DISCUSSION: Accurate laboratory testing is a critical component of dengue and chikungunya surveillance and control. This second round of EQA reveals good proficiency in molecular and serological diagnostics of these diseases in the Asia Pacific region. Further comprehensive diagnostic testing, including testing for Zika virus, should comprise future iterations of the EQA.
Fulltext Global Retinoblastoma Presentation and Analysis by National Income Level

Global Retinoblastoma Study Group, Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, et al.

JAMA Oncol, 2020 May 01;6(5):685-695.
PMID: 32105305 DOI: 10.1001/jamaoncol.2019.6716

IMPORTANCE: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale.
OBJECTIVES: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis.
DESIGN, SETTING, AND PARTICIPANTS: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017.
MAIN OUTCOMES AND MEASURES: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis.
RESULTS: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]).
CONCLUSIONS AND RELEVANCE: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.

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