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  1. Mat Zin AA, Zulkarnain S
    Asian Pac J Cancer Prev, 2019 Feb 26;20(2):321-325.
    PMID: 30803189
    Glioma is the commonest primary intracranial tumour and it has been the most predominant tumour in many studies.
    It accounts for 24.7% of all primary brain tumour and 74.6% of malignant brain tumour. Intraoperative diagnosis
    plays a crucial role in determining the patient management. Frozen section has been the established technique in
    providing rapid and accurate intraoperative diagnosis. However due to some disadvantages like ice crystal artefact,
    high expenditure and requirement of skilled technician, there is increase usage of cytology smear either replacing or
    supplementing frozen section technique. The aim of this review is to determine the diagnostic accuracy of cytology
    smear and frozen section in glioma and to see whether there is significant difference between those techniques. The
    overall diagnostic accuracy for frozen section in glioma ranging from 78.4% to 95% while for cytology smear, the
    diagnostic accuracy ranging from 50% to 100%. Based on certain literatures, no statistically difference was observed
    in diagnostic accuracy of cytology smear and frozen section. Thus, cytology smear provides an alternative method in
    establishing intraoperative diagnosis. Both cytology smear and frozen section are complimentary to each other. It is
    recommended to use both techniques to improve the diagnostic accuracy in addition with adequate knowledge, clinical
    history, neuroimaging and intraoperative findings.
  2. Nyi, Nyi Naing, Zabidi Azhar Mohd Hussin, Nawaz Hussin, Menaga, M., Aw Linda, Raihan, S., et al.
    MyJurnal
    A sample of 204 handicapped children below 12 years of age consisting of 121(59.3%) males and 83 (40.7%) females who were classified into various types of mental and physical handicaps, were surveyed in April and May 1996. The majority of those with mental handicaps were Down Syndrome while those with cerebral palsy were the mostfrequent cause of physical handicaps. A structured questionnaire was used for interviewing the children parents to evaluate their attitude towards their handicapped children. The majority of the parents expressed their opinions that having handicapped children was not a burden to them although these children had to be given more attention. However, a significant minority felt that the child would be afinancial burden to the family and that he/she would restrict the social life of the family. The majority of the children were sent to school, as parents felt it was their duty to do so. For those children not attending school, the majority of parents felt that the children would not benefit by going. The others could not do so because offinancial constraints or because of the distance between home and school. For these children, provid-ing hostel facilities in a boarding school could be the answer. This study shows that parental love and support plays a major role in ensuring optimal growth and development of a handicapped child
  3. Lo R, Mohamad S, Krishnamoorthy M, Mohamad I, Zulkarnain S, Hussain FA
    Medeni Med J, 2020;35(1):67-70.
    PMID: 32733752 DOI: 10.5222/MMJ.2020.22208
    Vallecular lymphoma is an extremely rare tumour of oropharynx. We report a case of 61-year-old gentleman presented with severe dysphagia and globus sensation for two months. Patient underwent endoscopic transoral tumour debulking for diagnostic and therapeutic purpose. Histopathologically, patient was diagnosed as mantle cell lymphoma (MCL). In this case report, atypical presentation of the disease, histopathological features and its current treatments are discussed.
  4. Zulkarnain S, Yunus N, Kandasamy R, Zun AB, Mat Zin AA
    Asian Pac J Cancer Prev, 2020 Oct 01;21(10):3085-3091.
    PMID: 33112571 DOI: 10.31557/APJCP.2020.21.10.3085
    OBJECTIVE: Glioma is the commonest primary malignant brain tumour. Diagnosis is made based on cytology smear, frozen section and histopathological examination. Intraoperative pathological diagnosis using either cytology smear, frozen section or combination of both, plays a crucial role in patient's future management and prognosis. This study aims to determine the accuracy of cytology smear and frozen section in glioma, and to compare the difference between both techniques.

    METHODS: A cross-sectional study was conducted involving 22 cases of glioma diagnosed intraoperatively from January 2013 until August 2019 in Hospital Universiti Sains Malaysia. The selected tissues were processed for cytology smear and frozen section. The remaining tissues were proceeded for paraffin section. The diagnosis was categorized as either low-grade or high-grade glioma based on cellularity, nuclear pleomorphism, mitotic count, microvascular proliferation and necrosis. The sensitivity and specificity of frozen section and cytology smears were determined based on paraffin section being as the gold standard. The accuracy of both techniques was compared using statistical analysis.

    RESULTS: The overall sensitivity and specificity of cytology smear were 100% and 76.9%, respectively. Meanwhile, the sensitivity and specificity of frozen section were 100% and 84.6%. There was no significant difference in diagnostic accuracy between cytology smear and frozen section in glioma (p>0.05).

    CONCLUSION: Cytology smears provides an alternative method for frozen section due to good cellularity and morphology on smear. Cytology smear is rapid, inexpensive, small amount of tissue requirement and less technical demand. This finding may benefit to the hospital or treatment centres where frozen section facility is unavailable.

  5. Ab Rahim SN, Nordin N, Wan Omar WFA, Zulkarnain S, Kumar S, Sinha S, et al.
    Cureus, 2023 Dec;15(12):e49835.
    PMID: 38045630 DOI: 10.7759/cureus.49835
    Magnesium (Mg2+) is a predominantly intracellular cation that plays significant roles in various enzymatic, membrane, and structural body functions. As a calcium (Ca2+) antagonist, it is imperative for numerous neuromuscular activities. The imbalance of body Mg2+  concentration leads to clinical manifestations ranging from asymptomatic to severe life-threatening complications. Therefore, the contribution of Mg2+ measurement regarding various laboratory and clinical aspects cannot be ignored. Mg2+ is often described as the forgotten analyte. However, its close relationship with body potassium (K+), Ca2+, and phosphate homeostasis proves that Mg2+ imbalance could co-exist as the root cause or the consequence of other electrolyte disorders. Meanwhile, several preanalytical, analytical, and postanalytical aspects could influence Mg2+ measurement. This review highlights Mg2+ measurement's laboratory and clinical issues and some analyte disturbances associated with its imbalance. Understanding this basis could aid clinicians and laboratory professionals in Mg2+ result interpretation and patient management.
  6. Nordin N, Ab Rahim SN, Wan Omar WFA, Zulkarnain S, Sinha S, Kumar S, et al.
    Cureus, 2024 Mar;16(3):e57243.
    PMID: 38559530 DOI: 10.7759/cureus.57243
    The accuracy of diagnostic results in clinical laboratory testing is paramount for informed healthcare decisions and effective patient care. While the focus has traditionally been on the analytical phase, attention has shifted towards optimizing the preanalytical phase due to its significant contribution to total laboratory errors. This review highlights preanalytical errors, their sources, and control measures to improve the quality of laboratory testing. Blood sample quality is a critical concern, with factors such as hemolysis, lipemia, and icterus leading to erroneous results. Sources of preanalytical errors encompass inappropriate test requests, patient preparation lapses, and errors during sample collection, handling, and transportation. Mitigating these errors includes harmonization efforts, education and training programs, automated methods for sample quality assessment, and quality monitoring. Collaboration between laboratory personnel and healthcare professionals is crucial for implementing and sustaining these measures to enhance the accuracy and reliability of diagnostic results, ultimately improving patient care.
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