1.The ‘widow maker’: Electrocardiogram features that should not be missed
Yusuf Muharam M ; Ahmad R ; Harmy MY
Malaysian Family Physician 2013;8(1):45-47
Patients with Wellen’s syndrome often present with chest pain and found to have specific precordial T-wave changes on the electrocardiogram (ECG). They subsequently develop a large anterior wall myocardial infarction. These specific electrocardiographic abnormalities are associated with critical stenosis of the proximal left anterior descending coronary artery (LAD). This syndrome is
often under-recognised and has fatal consequences; it is, therefore, also known as the widow maker. We highlight a case of a 39-year old gentleman who had a history of coronary artery disease and typical ECG characteristics of Wellen’s syndrome.
Electrocardiography
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chest pain
2.Presence of faecal coliforms and selected heavy metals in ice cubes from food outlets in Taman Universiti, Johor Bahru, Malaysia
Mahat, N.A., Meor Ahmad, Z., Abdul Wahab, R.
Tropical Biomedicine 2015;32(3):471-477
Consumption of iced beverages is common in Malaysia although specific research
focusing on its safety parameters such as presence of faecal coliforms and heavy metal
elements remains scarce. A study conducted in Kelantan indicated that faecal coliforms
were detected in the majority of the ice cube samples analyzed, largely attributable to
improper handling. Hence, it was found pertinent to conduct similar study in other parts of the
country such as Johor Bahru if the similar pattern prevailed. Therefore, this present crosssectional
study which randomly sampled ice cubes from 30 permanent food outlets in Taman
Universiti, Johor Bahru for detecting contamination by faecal coliforms and selected heavy
metal elements (lead, copper, manganese and zinc) acquires significance. Faecal coliforms
were detected in 11 (36.67%) of the samples, ranging between 1 CFU/100 mL to > 50 CFU/100
mL; two of the samples were grossly contaminated (>50 CFU/100 mL). Interestingly, while
positive detection of lead was observed in 29 of the 30 ice cube samples (mean: 0.511±0.105
ppm; range: 0.489-0.674 ppm), copper, manganese and zinc were not detected. In addition,
analysis on commercially bottled mineral water as well as in tap water samples did not detect
such contaminations. Therefore, it appears that (1) contamination of faecal coliforms in ice
cubes in food outlets in Malaysia may not be sporadic in pattern but rather prevalent and (2)
the source of water used for manufacturing the ice cubes that contained significant amount
of lead would suggest that (3) it was neither originated from the treated tap water supply nor
bottled mineral water or (4) perhaps contaminated during manufacturing process. Further
studies exploring the source of water used for manufacturing these ice cubes as well as the
handling process among food operators deserve consideration.
3.Identification of masses in digital mammogram using gray level co-occurrence matrices
A Mohd. Khuzi ; R Besar ; WMD Wan Zaki ; NN Ahmad
Biomedical Imaging and Intervention Journal 2009;5(3):1-13
Digital mammogram has become the most effective technique for early breast cancer detection modality. Digital
mammogram takes an electronic image of the breast and stores it directly in a computer. The aim of this study is to develop an automated system for assisting the analysis of digital mammograms. Computer image processing techniques
will be applied to enhance images and this is followed by segmentation of the region of interest (ROI). Subsequently, the textural features will be extracted from the ROI. The texture features will be used to classify the ROIs as either masses or non-masses. In this study normal breast images and breast image with masses used as the standard input to the proposed system are taken from Mammographic Image Analysis Society (MIAS) digital mammogram database. In MIAS database, masses are grouped into either spiculated, circumscribed or ill-defined. Additional information includes
location of masses centres and radius of masses. The extraction of the textural features of ROIs is done by using gray level co-occurrence matrices (GLCM) which is constructed at four different directions for each ROI. The results show that the GLCM at 0º, 45º, 90º and 135º with a block size of 8X8 give significant texture information to identify between masses and non-masses tissues. Analysis of GLCM properties i.e. contrast, energy and homogeneity resulted in receiver operating characteristics (ROC) curve area of Az = 0.84 for Otsu’s method, 0.82 for thresholding method and Az = 0.7 for K-mean clustering. ROC curve area of 0.8-0.9 is rated as good results. The authors’ proposed method contains no complicated algorithm. The detection is based on a decision tree with five criterions to be analysed. This simplicity leads to less computational time. Thus, this approach is suitable for automated real-time breast cancer diagnosis system
4.Effect of Dehulling and Cooking of Lentils (Lens Culinaris, L.) on Serum Glucose and Lipoprotein Levels in Streptozotocin-Induced Diabetic Rats
Amro MH Al-Tibi ; Hamed R Takruri ; Mousa N Ahmad
Malaysian Journal of Nutrition 2010;16(3):409-418
This study was conducted to investigate the effect of lentils on serum glucose
and serum lipid levels in diabetic rats. Forty adult male Sprague-Dawley rats, 12
weeks of age weighing 220-290g, were used. Diabetes was induced by streptozotocin at a level of 35 mg/kg intra-peritoneally. The animals were randomly divided into five groups, eight animals each: a casein diet (control),
raw whole lentil (RWL), cooked whole lentil (CWL), raw dehulled lentil (RDL) and cooked dehulled lentil (CDL). Animals were fed with experimental diets for
six weeks, sacrificed and blood samples were taken. Serum glucose level of the CDL group (387.9 ± 53.3 mg/dl) was significantly lower (P<0.05) than that of the
control, RDL and RWL groups (529.0 ± 11.7, 538.6 ± 45.0, 542.1 ± 32.2 mg/dl respectively). In addition, HDL concentration of CWL group (66.3 ± 1.9 mg/dl)
was significantly higher (P<0.01) than that of the control, RWL and RDL groups (54.9 ± 3.5, 50.8 ± 4.2, 54.0 ± 3.4 mg/dl respectively). However, there was no
significant difference in serum glucose and serum HDL between the CDL and CWL groups. No significant differences (p>0.05) were detected in triglycerides,
total cholesterol and LDL cholesterol among the experimental groups. It is concluded that cooked lentils rather than raw lentils was more effective in
lowering blood glucose and improving HDL cholesterol in diabetic rats. There was no difference between whole and dehulled lentils with regard to effects on
blood glucose and HDL cholesterol levels.
5.Oral bag-valve-mask insufflation technique to remove unilateral friable nasal foreign body in emergency department
PK Cheah ; R Ahmad ; CV Ho ; CC Lim
Malaysian Family Physician 2009;4(2 & 3):91-93
Nasal foreign body in children is not an uncommon presentation to the Emergency Department. Removal is essential.
Many methods of removal exist. Nasal wash technique is advocated mainly in friable foreign bodies. We report the
successful use of the oral bag-valve-mask insufflation technique to remove friable facial tissue in the left nose of a 2
year-old girl. We used a pediatric bag-valve-mask with a pop-off pressure relief valve to avoid barotrauma. Pop-off
pressure relief valve limits the pressure beyond 30mmHg. Conscious sedation was not required. There were no
complications.
6.Erectile Dysfunction and Methadone Maintenance Therapy
FITRI FAREEZ R ; AHMAD NAZRUN S ; RASHIDI MPM
Medicine and Health 2020;15(1):5-17
Erectile dysfunction is one of the most common side effects of methadone affecting more than half of methadone patient population. The problem is associated with prominent reduced quality of life. Erectile dysfunction may perpetuate greater problem if left untreated as patients may opt to use harmful self-treatment such as abusing methamphetamine. This illicit drug use to overcome the side-effects of methadone may lead to polysubstance use disorder that further compromise addiction therapy. To overcome this issue, both practitioners and patients play a major role in the management of erectile dysfunction. Patient awareness regarding erectile dysfunction and its impact as well as doctor’s active intervention to detect erectile dysfunction, are essential to improve the detection rate and management of erectile dysfunction. Frequent screening of erectile dysfunction and its risk factors will help with the identification of patients suffering from erectile dysfunction. Multiple treatments options such as bupropion, trazodone and many more are available to treat erectile dysfunction which will be further explored in this review.
7.Morphological descriptions of second and third instar larvae of Hypopygiopsis violacea Macquart (Diptera:Calliphoridae), a forensically important fly in Malaysia.
Ahmad Firdaus, M S ; Marwi, M A ; Syamsa, R A ; Zuha, R M ; Ikhwan, Z ; Omar, B
Tropical Biomedicine 2010;27(1):134-7
Hypopygiopsis violacea, a species of fly of forensic importance, was recovered from a corpse and described for the first time. The morphological structures of the second and third instar larvae of four specimens were examined using light microscope. Observations were focused on three main morphological characters: cephalopharyngeal skeleton, anterior and posterior spiracles. Cephalopharyngeal skeleton of second instar larva is darkly pigmented and without accessory sclerite below the mouth hook. The anterior spiracles of second and third instar larvae have 8-9 papillae each, arranged in a single row. The posterior spiracle of second instar larva has two spiracular slits with no thickening of peritreme. This differentiates it from the third instar, whereby the latter has three slits for each posterior spiracle. Cephalopharyngeal skeleton of third instar larva is heavily pigmented. An accessory sclerite is found below the hook part of third instar larva but is absent in second instar. Peritreme of the posterior spiracle of third instar larva is thick almost complete encircling a button. The intersegmental spines of the cuticular surface are dome-shaped and unicuspid. Third instar larva of this species is large with size approximately 15 mm long. These findings provide important identification features of immature stages of Hy. violacea which could be useful in forensic entomology.
8.Current status of parasitic infections among Pangkor Island community in Peninsular Malaysia
Ahmad, A.F. ; Ngui, R. ; Muhammad Aidil ; R., Lim, Y.A.L. ; Rohela, M.
Tropical Biomedicine 2014;31(4):836-843
Limited data is available on the prevalence of parasitic infections among the
island communities in Malaysia with most studies performed between 1960s-1980s. This
study was conducted to determine the current prevalence status of parasitic infections
among communities living in Pangkor Island Peninsular Malaysia. A total of 131 stool and 298
serum samples were collected and subjected to microscopic examination for intestinal protozoa
and helminths and detection of Toxoplasma gondii antibodies using commercial ELISA kits
respectively. In addition, thin and thick peripheral blood films were microscopically screened
for the presence of Plasmodium spp. and microfilariae respectively. The overall prevalence
of intestinal parasitic infections among Pangkor Island community was 9.9% (13/131) with T.
trichiura (5.3%) being the most common intestinal parasite detected. Toxoplasmosis was
reported in almost 60% of the community with the seroprevalence being significantly high
among females (64.7%) compared to males (52.8%) (p=0.038). None of those examined samples
were infected with intestinal sarcocystosis, malaria and filariasis. This study revealed that
the prevalence of intestinal parasitic infections among Pangkor Island community has been
greatly reduced compared to that reported 35 years ago. Massive improvements in the
socioeconomic status, personal hygiene, water facilities and sanitation may have contributed
to the low prevalence of parasitic infections in this community. Nevertheless, further studies
still need to be performed to determine the possible risk factors for the high prevalence of
toxoplasmosis in this community.
9.Spontaneous twin pregnancy in premature ovarian failure.
R Anna Liza ; R Z Alik ; Z Ahmad Murad ; I Ghazali
The Medical journal of Malaysia 2008;63(3):263-4
Premature Ovarian Failure (POF) is associated with subfertility. Despite efforts to induce ovulation, success rates are low. We report a case of POF spontaneously conceiving twins while on hormone replacement therapy.
Ovarian Failure, Premature
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Spontaneous
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Twin Multiple Birth
;
Pregnancy
;
success
10.Translation And Validation Of The Malay Post Traumatic Stress Disorder Checklist For Civilians
Rafidah Bahari ; Muhammad N Mohamad Alwi ; Muhammad R Ahmad ; Ismail Mohd Saiboon
ASEAN Journal of Psychiatry 2015;16(2):1-9
Objectives: There are a number of validated questionnaires available for the
screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist
for Civilians is one of them. However, none was translated into the Malay
Language and validated for use in the Malaysian population. The aim of this
study is to translate and validate the Malay PTSD Checklist for Civilians
(MPCL-C). Methods: The PCL-C was translated into the Malay Language and
back-translated. The reliability and validity of the MPCL-C were then
determined by administering them to those who presented at the emergency
department for motor vehicle accident at least one month before. Results: The
MPCL-C has good face and content validity. In terms of reliability, it is also
good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full
scale, re-experiencing, avoidance and arousal domains respectively. Conclusions:
The MPCL-C is a valid and reliable instrument to screen for PTSD in motor
vehicle accident victims for the studied population.