1.Prothrombotic markers in Thalassemia major patients: A
Sadia SULTAN ; Syed Mohammed IRFAN ; Syed Mustansir Hussain Zaidi
The Medical Journal of Malaysia 2018;73(4):185-189
Background: It is being increasingly recognised thatthalassemia major patients, like intermedia, have increasedpropensity for thromboembolism. Deficiency of naturalanticoagulants is more recently defined finding contributingto the hypercoagulable state. The aim this study is todetermine natural anticoagulants levels and their correlationwith maternal characteristics, haematological andbiochemical markers.
2.The Use of M2-Pyruvate Kinase as a Stool Biomarker for Detection of Colorectal Cancer in Tertiary Teaching Hospital: A Comparative Study
Shahidah CHE ALHADI ; Wan Zainira WAN ZAIN ; Zalina ZAHARI ; Mohd Nizam MD HASHIM ; Syed Hassan SYED ABD. AZIZ ; Zaidi ZAKARIA ; Michael Pak-Kai WONG ; Andee Dzulkarnaen ZAKARIA
Annals of Coloproctology 2020;36(6):409-414
Purpose:
Guaiac fecal occult blood test (gFOBT) has been the standard for colorectal screening but it has low sensitivity and specificity. This study evaluated the use of fecal tumor M2-pyruvate kinase (M2-PK) for detection of colorectal cancer and to compare with the current surveillance tool; gFOBT in symptomatic adult subjects underwent colonoscopy.
Methods:
Stool samples were collected prospectively from symptomatic adults who had elective colonoscopy from September 2014 to January 2016 and were analyzed with the ScheBo M2-PK Quick test and laboratory detection of fecal hemoglobin.
Results:
The results were correlated to the colonoscopy findings and/or histopathology report. Eighty-five subjects (age of 56.8 ± 15.3 years [mean ± standard deviation]) were recruited with a total of 17 colorectal cancer (20.0%) and 10 colorectal adenoma patients (11.8%). The sensitivity of M2-PK test in colorectal cancer detection was higher than gFOBT (100% vs. 64.7%). M2-PK test had a lower specificity when compared to gFOBT (72.5% vs. 88.2%) in colorectal cancer detection. The positive and negative predictive values were 47.2% and 100% for M2-PK test and 57.9% and 90.9% for gFOBT.
Conclusion
Fecal M2-PK Quick test has a high sensitivity for detection of colorectal cancer when compared to gFOBT, making it the potential choice for colorectal tumor screening biomarker in the future.
3.Dengue Virus Serotypes Circulating in Khyber Pakhtunkhwa Province, Pakistan, 2013-2015.
Muhammad SULEMAN ; Rani FARYAL ; Muhammad Masroor ALAM ; Salmaan SHARIF ; Shahzad SHAUKAT ; Uzma Bashir AAMIR ; Adnan KHURSHID ; Mehar ANGEZ ; Massab UMAIR ; Mian Muhammad SUFIAN ; Yasir ARSHAD ; Syed Sohail Zahoor ZAIDI
Annals of Laboratory Medicine 2017;37(2):151-154
From 2013 to 2015, the National Institute of Health, Pakistan, received 1,270 blood samples of suspected dengue cases reported from inpatient and outpatient departments of various hospitals in Khyber Pakhtunkhwa (KPK) province. In this study, we determined the circulating dengue virus (DENV) serotypes using real-time reverse transcriptase (RT)-PCR to understand the serotype-based epidemiology of DENV. All four serotypes (DENV-1 [6%], DENV-2 [33%], DENV-3 [47%], and DENV-4 [0.1%]) were found circulating during the study period. Our findings suggest the need for an active surveillance system coupled with the laboratory diagnosis, especially in the chronic endemic areas of the country. Public awareness programs are needed for effective control and prevention of outbreaks in the future.
Adolescent
;
Adult
;
Dengue/diagnosis/*epidemiology/virology
;
Dengue Virus/genetics/*isolation & purification
;
Disease Outbreaks
;
Female
;
Humans
;
Male
;
Middle Aged
;
Pakistan/epidemiology
;
RNA, Viral/genetics/metabolism
;
Real-Time Polymerase Chain Reaction
;
Serogroup
;
Young Adult
4.Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy
Nelson Rao PUSHPANATHAN ; Mohd Nizam Md HASHIM ; Zalina ZAHARI ; Syed Hassan Syed Abd. AZIZ ; Wan Zainira Wan ZAIN ; Rosnelifaizur RAMELY ; Michael Pak-Kai WONG ; Ikhwan Sani MOHAMAD ; Wan Mokhzani Wan MOKHTER ; Maya Mazuwin YAHYA ; Siti Rahmah Hashim Isa MERICAN ; Zaidi ZAKARIA ; Andee Dzulkarnaen ZAKARIA
Annals of Coloproctology 2022;38(6):409-414
Purpose:
Laparoscopic appendicectomy (LA) has several advantages over conventional open appendicectomy (OA). However, about 5% to 10% of LA patients still need to be converted to open surgery. Identifying risk factors that contribute to conversion to OA allows for early identification of patients who may benefit from primary OA. This study aimed to determine the conversion rate of LA to OA and to identify its associated risk factors among patients with acute or perforated appendicitis.
Methods:
A retrospective review of medical records was performed among patients with acute or perforated appendicitis who underwent LA between December 2015 and January 2017. With the use of multivariable logistic regression analyses, the predictors of conversion from laparoscopic to OA were investigated.
Results:
Out of 120 patients, 33 cases were converted to OA which gives a conversion rate of 27.5%. Among 33 patients who were converted to OA, 27 patients (81.8%) had perforated appendix, while in the LA group, perforated appendix cases consisted of 34.5% (P<0.001). Histopathology of the appendix was the predictor of conversion from LA to OA (adjusted odds ratio, 8.82; 95% confidence interval, 3.13–24.91; P<0.001).
Conclusion
The result from our study shows that the overall conversion rate for the study period was high. Patients with perforated appendicitis had a higher risk of conversion to OA. Therefore, preoperative diagnosis of perforated appendicitis may be paramount in predicting conversion to OA.
5.Predictors of early postoperative hypocalcemia after total parathyroidectomy in renal hyperparathyroidism
Poh Guan TAN ; Imi Sairi AB. HADI ; Zalina ZAHARI ; Maya Mazuwin YAHYA ; Wan Zainira WAN ZAIN ; Michael Pak Kai WONG ; Rosnelifaizur RAMELY ; Mohd Nizam MD HASHIM ; Syed Hassan SYED ABD. AZIZ ; Zaidi ZAKARIA ; Andee Dzulkarnaen ZAKARIA
Annals of Surgical Treatment and Research 2020;98(1):1-6
PURPOSE:
Patients with secondary hyperparathyroidism are at high risk for developing postoperative hypocalcemia. However, there are limited data regarding predictors of postoperative hypocalcemia in renal failure patient with secondary hyperparathyroidism. This study aimed to determine the clinical presentations of renal hyperparathyroidism and the predictors of early postoperative hypocalcemia after total parathyroidectomy.
METHODS:
Data of patients with renal hyperparathyroidism who underwent total parathyroidectomy between January 2007 to December 2014 were reviewed retrospectively. Patients were divided into 2 cohort groups according to their serum calcium levels within 24 hours of parathyroidectomy: the hypocalcemia group (calcium levels of 2 mmol/L or less), and the normocalcemia group (calcium levels more than 2 mmol/L). With the use of multivariable logistic regression analyses, the predictors of early postoperative hypocalcemia after total parathyroidectomy in patients with renal hyperparathyroidism were investigated.
RESULTS:
Among 68 patients, 56 patients (82.4%) were symptomatic preoperatively. Fifty patients (73.5%) presented with bone pain and 14 patients (20.6%) had muscle weakness. Early postoperative hypocalcemia occurred in 25 patients (36.8%). Preoperative alkaline phosphatase level was the predictor of early postoperative hypocalcemia (adjusted odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P = 0.002).
CONCLUSION
Results from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels.
6.Biliary ascariasis – A vicious cycle
Ikhwan Sani Mohamad ; Nurfariza Che Husin ; Ho Kah Yee ; Soh Jien Yen ; Syed Hassan Syed Aziz ; Zaidi Zakaria
Malaysian Family Physician 2021;16(2):83-85
Biliary ascariasis is a rare disease in a non-endemic area. However, it is one of the possible etiological factors for retarded growth as well as malnutrition in children. It may cause intestinal obstruction, appendicitis, biliary obstruction, liver abscess, hepatolithiasis, and pancreatitis in adults. Herein, we report a patient with ascending cholangitis secondary to biliary ascariasis who was successfully managed with Endoscopic Retrograde Cholangio Pancreaticography.
7. Reno-protective effect of garlic extract against immobilization stress induced changes in rats
Syed Kashif ZAIDI ; Shakeel Ahmed ANSARI ; Mohammad Alam JAFRI ; Ghulam Md. ASHRAF ; Shams TABREZ ; Naheed BANU
Asian Pacific Journal of Tropical Biomedicine 2015;5(5):364-369
OBJECTIVE: To examine immobilization stress-induced antioxidant defense alterations in rat kidney and the antioxidant effects of aqueous garlic extract in pre and post stress extract treatments. METHODS: Albino rats were treated with aqueous extract of garlic both before and 6 h of immobilization stress. Pro-oxidant eminence of rat kidney was assessed by determining the levels of glutathione, thiobarbituric acid reactive substances, aspartate aminotransferase, alanine aminotransferase, glucose, uric acid, alkaline phosphatase and antioxidant enzymes activities. RESULTS: In response to 6 h of immobilization stress, a significant rise in the level of kidney enzymes was recorded. However, antioxidant enzyme activities showed a sharp decline. CONCLUSIONS: The extract treatment before and after the stress reverted the activities of above mentioned enzymes towards their control values. Hence, garlic extract can be given as nutritional supplement for scavenging the free radicals generated in rat kidney.
8.A validation study of the Bahasa Malaysia version of the National Institute of Health Stroke Scale
Najma Kori ; Wan Asyraf Wan Zaidi ; Rabani Remli ; Azman Ali Raymond ; Norlinah Mohamed Ibrahim ; Hui Jan Tan ; Syed Zulkifli Syed Zakaria ; Zhe Kang Law ; Kartini Ahmad ; Wan Nafisah Wan Yahya ; Ramesh Sahathevan
Neurology Asia 2018;23(3):225-232
Background & Objectives: The National Institute of Health Stroke Scale (NIHSS) provides a valid
and quick assessment of stroke severity in hyperacute stroke management. Stroke patients who are
eligible for reperfusion therapy require prompt assessment. There is no validated Bahasa Malaysia
(BM) version of the NIHSS that allows easier assessment by BM-speaking health professionals.
This study aimed to translate and validate a BM version of the NIHSS. Methods: The English NIHSS
was translated to BM, then back translated to ensure linguistic accuracy. We also adapted the language
assessment of the NIHSS to be more culturally appropriate. Training and certification videos were
downloaded from the NIH website and dubbed into BM. We determined intra-class correlation and
unweighted kappa as the best measure of reliability. Median scores were used in the analysis for
language items. Results: One hundred and one raters participated in the test-retest reliability study.
Agreement between the original NIHSS and our translated version of the BM-NIHSS was good (ICC
= 0.738, 95% CI: 0.611 to 0.823). Fair to moderate agreement was found on item-by-item analysis
(unweighted κ=0.20-0.50) despite high observed agreement. Fifty patients participated in the language
assessment arm. Scores were better in BM for reading, naming objects and repetition (Mdn = 100, p
< 0.001). There was no difference in the median scores for the description component.
Conclusions: The BM-NIHSS is a valid translation of the NIHSS, and may be used in clinical practice
by BM-speaking healthcare professionals.
9. NS1 antigen: A new beam of light in the early diagnosis of dengue infection
Muhammad SULEMAN ; Rani FARYAL ; Muhammad SULEMAN ; Muhammad Masroor ALAM ; Salmaan SHARIF ; Shahzad SHAUKAT ; Uzma Bashir AAMIR ; Adnan KHURSHID ; Mehar ANGEZ ; Massab UMAIR ; Mian Muhammad SUFIAN ; Yasir ARSHAD ; Ghulam MUJTABA ; Syed Sohail Zahoor ZAIDI
Asian Pacific Journal of Tropical Medicine 2016;9(12):1212-1214
Objective To evaluate NS1 antigen detection ELISA for the early laboratory diagnosis of dengue virus infection. Methods The present study was conducted to evaluate the overall positivity of NS1 antigen detection ELISA and its comparison with viral RNA detection via real time PCR and IgM antibodies detection by ELISA. Results A total of 1270 serum samples were tested 86% (1097/1270) were detected positive by one or more than one diagnostic test. Out of 1 270, 64% (807/1270) were positive by NS1 ELISA and 52% (662/1270), 51% (646/1270) were positive by real-time RT-PCR and IgM ELISA respectively. Conclusions NS1 antigen detection ELISA is highly suitable diagnostic tools and it also has great value for use in outbreak and epidemic situation.
10.Clinical and Safety Outcomes of Endovascular Therapy 6 to 24 Hours After Large Vessel Occlusion Ischemic Stroke With Tandem Lesions
Milagros GALECIO-CASTILLO ; Mudassir FAROOQUI ; Ameer E. HASSAN ; Mouhammad A. JUMAA ; Afshin A. DIVANI ; Marc RIBO ; Michael ABRAHAM ; Nils H. PETERSEN ; Johanna T. FIFI ; Waldo R. GUERRERO ; Amer M. MALIK ; James E. SIEGLER ; Thanh N. NGUYEN ; Sunil SHETH ; Albert J. YOO ; Guillermo LINARES ; Nazli JANJUA ; Darko QUISPE-OROZCO ; Wondwossen TEKLE ; Syed F. ZAIDI ; Sara Y. SABBAGH ; Marta OLIVÉ-GADEA ; Tiffany BARKLEY ; Reade De LEACY ; Kenyon W. SPRANKLE ; Mohamad ABDALKADER ; Sergio SALAZAR-MARIONI ; Jazba SOOMRO ; Weston GORDON ; Charoskhon TURABOVA ; Juan VIVANCO-SUAREZ ; Aaron RODRIGUEZ-CALIENES ; Maxim MOKIN ; Dileep R. YAVAGAL ; Tudor JOVIN ; Santiago ORTEGA-GUTIERREZ
Journal of Stroke 2023;25(3):378-387
Background:
and Purpose Effect of endovascular therapy (EVT) in acute large vessel occlusion (LVO) patients with tandem lesions (TLs) within 6–24 hours after last known well (LKW) remains unclear. We evaluated the clinical and safety outcomes among TL-LVO patients treated within 6–24 hours.
Methods:
This multicenter cohort was divided into two groups, based on LKW to puncture time: early window (<6 hours), and late window (6–24 hours). Primary clinical and safety outcomes were 90-day functional independence measured by the modified Rankin Scale (mRS: 0–2) and symptomatic intracranial hemorrhage (sICH). Secondary outcomes were successful reperfusion (modified Thrombolysis in Cerebral Infarction score ≥2b), first-pass effect, early neurological improvement, ordinal mRS, and in-hospital and 90-day mortality.
Results:
Of 579 patients (median age 68, 32.1% females), 268 (46.3%) were treated in the late window and 311 (53.7%) in the early window. Late window group had lower median National Institutes of Health Stroke Scale score at admission, Alberta Stroke Program Early Computed Tomography Score, rates of intravenous thrombolysis, and higher rates for perfusion imaging. After adjusting for confounders, the odds of 90-day mRS 0–2 (47.7% vs. 45.0%, adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.49–1.02), favorable shift in mRS (aOR 0.88, 95% CI 0.44–1.76), and sICH (3.7% vs. 5.2%, aOR 0.56, 95% CI 0.20–1.56) were similar in both groups. There was no difference in secondary outcomes. Increased time from LKW to puncture did not predicted the probability of 90-day mRS 0–2 (aOR 0.99, 95% CI 0.96–1.01, for each hour delay) among patients presenting <24 hours.
Conclusion
EVT for acute TL-LVO treated within 6–24 hours after LKW was associated with similar rates of clinical and safety outcomes, compared to patients treated within 6 hours.