1.Influence of Different Types of Contralateral Suppression Tones on Otoacoustic Emission in Children With Autism Spectrum Disorder
Fatin Nabilah JAMAL ; Ahmad Aidil Arafat DZULKARNAIN ; Nadzirah Ahmad BASRI ; Sarah RAHMAT ; Fatin Amira SHAHRUDIN ; Mohd. Zulfaezal Che AZEMIN ; Shahrul Na’im SIDEK ; Hazlina Md YUSOF ; Siti Rafiah Abd. HAMID
Journal of Audiology & Otology 2025;29(1):49-56
Background and Objectives:
Auditory sensory gating deficits are abnormalities in patients with autism spectrum disorder (ASD) that may lead to sensory processing difficulties. It is particularly difficult for children with ASD to distinguish multiple auditory stimuli, which hinders them from focusing on a single auditory stimulus and separating unnecessary sounds. Suppression of otoacoustic emission (OAE) is an approach used to identify sensory gating deficits in the general population, specifically for children with ASD. This study aimed to investigate the suppression effect of various types of sound suppressors to measure their sensory gating capacity in children with ASD.
Subjects and Methods:
Twenty children including 10 with ASD and 10 normally developing children aged 6-12 years were recruited for this study. One accessible ear was exposed to transient-evoked OAE, whereas the other was exposed to suppressor tones. Contralateral suppressors included white noise, Quranic recitations, environmental noise, and natural sound. The magnitude of OAE suppression was determined from the difference between the OAE amplitude with and without the masker (in dB sound pressure levels) for all sound types. The sound with the highest suppression effect was determined using effect size calculation and repeated-measures analysis of variance at a 95% confidence level. A high suppression effect may suggest a high sensory gating performance, whereas low suppression may indicate low sensory gating performance.
Results:
Based on the analysis, the sound with the highest suppression effect was that of the waterfall. The suppression results were supported by descriptive analysis findings and effect-size calculations.
Conclusions
This study provides a better understanding of the alternative sound stimuli, besides the standard white noise tone, for the assessment of sensory gating deficits among children with ASD. Sounds with a high suppression effect have the potential to be used as sound therapy interventions for children with ASD as part of rehabilitation and therapy.
2.Influence of Different Types of Contralateral Suppression Tones on Otoacoustic Emission in Children With Autism Spectrum Disorder
Fatin Nabilah JAMAL ; Ahmad Aidil Arafat DZULKARNAIN ; Nadzirah Ahmad BASRI ; Sarah RAHMAT ; Fatin Amira SHAHRUDIN ; Mohd. Zulfaezal Che AZEMIN ; Shahrul Na’im SIDEK ; Hazlina Md YUSOF ; Siti Rafiah Abd. HAMID
Journal of Audiology & Otology 2025;29(1):49-56
Background and Objectives:
Auditory sensory gating deficits are abnormalities in patients with autism spectrum disorder (ASD) that may lead to sensory processing difficulties. It is particularly difficult for children with ASD to distinguish multiple auditory stimuli, which hinders them from focusing on a single auditory stimulus and separating unnecessary sounds. Suppression of otoacoustic emission (OAE) is an approach used to identify sensory gating deficits in the general population, specifically for children with ASD. This study aimed to investigate the suppression effect of various types of sound suppressors to measure their sensory gating capacity in children with ASD.
Subjects and Methods:
Twenty children including 10 with ASD and 10 normally developing children aged 6-12 years were recruited for this study. One accessible ear was exposed to transient-evoked OAE, whereas the other was exposed to suppressor tones. Contralateral suppressors included white noise, Quranic recitations, environmental noise, and natural sound. The magnitude of OAE suppression was determined from the difference between the OAE amplitude with and without the masker (in dB sound pressure levels) for all sound types. The sound with the highest suppression effect was determined using effect size calculation and repeated-measures analysis of variance at a 95% confidence level. A high suppression effect may suggest a high sensory gating performance, whereas low suppression may indicate low sensory gating performance.
Results:
Based on the analysis, the sound with the highest suppression effect was that of the waterfall. The suppression results were supported by descriptive analysis findings and effect-size calculations.
Conclusions
This study provides a better understanding of the alternative sound stimuli, besides the standard white noise tone, for the assessment of sensory gating deficits among children with ASD. Sounds with a high suppression effect have the potential to be used as sound therapy interventions for children with ASD as part of rehabilitation and therapy.
3.Influence of Different Types of Contralateral Suppression Tones on Otoacoustic Emission in Children With Autism Spectrum Disorder
Fatin Nabilah JAMAL ; Ahmad Aidil Arafat DZULKARNAIN ; Nadzirah Ahmad BASRI ; Sarah RAHMAT ; Fatin Amira SHAHRUDIN ; Mohd. Zulfaezal Che AZEMIN ; Shahrul Na’im SIDEK ; Hazlina Md YUSOF ; Siti Rafiah Abd. HAMID
Journal of Audiology & Otology 2025;29(1):49-56
Background and Objectives:
Auditory sensory gating deficits are abnormalities in patients with autism spectrum disorder (ASD) that may lead to sensory processing difficulties. It is particularly difficult for children with ASD to distinguish multiple auditory stimuli, which hinders them from focusing on a single auditory stimulus and separating unnecessary sounds. Suppression of otoacoustic emission (OAE) is an approach used to identify sensory gating deficits in the general population, specifically for children with ASD. This study aimed to investigate the suppression effect of various types of sound suppressors to measure their sensory gating capacity in children with ASD.
Subjects and Methods:
Twenty children including 10 with ASD and 10 normally developing children aged 6-12 years were recruited for this study. One accessible ear was exposed to transient-evoked OAE, whereas the other was exposed to suppressor tones. Contralateral suppressors included white noise, Quranic recitations, environmental noise, and natural sound. The magnitude of OAE suppression was determined from the difference between the OAE amplitude with and without the masker (in dB sound pressure levels) for all sound types. The sound with the highest suppression effect was determined using effect size calculation and repeated-measures analysis of variance at a 95% confidence level. A high suppression effect may suggest a high sensory gating performance, whereas low suppression may indicate low sensory gating performance.
Results:
Based on the analysis, the sound with the highest suppression effect was that of the waterfall. The suppression results were supported by descriptive analysis findings and effect-size calculations.
Conclusions
This study provides a better understanding of the alternative sound stimuli, besides the standard white noise tone, for the assessment of sensory gating deficits among children with ASD. Sounds with a high suppression effect have the potential to be used as sound therapy interventions for children with ASD as part of rehabilitation and therapy.
4.Normal Pedobarography Values in a Multiracial Community of Malaysia: A Cross-Sectional Study
Haidar MN ; Che-Ahmad A ; Ayeop MAS ; Ahmad-Ismanii MS ; Nik-Alyani NAA
Malaysian Orthopaedic Journal 2025;19(No. 3):1-9
Introduction: While pedobarography is emerging in
Malaysia for foot-related clinical and research use, there are
no published normative foot plantar pressure values. This
study aimed to identify pressure values and areas of
distribution in the normal foot of the multiracial population
in Pahang, Malaysia. The differences by ethnic groups,
gender, and BMI levels were also investigated.
Materials and methods: In this cross-sectional study, 600
normal feet without pre-existing diabetes mellitus and any
lower limb and spine pain were assessed using Emed-q100
pedobarography platform device and EMED/E (Expert)
software from January 2018 to December 2018. The data
were analysed using SPSS, with descriptive statistics for
demographics and foot pressure, Pearson Chi-Square for
associations, t-tests for gender differences, and one-way
ANOVA for comparisons across ethnicity and BMI groups.
Results: The mean maximum peak pressure (MPP) was
measured at 508.98 kPa (SD 164.06) with significant
differences by BMI whereby the score was highest in the
obese (p<0.001). No significant differences by gender and
ethnicity were reported. In terms of peak pressure area
(PPA), most (42.2%) were observed in the first metatarsal
head and big toe region (1MH&T), followed by second
metatarsal head (2MH) (31.5%). For overweight and obese,
PPA mostly distributed in 2MH (34.8% and 50%,
respectively). Significant differences in PPA were also seen
between races. There was no significant difference in the
pressure area distribution by gender.
Conclusion: The MPP is affected by BMI while PPA
distribution is affected by BMI and ethnicity. These findings
can be used as an initial reference for further studies related
to orthopaedic clinical applications, particularly involving
the Malaysian population with various ethnicities and
cultural backgrounds.
5.Obstacles and Facilitators in Daily Living Activities Among Persons with Spinal Cord Injury: A Systemic Review
Faizan Jameel Khanzada ; Mohammad Ghazali Masuri ; Erna Faryza Mohd Poot ; Mohd Zulkifli Abdul Rahim ; Ahmad Zamir Che Daud
Malaysian Journal of Medicine and Health Sciences 2024;20(No.1):271-280
Introduction: This systematic review aimed to investigate the level of participation, obstacles, and facilitator factors
that influence activities of daily living among persons with spinal cord injury (SCI). Methods: A comprehensive
search was conducted in four online databases, namely Google Scholar, PubMed, OT Seeker, and Cochrane Library
covering the ten-years period from January 2012 to December 2022. Inclusion criteria encompassed original published studies in English focusing on daily activities, work, participation, obstacles, and facilitators in persons with
SCI. Non-peer review sources (e.g., abstracts, grey literature, preprints), and studies unrelated to occupational therapy were excluded. The selected studies were assessed for quality using McMaster University Occupational Therapy
Evidence-Based Practice critical review form. Results: Out of the 678 articles identified, ten studies were included
after the screening, exploring participation in daily living activities, employment, return to work, leisure activities,
family tasks, and community mobility among persons with SCI. Obstacles and facilitators influencing participation
in activities of daily living were classified using the International Classification of Functioning, Disability, and Health
(ICF) framework. This review highlighted that long-term participation is challenging for persons with SCI, affected
by obstacles such as body functions, pain, low self-esteem, and environmental and social factors. Conclusion: The
findings underscore the importance of adopting a multidisciplinary rehabilitation approach to enhance participation
in daily activities for persons with SCI. Occupational therapy plays a significant role in improving participation levels
among persons with SCI.
6.Modulation Agents of Wound Healing in Ocular Surgeries
Yaakub Azhany ; Mohd-Yusof Siti-Fairuz ; Azlina Ahmad ; Wan Nazirah Wan Yusuf ; Low Jen Hou ; Ahmad-Tajudin Liza-Sharmini ; Jemaima Che Hamzah
Malaysian Journal of Medicine and Health Sciences 2024;20(No.1):293-303
Wound healing is a complex process that includes haemostasis and inflammation, followed by a proliferation period and repair and finally remodelling. Ocular surgeries, particularly in glaucoma cases, aim at minimal fibrosis to preserve the function of trabeculectomy as an alternative pathway for aqueous drainage. Hence, it is important to find an agent to modulate the wound healing process. This review presents compilation of wound modulation agents that have been tested in vitro, in vivo, or clinically on patients undergoing ocular surgeries, particularly for glaucoma. We identified agents into four groups, mostly for glaucoma filtration operations: anti-metabolites, anti-growth factors, mechanical barriers and rho kinases. The effect of these agents is highlighted in this review. In conclusion,
despite recognized drawbacks of antimetabolites, they are still regarded as the gold standard and the most efficient treatment as anti-scarring agents use in ocular surgeries. More studies are needed to inquire agents that efficient yet has minimal adverse effects both in short and long term.
7.Serum Procalcitonin (PCT) - Is there a Role as an Early Biomarker in Infected Diabetic Foot Ulcer (IDFU) Patients?
Omar J ; Ahmad NS ; Che-Soh NAA ; Wan-Azman WN ; Yaacob NM ; Abdul-Ghani NS ; Abdullah MR
Malaysian Orthopaedic Journal 2023;17(No.2):62-69
Introduction: Infected diabetic foot ulcers may lead to
serious complications if not recognised in the early stage.
Diagnosis of infection is particularly challenging at that
stage; thus, a sensitive inflammatory biomarker may be
helpful. We aimed to evaluate the role of procalcitonin (PCT)
as an early biomarker for infected diabetic foot ulcers
(IDFU).
Materials and method: This cross-sectional study was
conducted at Klinik Rawatan Keluarga (KRK), Orthopedic
clinic and wards in Hospital Universiti Sains Malaysia
(USM) from May 2020 to December 2020. A total of 264
participants were recruited and divided into three groups: 50
diabetic patients with no ulcers (control), 107 patients with
non-infected diabetic foot ulcers (NIDFU), and 107 patients
with infected diabetic foot ulcers (IDFU). The level of PCT
was taken for all patients. Total white count (TWC) and Creactive protein (CRP) were taken only for IDFU patients.
Diagnosis of infection was based on the Infectious Disease
Society of America-International Working Group of Diabetic
Foot (IDSA-IMWGDF), and the severity of infection was
graded according to the Wagner Classification.
Results: The level of PCT was higher in IDFU than in
NIDFU and diabetic patient, with a median (IQR) of 0.355
(0.63) ng/mL, 0.077 (0.15) ng/mL and 0.028 (0.02) ng/mL,
respectively. PCT and CRP showed moderate positive
correlations in IDFU patients (p<0.001). The sensitivity and
specificity were 63.6% and 83.2%, respectively, at the best
cut-off at 0.25 ng/mL.
Conclusion: PCT is a valuable biomarker for the diagnosis
of infection; however, it adds little value in the early
diagnosis of IDFU in view of its low sensitivity.
8.Magnetic Resonance Imaging Anatomy of Alar Ligament: A Review of Literature
Raihanah Haroon ; Siti Kamariah Che Mohamed ; Karimah Hanim Abd. Aziz
Malaysian Journal of Medicine and Health Sciences 2023;19(No.5):389-398
Alar ligament is one of the most important craniocervical junction (CCJ) ligaments; acting as stabilizer of CCJ and
limiting axial rotation. It may be involved in various pathological processes including trauma. Magnetic resonance
imaging (MRI) is increasingly being used in cervical spine trauma as a supplement to conventional radiography and
computed tomography (CT) to detect a wide range of severe cervical spine injuries. MR depiction of alar ligament
requires special sequences despite no known established MR sequence is available. However, the role of MRI in
minor or moderate trauma, including whiplash injuries, has long been debated, particularly when neurological dysfunction is absent, because no anatomical disruption other than degenerative disc disease have been reported. In this
review, we provide detailed account on the current knowledge of MR visualization of normal alar ligament; outlining
the variations in its signal intensity, dimension, shape and orientation.
9.Does an Asian-based Diet Sufficient to Meet the Nutritional Demands of Endurance Athletes?: A Cross-sectional Study
Zaini Bahari ; Nik Shanita Safii ; Ahmad Munir Che Muhamed
Malaysian Journal of Medicine and Health Sciences 2023;19(No.6):51-61
Introduction: Limited studies have examined the dietary intake pattern of Malaysian endurance athletes. Differences in the types of foods consumed between Malaysian and Western population leads to varying nutritional intake
values. This study aimed to characterise the dietary intake of Malaysian endurance athletes as compared to sports
nutrition recommendations, and to determine the associations between participants’ backgrounds and macronutrients intake status. Methods: A total of 85 endurance-trained Malaysian athletes participated in a cross-sectional
study. Dietary intake for three days throughout the training season was evaluated using 24-hour dietary recall. The
macronutrients and micronutrients intakes were compared to the nutritional recommendation for athletes and the
Recommended Nutrient Intakes (RNI), respectively. The food serving size was compared to the Malaysian Food Pyramid 2020. Results: Of all participants, 51% met the minimum recommendations for carbohydrate (CHO) intake (6g/
kg/day). For protein intake, 88% of participants had surpassed the lower limit of 1.2g/kg/day. The lower limit of fat
intake (20% of total daily energy intake) was met by 99% of the participants. Most of the participants had a suboptimal intake of calcium, vitamin A, and vitamin E, while all had inadequate vitamin D intake. The athletes’ institution
was significantly associated with the CHO intake status. Also, the athletes’ institution and the highest education level
were significantly associated with the protein intake status. Conclusion: Athletes who practised Asian-based diets
were able to achieve the energy, protein, and fat intake recommendations. However, there was a suboptimal intake
of the CHO and micronutrients as compared to the recommendations.
10.Assessment of Daytime and Nighttime Ground Level Ozone Pollution in Malaysian Urban Areas
Aimi Nursyahirah Ahmad ; Samsuri Abdullah ; Amalina Abu Mansor ; Nazri Che Dom ; Ali Najah Ahmed ; Nurul Ain Ismail ; Marzuki Ismail
Malaysian Journal of Medicine and Health Sciences 2023;19(No.6):242-248
Introduction: Ozone (O3
) is a significant component of photochemical smog as a typical secondary which is formed
via nitrogen oxide photochemical interactions with volatile organic compounds (VOCs). This research discerns the
complex influence of meteorological parameters and air pollutants influencing O3
concentrations. Methods: Data
were acquired from 1 January 2018 until 31 December 2020 that including ozone (O3
), nitrogen oxide (NOx), nitric
oxide (NO), sulphur dioxide (SO2
), nitrogen dioxide (NO2
), carbon monoxide (CO), particulate matter (PM10, PM2.5),
wind speed, solar radiation, temperature, and relative humidity (RH). Data were analysed using descriptive statistics
in terms of line graphs. Results: The results demonstrate that the O3
concentration peaked around 14:00 hours and
dropped at night (20:00 hours) owing to the lack of sunshine and redox processes. Conclusion: In conclusion, ozone
precursors played an important role in ozone formation and the findings of this research are valuable for policymakers and other interested parties


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