bluuebunny/crossref_metadata_2025 huggingface dataset:
The mechanistic role of catalytic residues in non-stereo dehalogenase (DehE)
Authors: Abdul Hamid Azzmer Azzar , Hasanussin Muhammad
Published: January 2021

Introduction: DehE or non-stereospecific dehalogenase from Rhizobium sp. RC1 catalyzes the hydrolytic dehalogenation of both isomers of D,L-2-haloacids to produce an inverted configuration of 2-hydroxyl acid. The enzymatic degradation for the removal of halides from haloacid substance has been highlighted since the enzyme itself is a potential candidate as bio-remediation agent. However, the mechanistic role of active site residues for dehalogenase is still unclear, especially for non-stereospecific ones. Method: In this study, using computational analysis, the complex structure of DehE docked with catalytic water (DehE-H2O) was subjected to MD simulation to study the mechanistic role of catalytic residues, especially Asn114 and Asp189 towards catalytic water. Results: Our findings confirmed that Asn114 hold the catalytic water at distance of ~4 Å while Asp189 was appropriately oriented towards catalytic water for catalysis reaction throughout the simulation process. Conclusions: The results attained here will play important role in elucidating the direct attack mechanism of halogenated compound by non-stereospecific haloacid dehalogenase. Moreover, this research could suggest different solvent that can be used in dehalogenation to produce a beneficial product other than hydroxyl acid.
Incidence of chronic Hepatitis B among Orang Asli in Pahang
Authors: Mohd Firdaus Mohd Al-Baqlish , Poh Tee Hoi
Published: January 2021

Introduction: The rate of Hepatitis B infection in Malaysia is 4.7% and the prevalence of Hepatitis B infection varies among ethnic group in Malaysia. The estimated prevalence of chronic Hepatitis B among Orang Asli in Malaysia is 8.3%. Methods: 232 Orang Asli participated in this study on a voluntary basis during two health screening in two Orang Asli Villages. Subjects serum HBsAg and HBsAb titres were taken and analyzed. Results: From 232 participants, there are 24 subjects who are HBsAg positive (10.3%) and only 15.9% of the population study has immunity to Hepatitis B. Conclusions: The incidence of chronic Hepatitis B among Orang Asli in Pahang is higher than the general population, and the rate of immunity to Hepatitis B are low compared to the general population.
Biotechnological potential of Kuantan mangrove actinomycete, Micromonospora K3-13
Authors: Mohd Omar Suhaila , Zainal Abidin Zaima Azira , Abdul Malek Nur Fathiah , Mohd Farouk Norsyafawati , Zainuddin Zarina , Chowdhury Ahmed Jalal Khan
Published: January 2021

Introduction: Mangrove is a complex and unique ecosystem which experiences periodical tidal flooding inundated with low, moderate and high salinity water. Its muddy soil is rich in organic matter derived from the efficient nutrient cycling system and decomposition of mangrove leaves. An adaptation of mangrove microorganisms towards these environmental factors could promote the production of interesting bioactive compounds and enzymes. Methods: This study determines to unravel the identity and biotechnological potential of a Kuantan mangrove actinomycete, strain K3-13, through morphology observation, molecular identification, antimicrobial test and xylan degradation test. Results: The orange-colored mycelium-forming isolates produced spores after a long incubation period, and showed characteristics that resembled Micromonaspora colonies. Phylogenetic analysis of the 16S rRNA gene sequence of strain K3-13 indicated that the highest similarity was to Micromonospora carbonacea DSM43168 (99%). It was observed that K3-13 produced blue diffusible pigment upon cultivation on agar media. Cross streak assay conducted to detect antimicrobial activity indicated that K1-13 has strong antibacterial activity against Bacillus subtilis and Staphylococcus aureus. K3-13 also showed positive xylanase activity by exhibiting decolourization zone in the agar-based assay using azo-xylan as substrate. Conclusions: On the basis of its ability to produce blue pigment, antimicrobial activity against at least two test organisms and positive xylan degrading activity, Micromonaspora K3-13 is concluded as strain worth exploring for its potential biotechnological application as a natural dye, antibacterial drugs and Xylan biodegraders.
An Examination of Medical Imaging Literature in Malaysian Citation Index (MyCite)
Authors: Kamarudin Nurul Husna , Ab Rahman Nor Azlina , Zainuddin Zainul Ibrahim
Published: January 2021

Introduction: The Medical imaging service in Malaysia is expanding. The presence of imaging technologies needs to be supported by homegrown research to optimize their use. This study investigated the contribution of researches by Malaysian practitioners to the field of Medical imaging in the Malaysian Citation index (MyCite) database. Materials and method: Bibliometric and thematic analyses were performed on publications featured in the database from 2006 to 2016 using 13 keywords; radiology, radiography, medical imaging, radiation, x-ray, neuroimaging, nuclear imaging, magnetic resonance imaging, computed tomography scan, mammogram, ultrasound, fluoroscopy, and intravenous urogram. Results: A total of 268 articles were identified. The study reported the publications from Malaysians (54.1%) followed by non-Malaysians (41.8%) and collaboration between authors (4.1%). The researchers were mostly from university-based (67.4%) and hospital university-based (21.3%) compared to clinical-based (5.6%) researchers. For thematic analysis, the majority of the authors focused on certain topics such as clinical (42.9%) and modality (20.1%) with only a few on safety (12.3%), technical (9.7%), education (7.46%), professionalism (4.5%), quality (2.6%) and economy (0.4%) researches. Conclusion: The low number of publications related to Medical imaging do not reflect the real involvement of practitioners in research. Their research findings could have been indexed in other databases besides MyCite. However, the open access facility offered by MyCite should be optimized. The involvement of clinical-based practitioners can be enhanced in areas involving safety, technical, education, professionalism, quality and economy. Collaborative efforts by the practitioners could increase the number of publications and enhance homegrown research that will address local needs.
Factors Influencing Functional Outcome of Philos Plate Fixation for Proximal Humerus Fractures
Authors: Ab. Wahid Hazwan , Siron Khairul Nizam , Zakiran Ahmad
Published: January 2021

Introduction: Displaced and unstable proximal humerus fractures are difficult to treat and they have high morbidity. The main goal is to achieve painless shoulder with full recovery of the shoulder joint motion. Impingement syndrome is one of the commonest postoperative complication. This study aim is to appreciate the functional outcomes of Philos-plate fixation for proximal humerus fractures and to establish association with high plate positioning with impingement syndrome of the shoulder after Philos-plate fixation. Materials and method: This is a retrospective study, reviewing 26 patients who had proximal humeral fractures and underwent open reduction and Philos-plate fixation between December 2010 and January 2015 in Hospital Tengku Ampuan Afzan, Kuantan. Preoperative X-rays or CT scans were inspected, follow-up visits and X-ray images were obtained at every follow-up to evaluate the plate position and bone union. Assessments of impingement syndrome and other complications were done and also functional outcome measured with Constant shoulder scoring system during final follow-up. Results: Almost 70% of patients achieved good (Constant score: 71-85) to excellence (Constant score: 86-100) outcome, with 77.54 mean Constant score. All cases achieved union. None of the cases developed complications like malunion, infection, AVN, and loosening of implant while 2 cases complicated with shoulder impingement post operatively. Among all the factors, age more than 60 years, and high plate position found to be a significant factor in the outcome of the surgery where both factors yielded significantly less mean Constant scores. Neer 3 parts fractures have higher mean of Constant score compare to Neer 4 parts fractures and high plate position is significantly associated with impingement syndrome postoperatively. Conclusion: This study showed that age, fracture type and plate position were key factors affecting shoulder function after Philos locking plate fixation surgery. We recommend that plate should be position at most 10mm from the greater tubercle to prevent impingement syndrome postoperatively and for better functional outcome.
Outcome of Pseudoaneurysm Repair: A Single Tertiary Center Experience in Pahang, Malaysia
Authors: Othman Ahmad Faidzal , NorHisham Mohamad , Abdul Rahman Azmi
Published: January 2021

Introduction: Symptomatic arterial pseudoaneurysm is not an uncommon emergent vascular case presenting to a tertiary hospital. These are mainly associated with infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and mortality present a challenge to the surgeons managing these cases. Materials and method: We retrospectively reviewed all case notes of all pseudoaneurysm repair done at our centre from Jan 2015 to May 2017. Results: A total of 20 cases were treated surgically, with majority 16(80%) had ligation of the affected arteries. The rest were managed with reconstruction of the arteries with synthetic graft. In 7 patients (35%), the aetiology was identified as iatrogenic intravenous drug injection. Staphylococcus aureus remained the main causative organism with Treponema Pallidum and Burkholderia pseudomallei as the other organisms identified in the cultures. Our 3 patients with graft reconstruction had long term oral antibiotics upon discharge. Conclusion: Majority of pseudoaneurysms presented to our center results in ligation of the artery. Repair of mycotic aneurysm needs careful consideration as graft infection remains a lethal complication and no consensus is available regarding the duration of post-operative antibiotic cover.
Prediction of Clinical Symptoms of Schizophrenia Based on Comt Methylation Marker
Authors: Abd Rahim Nour El Huda , Rahim Mohd Nabil Fikri , Ku Zaifah Norsidah , Mohd Noor Hanisah , Abdullah Kartini , A. Talib Norlelawati
Published: January 2021

Introduction: The dopamine hypothesis of schizophrenia is based on the fact that hyperdopaminergic state is involved in causing psychosis and antipsychotic drugs block the dopamine receptor. COMT regulates the homeostatic levels of neurotransmitter dopamine in the synapses and plays a role in the neurocognitive function. The dysregulation of dopamine in the prefrontal cortex influences the cognitive function and the severity of the psychotic symptoms in schizophrenia. During epigenetic event, methylated COMT gene may cause reduction in its expression and contribute to the clinical presentation of schizophrenia. Therefore, the aim of this study was to assess the feasibility of using COMT DNA methylation for the prediction of specific psychotic presentation of schizophrenia. Materials and method: In this study, 138 schizophrenia patients were recruited from the Psychiatry Clinic, Hospital Tengku Ampuan Afzan, Kuantan Pahang. Genomic DNA from peripheral blood was subjected to the Methylight Taqman® analysis for quantitative measurement of the COMT DNA methylation. The psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Results: The regression analysis showed that the Positive and Excited subdomains of PANSS were significant predictors of COMT hypomethylation (β= -0.288, p= -0.031; β= - 0.288, p= -0.031). The Excited subdomain of PANSS was negatively correlated with COMT DNA methylation (r 2 = -0.380, p= 0.000) as well as the Depressed subdomain (r 2 = -0.288, p= 0.001). Conclusion: The relationship between DNA methylation of COMT with the positive, excited and depressed symptoms might indicate the epigenetic role of COMT gene in the manifestation of schizophrenia.
Radiological Findings of Pulmonary Tuberculosis in Patients with and Without HIV Infections
Authors: Hassan Radhiana binti , Fauzi Haziq Hussaini bin , Yusoff Kamil Irsyad bin , Mohd Satar Muhammad Faizol bin , Pasi Hafizah bt
Published: January 2021

Introduction: Radiological manifestation of pulmonary tuberculosis in HIV positive patients is different with HIV negative patients. We aim to determine the differences in chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected patients in HTAA. Materials and method: A retrospective study was conducted in Chest Clinic, Hospital Tunku Ampuan Afzan, Kuantan Pahang. There were 101 chest radiographs with sputum smear-positive retrieved and reviewed. Socio-demographic status and chest radiographs findings were documented and analyzed. Results: Of the 101 patients, 12 patients were HIV positive. Of the 89 HIV negative patients, 96% had consolidation change on chest radiograph, in contrast with HIV positive patients, only 4% among them had this appearance and this is statistically significant (p value less than 0.05). Mediastinal lymphadenopathy is significantly higher (17%) in HIV positive patients compared to HIV negative patients (1%). Normal chest radiographs were more common in HIV positive patients (33%) as compared to HIV negative patients (2%). Conclusion: HIV positive patients with pulmonary tuberculosis exhibit different radiological manifestation on chest radiograph when compared to HIV negative patients.
The Levels of Depression, Anxiety and Stress on Pre and Post Knee Arthroplasty Patients
Authors: Abdul Razak Ardilla Hanim , Zulkifly Ahmad Hafiz , Musa Ramli , Awang Mohd Shukrimi , Goh Kian Liang
Published: January 2021

Introduction: Total knee arthroplasty represents a major advance in the treatment of degenerative joint disease. It provides excellent restoration of joint function and pain relief. The primary indication for total knee arthroplasty is to relieve pain caused by severe arthritis, with or without significant deformity. This study is to assess psychological impact pre and post arthroplasty. Materials and method: A prospective study on a cohort of patients from June 2010 untill December 2011 admitted to Hospital Tengku Ampuan Afzan for total knee replacement. Cognition tested using DASS21 (Depression Anxiety Stress Scales 21). Questionnaires were distributed 2 days before the operation and 6 months after the operation during clinic follow up. Verbal consent acquired from the patients before giving the questionnaires. Sets of questions are self-administered. Results: As for DASS 21 analysis, pre and post-operative depression was 19.91±4.92 and 6.42±3.64 respectively. Moderate depression became normal post-operative. Questions regarding positive feeling, courage to do things, hope, self- appreciation and the meaning of life were asked pre and post operatively. Pre-operative anxiety was 19.49±4.92 and post-operative anxieties at 6 months were 6.42±3.64. Severe anxiety became normal after 6 months. Patients were asked about mouth dryness, difficulty in breathing on resting, tremor, panicking and unnecessary anxiety pre and post operatively. Post-operative stress improved tremendously from 22.47±4.27 down to 8.56±3.42. Conclusion: As a conclusion, total knee arthroplasty is well accepted in Malaysia. It improves patients’ social and emotional well-being. With the current advancement in total knee arthroplasty, surgeons not only looking into the post-operative physical function, they also look after the cognitive function as the outcome measure of total knee arthroplasty.
Traumatic Pediatric Atlantoaxial Rotatory Dislocation Successfully Reduced with 1 Month Total of Halter Traction: A Case Report
Authors: Ab. Wahid Hazwan , Kow Ren Yi , Khan Ed Simor , Komahen Colin
Published: January 2021

The occurrence of atlantoaxial rotatory subluxation is fairly uncommon; however, it is more common to be encountered in the paediatric population, typically seen after a retropharyngeal inflammation or after a minor trauma. Ligamentous laxity, shallower and more horizontally oriented facet joints especially at the C1-2 joint making them prone to have atlantoaxial subluxation or dislocation. If recognized early it can be successfully managed non-surgically before chronic inflammatory changes affect the ligaments and joint structure of the C1-2 complex. However, there is no standard treatment protocol as some authors like Nael et al and Haliasos and Norris recommended more invasive Halo skull traction. Thus, we report this case managed with less invasive Halter traction with no risk of pin site infections. We present the case of a 12-year-old Malay boy with traumatic atlantoaxial dislocation who came to us after he slipped and fell, presented with neck pain and torticollis to the left side but without other neurological deficits. A computed-tomography (CT) scan revealed an atlantoaxial rotation of 47 to the left without any signs of osseous lesions. MRI was also done and all ligaments were intact. The neck was then reduced by cautious rotation with Halter traction with the cervical spine in the neutral position with slight flexion thus avoiding harm by potential posttraumatic disc lesions. The patient was put on Halter traction for a total of one month. Post-traction revealed full range of motion of the neck without any tenderness, head and neck alignment restored to neutral position. In the children population, atlantoaxial subluxation is a rare condition but is severe if left untreated. Early treatment implies a non-surgical approach and a good outcome is observed in our case as well as reported by other authors.
An Experiment Of Using X-Ray Microtomography (XMT) To Study The Depth Of Bonding Agent Penetration Into Dentinal Tubules
Authors: Mohd Kenali Norzaiti
Published: January 2021

Introduction: This is a novel study of the depth of penetration of bonding agents (BA) by using a miniaturised CT-scan, XMT.The Linear Attenuation Coefficient describes the fraction of a beam of x-rays or gamma rays that is absorbed or scattered per unit thickness of the absorber. The higher the LAC, the more opaque the image is. Materials and Methods: The primer and sealer of bonding agent (BA) were added with contrast, iodine and tin methacrylate respectively. Each drop of the mixture were scanned for 1 hour with Mu Cat2 XMT. Linear Attenuation co-efficient (LAC) of the BA must be optimized to appear more than the enamel & dentine. 3 extracted molar teeth were sectioned up to the dentine layer and the dentine were acid etched, dried and applied with the BA. The teeth were scanned by using the same machine for 24 hours and the penetration depth of the BA was studied by using in house (Queen Mary University of London) software. Results: The LAC of dentine was 1.6 cm-1, enamel 2.6 cm-1 and the primer was 3.2 cm-1. Penetration depth of BA was about 30-300um. However, the penetration depth of the BA were not homogenous throughout the dentine. Conclusion(s): We have demonstrated that XMT gives a clear picture of penetration depth of the contrast added primer with iodine that warrants further studies in this field.
Effects Of Impacted Lower Third Molar Removal On Alveolar Bone Height And Periodontal Parameters Of Adjacent Second Molar
Authors: Wan Abdul Aziz Wan Nur Alwani bt , Jaafar Azlan b , Samsudin Ahmad Dzulfikar b
Published: January 2021

Introduction: The effect of surgical removal of impacted third molars on the periodontal parameters of adjacent second molar revealed inconsistent results. Some authors suggested improvement of periodontal parameters distal to second molar, whilst others demonstrated loss of attachment and reduction of alveolar bone height. This study was conducted to evaluate the alveolar bone height (ABH) and periodontal status of second molar after the surgery. Materials and Methods: Out of 42 subjects selected, 33 subjects completed the study. Only subject who had mesio-angular or horizontal impaction of third molar with available previous records of digital orthopantomogram (OPG) were recruited into the study. ABH of adjacent second molar on the previous OPG were compared with the current OPG using technique described by Krausz et al., (2005). Other paramaters such as probing pocket depth (PPD), bleeding on probing (BOP), recession (REC) were also recorded. Results:  There was significant reduction (p<0.001) in mean ABH at distal of second molar between pre-surgery (4.30±1.09mm) and post-surgery (2.80±2.05mm). No significant different was found in ABH between 47 and 37 at baseline; (4.09±1.09mm vs 4.30±2.55mm) and post-surgery (3.00±2.20mm vs 2.70±2.35mm) where p<0.423. Distal sites of second molars consistently showed significantly higher mean PPD (3.76±1.32mm) when compared with mesial, mid buccal and mid lingual sites (p<0.001). Higher frequency of BOP (90.9%) were also recorded for distal sites. Conclusion(s):  Within the limitation of this study, surgical removal of impacted third molars demonstrated significant reduction in ABH of second molar post surgically. Significantly deeper PPD were also recorded at distal sites as compared to other sites.
Facial Profile Of Bataknese Based On Nose, Lips And Chin Proportions
Authors: Bahirrah Siti
Published: January 2021

Introduction: The success of orthodontic treatment is often associated with the improvement of facial appearance. Soft tissues of the nose, lips and chin are important factors in determining the beauty of the face. The aim of this study was to determine the facial profile of the Bataknese based on the proportion of soft tissue facial components such as nose, lips and chin. Materials and Methods: This research was an observational study with a cross-sectional design. The samples of this research consists of 48 Batak tribe students in FKG USU Medan. This research was carried out by using 48 lateral cephalometry obtained from Batak tribe students who fit the inclusion criteria.Determination of soft tissue facial profile was carried out with Skinazi method. Results: The mean proportion results obtained from the soft tissue facial components of the nose was 64.41%, upper lip 13.79%, lower lip 14.80% and chin 6.86%. The results showed soft tissue facial profile obtained descriptively from the Bataknese were highest in nose proportion followed by lower lip, upper lip and the smallest were chin proportion. Large proportion of the nose and small proportion of chin showed that facial profile of the Bataknese were convex. The results of t- test and Mann Whitney analysis of nose, upper lip, lower lip and chin proportion showed there were no difference between male and female (p>0.05). Conclusion(s): The findings of this research showed that the soft tissue facial profile based on nose, lips and chin propotions in male and female from Batak tribe were convex.
Prevalence Of Hypodontia In Patients Attending Orthodontic Clinic In Kuala Terengganu
Authors: Shakirah Said Salma , Abdul Rahim Farah Salwa , Jaapar Mustaffa
Published: January 2021

Introduction: The objective of this study was to determine the prevalence and the pattern of hypodontia among orthodontic patients in Klinik Pergigian Jalan Sultan Mahmud, Kuala Terengganu. Materials and Methods: A retrospective of 351 orthodontic patients record review study was conducted; comprised of 104 males and 247 females. The records were reviewed by trained dental officer between October 2016 and June 2017. The Chi-square and Fisher's Exact Tests were carried out for statistical analysis. Results: The prevalence of hypodontia was 10.8%. Thirty-eight patients were found to have at least single missing tooth. A significant difference was found between males and females of having hypodontia (p = 0.048). No significant difference was found for hypodontia patients by races (p = 0.829). The maxillary lateral incisor was the most frequently missing tooth followed by mandibular second premolars and mandibular lateral incisors. Hypodontia cases observed tended to be more likely occurred in the upper left arch compared to the lower arch. The majority of hypodontia patients had single missing tooth, but rarely more than 3 missing teeth. Hypodontia patients had mainly Class III malocclusion, however no statistically significant was found (p= 0.081). Conclusion(s): The prevalence of hypodontia of this study was within the range of what is being reported in the literature and showed gender significant. Hypodontia was mainly involved maxillary lateral incisors; more prevalent in the upper arch; and mostly observed in patients with Class III malocclusion in the study sample. Early detection and accurate diagnosis are essential. Therefore, alternative treatment modalities can be well planned under multidisciplinary team approach in restoring the aesthetic and function.
Relationship Between Sociodemographic Backgrounds And Mothers' Oral Health Knowledge, Attitude And Practice Of Their Preschool Children
Authors: Sayed Kamar Syarifah Haizan , Jelani Noor Inani , Mohamad Nor Noraini
Published: January 2021

Introduction: Mothers play important roles in their children's oral health. The aim of this study is to determine the relationship between mothers’ sociodemographic backgrounds and their oral health knowledge, attitude and practice of their preschool children. Materials and Methods: A cross sectional study was conducted among 149 mothers of 4 to 6-year-old preschool children from selected kindergartens. Stratified cluster sampling was done to select kindergartens from urban and suburban areas in Kuantan, Pahang. Knowledge and attitude of mothers were assessed using selfadministered questionnaires and children's oral health practice was recorded using three days tooth brushing diary. Data were analyzed using SPSS version 16.0. Results: Mothers had high oral health knowledge (Mean score 73.6%, SD 1.3%) and attitude (Mean score 73.2%, SD 2.4%) scores. Significant relationships were reported between mothers' oral health knowledge and age (p=0.037), educational status (p0.05). Conclusion(s): Lack of further education, low household income and living further away from the city contributed to low oral health knowledge and poor oral health attitude among mothers, towards their preschool children. Younger mothers had lower oral health knowledge, whereas older mothers had poorer oral health attitude.
A Pilot Survey on Knowledge,Attitude and Practice Towards the Islamisation of Knowledge As Perceived by the Staff of Kulliyyah of Allied Health Sciences, International Islamic University Malaysia
Authors: Azura SHAHDAN Intan , RAHMAT Sarah , ZAHARI Ilyanoon , Syed Abdul Rahman Sharifah Nurul Natasha , Mohd. Shafri Mohd. Affendi
Published: January 2021

This preliminary study investigated the: (i) level of knowledge, attitude and practice (KAP) among members of Kulliyyah of Allied Health Sciences (KAHS), International Islamic University Malaysia (IIUM) regarding Islamisation of knowledge (IOK);  (ii) correlation of KAP and IOK with the duration of service and level of exposure to IOK-related activities; (iii) comparison of KAP between departments in KAHS towards the understanding of IOK, and (iv) level of KAP in IOK between KAHS academics and non-academic staff.  Since studies on the integration of religious worldview in health sciences faculties are scarce, this study will be investigating the effectiveness of IOK programmes at the faculty level. A total of 74 staff participated in the study. The response rate was 65.5% out of 113 distributed questionnaires. All respondents have average knowledge (50±28%) in IOK and showed positive attitude (78±32.5%) towards IOK.  The knowledge of Islamisation in KAHS correlates positively with the duration of service (p<0.05) and the level of exposure to IOK-related activities (p<0.05). However, answers given to some questions indicated that the staff perceptions and knowledge of IOK are ambiguous and may suggest a misunderstanding of the Islamisation term. Furthermore, an average score was found among the academic respondents with regards to their integration of IOK into practice.  These shortcomings may affect the integration and implementation of IOK either in classrooms, clinics or offices and lead to a poor integration of the Islamisation agenda to the students as well as the patients. Hence, there is a need to design workshops and programmes more towards practical approaches of IOK into health-based sciences as well as the implementation of IOK agenda at the workplace, rather than the theoretical aspects per se. In conclusion, most of the respondents have positive attitude towards the IOK movement in KAHS despite the high level of knowledge among some members, in particular the academic staff, is not yet translated into practice.
Anatomy of Musculoskeletal System in the Light of the Qur’an and Hadith
Authors: Yusof Nurul Asyiqin , Che Mohamad Che Anuar , Hassan Ahmad Nizam
Published: January 2021

The integration of human knowledge between the medical and health care sciences with revealed knowledge was established since the era of Al-Razi (Rhazes), Ibn Sina (Avicenna), Ibn Rushd (Averroes), AlZahrawi (Albucasis) and others. However, the glorious period of Islamic medicine gradually declined after the period of 'Abbasiyyah and 'Uthmaniyyah. At present, many scholars tend to separate the modern medicine and the revealed knowledge, resulting in the disconnection between these two fields. There is little to suggest the presence of reference collections that integrate the Qur’an and Hadith with medicine. This review aimed to fill that gap. Relevant Qur’anic verses and authentic Hadith of the Prophet Muhammad (peace be upon him; henceforth PBUH) in relation to a specific field in medicine i.e. the anatomy of human musculoskeletal system was extracted. The musculoskeletal system is unique in which it forms the ‘backbone’ of normal human posture. The system plays a vital role in maintaining human daily activities. From this review, it is noted that many Qur’anic verses and Hadith relate to the musculoskeletal system. A few examples include the number human joints and its relationship with the daily prayers (Salah), the daily charitable act recommended to all Muslim, the coccyx bone that is indestructible and shall be the source for human resurrection during the hereafter, and others. These examples necessitate for a more in-depth analysis to enlighten the revealed knowledge from the medical perspective.
Machine Learning Cases in Clinical and Biomedical Domains
Authors: Che Azemin Mohd Zulfaezal , Ashimi Tijani Ahmed , Syah Md Muziman
Published: January 2021

The aim of this paper is twofold: Firstly, to provide introductory knowledge to the reader who has little or no knowledge of machine learning with examples of applications in clinical and biomedical domains, and secondly, to compare and contrast the concept of Artificial Neural Network (ANN) and the Qur’anic concept of intellect (aql) in the Qur’an. Learning algorithm can generally be categorised into supervised and unsupervised learning. To better understand the machine learning concept, hypothetical data of glaucoma cases are presented. ANN is then selected as an example of supervised learning and the underlying principles in ANN are presented with general audience in mind with an attempt to relate the mechanism employed in the algorithm with Qur’anic verses containing the verbs derived from aql. The applications of machine learning in clinical and biomedical domains are briefly demonstrated based on the author’s own research and most recent examples available from University of California, Irvine Machine Learning Repository. Selected verses which indicate motivation to use the intellect in positive manners and rebuke to those who do not activate the intellect are presented. The evidence found from the verses suggests that ANN shares similar learning process to achieve belief (iman) by analysing the similitudes (amsal) introduced to the algorithm.
Stem Cells Research: Therapeutic Potentials and Ethical Issues from Islamic Perspective
Authors: Che Mohamad Che Anuar , Hashi Abdurezak Abdullahi
Published: January 2021

The advancement in human stem cell research has promised a viable alternative treatment for a range of ‘incurable diseases’ such as neurological diseases. To date, several studies have documented substantial evidences on the therapeutic properties of stem cells in promoting repair in different diseases including common neurological disorders i.e. ischaemic stroke and spinal cord injury. However, the progress of stem cell research has been surrounded by ethical issues which largely due to the usage of human embryos as one of the sources. These embryonic stem cells which originally derived from human embryo of aborted foetus or already existing human embryonic stem cells (hESCs) lines, has sparked an intense moral and religious argument among people of various faith, including Muslim community. From the therapeutic point of view, amongst the currently available stem cells, hESCs show the greatest potential for the broadest range of cell replacement therapies and are regarded as the most commercially viable. This review focuses on the major ethical issues, particularly to Muslim community, related to human embryonic stem cells research with special emphasis on the moral status of the embryo and the beginning of life according to the Islamic ethics and rulings. In this paper, we also discuss some ethical positions towards embryonic stem cell research in the Islamic world, including official regulations existing in some Muslim countries. We examine the justification and the necessity on the usage of hESCs following the newly discovered Induced Pluripotent Stem Cells (IPSCs) in the laboratory. In addition, we supplement the discussions with the general views and positions from the other two Abrahamic religions i.e. Christianity and Judaism.
The Role of Psychiatrists and Muslim Faith Healers in Mental Health Issues
Authors: Razali Zul Azlin , Tahir M. Faiz
Published: January 2021

Following the announcement of Traditional and Complementary Medicine Act 2013, Muslim faith healers are slowly gaining grounds to make their practice mainstream. One of the major characteristics of Muslim faith healers is the strong inclination to attribute mental illnesses to Jinn possession (demonic possession). Unlike other traditional healers, Muslim faith healers’ primary mode of treatment is Ruqyah, an incantation or generally considered as ‘Du’a or prayers. This article is a sharing by a psychiatrist who has been actively engaging with faith healers in order to understand the world of faith healing including the attitude and knowledge of both the healers and clients while attempting to educate them on modern psychiatry based on bio-psycho-socio-spiritual paradigm. The methodology: 1) Involvement in symposium, seminar and focused group discussion, either as participant or as speaker. 2) Collaborating with local spiritual leader to conduct workshop on mental illness in mosques. 3) Writing articles in scientific and popular publications with and without faith healers as the collaborators. 4) Appearing in radio advocating and discussing about the dilemma of mental illness issue from the religious perspectives, and 5) Participate in workshop conducted by Muslim faith healers. As a result, several issues come to the author’s attention. The divisions of Muslim faith healers are rather complicated, for example Malay traditional healers or bomoh should not be categorized in the same group as Muslim faith healers. The oft-quoted ‘Islamic Medicine’ is problematic in view that it is laced with elements of local cultural value and practice which are not necessarily authentically Islamic. Since Malays make up the biggest community in Malaysia, one has to differentiate between Islam and Muslim. Majority of Muslims misunderstood the term Ruqyah as a form of healing exclusively done by the Muslim faith healers. In conclusion, psychiatrists should engage more proactively with faith and spiritual healers in order to curb stigmatization and delay in seeking psychiatric care and treatment.
A Study of Fasting Type 2 Diabetes Mellitus Patients With Acute Complications During Ramadan in Hospital Tengku Ampuan Afzan, Kuantan, Pahang
Authors: Mansor Nur Diyana Asyiqin , Jaafar Nur Faqihah , Mohamed Ruslan Abdullah Ammar , Zakaria Miza Hiryanti , Shahar Mohammad Arif
Published: January 2021

Introduction: A large number of Muslims fast during the holy month of Ramadan worldwide. A specific approach is needed to manage diabetic patients who intend to fast during Ramadan because of potential harm. Thus, the study aimed to describe the sociodemography and the characteristic of fasting diabetic patients admitted due to acute diabetic complications during Ramadan. Materials and Methods: A cross-sectional study was conducted among fasting diabetic patients in Hospital Tengku Ampuan Afzan (HTAA) who were admitted due to severe hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome and uncontrolled diabetes mellitus during the month of Ramadan 2017/1438H. Subjects were interviewed and blood investigation results were obtained from medical records and recorded in patients' case report. Results: Thirteen patients who were admitted due to acute complications of diabetics during Ramadan were included in this study. Of these, 38.5% had severe hypoglycemia, 23.1% diabetic ketoacidosis, 15.4% hyperglycemia hyperosmolar syndrome and 23.1% uncontrolled diabetes mellitus. All of the patients had a long standing diabetes mellitus (median duration of 10 years). HbA1C was high (11.5%) among hyperglycemic subjects. Types of treatment and previous history of severe hypoglycemia prior to Ramadan were the only independent factors identified to be related with acute complications of diabetes during fasting month (p=0.030 and p=0.032 respectively). Insulin, either alone or in combination with oral hypoglycemic agent, was associated with higher number of hypoglycemic event. Conclusion: The significant risk factors found were consistent with other studies. A thorough, individualized and holistic approach is needed in managing patients with diabetes who intend to fast.
Biomechanical Analysis of Crossed Pinning Construct on Supracondylar Fracture of Humerus in Children: Does Point of Crossing Matters?
Authors: Soldin Mohd Aizat Azfar Bin , Awang Mohd Shukrimi bin , Razak Ardilla Hanim Binti
Published: January 2021

Introduction: Percutaneous pin fixation either by crossed pinning construct (CPC) or lateral divergent pinning construct (LDPC) are the recommended treatment for displaced supracondylar humerus fractures (SCHF) in children. Several studies had compared the biomechanical stability between these two, however, a biomechanical analysis of varying crossing point location in CPC has not been performed previously. The aim of this study was to compare the stability of various crossing point location in CPC and LDPC. Materials and Methods: Thirty synthetic humeri were osteotomized at mid olecranon fossa, anatomically reduced and pinned using two 1.6 mm Kirschner wiresin five different constructs namely centre point, medial point, lateral point, superior point and LDPC. Six samples were prepared for each construct and were tested for extension, flexion, valgus, varus, internal rotation and external rotation forces by using Universal Tensile Machine and the data were analysed with R Statistic. Results: The centre point CPC was the stiffest while the LDPC and medial point CPC were the least stiff construct for linear and rotational force respectively. Lateral point CPC, and superior point CPC showed no statistically significant difference when compared to centre point CPC. Conclusion: The centre point CPC was the most stable construct while the LDPC and medial point CPC were the least stable. The stability of lateral point CPC and superior point CPC were statistically comparable to centre point CPC. Clinically, this will help the treating surgeon to reduce the numbers of attempt during K-wire insertion in order to get perfect centre point CPC.
Body Weight Perception Versus Body Weight Status: How Good is The Agreement?
Authors: Jamani Nurjasmine Aida binti , Said Abdul Hadi bin , Abd.Aziz Karimah Hanim binti , Abd Rahman Mohd Aizuddin bin
Published: January 2021

Introduction: Body weight perception is an important underlying psychological factor associated with body weight. Overemphasis on thinness among adolescents can lead to unhealthy dieting practices and eating disorders, whereas underestimation of body weight may increase risk of the development of overweight and obesity. This study measured the agreement between body weight perception and body weight status (BMI) among late adolescents in Kuantan. Materials and Methods: A cross-sectional study was conducted from April to August 2018 among 418 adolescents of six higher learning institutions in Kuantan; aged 17-19 years old. Weight and height were measured and BMI was calculated. Self-administered, validated questionnaires; Figure Rating Scale (FRS) and International Physical Activity Questionnaire (IPAQ) were used. The strength of agreement between BMI and body weight perception was examined using Kappa statistics. Results: Overall, 37.6% of total participants misjudged their own body weight. Of particular note, 51.9% of real underweight participants misperceived body weight as normal weight and overweight while 47.2% of obese participants incorrectly perceived their body weight as overweight. The agreement between body weight perception and body mass index was poor (k=-0.09, p< 0.01). The discrepancy more marked in male (k = -0.11, p<0.01). Conclusions: Body weight perception was not in agreement with actual weight in late adolescents. Accurate body weight perception is an important factor in late adolescent’s weight management behaviour. More effort should be done in order to correct misperception among this age group for their health benefits.
Bone and Joint Reconstruction Using Ilizarov Circular External Fixation Device
Authors: Yusof Nazri Bin Mohd , Sulong Ahmad Fadzly
Published: January 2021

Introduction: Ilizarov circular external fixation device is a versatile external fixation device which can be used for bone and joint reconstruction such as fracture fixation, bone transport, lengthening, shortening, and correction of deformity and contracture. It is a complex procedure and requires patients understanding, motivation, pin site care and rehabilitation to ensure successful treatment and avoiding complication. The aim of this study was to review cases of bone and joint reconstruction using Ilizarov external fixation device. Materials and Methods: From 2006 till 2018, 59 patients with the mean age of 34.8 (10-69) years old underwent these procedures. There were 49 tibias, three femurs, one humerus, three elbows, two knees and one ankle reconstruction. 18 open fractures, 16 non- union, seven tibial plateau fractures, 10 implant related infections, one valgus mal-union and one shortening. There were also 4 dislocations and two flexion contracture. The procedure that were done include 31 bone transport, 18 fracture fixation, three joint reduction, two correction of flexion contracture, two shortening of tibia and one each for lengthening, deformity correction and arthrodesis. Results: Forty seven (80%) patients achieved the objective of operation: 41 fractures united, three joints were reduced, two achieved knee extension and one deformity corrected. Five developed non-union, of which two not compliant to treatment, two had failed bone transport and one died during the treatment due to medical problem not related to the Ilizarov fixation. Conclusion: Ilizarov circular external fixation is an effective device for joint and bone reconstruction in majority of patients.
Comparison between High Frequency and Low Frequency Portable Transcutaneous Electrical Nerve Stimulation in Patients with Knee Osteoarthritis: A prospective Randomized Study
Authors: Poh Thean Charles Ang , Awang Mohd Shukrimi , Athar Satriya Sabir Husin
Published: January 2021

Introduction: Knee osteoarthritis has been an increasing problem in the society causing significant morbidity. The current trend of medical treatment is moving from pharmacological to non pharmacological methods of treatment thereby reducing the side effect and the cost burden of the pharmacological means. TENS therapy has been studied in the past to treat pain knee osteoarthritis related pain, however that is a mix report on its success. After careful understanding and various literature review on the mechanism of TENS therapy, the author narrowed down the success of the therapy may be frequency related (inappropriate frequency used). Materials and Methods: The first 100 patient who attended the outpatient department diagnosed with knee osteoarthritis (based on Kellgren and Lawrence grade 2-4) who willingly consented, were selected and randomly allocated to two arms (high- frequency and Low- frequency). A baseline score was taken based on the Oxford knee score, WOMAC, Lesquene index and Visual Analog Score. They were followed up on the 1 st and 3rd month for assessment. Results: There was a significant improvement in the activities of daily living in the high frequency group (p0.95). However, both groups showed significant improvement in the Visual Analog score with no statistical difference. Conclusion: TENS therapy is a good non-pharmacological alternative to treat knee osteoarthritis, provided the right method and frequency is used.
Derivation of a New Bioscore for Predicting Mortality in Sepsis
Authors: Wan Muhd Shukeri Wan Fadzlina , Md. Ralib Azrina , Mat-Nor Mohd Basri
Published: January 2021

Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating outcome in sepsis. We aimed to derive a new bioscore for predicting 30-day mortality in sepsis using a combination of biomarkers and clinical indexes. Materials and Methods: This secondary analysis of a prospectively collected data included 159 septic patients admitted to an intensive care unit (ICU). We collected data for key variables considered for inclusion in the score which included: age, sex, source of admission, comorbidities, microorganism, bacteraemia, site of infection, septic shock status, baseline Simplified Acute Physiological Score II, Sequential Organ Failure Assessment (SOFA) score (total and organ sub-scores), C-reactive protein, procalcitonin and interleukin-6 (IL-6). Approximate quintiles of each variable were assigned points based on the strength of their association with 30-day mortality. Results: Based on the statistical significance in the logistic regression model, the final score used candidate variables of age, central nervous system and liver SOFA sub-scores and IL-6. The bioscore predicted 30-day mortality with a very good performance [area under the receiver operating characteristic curve 0.814 (95% CI 0.745-0.871, p <0.0001)] in our sepsis cohort. A bioscore greater than 4 predicted 30-day mortality with 80.4% sensitivity, 69.9% specificity, 2.67 positive likelihood ratio and 0.28 negative likelihood ratio. As the score increased, so did mortality rate. Conclusion: A new bioscore combining age, central nervous system and liver SOFA sub-scores and IL-6 measured on ICU admission improves prediction of mortality in sepsis.