The growth of Developmental Pediatrics as a formal entity is somewhat slower than any other subsp... more The growth of Developmental Pediatrics as a formal entity is somewhat slower than any other subspecialties in Malaysia. Medical students in the country spend 5 years in medical school, of which 10 weeks are allocated to pediatrics, during which 2-3 weeks are spent in community clinics. Here, they are exposed to aspects of developmental and community pediatrics. The rest of their pediatric exposure usually consists of intensive disease-based approaches interspersed with some developmental issues depending on the interests of the attending clinicians.
This paper reviews the subject of tuberous sclerosis complex and presents data in eight cases of ... more This paper reviews the subject of tuberous sclerosis complex and presents data in eight cases of this condition, admitted to Hospital Universiti Sains Malaysia over a period of 8.5 years. The average age at presentation was 53 months. Seizures were the most common presenting feature. Male to female ratio was 3:1. Family history was present in four patients. All of the patients had one or more skin lesions. Six of them had retinal in six patients. Two patients had renal angiomyolipomas. A high index of hamartomas. Cardiac tumours were found in two patients. Multiple subependymal hamartomas were detected in six patients. Two patients had renal angiomyolipomas. A high index of suspicion and a detailed physical examination is required to diagnose this rare disorder.
In Malaysia, medical students graduate from university at the age of 24 after going through 5 yea... more In Malaysia, medical students graduate from university at the age of 24 after going through 5 years of medical training. Given the most rapid career pathway, the first opportunity to enter the Pediatric Residency Program is at the age of 27, as graduates are required to do three years of compulsory training in the Ministry of Health (MoH).
Perforated appendix is a serious .surgical condition that carries a high morbidity. Antibiotic tr... more Perforated appendix is a serious .surgical condition that carries a high morbidity. Antibiotic treatment is often started before the availability of bacteriological reports. The choice of antibiotics would depend on the bacteriology associated with perforated appendix. In a retrospective survey of the bacteriology of peritoneal pus obtained from cases of perforated appendix at the General Hospital, Kuala Lumpur, E. coli was found to be the most commonly encountered organism. This was followed in order of decreasing frequency by streptococci, Bacteroides species, Klebsiella-Enterobacter group and Pseudomonas aeruginosa. From the results of the antibiotic sensitivities an antibiotic regimen comprising of a combination of gentamicin, metronidazole and penicillin is recommended as appropriate chemotherapy in perforated appendix.
Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gra... more Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gram-negative infections. However, gentamicin like other aminoglycosides, has a narrow therapeutic index and is potentially ototoxic and nephrotoxic. Blood levels following administration of gentamicin has been shown to be highly unpredictable and monitoring of gentamicin levels is necessary to ensure effective therapeutic levels as well as to avoid toxicity. The Department of Microbiology, Universiti Kebangsaan Malaysia offers such a monitoring service. This paper analyses the results of 135 such estimations performed between August 1979 and May 1981. It is shown that a significant proportion of patients were receiving either too much or too little gentamicin. Empirical determinations of dosages is unsatisfactory and as the microbiological assay method of determining gentamicin levels is both easy to perform and inexpensive, such a service should be offered by all general hospitals in Malaysia. MATERIALS AND METHODS Serum samples were obtained from a total of 135 patients in the General Hospital, Kuala Lumpur. Hussin, Z BSc (Hons) (Otago)
In this issue of The Malaysian Journal of Medical Sciences, pertinent points are raised by A. Fua... more In this issue of The Malaysian Journal of Medical Sciences, pertinent points are raised by A. Fuad et. al. In his article entitled "Anticipated difficulties in House-Officership for graduating medical students of the School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan". This article deals with the difficulties anticipated by graduating medical students upon entering the period of housemanship. The findings of their study provide no real suprises. Medical graduates rated "communications skills" as the competency they feel that they are least prepared for, Such a bold study has never bean undertaken in Malaysia, although serious concerns have been voiced elsewhere in the world (1,2). The history of medical education in Malaysia is relatively short. However within a short period of time medical schools have multiplied, both in the public as well as the private sectors. To date there are 6 public medical schools with a total enrolment of almost 4000 students. In addition, 4 private medical schools are also in place with a total enrolment of 2000 students. With the well known problems of shortage of teaching staff in medical schools it is not suprising that many house officers feel inadequate about their in ability to communicate effectively with patients. Existing medical schools, boast of their abilities to deliver this important aspect of medical education in the most comprehensive manner. A closer look at each of their curricular however reveals that the real proportion of time devoted to communicating effectively with patients is far from satisfactory. Medical schools tend to push this agenda to the realms of the Department of Family Medicine. More innovative schools would attempt to have a specific course on communication.
Forty-two previously untreated male patients with uncomplicated gonococcal urethritis were treate... more Forty-two previously untreated male patients with uncomplicated gonococcal urethritis were treated with a single dose oral regimen comprising 3 gm ofamoxycillin and 125 mg of clavulanic acid. Thirty-five patients returned for follow-up and the cure rate among them was 89 percent. The cure rate for patients infected with penicillinase producing Neisseria gonorrhoeae (PPNG) was 73 percent. Further work is required to establish the optimum dosage for this particular regimen.
planned to continue using it for teaching (mean 4.0, SD 0.5). They reported inadequate time to ha... more planned to continue using it for teaching (mean 4.0, SD 0.5). They reported inadequate time to have learners perform EPs, however (mean 2.1, SD 1.3). Inter-rater reliability on the 20 EPs showed substantial agreement for Searching (j = 0.70) and Application of Evidence (j = 0.72); moderate agreement for Overall Competence (j = 0.57) and Evaluation of Evidence (j = 0.44); and fair agreement for Question Formation (j = 0.22). Residents reported that using the EP improved their EBM skills and allowed them to apply previous EBM teaching. Both teaching staff and residents reported lack of time as a barrier to performing EPs in the inpatient setting and recommended online versions of the forms. The EP is feasible to use during inpatient rotations with modest faculty training. Inter-rater reliability was generally good, but requires further assessment. The EP can be a useful method for determining residents' EBM competence.
Duchenne Muscular Dystrophy (DMD) adalah satu istilah yang digunakan untuk sejenis penyakit yang ... more Duchenne Muscular Dystrophy (DMD) adalah satu istilah yang digunakan untuk sejenis penyakit yang menjejaskan otot kanak-kanak.
Abortion has been largely avoided in Muslim communities. However, Islamic jurists have establishe... more Abortion has been largely avoided in Muslim communities. However, Islamic jurists have established rigorous parameters enabling abortion of fetuses with severe congenital abnormalities. This decision-making process has been hindered by an inability to predict the severity of such prenatally-diagnosed conditions, especially in genetic disorders with clinical heterogeneity, such as spinal muscular atrophy (SMA). Heterogeneous phenotypes of SMA range from extremely severe type 1 to very mild type 4. Advances in molecular genetics have made it possible to perform prenatal diagnosis and to predict the types of SMA with its potential subsequent severity. Such techniques will make it possible for clinicians working in predominantly Muslim countries to counsel their patients accurately and in harmony with their religious beliefs. In this paper, we discuss and postulate that with our current knowledge of determining SMA types and severity with great accuracy, abortion is legally applicable for type 1 SMA.
Cochrane Database of Systematic Reviews, Sep 3, 2014
Background: Rapamycin has gained significant attention for its potential activity in reducing the... more Background: Rapamycin has gained significant attention for its potential activity in reducing the size of TSC-associated tumors, thus providing alternative to surgery. This study aimed at determining the efficacy of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with Tuberous Sclerosis Complex (TSC). Methods: Our data sources included electronic searches of the PubMed. We included into our meta-analysis any type of non-randomized study that reported the use of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with TSC. Data was entered into Cochrane Review Manager Version 5.3 and analyzed. Results: Four case reports and 4 clinical trials were included. Five patients from the case reports (all with SEGA) and 91 patients from the clinical trials (41 with SEGA, 63 with kidney angiomyolipoma and 5 with liver angiomyolipoma) were included into the analysis. Volume and diameter of SEGAs were significantly reduced by mean difference of 1.23 cc (95 % CI −2.32 to −0.13; p = 0.03) and 7.91 mm (95 % CI −11.82 to −4.01; p < 0.0001), respectively. Volume and mean of sum of longest diameter of kidney angiomyolipomas were significantly reduced by mean difference of 39.5 cc (95 % CI −48.85 to −30.15; p <0.00001) and 69.03 mm (95 % CI −158.05 to 12.65; p = 0.008), respectively. In liver angiomyolipomas, however, reduction in tumor size was not evident. Sum of longest diameter of liver angiomyolipomas in 4 patients were enlarged by 2.7 mm (95 % CI 28.42 to −23.02) by the end of treatment, though not significant (p = 0.84). Conclusions: Rapamycin and rapalogs showed efficacy towards reducing the size of SEGA and kidney angiomyolipoma but not liver angiomyolipomas. This finding is strengthening the conclusion of our Cochrane systematic review on the randomized trials.
Southeast Asian Journal of Tropical Medicine and Public Health, Jul 1, 2006
The number of cases of neurological disease is expected to rise in the next 10 years, making this... more The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.
International journal of social science and humanity, 2011
Introduction: Diagnosis of cancer in children poses a challenging situation for parents to cope w... more Introduction: Diagnosis of cancer in children poses a challenging situation for parents to cope with. Method: Seventy-nine (N = 79) parents whose children are receiving treatment for cancer in Hospital Universiti Sains Malaysia participated in this cross-sectional descriptive study. They completed a set questionnaire measuring their level of anxiety and stress, knowledge about cancer, and amount of activities they perform with or for the child to enhance the child's coping abilities, in addition to children's psychological problems. Socio-demographic information was obtained. Results: Parents with higher cancer knowledge reported reduced stress (p<0.01) and anxiety (p<0.05). The higher the income (p<0.05) and education (p<0.01), the higher cancer knowledge. Parental stress was negatively correlated with income (p<0.05) and education (p<0.01), indicating that the better educated and higher the salary, less stress symptoms. Highly educated parents engaged in more activities with their children (p<0.05). Parental anxiety was correlated significantly with children's current treatment including chemotherapy procedure (p<0.01), 'In-patient' Vs 'Outpatient' (p<0.01), and children's condition (p<0.01). Parents of hospitalized children who underwent chemotherapy were significantly more anxious than their counterparts. Parents who perceived their children's current condition as 'very good', reported reduced anxiety, compared to those who reported their child's condition as 'ok'. The more psychological problems the children had, the higher parental anxiety (p<0.05) and stress symptoms (p<0.01). Discussion: Some groups of parents reported more psychological difficulties compared to others. Ongoing psychological assessment and intervention may reduce parental stress by increasing coping and reducing children psychological problems.
The survival motor neuron 1 (SMN1) gene has been recognized to be responsible for spinal muscular... more The survival motor neuron 1 (SMN1) gene has been recognized to be responsible for spinal muscular atrophy (SMA) because it is homozygously deleted in more than 90% of SMA patients, irrespective of their clinical severity, whereas the neuronal apoptosis inhibitory protein (NAIP) gene is now considered to be a modifying factor of the severity of SMA. In Malaysia, it remains to be elucidated whether deletion of the SMN1 gene is also a main cause of SMA or whether deletion of the NAIP gene is found in the SMA patients. To clarify the pathogenesis of SMA in Malaysia, a deletion analysis of the SMN1 and NAIP genes was performed in 24 Malaysian SMA patients. Deletion analysis of exons 7 and 8 of the SMN1 gene was performed according to the method described by van der Steege et al., while deletion analysis of exon 5 of the NAIP gene was performed according to a method described by Roy et al. Homozygous deletion of SMN1 exon 7 and exon 8 were identified in 19 out of 24 patients (79%). As to the NAIP gene, deletion of exon 5 was detected in six out of 24 patients (25%). NAIP gene deletion was correlated with severity of the disease. Deletion of the SMN1 exon 7 is a major cause of SMA in Malaysia, and NAIP gene deletions are not rare in type I SMA in Malaysia. The lower percentage of the SMN1 gene deletion may be due to the possibility that the present study included some patients without SMN1 gene abnormality and/or some patients with non-deletion type mutations in the SMN1 gene.
International journal of human and health sciences, Mar 5, 2021
The lockdown from March to November 2020 in its various forms have seriously impacted education o... more The lockdown from March to November 2020 in its various forms have seriously impacted education of children, both nationally and internationally. In Malaysia; more than 1 million students were affected and 100,000 teachers and 20,438 members of school support staff were forced to stay at home. UNICEF noted that 24 million children around the world will drop out and students from vulnerable communities will be particularly and failed to return to class. This has forced almost all education providers to switch the education deliveries online. While some of the more established educational institutions which are more prepared than others, sailed plainly through this switch, a sizable majority found this switch a devastating blow to the delivery of education especially to children. The Parent Group for Education, Malaysia reported that 66% Malaysian children do not have good internet connectivity at home and the Ministry of Education also reported that 37% do not own devices for online learning. The outcome of these is almost predictable. 20% children were discovered to have lost interest in schoolwork and become demotivated while 7% have indeed dropped out from school. Although most children are no stranger to handphones and other devices, the use of these for education is daunting. For the first 10 weeks of the MCO, online teaching is noted to be adhoc , random, unstructured and even non-existent. Timetable was created in May but not strictly adhered to by teachers who are not familiar with technology. The Ministry of Education set up a free portal such as www.eduwebtv.moe.edu.my and the Digital Educational Learning Initiative Malaysia (DELIMA) as immediate mitigation. The future and the new norm for education is predictable and we have no choice. Online education delivery has to be strengthened by firm efforts to boost connectivity. School digital packages should consist of laptops or tablets, with video cams, telecommunication towers, especially in the rural areas must be built urgently. Mini and micro credentialing of children and teachers must be held to train them on the basics of online teaching, while more immersive applications are being prepared. We have little choice. International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S4
The growth of Developmental Pediatrics as a formal entity is somewhat slower than any other subsp... more The growth of Developmental Pediatrics as a formal entity is somewhat slower than any other subspecialties in Malaysia. Medical students in the country spend 5 years in medical school, of which 10 weeks are allocated to pediatrics, during which 2-3 weeks are spent in community clinics. Here, they are exposed to aspects of developmental and community pediatrics. The rest of their pediatric exposure usually consists of intensive disease-based approaches interspersed with some developmental issues depending on the interests of the attending clinicians.
This paper reviews the subject of tuberous sclerosis complex and presents data in eight cases of ... more This paper reviews the subject of tuberous sclerosis complex and presents data in eight cases of this condition, admitted to Hospital Universiti Sains Malaysia over a period of 8.5 years. The average age at presentation was 53 months. Seizures were the most common presenting feature. Male to female ratio was 3:1. Family history was present in four patients. All of the patients had one or more skin lesions. Six of them had retinal in six patients. Two patients had renal angiomyolipomas. A high index of hamartomas. Cardiac tumours were found in two patients. Multiple subependymal hamartomas were detected in six patients. Two patients had renal angiomyolipomas. A high index of suspicion and a detailed physical examination is required to diagnose this rare disorder.
In Malaysia, medical students graduate from university at the age of 24 after going through 5 yea... more In Malaysia, medical students graduate from university at the age of 24 after going through 5 years of medical training. Given the most rapid career pathway, the first opportunity to enter the Pediatric Residency Program is at the age of 27, as graduates are required to do three years of compulsory training in the Ministry of Health (MoH).
Perforated appendix is a serious .surgical condition that carries a high morbidity. Antibiotic tr... more Perforated appendix is a serious .surgical condition that carries a high morbidity. Antibiotic treatment is often started before the availability of bacteriological reports. The choice of antibiotics would depend on the bacteriology associated with perforated appendix. In a retrospective survey of the bacteriology of peritoneal pus obtained from cases of perforated appendix at the General Hospital, Kuala Lumpur, E. coli was found to be the most commonly encountered organism. This was followed in order of decreasing frequency by streptococci, Bacteroides species, Klebsiella-Enterobacter group and Pseudomonas aeruginosa. From the results of the antibiotic sensitivities an antibiotic regimen comprising of a combination of gentamicin, metronidazole and penicillin is recommended as appropriate chemotherapy in perforated appendix.
Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gra... more Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gram-negative infections. However, gentamicin like other aminoglycosides, has a narrow therapeutic index and is potentially ototoxic and nephrotoxic. Blood levels following administration of gentamicin has been shown to be highly unpredictable and monitoring of gentamicin levels is necessary to ensure effective therapeutic levels as well as to avoid toxicity. The Department of Microbiology, Universiti Kebangsaan Malaysia offers such a monitoring service. This paper analyses the results of 135 such estimations performed between August 1979 and May 1981. It is shown that a significant proportion of patients were receiving either too much or too little gentamicin. Empirical determinations of dosages is unsatisfactory and as the microbiological assay method of determining gentamicin levels is both easy to perform and inexpensive, such a service should be offered by all general hospitals in Malaysia. MATERIALS AND METHODS Serum samples were obtained from a total of 135 patients in the General Hospital, Kuala Lumpur. Hussin, Z BSc (Hons) (Otago)
In this issue of The Malaysian Journal of Medical Sciences, pertinent points are raised by A. Fua... more In this issue of The Malaysian Journal of Medical Sciences, pertinent points are raised by A. Fuad et. al. In his article entitled "Anticipated difficulties in House-Officership for graduating medical students of the School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan". This article deals with the difficulties anticipated by graduating medical students upon entering the period of housemanship. The findings of their study provide no real suprises. Medical graduates rated "communications skills" as the competency they feel that they are least prepared for, Such a bold study has never bean undertaken in Malaysia, although serious concerns have been voiced elsewhere in the world (1,2). The history of medical education in Malaysia is relatively short. However within a short period of time medical schools have multiplied, both in the public as well as the private sectors. To date there are 6 public medical schools with a total enrolment of almost 4000 students. In addition, 4 private medical schools are also in place with a total enrolment of 2000 students. With the well known problems of shortage of teaching staff in medical schools it is not suprising that many house officers feel inadequate about their in ability to communicate effectively with patients. Existing medical schools, boast of their abilities to deliver this important aspect of medical education in the most comprehensive manner. A closer look at each of their curricular however reveals that the real proportion of time devoted to communicating effectively with patients is far from satisfactory. Medical schools tend to push this agenda to the realms of the Department of Family Medicine. More innovative schools would attempt to have a specific course on communication.
Forty-two previously untreated male patients with uncomplicated gonococcal urethritis were treate... more Forty-two previously untreated male patients with uncomplicated gonococcal urethritis were treated with a single dose oral regimen comprising 3 gm ofamoxycillin and 125 mg of clavulanic acid. Thirty-five patients returned for follow-up and the cure rate among them was 89 percent. The cure rate for patients infected with penicillinase producing Neisseria gonorrhoeae (PPNG) was 73 percent. Further work is required to establish the optimum dosage for this particular regimen.
planned to continue using it for teaching (mean 4.0, SD 0.5). They reported inadequate time to ha... more planned to continue using it for teaching (mean 4.0, SD 0.5). They reported inadequate time to have learners perform EPs, however (mean 2.1, SD 1.3). Inter-rater reliability on the 20 EPs showed substantial agreement for Searching (j = 0.70) and Application of Evidence (j = 0.72); moderate agreement for Overall Competence (j = 0.57) and Evaluation of Evidence (j = 0.44); and fair agreement for Question Formation (j = 0.22). Residents reported that using the EP improved their EBM skills and allowed them to apply previous EBM teaching. Both teaching staff and residents reported lack of time as a barrier to performing EPs in the inpatient setting and recommended online versions of the forms. The EP is feasible to use during inpatient rotations with modest faculty training. Inter-rater reliability was generally good, but requires further assessment. The EP can be a useful method for determining residents' EBM competence.
Duchenne Muscular Dystrophy (DMD) adalah satu istilah yang digunakan untuk sejenis penyakit yang ... more Duchenne Muscular Dystrophy (DMD) adalah satu istilah yang digunakan untuk sejenis penyakit yang menjejaskan otot kanak-kanak.
Abortion has been largely avoided in Muslim communities. However, Islamic jurists have establishe... more Abortion has been largely avoided in Muslim communities. However, Islamic jurists have established rigorous parameters enabling abortion of fetuses with severe congenital abnormalities. This decision-making process has been hindered by an inability to predict the severity of such prenatally-diagnosed conditions, especially in genetic disorders with clinical heterogeneity, such as spinal muscular atrophy (SMA). Heterogeneous phenotypes of SMA range from extremely severe type 1 to very mild type 4. Advances in molecular genetics have made it possible to perform prenatal diagnosis and to predict the types of SMA with its potential subsequent severity. Such techniques will make it possible for clinicians working in predominantly Muslim countries to counsel their patients accurately and in harmony with their religious beliefs. In this paper, we discuss and postulate that with our current knowledge of determining SMA types and severity with great accuracy, abortion is legally applicable for type 1 SMA.
Cochrane Database of Systematic Reviews, Sep 3, 2014
Background: Rapamycin has gained significant attention for its potential activity in reducing the... more Background: Rapamycin has gained significant attention for its potential activity in reducing the size of TSC-associated tumors, thus providing alternative to surgery. This study aimed at determining the efficacy of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with Tuberous Sclerosis Complex (TSC). Methods: Our data sources included electronic searches of the PubMed. We included into our meta-analysis any type of non-randomized study that reported the use of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with TSC. Data was entered into Cochrane Review Manager Version 5.3 and analyzed. Results: Four case reports and 4 clinical trials were included. Five patients from the case reports (all with SEGA) and 91 patients from the clinical trials (41 with SEGA, 63 with kidney angiomyolipoma and 5 with liver angiomyolipoma) were included into the analysis. Volume and diameter of SEGAs were significantly reduced by mean difference of 1.23 cc (95 % CI −2.32 to −0.13; p = 0.03) and 7.91 mm (95 % CI −11.82 to −4.01; p < 0.0001), respectively. Volume and mean of sum of longest diameter of kidney angiomyolipomas were significantly reduced by mean difference of 39.5 cc (95 % CI −48.85 to −30.15; p <0.00001) and 69.03 mm (95 % CI −158.05 to 12.65; p = 0.008), respectively. In liver angiomyolipomas, however, reduction in tumor size was not evident. Sum of longest diameter of liver angiomyolipomas in 4 patients were enlarged by 2.7 mm (95 % CI 28.42 to −23.02) by the end of treatment, though not significant (p = 0.84). Conclusions: Rapamycin and rapalogs showed efficacy towards reducing the size of SEGA and kidney angiomyolipoma but not liver angiomyolipomas. This finding is strengthening the conclusion of our Cochrane systematic review on the randomized trials.
Southeast Asian Journal of Tropical Medicine and Public Health, Jul 1, 2006
The number of cases of neurological disease is expected to rise in the next 10 years, making this... more The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.
International journal of social science and humanity, 2011
Introduction: Diagnosis of cancer in children poses a challenging situation for parents to cope w... more Introduction: Diagnosis of cancer in children poses a challenging situation for parents to cope with. Method: Seventy-nine (N = 79) parents whose children are receiving treatment for cancer in Hospital Universiti Sains Malaysia participated in this cross-sectional descriptive study. They completed a set questionnaire measuring their level of anxiety and stress, knowledge about cancer, and amount of activities they perform with or for the child to enhance the child's coping abilities, in addition to children's psychological problems. Socio-demographic information was obtained. Results: Parents with higher cancer knowledge reported reduced stress (p<0.01) and anxiety (p<0.05). The higher the income (p<0.05) and education (p<0.01), the higher cancer knowledge. Parental stress was negatively correlated with income (p<0.05) and education (p<0.01), indicating that the better educated and higher the salary, less stress symptoms. Highly educated parents engaged in more activities with their children (p<0.05). Parental anxiety was correlated significantly with children's current treatment including chemotherapy procedure (p<0.01), 'In-patient' Vs 'Outpatient' (p<0.01), and children's condition (p<0.01). Parents of hospitalized children who underwent chemotherapy were significantly more anxious than their counterparts. Parents who perceived their children's current condition as 'very good', reported reduced anxiety, compared to those who reported their child's condition as 'ok'. The more psychological problems the children had, the higher parental anxiety (p<0.05) and stress symptoms (p<0.01). Discussion: Some groups of parents reported more psychological difficulties compared to others. Ongoing psychological assessment and intervention may reduce parental stress by increasing coping and reducing children psychological problems.
The survival motor neuron 1 (SMN1) gene has been recognized to be responsible for spinal muscular... more The survival motor neuron 1 (SMN1) gene has been recognized to be responsible for spinal muscular atrophy (SMA) because it is homozygously deleted in more than 90% of SMA patients, irrespective of their clinical severity, whereas the neuronal apoptosis inhibitory protein (NAIP) gene is now considered to be a modifying factor of the severity of SMA. In Malaysia, it remains to be elucidated whether deletion of the SMN1 gene is also a main cause of SMA or whether deletion of the NAIP gene is found in the SMA patients. To clarify the pathogenesis of SMA in Malaysia, a deletion analysis of the SMN1 and NAIP genes was performed in 24 Malaysian SMA patients. Deletion analysis of exons 7 and 8 of the SMN1 gene was performed according to the method described by van der Steege et al., while deletion analysis of exon 5 of the NAIP gene was performed according to a method described by Roy et al. Homozygous deletion of SMN1 exon 7 and exon 8 were identified in 19 out of 24 patients (79%). As to the NAIP gene, deletion of exon 5 was detected in six out of 24 patients (25%). NAIP gene deletion was correlated with severity of the disease. Deletion of the SMN1 exon 7 is a major cause of SMA in Malaysia, and NAIP gene deletions are not rare in type I SMA in Malaysia. The lower percentage of the SMN1 gene deletion may be due to the possibility that the present study included some patients without SMN1 gene abnormality and/or some patients with non-deletion type mutations in the SMN1 gene.
International journal of human and health sciences, Mar 5, 2021
The lockdown from March to November 2020 in its various forms have seriously impacted education o... more The lockdown from March to November 2020 in its various forms have seriously impacted education of children, both nationally and internationally. In Malaysia; more than 1 million students were affected and 100,000 teachers and 20,438 members of school support staff were forced to stay at home. UNICEF noted that 24 million children around the world will drop out and students from vulnerable communities will be particularly and failed to return to class. This has forced almost all education providers to switch the education deliveries online. While some of the more established educational institutions which are more prepared than others, sailed plainly through this switch, a sizable majority found this switch a devastating blow to the delivery of education especially to children. The Parent Group for Education, Malaysia reported that 66% Malaysian children do not have good internet connectivity at home and the Ministry of Education also reported that 37% do not own devices for online learning. The outcome of these is almost predictable. 20% children were discovered to have lost interest in schoolwork and become demotivated while 7% have indeed dropped out from school. Although most children are no stranger to handphones and other devices, the use of these for education is daunting. For the first 10 weeks of the MCO, online teaching is noted to be adhoc , random, unstructured and even non-existent. Timetable was created in May but not strictly adhered to by teachers who are not familiar with technology. The Ministry of Education set up a free portal such as www.eduwebtv.moe.edu.my and the Digital Educational Learning Initiative Malaysia (DELIMA) as immediate mitigation. The future and the new norm for education is predictable and we have no choice. Online education delivery has to be strengthened by firm efforts to boost connectivity. School digital packages should consist of laptops or tablets, with video cams, telecommunication towers, especially in the rural areas must be built urgently. Mini and micro credentialing of children and teachers must be held to train them on the basics of online teaching, while more immersive applications are being prepared. We have little choice. International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S4
Uploads
Papers by Zabidi Hussin