Browse publications by year: 2011

  1. Njinaka I, Uhumwangho OM, Edema OT, Dawodu OA, Omoti AE
    Malays J Med Sci, 2011 Jul;18(3):43-8.
    PMID: 22135600
    BACKGROUND: Workers in the sawmilling industry are at risk of various ocular hazards as a direct result of the sawmilling processes. The aim of this study was to determine the pattern of conjunctival disorders between technical and administrative sawmill workers in Benin, Nigeria.

    METHODS: A cross-sectional study was performed on sawmill workers in Benin, Nigeria, between January and May 2009, with the aid of pre-tested questionnaires. Ocular examination was performed on all subjects. Data obtained were recorded and analysed using SPSS version 13.

    RESULTS: A total of 553 sawmill workers were studied, among whom 449 (81.2%) and 104 (18.8%) were technical and administrative workers, respectively. There were 496 (89.7%) males and 57 (10.3%) females. The age range was 15-80 years, with a mean of 38.9 years (SD 12.8). Pingueculum was found in 127 (23%) workers, among whom 122 (27.2%) were technical workers and 5 (4.8%) were administrative workers. Pterygium was present in 65 (11.8%) workers, among whom 64 (14.3%) were technical workers and 1 (1%) was an administrative worker. Seven (1.6%) technical workers used protective eyewear; 2 (0.4%) wore this protective eyewear regularly.

    CONCLUSION: Technical sawmill workers are at risk of developing conjunctival disorders, which result from chronic ocular irritation. This can be prevented by the provision of protective eye devices in the workplace.

  2. Prasad AM, Ramnarayan K, Nalini K, Bairy KL
    Indian J Pharmacol, 2011 Jul;43(4):389-92.
    PMID: 21844991 DOI: 10.4103/0253-7613.83107
    BACKGROUND: Treatment of cancers with cytotoxic agents such as tyrosine kinase inhibiting drugs often, but not always, result in transient to permanent testicular dysfunction. Germ cells are important targets of many chemicals. Most of the drugs are genotoxins and induce irreversible effect on genetic makeup. These mutagenic changes are proportionally related to carcinogenesis. This is alarmingly dangerous in youth and children, since these effects last longer, affecting fertility or forming basis for carcinogenesis. There is paucity of reports on planned studies of imatinib on the testicular function. Hence, the study was planned to assess the effects of imatinib on biochemical markers of testicular functions in male Swiss albino mice.

    MATERIALS AND METHODS: Male Swiss albino mice were treated with imatinib and sacrificed at the end of first, second, fourth, fifth, seventh, and tenth week after the last exposure to imatinib. The testis were removed, weighed, and processed for biochemical analysis.

    RESULTS: The intratesticular testosterone level was significantly (P<0.001) reduced in treated groups and severe effect was observed on week 4 and 5. The intratesticular lactate dehydrogenase (LDH) level was significantly increased by imatinib in all treated groups up to week 5.

    CONCLUSION: Imatinib does affect testosterone and LDH level significantly, but this effect is reversible once the drug is withdrawn. This finding may help the clinicians to plan and address the fertility-related issues in young patients of reproductive age who are being treated with imatinib for gastrointestinal tumors and chronic myeloid leukemia.

  3. Pridmore S
    Malays J Med Sci, 2011 Oct;18(4):78-83.
    PMID: 22589676
    Medicalisation is the misclassification of non-medical problems as medical problems. A common form of medicalisation is the misclassification of normal distress as a mental disorder (usually a mood disorder). Suicide is medicalised when it is considered a medical diagnosis per se, when it is considered to be secondary to a mental disorder when no mental disorder is present, and when no mental disorder is present but the management of suicidal behaviour associated with distress is believed to be the sole responsibility of mental health professionals. In the West, psychological autopsies have led to the belief that all or almost all suicide is the result of mental disorder. However, there are reservations about the scientific status of such studies. The actions of psychological autopsy researchers, coroners/magistrates, police, policy writers, and grieving relatives all contribute. Medicalisation of suicide has the potential to distort research findings, and caution is recommended.
  4. Mohd Aris NK, Md Ismail NA, Mahdy ZA, Ahmad S, Mohd Naim N, Siraj HH, et al.
    Recent association studies have described genetic variants among type 2 diabetes mellitus (T2DM) and their related traits. Gestational diabetes mellitus (GDM) is pathophysiologically similar to T2DM and may share genetic susceptibility.However, genetic susceptibility within GDM in our own population is still not yet explored. This study was to determine the association of GDM genetic variants in the Malaysian population. We genotyped 384 T2DM related SNPs among 174 cases of GDM and 114 controls of pregnant women using Illumina’s Golden Gate genotyping assay. In this case-control study, a custom of 384-SNP plex of 236 candidate genes was designed using the Illumina’s Assay Design Tool. The data analysis showed 12 SNPs had a significant association with GDM among Malaysians with p values 0.002 to 0.048 with their respective odd ratios. The SNPs rs7754840, rs10946398, rs9465871, rs7756992, rs6823091, rs7935082,rs237889, rs7903146, rs7961581 were significant under additive model while rs10811661, rs1016472, rs2270031 were associated with GDM under recessive model. Three SNPs namely rs7935082, rs1016472 and rs2270031 had reduced risk towards GDM while another nine SNPs which were rs7754840, rs10946398, rs9465871, rs7756992,rs10811661, rs6823091, rs237889, rs7903146 and rs7961581 had increased risk as much 1.75 to 2.62 times. Twelve genetic variants of T2DM were replicated in the SNP profiling among Malaysians GDM. Thus with a more significant result in a bigger sample, SNP screening is potentially a useful method in predicting the risk of gestational diabetes mellitus.
    Study name: The Malaysian Cohort (TMC) project
    MeSH terms: Adult; Diabetes Mellitus, Type 2; Humans; Malaysia; Pregnancy; Case-Control Studies; Diabetes, Gestational; Genetic Predisposition to Disease
  5. Chan M, Yang J, Song Y, Burman C, Chan P, Li S
    Biomed Imaging Interv J, 2011 Apr;7(2):e11.
    PMID: 22287985 DOI: 10.2349/biij.7.2.e11
    PURPOSE: The imaging characteristics of two popular kV cone-beam CT (CBCT) and two MVCT systems utilised in image-guided radiation therapy (IGRT) were evaluated.

    MATERIALS AND METHODS: The study was performed on Varian Clinac iX, Elekta Synergy S, Siemens Oncor, and Tomotherapy. A CT phantom (Catphan-504, Phantom Laboratory, Salem, NY) was scanned for measurements of image quality including image noise, uniformity, density accuracy, spatial resolution, contrast linearity, and contrast resolution. The measurement results were analysed using in-house image analysis software. Reproducibility, position correction, and geometric accuracy were also evaluated with markers in a smaller alignment phantom. The performance evaluation compared volumetric image properties from these four systems with those from a conventional diagnostic CT (CCT).

    RESULTS: It was shown that the linearity of the two kV CBCT was fairly consistent with CCT. The Elekta CBCT with half-circle 27-cm FOV had higher CT numbers than the other three systems. The image noises of the Elekta kV CBCT, Siemens MV CBCT, and Tomotherapy fan-beam CT (FBCT) are about 2-4 times higher than that of the Varian CBCT. The spatial resolutions of two kV CBCTs and two MV CBCTs were 8-11 lp/cm and 3-5 lp/cm, respectively.

    CONCLUSION: Elekta CBCT provided a faster image reconstruction and low dose per scan for half-circle scanning. Varian CBCT had relatively lower image noise. Tomotherapy FBCT had the best uniformity.

  6. Külheim C, Yeoh SH, Wallis IR, Laffan S, Moran GF, Foley WJ
    New Phytol, 2011 Sep;191(4):1041-1053.
    PMID: 21609332 DOI: 10.1111/j.1469-8137.2011.03769.x
    Eucalyptus is characterized by high foliar concentrations of plant secondary metabolites with marked qualitative and quantitative variation within a single species. Secondary metabolites in eucalypts are important mediators of a diverse community of herbivores. We used a candidate gene approach to investigate genetic associations between 195 single nucleotide polymorphisms (SNPs) from 24 candidate genes and 33 traits related to secondary metabolites in the Tasmanian Blue Gum (Eucalyptus globulus). We discovered 37 significant associations (false discovery rate (FDR) Q < 0.05) across 11 candidate genes and 19 traits. The effects of SNPs on phenotypic variation were within the expected range (0.018 < r(2) < 0.061) for forest trees. Whereas most marker effects were nonadditive, two alleles from two consecutive genes in the methylerythritol phosphate pathway (MEP) showed additive effects. This study successfully links allelic variants to ecologically important phenotypes which can have a large impact on the entire community. It is one of very few studies to identify the genetic variants of a foundation tree that influences ecosystem function.
    MeSH terms: Alleles; Cyclohexanols/metabolism; Eucalyptus/genetics*; Eucalyptus/metabolism; Eucalyptus/chemistry; Gene Frequency; Genetic Markers; Genotype; Species Specificity; Linkage Disequilibrium; Genes, Plant*; Plant Leaves/metabolism; Plant Leaves/chemistry*; Alkyl and Aryl Transferases/metabolism; Polymorphism, Single Nucleotide; Monoterpenes/metabolism; Quantitative Trait Loci; Metabolome*
  7. Siotia J, Gupta SK, Acharya SR, Saraswathi V
    Int J Comput Dent, 2011;14(4):321-34.
    PMID: 22324223
    Radiographic examination is essential in diagnosis and treatment planning in endodontics. Conventional radiographs depict structures in two dimensions only. The ability to assess the area of interest in three dimensions is advantageous. Computed tomography is an imaging technique which produces three-dimensional images of an object by taking a series of two-dimensional sectional X-ray images. DentaScan is a computed tomography software program that allows the mandible and maxilla to be imaged in three planes: axial, panoramic, and cross-sectional. As computed tomography is used in endodontics, DentaScan can play a wider role in endodontic diagnosis. It provides valuable information in the assessment of the morphology of the root canal, diagnosis of root fractures, internal and external resorptions, pre-operative assessment of anatomic structures etc. The aim of this article is to explore the clinical usefulness of computed tomography and DentaScan in endodontic diagnosis, through a series of four cases of different endodontic problems.
    MeSH terms: Adult; Dental Pulp Cavity/abnormalities; Dental Pulp Cavity/injuries; Diagnosis, Differential; Humans; Image Processing, Computer-Assisted/methods; Incisor/abnormalities; Male; Middle Aged; Molar/injuries; Patient Care Planning; Root Canal Therapy*; Software*; Tomography, X-Ray Computed/methods*; Tooth Root/injuries; Imaging, Three-Dimensional/methods*; Young Adult
  8. Yau YH, Chandrasegaran D, Badarudin A
    Build Environ, 2011 May;46(5):1125-1132.
    PMID: 32288016 DOI: 10.1016/j.buildenv.2010.11.013
    Hospital and healthcare facilities have diverse indoor environment due to the different comfort and health needs of its occupants. Currently, most ventilation studies revolve around specialised areas such as operating rooms and isolation rooms. This paper focuses on the ventilation of multiple-bed hospital wards in the tropical climate, taking into account the design, indoor conditions and engineering controls. General ward layouts are described briefly. The required indoor conditions such as temperature, humidity, air movements and indoor air quality in the ward spaces are summarized based on the current guidelines and practices. Also, recent studies and engineering practices in the hospital indoor environment are elaborated. Usage of computational fluid dynamics tools for the ventilation studies is discussed as well. As identified during the review, there is an apparent knowledge gap for ventilation studies in the tropics compared with temperate climates, as fact studies have only been published for hospital wards in countries with a temperate climate. Therefore, it is highlighted that specific tropical studies along with novel engineering controls are required in addressing the ventilation requirements for the tropics.
  9. Hampson F, Sinclair M, Smith S
    Biomed Imaging Interv J, 2011 01 01;7(1):e8.
    PMID: 21655117 DOI: 10.2349/biij.7.1.e8
    The role of surgery in the morbidly obese is becoming more prominent. There are a variety of surgical approaches which can be used and radiology plays a crucial role in post operative follow up, particularly in the management of complications. Many general radiologists remain unfamiliar with both the normal and abnormal appearances after bariatric surgery and this pictorial review aims to bridge this gap.
  10. Nor Rashid N, Yusof R, Watson RJ
    J Gen Virol, 2011 Nov;92(Pt 11):2620-2627.
    PMID: 21813705 DOI: 10.1099/vir.0.035352-0
    Human papillomaviruses (HPVs) with tropism for mucosal epithelia are the major aetiological factors in cervical cancer. Most cancers are associated with so-called high-risk HPV types, in particular HPV16, and constitutive expression of the HPV16 E6 and E7 oncoproteins is critical for malignant transformation in infected keratinocytes. E6 and E7 bind to and inactivate the cellular tumour suppressors p53 and Rb, respectively, thus delaying differentiation and inducing proliferation in suprabasal keratinocytes to enable HPV replication. One member of the Rb family, p130, appears to be a particularly important target for E7 in promoting S-phase entry. Recent evidence indicates that p130 regulates cell-cycle progression as part of a large protein complex termed DREAM. The composition of DREAM is cell cycle-regulated, associating with E2F4 and p130 in G0/G1 and with the B-myb transcription factor in S/G2. In this study, we addressed whether p130-DREAM is disrupted in HPV16-transformed cervical cancer cells and whether this is a critical function for E6/E7. We found that p130-DREAM was greatly diminished in HPV16-transformed cervical carcinoma cells (CaSki and SiHa) compared with control cell lines; however, when E6/E7 expression was targeted by specific small hairpin RNAs, p130-DREAM was reformed and the cell cycle was arrested. We further demonstrated that the profound G1 arrest in E7-depleted CaSki cells was dependent on p130-DREAM reformation by also targeting the expression of the DREAM component Lin-54 and p130. The results show that continued HPV16 E6/E7 expression is necessary in cervical cancer cells to prevent cell-cycle arrest by a repressive p130-DREAM complex.
    MeSH terms: Cell Cycle*; Epithelial Cells/physiology; Epithelial Cells/virology; Humans; Oncogene Proteins, Viral/metabolism*; Repressor Proteins/antagonists & inhibitors; Repressor Proteins/metabolism*; Cell Line, Tumor; Cell Proliferation; Crk-Associated Substrate Protein/antagonists & inhibitors; Crk-Associated Substrate Protein/metabolism*; Papillomavirus E7 Proteins/metabolism*; Kv Channel-Interacting Proteins/antagonists & inhibitors; Kv Channel-Interacting Proteins/metabolism*; Human papillomavirus 16/pathogenicity*; Host-Pathogen Interactions*; Protein Multimerization
  11. Citation:
    Guidelines on health research involving minors. Kuala Lumpur: National Institute of Health, Ministry of Health Malaysia; 2011 [MREC DOC.01-2010]
    MeSH terms: Child; Humans; Informed Consent; Malaysia; Research; Guidelines as Topic; Ethics, Research; Minors; Informed Consent By Minors
  12. Mukhtar F, Oei TPS
    DOI: 10.2174/157340011797183201
    Transforming western technology to Eastern populations, including Malaysia, presents important implications in understanding the development, maintenance, and treatment of depression. The present paper aims to review the literature on the prevalence of depression studies in Malaysia. PsycINFO, Medline databases, local journals, and 13 published articles, were included in the current review. Findings were presented in three categories i.e., 'prevalence of depression in primary care', 'general community', and 'among clinical population'. Major limitations of previous studies were noted, and thus, problems associated with the implementation and future direction of clinical and research on depression in Malaysia, was provided. In short, the contribution of empirical research on the prevalence of depression has remained inconsistent and fragmented and it is therefore, a time to venture modification. © 2011 Bentham Science Publishers.
    MeSH terms: Depressive Disorder; Humans; Malaysia; Prevalence; Depression, Postpartum
  13. Abdul Rahman AA, Al Sadat N, Low WY
    Journal of Men's Health, 2011;8:S50-S53.
    DOI: 10.1016/S1875-6867(11)60021-3
    Background: The objective of this study was to identify the prevalence and associated factors of erectile dysfunction (ED) among men who frequented public primary care clinics in an urban district in Malaysia.
    Methods: A total of 1331 men aged 40-76 years participated in this cross-sectional study. Information on demographic information, medical history and lifestyle factors were obtained through self administered questionnaire. ED was assessed using the International Index of Erectile Function (IIEF-5).
    Results: The participants' age ranged from 40-79 years with a mean of 54.7 (±8.3) years. The prevalence of ED was 69.5%. In terms of severity, 33.1% had mild, 26.6% moderate and 9.8% severe ED. The participants with increased age had reportedly higher prevalence of ED. The prevalence of ED increased from 49.7% of men in their 40s to 66.5%, 92.8% and 93.9% of men in their 50s, 60s and 70s respectively. The prevalence of moderate and severe ED also increased with age. The prevalence of severe ED was only 2.1% of men in their 40s and rose to 22.4% of men aged more than 60 years. The prevalence of ED among those with diabetics or heart disease was the highest (89.2%) followed by hypertensives (80.4%) and hypercholesterolaemia (78.9%). Men in their 50s (OR = 2.0) and 60s (OR = 13.5) had higher odds in ED.
    Conclusions: This study found that ED was common among men aged 40 years and above at the primary care setting. The prevalence and severity of ED increased with age. © 2011 WPMH GmbH.
    MeSH terms: Adult; Aged; Ambulatory Care Facilities; Cross-Sectional Studies; Humans; Erectile Dysfunction; Malaysia; Male; Men; Prevalence; Men's Health
  14. Ab Rahman AA, Al-Sadat N, Low WY
    Journal of Men's Health, 2011;8 Suppl 1:S94-S96.
    DOI: 10.1016/S1875-6867(11)60033-X
    Background: To examine the self-reported erectile problem and help-seeking behaviour among men.
    Methods: A cross-sectional study was carried out among 1331 men aged 40 years and above who attended public primary care clinics in an urban district in Malaysia. Questions were asked regarding presence of erectile problem, help-seeking behaviour and treatment sought.
    Results: The mean age was 54.7 (±8.3), ranging from 40 to 79 years. Among the subjects, 69.5% (n = 925) had erectile dysfunction (ED); however, only 54.8% reported having difficulty with erection. The subjects with severe ED had higher proportion of self-reported ED (90.8%) than moderate (75.7%) and mild ED (27.4%). More than two-third of the subjects (67.2%) have spoken to someone about their difficulty; of these, 54.1% spoke to their spouse or partner, 6.3% to friends and 5.3% to family members. Only 32.4% had initiated the discussion with their doctor, whereas only 10.5% reported that their doctor had raised the issue. Among the men who did not seek any help, reasons were: ED normal part of aging (37.9%), due to health condition (32.2%), ED was caused by medication (9.4%) and they were embarrassed (7.3%). Only 4.4% had sought treatment. More than one third participants (35%) had used Sildenafil while most had used other traditional medicines such as Tongkat Ali, massage and Chinese herbs.
    Conclusions: Self-reported erectile problem among men is common. However, ED is not a health condition that patients would commonly discuss with their doctors despite the fact that they are already seeing doctors for various other medical reasons. © 2011 WPMH GmbH.
    MeSH terms: Complementary Therapies; Ambulatory Care Facilities; Cross-Sectional Studies; Humans; Erectile Dysfunction; Malaysia; Male; Men; Primary Health Care; Men's Health
  15. Tan WP, Fong ZV, Tong SF, Low WY, Tan HM
    Journal of Men's Health, 2011;8:S81-S83.
    DOI: 10.1016/S1875-6867(11)60029-8
    Background: Men's major concern (MMC) is a common quality of life issue affecting the aging male population. This paper examines the association between MMC and cardiometabolic diseases in Malaysian men in an urban setting.
    Methods: A cross-sectional community based study was conducted in an urban area involving 1046 men, aged over 40 years and above, who were randomly selected using the electoral roll in Selangor Malaysia. Participants were assessed by trained doctors using structured questionnaire which included medical history, IIEF-5 to assess men's erectile dysfunction and IPSS score to assess prostatic symptoms. Clinical assessments including blood pressure, weight, height and waist circumference were performed. In addition, biochemical assessments for fasting blood glucose and lipid profile were done.
    Results: The response rate was 62.8%. The mean age of the participants was 55.8±8.4 (range: 41-93) years. Around two fifth of the participants (39.8%) had no MMC, 28.4% were diagnosed with 1 MMC, 9.9% with 2MMCs and 1.2% with 3MMCs. Increasing number of MMCs were significantly associated with increasing rate of cardiometabolic diseases (No MMC = 26.2%, 1 MMC = 43.4%, 2 MMCs = 63.5% and 3 MMCs = 69.2%) (P < 0.01) and metabolic syndrome based on Asian criteria (No MMC = 21.5%, 1 MMC = 39.0%, 2 MMCs = 49.1%, 3 MMCs = 62.5%) (P < 0.01). Participants with one or more MMC significantly showed a higher proportion of undiagnosed diabetes as well as reported diabetes (No MMC = 1.7%, 1 or more MMCs = 3.6%) when compared to participants without MMC (P ≤ 0.01).
    Conclusions: Men's Major Concerns (e.g., ED, LUTS and TD) were associated with cardiometabolic diseases and collectively, they could be used as an important portal to men's health. © 2011 WPMH GmbH.
    MeSH terms: Adult; Aged; Blood Pressure; Body Height; Body Weight; Cross-Sectional Studies; Humans; Erectile Dysfunction; Malaysia; Urban Population; Waist Circumference
  16. Sharifuddin N, Abdul Aziz AF, Sheikh Hamzah M, Abdul Rashid R, Zainuddin Z, Wan Puteh SE, et al.
    Background: Erectile dysfunction (ED) is common amongst hypertensive men. Hypertensive patients often attribute it to antihypertensive drugs, although conflicting evidence linking ED with antihypertensive medication exists. The objectives were to determine the prevalence and severity of ED, the type of treatment sought, and the risk factors for ED among hypertensive men.
    Method: A cross-sectional survey conducted over six months from June to November 2008 at University Kebangsaan, Malaysia Medical Centre, Kuala Lumpur. Inclusion criteria included hypertensive men above 30 years old, with essential hypertension for at least three months. We excluded diabetics, a history of pelvic surgery and known psychiatric illnesses. The International Index of Erectile Function-5 (IIEF-5) assessment was used with a standardised checklist. We analysed data using SPSS, to assess the prevalence and association of ED with selected variables.
    Results: Of the 200 participants screened, 35.5% perceived that they had ED. However, prevalence increased to 69% after screening using an IIEF-5 questionnaire. Forty-eight per cent were reported to have moderate-to severe ED. ED was significantly associated with age (p-value = 0.0001). No significant associations were found between ED and the duration of the hypertension (p-value = 0.505), hypertension control (p-value > 0.05), smoking status (p-value = 0.858) or number of antihypertensive medication taken (p-value > 0.05). Among perceived and proven ED patients, traditional medicines were mainly used for treatment (18.3% and 17.2% respectively).
    Conclusion: ED is a problem among hypertensive patients. It was associated with age but not with hypertension duration, control, number of antihypertensive drugs or smoking. Physicians should enquire about ED symptoms in hypertensive patients, as most of them resorted to self-treatment with traditional medicines. © SAAFP.
    MeSH terms: Adult; Aged; Ambulatory Care Facilities; Antihypertensive Agents; Cross-Sectional Studies; Hospitals, University; Humans; Hypertension; Erectile Dysfunction; Malaysia; Male; Medicine, Traditional; Outpatient Clinics, Hospital; Self Care; Smoking; Prevalence
  17. Tey LS, Ferreira L, Wallace A
    Accid Anal Prev, 2011 Nov;43(6):2134-2141.
    PMID: 21819844 DOI: 10.1016/j.aap.2011.06.003
    Railway level crossings are amongst the most complex of road safety control systems, due to the conflicts between road vehicles and rail infrastructure, trains and train operations. Driver behaviour at railway crossings is the major collision factor. The main objective of the present paper was to evaluate the existing conventional warning devices in relation to driver behaviour. The common conventional warning devices in Australia are a stop sign (passive), flashing lights and a half boom-barrier with flashing lights (active). The data were collected using two approaches, namely: field video recordings at selected sites and a driving simulator in a laboratory. This paper describes and compares the driver response results from both the field survey and the driving simulator. The conclusion drawn is that different types of warning systems resulted in varying driver responses at crossings. The results showed that on average driver responses to passive crossings were poor when compared to active ones. The field results were consistent with the simulator results for the existing conventional warning devices and hence they may be used to calibrate the simulator for further evaluation of alternative warning systems.
    MeSH terms: Accident Prevention; Accidents, Traffic/prevention & control; Adolescent; Adult; Aged; Female; Humans; Human Engineering; Male; Middle Aged; Protective Devices*; Railroads*; Social Control, Formal; Video Recording; Young Adult
  18. Dollah R, Yaacob A, Ismail AH, Che Hussin CM
    Objective: The assay for anti-cyclic citrullinated peptide (anti-CCP) antibody is a recent test of interest due to low diagnostic specificity of rheumatoid factor in the diagnosis of rheumatoid arthritis. To determine the sensitivity and specificity of anti-CCP antibodies in rheumatoid arthritis patients using American College of Rheumatology (ACR) criteria as a gold standard.
    Design: A cross sectional study was conducted from January 2008 to December 2008 on 100 patients with rheumatoid arthritis and 153 patients with arthritis or arthralgia but not fulfilling ACR criteria for rheumatoid arthritis.
    Materials and Methods: Serum from each subject was tested for anti-CCP antibodies and IgM rheumatoid factor (IgM RF) by an enzyme linked immunosorbent assay (ELISA). Sensitivity and specificity of the tests were evaluated using the ACR criteria as the gold standard. Data was analyzed using SPSS version 12.0 software. The association between the two categorical variables were tested using chi-square test. The differences between the two groups were tested using independent t-test. Results: The sensitivity of anti-CCP antibodies was 71% with 94.8% of specificity. For rheumatoid factor the sensitivity was 85% and the specificity was 74.5%. Positive predictive value for anti-CCP antibodies was 89.9% whereas for rheumatoid factor it was 68.5%. The sensitivity of ACR criteria with inclusion of anti- CCP antibodies was 100% and specificity of 94.8% (95%CI: 91.3%, 98.2%).
    Conclusion: Anti-CCP antibody has a higher diagnostic accuracy compared to the RF. Anti-CCP antibody is a useful laboratory marker to support the diagnosis of rheumatoid arthritis and to differentiate patients with rheumatoid arthritis from rheumatoid arthritis-like symptoms. Therefore, it is suggested that anti-CCP antibodies should be included as another laboratory supportive criterium besides RF test in ACR criteria in the diagnosis of RA.
    Study site: family medicine clinic, rheumatology clinic and immunology laboratory of Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia
    MeSH terms: Ambulatory Care Facilities; Arthritis, Rheumatoid; Cross-Sectional Studies; Hospitals, University; Humans; Malaysia; Outpatient Clinics, Hospital; Peptides, Cyclic; Predictive Value of Tests; Sensitivity and Specificity
  19. Citation: The third report of the National Eye Database 2009. Goh PP, Salowi MA, editors. Kuala Lumpur: Clinical Research Centre; 2011
    MeSH terms: Eye Diseases; Humans; Malaysia; Registries
  20. Citation: Practical Guide to Diabetes Management in Ramadan. Kuala Lumpur: Ministry of Health, Malaysia; 2015

    Keywords: CPG
    MeSH terms: Diabetes Mellitus, Type 2; Endocrinology; Humans; Insulin; Malaysia; Guidelines as Topic
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