Browse publications by year: 2015

  1. Global Burden of Disease Study 2013 Collaborators
    Lancet, 2015 Aug 22;386(9995):743-800.
    PMID: 26063472 DOI: 10.1016/S0140-6736(15)60692-4
    BACKGROUND: Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
    METHODS: Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries.
    FINDINGS: Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013.
    INTERPRETATION: Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
    FUNDING: Bill & Melinda Gates Foundation.
    Malaysian collaborators: Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lampur, Malaysia (Prof N Mohamed Ibrahim MBBch); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Selangor, Malaysia (R Sahathevan PhD); Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Selangor, Malaysia (C T Sreeramareddy MD); WorldFish, Penang, Malaysia (A L Thorne-Lyman ScD); TCM Medical TK SDN BHD TCM, Nusajaya, Johor Bahru, Malaysia (K Yun Kin PhD)
    MeSH terms: Acute Disease/epidemiology*; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Chronic Disease/epidemiology*; Developing Countries/statistics & numerical data; Female; Disabled Persons/statistics & numerical data*; Humans; Infant; Infant, Newborn; Male; Middle Aged; Residence Characteristics/statistics & numerical data; Global Health/statistics & numerical data; Wounds and Injuries/epidemiology*; Incidence; Prevalence; Cost of Illness; Age Distribution; Sex Distribution; Developed Countries/statistics & numerical data; Young Adult; Neglected Diseases/epidemiology
  2. Ziganshina LE, Abakumova T
    PMID: 26083192 DOI: 10.1002/14651858.CD007026.pub3
    BACKGROUND: Cerebrolysin is a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue, which has potential neuroprotective and neurotrophic properties. It is widely used in the treatment of acute ischaemic stroke in Russia, China, and other Asian and post-Soviet countries.

    OBJECTIVES: To assess the benefits and risks of Cerebrolysin for treating acute ischaemic stroke.

    SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (October 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (November 2014), MEDLINE (1966 to November 2014), EMBASE (1974 to November 2014), Web of Science Core Collection, with Science Citation Index (1940 to November 2014), LILACS (1982 to December 2014), OpenGrey (1980 to December 2014), and a number of Russian Databases (1998 to December 2014). We also searched reference lists, ongoing trials registers and conference proceedings, and contacted the manufacturer of Cerebrolysin, EVER Neuro Pharma GmbH (formerly Ebewe Pharma).

    SELECTION CRITERIA: Randomised controlled trials comparing Cerebrolysin started within 48 hours of stroke onset and continued for at least two weeks with placebo or no treatment in people with acute ischaemic stroke.

    DATA COLLECTION AND ANALYSIS: Two review authors independently applied inclusion criteria, assessed trial quality and risk of bias, and extracted data.

    MAIN RESULTS: We included one trial involving 146 participants. We evaluated risk of bias and judged it to be high for generation of allocation sequence, low for allocation concealment, high for incomplete outcome data (attrition bias), unclear for blinding, high for selective reporting and high for other sources of bias. The manufacturer of Cerebrolysin, pharmaceutical company Ebewe, provided Cerebrolysin and the placebo, as well as the randomisation codes. There was no difference in the number of deaths (6/78 in Cerebrolysin group versus 6/68 in placebo group; risk ratio (RR) 0.87, 95% confidence interval (CI) 0.29 to 2.58) or in the total number of adverse events (16.4% versus 10.3%; RR 1.62, 95% CI 0.69 to 3.82) between the treatment and control groups.

    AUTHORS' CONCLUSIONS: Routine administration of Cerebrolysin to people with acute ischaemic stroke cannot be supported by the available evidence from RCTs.

    MeSH terms: Acute Disease; Amino Acids/therapeutic use*; Humans; Randomized Controlled Trials as Topic; Neuroprotective Agents/therapeutic use*; Stroke/drug therapy*
  3. Aziz Z, Cullum N
    PMID: 26134172 DOI: 10.1002/14651858.CD002933.pub6
    BACKGROUND: Leg ulceration is a common, chronic, recurring condition. The estimated prevalence of leg ulcers in the UK population is 1.5 to 3 per 1000. Venous ulcers (also called stasis or varicose ulcers) comprise 80% to 85% of all leg ulcers. Electromagnetic therapy (EMT) is sometimes used as a treatment to assist the healing of chronic wounds such as venous leg ulcers.

    OBJECTIVES: To assess the effects of EMT on the healing of venous leg ulcers.

    SEARCH METHODS: For this fourth update, we searched The Cochrane Wounds Group Specialised Register (searched 30 January 2015); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 12).

    SELECTION CRITERIA: Randomised controlled trials comparing EMT with sham-EMT or other treatments.

    DATA COLLECTION AND ANALYSIS: Standard Cochrane Collaboration methods were employed. At least two review authors independently scrutinised search results and obtained full reports of potentially eligible studies for further assessment. We extracted and summarised details of eligible studies using a data extraction sheet, and made attempts to obtain missing data by contacting study authors. A second review author checked data extraction, and we resolved disagreements after discussion between review authors.

    MAIN RESULTS: Three randomised controlled trials (RCTs) of low or unclear risk of bias, involving 94 people, were included in the original review; subsequent updates have identified no new trials. All the trials compared the use of EMT with sham-EMT. Meta-analysis of these trials was not possible due to heterogeneity. In the two trials that reported healing rates; one small trial (44 participants) reported that significantly more ulcers healed in the EMT group than the sham-EMT group however this result was not robust to different assumptions about the outcomes of participants who were lost to follow up. The second trial that reported numbers of ulcers healed found no significant difference in healing. The third trial was also small (31 participants) and reported significantly greater reductions in ulcer size in the EMT group however this result may have been influenced by differences in the prognostic profiles of the treatment groups.

    AUTHORS' CONCLUSIONS: It is not clear whether electromagnetic therapy influences the rate of healing of venous leg ulcers. Further research would be needed to answer this question.

    MeSH terms: Humans; Varicose Ulcer/therapy*; Wound Healing*; Randomized Controlled Trials as Topic; Magnetic Field Therapy/methods*
  4. Aziz Z, Bell-Syer SE
    PMID: 26334539 DOI: 10.1002/14651858.CD002930.pub6
    BACKGROUND: Pressure ulcers are defined as areas "of localized damage to the skin and underlying tissue caused by pressure, shear, friction and/or the combination of these". Electromagnetic therapy (EMT), in which electrodes produce an electromagnetic field across the wound, may improve healing of chronic wounds such as pressure ulcers.

    OBJECTIVES: To assess the effects of EMT on the healing of pressure ulcers.

    SEARCH METHODS: For this update we searched the Cochrane Wounds Group Specialised Register (searched 10 June 2015); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 6); Ovid MEDLINE (2014 to 10 June 2015); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, 10 June 2015); Ovid EMBASE (2014 to 10 June 2015); and EBSCO CINAHL (2014 to 6 July 2012).

    SELECTION CRITERIA: Randomised controlled trials comparing EMT with sham EMT or other (standard) treatment.

    DATA COLLECTION AND ANALYSIS: For this update two review authors independently scrutinised the results of the search to identify relevant RCTs and obtained full reports of potentially eligible studies. In previous versions of the review we made attempts to obtain missing data by contacting study authors. A second review author checked data extraction and disagreements were resolved after discussion between review authors.

    MAIN RESULTS: We identified no new trials for this update.Two randomised controlled trials (RCTs), involving 60 participants, at unclear risk of bias were included in the original review. Both trials compared the use of EMT with sham EMT, although one of the trials included a third arm in which only standard therapy was applied. Neither study found a statistically significant difference in complete healing in people treated with EMT compared with those in the control group. In one trial that assessed percentage reduction in wound surface area, the difference between the two groups was reported to be statistically significant in favour of EMT. However, this result should be interpreted with caution as this is a small study and this finding may be due to chance. Additionally, the outcome, percentage reduction in wound area, is less clinically meaningful than complete healing.

    AUTHORS' CONCLUSIONS: The results provide no strong evidence of benefit in using EMT to treat pressure ulcers. However, the possibility of a beneficial or harmful effect cannot be ruled out because there were only two included trials, both with methodological limitations and small numbers of participants. Further research is recommended.

    MeSH terms: Pressure Ulcer/therapy*; Female; Humans; Male; Wound Healing; Randomized Controlled Trials as Topic; Magnetic Field Therapy/methods*
  5. Citation: The seventh report of the National Eye Database 2013. Salowi MA, et al, editors. Kuala Lumpur: Clinical Research Centre; 2015
    MeSH terms: Eye Diseases; Humans; Malaysia; Registries
  6. Clinical Practice Guidelines: Management of Osteoporosis, Second Edition. Putrajaya: Ministry of Health, Malaysia; 2015
    MeSH terms: Humans; Malaysia; Osteoporosis; Rheumatology; Guidelines as Topic
  7. Citation: Antibiotic In Oral Surgery For Prevention Of Surgical Site Infection, Second Edition. Putrajaya: Ministry of Health, Malaysia; 2015.
    MeSH terms: Dentistry; Humans; Malaysia; Surgical Wound Infection; Guidelines as Topic; Antibiotic Prophylaxis
  8. MeSH terms: Adult; Dengue; Humans; Infection; Malaysia; Guideline
  9. MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2; Endocrinology; Humans; Malaysia; Guideline
  10. MeSH terms: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Endocrinology; Fasting; Humans; Islam; Malaysia; Religion; Guideline
  11. MeSH terms: Adult; Child; Humans; Malaysia; Scabies; Guideline
  12. MeSH terms: Uterine Cervical Neoplasms; Humans; Malaysia; Guidelines as Topic
  13. Ravindra S S, Kumar N, Shetty SD, Guru A
    Ethiop J Health Sci, 2015 Jan;25(1):108.
    PMID: 25733792
    MeSH terms: Attitude of Health Personnel*; Attitude to Health*; Curriculum; Education, Medical; Humans; Tissue and Organ Procurement*; Students, Medical*; Tissue Donors*; Organ Transplantation*
  14. Huang C, Lou C, Chuang Y, Lin J, Liu C, Yu Z
    Sains Malaysiana, 2015;44:1757-1763.
    Following rapid technological and industrial development, factories have been equipped with a great deal of machines.
    The blend of industrial and residential areas in turn resulted in many environmental problems. In particular, machine
    operation causes noise pollution that easily causes physiological and psychological discomfort for the human body thus
    makes noise abatement a crucial and urgent issue. In this study, vermiculite functional fillers were added to polyurethane
    (PU) foam mixtures in order to form sound absorbent PU foams. The correlations between the contents of functional fillers
    and the sound absorption of flexible and rigid PU foams were then examined. The optimal PU foams were combined with
    PET/carbon fiber matrices in order to yield the electromagnetic shielding effectiveness. The sound absorption, noise
    reduction coefficient (NRC), electromagnetic shielding effectiveness and resilience rate of the composite boards were
    finally evaluated. The test results indicated that rigid PU foam composites can reach a sound absorption coefficient of
    0.8 while the flexible PU foam composites have higher mechanical properties.
    MeSH terms: Industrial Development; Aluminum Silicates; Carbon; Humans; Industry; Noise; Polyurethanes; Sound; Human Body; Electromagnetic Phenomena
  15. Chen Th, Chen Ty
    Sains Malaysiana, 2015;44:1751-1756.
    The high strain rate properties and microstructure observations of cobalt base superalloyd contains 0.9% Ti were
    investigated using Hopkinson bar. These cobalt base superalloys are tested at strain rates of 2×103
    , 3×103
    and 4×103
    s-1
    and at different temperatures (25, 500 and 900°C), respectively. It is found that the stress flow and strain rate sensitivity
    increases with increasing strain rate but decrease with increasing temperature. The microstructure observations confirm
    that the high strain rate mechanical behavior of the cobalt base superalloys specimens are directly related to the effects
    of the strain rate, temperature and the evolution of the microstructural texture. The strengthening mechanism in cobalt
    base superalloys is the multiplication of dislocation. The dislocation density increases with increasing strain rate but
    decrease with increasing temperature.
  16. Kim SH, Kim DW
    Sains Malaysiana, 2015;44:1745-1750.
    A fracture, which mostly results from a fall, is fatal for the elderly. A fall occurred when a person cannot maintain the
    body position. Most falls occurred when a person walks on a slippery surface or trips over an object on the ground during
    a gait. Most people try to avoid falls instinctively and fall when their attempt fails. As such, this study investigated the
    difference between two movements- a movement to avoid falls and a forward-falling movement without a fall-avoiding
    movement- by analyzing the body movements of the subjects. A fast-moving fall-guiding device with a pneumatic actuator
    was used to guide falls. The movement of the device could simulate a foot slip that may happen during daily activities.
    A three-axis acceleration sensor and a Bluetooth module were used to avoid disturbing the body movement during a fall
    as a wire sensor or a movement analysis system does.
    MeSH terms: Acceleration; Accidental Falls; Aged; Gait; Humans; Movement; Posture
  17. Hsueh YC, Wang BJ, Yu ZR, Wang CC, Koo M
    Sains Malaysiana, 2015;44:1739-1744.
    γ-linolenic acid is an essential omega-6 unsaturated fatty acid made in the human body from linoleic acid. It can be
    metabolized to various important eicosanoids and it is also a precursor of prostaglandin E and several other active
    substances that are associated with anti-inflammatory properties. Arthrospira platensis is known to contain relatively
    large quantities of γ-linolenic acid. The aim of this study was to investigate the optimal parameters under a continuous
    preparation method of γ-linolenic acid from A. platensis using supercritical carbon dioxide technology. A Box-Behnken
    experimental design and response surface methodology were used to optimize combinations among pressure (10, 20
    and 30 MPa), temperature (40, 50 and 60°C) and flow rate of A. platensis extract liquor (1, 2 and 3 mL/min) for yield
    of γ-linolenic acid. The results showed that the extraction of γ-linolenic acid from A. platensis was optimized at a
    temperature of 60°C, a pressure of 30 MPa and a flow rate of 3 mL/min. These parameters could be used as a basis for
    facilitating future scale-up industrial applications.
  18. Kim SH, Kim DW, Oh HY
    Sains Malaysiana, 2015;44:1729-1738.
    Cervical cancer afflicts women worldwide. The patients’ mortality with cancer has been increased by changing to
    westernized dietary habit and lifestyle. In order to detect early cervical cancer, a liquid-based cytology (LBC) was used
    to examine the exfoliated cells collected from the cervix. This procedure helps to decrease the mortality rate. However,
    this test mostly involves manual examination by the pathologists. This procedure needs to develop more efficient tool
    in detecting cervical cancer which rate kept increasing. As such, this study was designed to develop some methods to
    increase the effectiveness of LBC. The diagnosis algorithm was also established to diagnose the processed cell images
    via an imaging process algorithm based on the diagnosis criteria. A cell diagnosis program based on GUI, combined
    with the imaging process and the diagnosis algorithms were developed to automate the test process. The results of this
    studies showed that this new program can be used for effective diagnosis of cervical cancer. Moreover, it was deemed
    to increase the precision and accuracy of diagnosis and save patient time.
  19. Lin CJ, Lin HY, Yu CY, Wu CF
    Sains Malaysiana, 2015;44:1721-1728.
    In this paper, an interactively recurrent functional neural fuzzy network (IRFNFN) with fuzzy differential evolution (FDE)
    learning method was proposed for solving the control and the prediction problems. The traditional differential evolution
    (DE) method easily gets trapped in a local optimum during the learning process, but the proposed fuzzy differential
    evolution algorithm can overcome this shortcoming. Through the information sharing of nodes in the interactive layer,
    the proposed IRFNFN can effectively reduce the number of required rule nodes and improve the overall performance of
    the network. Finally, the IRFNFN model and associated FDE learning algorithm were applied to the control system of the
    water bath temperature and the forecast of the sunspot number. The experimental results demonstrate the effectiveness
    of the proposed method.
    MeSH terms: Algorithms; Baths; Forecasting; Temperature; Neural Networks (Computer); Solar Activity; Information Dissemination
  20. Chang Ys
    Sains Malaysiana, 2015;44:1715-1720.
    Sewage treatment is an important issue in a country for public health and environmental protection. The treatment
    process not only consumes energy but also emits CO2
    . In this research, the idea of streamlined life cycle assessment was
    applied. The CO2
    emission from sewage treatment was assessed from direct energy consumption of four major sewage
    treatment plants in Taiwan. The results showed that the CO2
    emission at in-plant sewage treatment stage takes more
    than 95% of total CO2
    emission for most plants. The results suggested that CO2
    emission of sewage treatment can be
    calculated from energy consumption at in-plant sewage treatment stage to simplify the calculation. The CO2
    emission
    of sewage treatment was then assessed from sewage plants in Taiwan using in-plant electricity consumption. The unit
    CO2
    emission of sewage treatment in Taiwan is 0.216 kg-CO2
    /m3
    . This database will be an important reference for water
    resource research and future government environmental policies.
    MeSH terms: Carbon Dioxide; Conservation of Natural Resources; Electricity; Government; Public Health; Research; Sewage; Taiwan; Water; Environmental Policy
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