Browse publications by year: 2016

  1. Zaris SNABSM, Ahmad MSB, Mohamed SZB, Shuid ANB, Mohamed INB, Mokhtar SAB
    Malaysia is a multi-ethnic country with an osteoporosis prevalence of 24.1% in 2005. Only few study reported on osteoporosis awareness. Aim of this study was to investigate the awareness and knowledge regarding osteoporosis among persons attending orthopaedic clinic at Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur. A total of 368 participants (male and female) aged 20 years old or older, was assessed using the Osteoporosis Questionnaire (OPQ). The mean total OPQ score was 1.7 (SD ± 3.08; range -5 to 9; maximum possible score 20). Subjects with family history of osteoporosis and high education level were found to have significantly higher OPQ scores (p<0.05). However, there was no significant difference (p>0.05) with respect to different age groups, gender, ethnicities, and menopausal status. The main source of osteoporosis knowledge was magazine/newspaper (45.9%). An overall low score indicates that new strategies to increase awareness of osteoporosis among the public is urgently required.
    MeSH terms: Adult; Cross-Sectional Studies; Female; Hospitals, University; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Male; Osteoporosis; Outpatient Clinics, Hospital
  2. Mohd Said MS, Bin Shudim SS, Mohamad K, Shaharir SS, Kong NCT, Ali RA
    Egyptian Rheumatologist, 2016;38:189-194.
    DOI: 10.1016/j.ejr.2015.12.001
    Aim of the work This work aimed to determine the frequency of subclinical memory dysfunction in a group of Malaysian systemic lupus erythematosus (SLE) patients and to study its relation to clinical characteristics, laboratory investigations and disease activity. Patients and methods Fifteen SLE patients attending the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and not known to have neuropsychiatric lupus were recruited. These patients were assessed using the Wechsler Memory Scale. Disease activity was assessed using the SLE disease activity index 2000 (SLEDAI-2K). Results The median age of the patients was 28 years (25–37 years) and they were 14 females and one male. Their median disease duration was 9.3 years (4.8–10 years). Their median SLEDAI-2K was 4 (0–6). Memory dysfunction was identified in 7/15 (46.7%) SLE patients and was significantly associated with lower serum thyroxine levels (median 12.27; 11.8–13.3 μg/dl) (p = 0.027) compared to those without memory impairment (15.48; 14.39–16.56 μg/dl). Auditory memory impairment was associated with the education level as the auditory memory index was significantly lower in patients with secondary education (n = 7, median 88; 86.5–91.5) compared to those who received tertiary education (n = 8, median 103; 97.5–119.5) (p = 0.025) while visual memory was influenced by disease duration (p = 0.016). There was no association between overall memory dysfunction and disease duration, number of relapses, clinical manifestations and SLEDAI-2K scores. Conclusion There is a high frequency of subclinical memory dysfunction among SLE patients. A remarkable association is present with lower thyroxine. Auditory memory impairment is related to the level of education and visual memory to disease duration. © 2015 The Authors
    MeSH terms: Adult; Alkaline Phosphatase; Creatinine; Cross-Sectional Studies; Educational Status; Female; Hospitals, University; Humans; Hypothyroidism; Leukocyte Count; Lupus Erythematosus, Systemic*; Malaysia; Male; Prednisolone; Serology; Thyrotropin; Thyroxine; Age Distribution
  3. GBD 2015 Mortality and Causes of Death Collaborators
    Lancet, 2016 Oct 08;388(10053):1459-1544.
    PMID: 27733281 DOI: 10.1016/S0140-6736(16)31012-1
    BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.
    METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).
    FINDINGS: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.
    INTERPRETATION: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
    FUNDING: Bill & Melinda Gates Foundation.
    Malaysian collaborators: Southern University College, Skudai, Malaysia (Y J Kim PhD); School of Medical Sciences, University of Science Malaysia, Kubang Kerian, Malaysia (K I Musa MD); Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia (R Sahathevan PhD); Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia (C T Sreeramareddy MD); WorldFish, Penang, Malaysia (A L Thorne-Lyman ScD)
    MeSH terms: Cause of Death*; Communicable Diseases/epidemiology; Humans; Life Expectancy/trends*; Mortality/trends; Global Health; Mortality, Premature
  4. Ng RT, Lee WS, Ang HL, Teo KM, Yik YI, Lai NM
    Cochrane Database Syst Rev, 2016 11 11;11:CD010873.
    PMID: 27841439
    BACKGROUND: Childhood constipation is a common problem with substantial health, economic and emotional burdens. Existing therapeutic options, mainly pharmacological, are not consistently effective, and some are associated with adverse effects after prolonged use. Transcutaneous electrical stimulation (TES), a non-pharmacological approach, is postulated to facilitate bowel movement by modulating the nerves of the large bowel via the application of electrical current transmitted through the abdominal wall.

    OBJECTIVES: Our main objective was to evaluate the effectiveness and safety of TES when employed to improve bowel function and constipation-related symptoms in children with constipation.

    SEARCH METHODS: We searched MEDLINE (PubMed) (1950 to July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 7, 2015), EMBASE (1980 to July 2015), the Cochrane IBD Group Specialized Register, trial registries and conference proceedings to identify applicable studies .

    SELECTION CRITERIA: Randomized controlled trials that assessed any type of TES, administered at home or in a clinical setting, compared to no treatment, a sham TES, other forms of nerve stimulation or any other pharmaceutical or non-pharmaceutical measures used to treat constipation in children were considered for inclusion.

    DATA COLLECTION AND ANALYSIS: Two authors independently assessed studies for inclusion, extracted data and assessed risk of bias of the included studies. We calculated the risk ratio (RR) and corresponding 95% confidence interval (CI) for categorical outcomes data and the mean difference (MD) and corresponding 95% CI for continuous outcomes. We evaluated the overall quality of the evidence supporting the outcomes assessed in this review using the GRADE criteria.

    MAIN RESULTS: One study from Australia including 46 children aged 8 to 18 years was eligible for inclusion. There were multiple reports identified, including one unpublished report, that focused on different outcomes of the same study. The study had unclear risk of selection bias, high risks of performance, detection and attrition biases, and low risks of reporting biases.We are very uncertain about the effects of TES on bowel movements, colonic transit, soiling symptoms and quality of life due to high risk of bias, indirectness and imprecision. For our outcomes of interest the 95% CI of most analysis results include potential benefit and no effect. There is insufficient evidence to determine the effect of TES on bowel movements and colonic transit. The study reported that 16/21 children in the TES group and 15/21 in the sham group had > 3 complete spontaneous bowel movements (CSBM) per week (RR 1.07, 95% CI 0.74 to 1.53; very low-quality evidence). Ten out of 14 children in the TES group had improved colonic transit compared to 1/7 in the sham group (RR 5.00, 95% CI 0.79 to 31.63; very low-quality evidence). Mean colonic transit rate, measured as the position of the geometric centre of the radioactive substance ingested along the intestinal tract, was higher in children who received TES compared to sham (MD 1.05, 95% CI 0.36 to 1.74; one study, 30 participants; very low-quality evidence). The radiological assessment of colonic transit outcomes means that these results might not translate to important improvement in clinical symptoms or increased bowel movements. There is insufficient evidence to determine the effect of TES on symptoms and quality of life (QoL) outcomes. Nine out of 13 children in the TES group had improved soiling-related symptoms compared to 4/12 sham participants (RR 2.08, 95% CI 0.86 to 5.00; very low-quality evidence). Four out of 8 TES participants reported an improvement in QoL compared to 1/8 sham participants (RR 4.00, 95% CI 0.56 to 28.40; very low-quality evidence). The effects of TES on self-perceived (MD 5.00, 95% CI -1.21 to 11.21; one study, 33 participants; very low-quality evidence) or parent-perceived QoL (MD -0.20, 95% CI -7.57 to 7.17, one study, 33 participants; very low-quality evidence) are uncertain. No adverse effects were reported in the included study.

    AUTHORS' CONCLUSIONS: The results for the outcomes assessed in this review are uncertain. Thus no firm conclusions regarding the efficacy and safety of TES in children with chronic constipation can be drawn. Further randomized controlled trials assessing TES for the management of childhood constipation should be conducted. Future trials should include clear documentation of methodologies, especially measures to evaluate the effectiveness of blinding, and incorporate patient-important outcomes such as the number of patients with improved CSBM, improved clinical symptoms and quality of life.

    MeSH terms: Adolescent; Child; Chronic Disease; Constipation/therapy*; Transcutaneous Electric Nerve Stimulation*; Humans; Randomized Controlled Trials as Topic
  5. ISBN: 978-967-0769-14-1
    Citation: Jadual Pelupusan Rekod Perubatan. Putrajaya: Kementerian Kesihatan Malaysia; 2016
    MeSH terms: Malaysia; Medical Records; Guidelines as Topic
  6. Citation: The eighth report of the National Eye Database 2014. Goh PP, Salowi MA, Adnan TH, Sa'at N, editors. Kuala Lumpur: Clinical Research Centre; 2016
    MeSH terms: Eye Diseases; Humans; Malaysia; Registries
  7. MeSH terms: Adolescent; Child; Diabetes Mellitus, Type 1; Endocrinology; Humans; Malaysia; Guideline
  8. MeSH terms: Humans; Psychiatry; Smoking; Tobacco Use Disorder; Guidelines as Topic; Tobacco Use Cessation
  9. MeSH terms: Humans; Malaysia; Nasopharyngeal Neoplasms; Guidelines as Topic
  10. Shaha MKK, Sirata HM, Jamil S, Jalil J
    Nat Prod Commun, 2016 Sep;11(9):1275-1278.
    PMID: 30807020
    A new pyranoflavone, methoxycyclocommunol (1) together with four known flavonoids, artonin F (2), heteroflavanone A (3), cudraflavone C (4) and cyclocommunol (5) were isolated from the bark of Artocarpus integer var. silvestris Corner. Their structures were elucidated through extensive spectroscopic- techniques (UV, IR, MS, 1D-NMR and 2D-NMR) and by comparison with literature data. All the pure compounds were tested for their anti-inflammatory activities by using screening kit and radioimmunoassay methods. In a 15-lipoxygenase (15-LOX) inhibitory assay, compounds 1, 2, 4 and 5 gave weak percentages of inhibition, 16.5, 18.3, 17.6, 10.2%, respectively at the concentration of 100 μM. Compounds 1, 3 and 4, however, showed strong dose- dependent inhibition towards prostaglandin E₂ (PGE₂) production in lipopolysaccharide-induced human whole blood using a radioimmunoassay method with IC₅₀ values of 4.3, 0.8, and 0.07 μM, respectively suggesting that they strongly exhibited cyclooxygenase-2 (COX-2) activity.
    MeSH terms: Anti-Inflammatory Agents/isolation & purification; Anti-Inflammatory Agents/pharmacology*; Arachidonate 15-Lipoxygenase; Flavonoids/isolation & purification; Flavonoids/pharmacology*; Humans; Malaysia; Dinoprostone/antagonists & inhibitors; Molecular Structure; Lipoxygenase Inhibitors/isolation & purification; Lipoxygenase Inhibitors/pharmacology; Cyclooxygenase Inhibitors/isolation & purification; Cyclooxygenase Inhibitors/pharmacology*; Plant Bark/chemistry*; Artocarpus/chemistry*
  11. Abdollahi F, Agajani-Delavar M, Zarghami M, Lye MS
    Iran J Psychiatry Behav Sci, 2016 Mar;10(1):e426.
    PMID: 31168307 DOI: 10.17795/ijpbs-426
    Background: Post-partum depression (PPD) can produce adverse symptoms that make motherhood one of the most tumultuous events in a female's life. First-time mothers who have problems adapting themselves to the mother's role are more vulnerable to PPD.

    Objectives: The current study aimed to explore the extent of social support and parental self-efficacy on PPD, this study was conducted among the first-time pregnant women.

    Patients and Methods: A prospective cohort study assessed the depressive symptoms and related factors among 838 first-time not depressed pregnant women from third trimester of pregnancy to 12 weeks postpartum who attended primary health centers (Jan to July 2009). The study employed Edinburgh postnatal depression scale, social support appraisals scale, network orientation scale, marital inventory, parental expectation survey and socio-demographic questionnaires. Logistic regression was used for data analysis.

    Results: The incidence of depression was 10.7% at three months post-partum. The adjusted odds ratio showed the PPD was associated with perceived social isolation (OR = 1.06; 95% CI = 1.01 - 1.12), lack of marital satisfaction (OR = 0.91; 95% CI = 0.86 - 0.97) and low parental self-efficacy (OR = 0.74; 95% CI = 0.65 - 0.85).

    Conclusions: A high incidence of PPD was identified among the first-time mothers which makes PPD one of the major health problems in females. The important effects of perceived social isolation, maternal parental self-efficacy, and marital satisfaction on reducing the risk of PPD should be considered.

    MeSH terms: Depression; Depressive Disorder; Female; Humans; Marriage; Mothers; Personal Satisfaction; Pregnancy; Pregnancy Trimester, Third; Prospective Studies; Psychiatric Status Rating Scales; Surveys and Questionnaires; Social Isolation; Social Support; Incidence; Logistic Models; Odds Ratio; Depression, Postpartum; Self Efficacy; Postpartum Period
  12. Chong VH, Telisinghe PU, Lim E, Tan J, Chong CF
    Asian Pac. J. Cancer Prev., 2016;17(2):845-9.
    PMID: 26925690
    BACKGROUND: Worldwide, the incidence of cancers is increasing and is becoming a major public health issue, including those in the Asia Pacific region. South-East Asia is a region with diverse populations with different disease spectra. This study looked at the spectrum of cancers among South-East Asians working in Brunei Darussalam.

    MATERIALS AND METHODS: The cancer registry from 1994 to 2012 maintained by the State Laboratory was retrospectively reviewed. Crude incidence rates were calculated based on the population census of 2010.

    RESULTS: Altogether, there was a total of 418 cancer cases diagnosed among South-East Asians, giving an incidence of 5.1% (n=418/8,253). The affected nationals in decreasing frequency were Malaysians (53.1%), followed by Filipinos (25.8%), Indonesians (15.3%), Thais (3.8%), Myanmese (1.7%) and Vietnamese (0.2%) with no recorded cases for Singapore and the People's Republic of Laos. The overall mean age of diagnosis was 46.1±4.2 years old, with an increasing trend over the years (p<0.05 ANOVA). The overall gender ratio was 42.3:57.7 (male:female), more females among the Filipinos and Indonesians, more males among the Thais, and equal representation among the Malaysians and the Myanmese. The most common were cancers of the digestive system (19.9%), followed by female reproductive/gynecologic system (16.0%), breast (15.6%), hematological/lymphatic (12.0%) and head/neck (8.1%). There were differences in the prevalence of cancers among the various nationalities with highest crude incidence rate among the Myanmese (141.2/100,000), followed by the Malaysian (88.5/100,000), and the Filipinos (40.6/100,000) and the lowest among the Thais (18.4/100,000), Indonesians (10.5/100,000) and the Vietnamese (6.3/100,000).

    CONCLUSIONS: Cancers among South-East Asian residing in Brunei Darussalam accounted for 5.1% of all cancers. The most common cancers were cancers of the digestive, gynecologic/female reproductive system and breast with certain types slowly increasing in proportions. There mean age of diagnoses was increasing.

    MeSH terms: Adenocarcinoma/epidemiology*; Adult; Asia/epidemiology; Brunei; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasms/epidemiology*; Prognosis; Retrospective Studies; Incidence
  13. Mallhi TH, Khan AH, Sarriff A, Adnan AS, Khan YH
    J Bras Nefrol, 2016 12;38(4):483-484.
    PMID: 28001178 DOI: 10.5935/0101-2800.20160078
    MeSH terms: Humans; Intensive Care Units*; Acute Kidney Injury*
  14. Wan Fazilah Fazlil Ilahi, Desa Ahmad
    Sains Malaysiana, 2016;46:975-980.
    A well-known planting medium in soilless culture is a coconut based material famously known in Malaysia as cocopeat.
    It is a viable ecologically friendly peat soil substitute for containerized crop production. The multipurpose growing media
    had received much interest particularly in commercial applications. This study focused on the physical and hydraulic
    characteristics of cocopeat perlite mixture as a growing media in containerized plant production. Perlite was added to
    cocopeat at a ratio of 3 cocopeat: 1 perlite. Bulk density, particle density, porosity, particle size distribution, water holding
    capacity, wettability and hydraulic conductivity of the media were evaluated. About 82.93% of the total particles were
    in the range between 0.425 and 4 mm in diameter at a bulk density of 0.09 g/cm3
    . Total porosity (79%) and wettability
    improved with the incorporation of perlite to cocopeat. This study showed that water holding capacity was very high at
    912.54% whereas the saturated hydraulic conductivity was low at 0.1 cm/s. The results showed that adding perlite to
    cocopeat had improved the physical and hydraulic characteristics of the media.
    MeSH terms: Crop Production; Aluminum Oxide; Cocos; Ecology; Malaysia; Particle Size; Silicon Dioxide; Soil; Water; Porosity; Wettability
  15. Siti Zamratol-Mai Sarah Mukari, Nashrah Maamor, Wan Syafira Ishak, Wan Fazlina Wan Hashim
    Sains Malaysiana, 2016;45:1405-1411.
    There is a lack of population-based data on prevalence of hearing loss in Malaysia. The purpose of this population-based study was to determine the prevalence of hearing loss and its risk factors among 382 older adults aged 60 years and above, recruited through multistage random sampling in Selangor. Hearing level was measured using pure tone audiometry. Hearing loss was classified into at least mild hearing loss and significant hearing loss based on the pure tone average (PTA) of 0.5, 1, 2 and 4 kHz. The examination also included face-to-face interview on hearing related medical history, noise exposure and hearing aid use. Overall, the prevalence of at least mild hearing loss and significant hearing loss were 73.6% (95% CI: 69.4 - 77.4) and 24.6% (95% CI: 20.8 - 28.7), respectively. The odds for at least ‘mild hearing loss’ were male gender, Chinese ethnicity, residing in urban areas, had no formal education or primary school education and history of hypertension. The risk for ‘significant hearing loss’ was significantly higher in males, those who lived in urban areas and elderly with cognitive impairment. Chinese and Indian ethnicities had significantly lower risks than Malay ethnic to have significant hearing loss. Despite the high prevalence of hearing loss, only 4.4% who might benefit from hearing aids wore them. In conclusion, findings from this study show high prevalence of hearing loss among the elderly population. Given the significant association between hearing loss and cognitive impairment, future studies should explore the role of hearing amplification in alleviating or slowing the progress of cognitive decline.
  16. Fun SP, Norhani Mohidin, Azzatul Ainur Mohd Kamal, Zainora Mohammed, Bariah Mohd-Ali
    Sains Malaysiana, 2016;45:1399-1403.
    The purpose of this study was to examine the effects of mild cognitive impairment on pattern electroretinogram (pERG)
    among urban elderly Malays. A total of 36 subjects aged 60 years and above comprising of 18 MCI subjects and 18
    normal controls were recruited for this study. The inclusion criteria for both the MCI and normal subjects included best
    corrected distance visual acuity ≥ 6/9 (Snellen) with refractive error less than ±4.00 DS and/or ±2.00 DC (astigmatism),
    near visual acuity ≥ N8, absence or no previous history of any significant media opacities, retinal disorders and ocular
    pathologies. pERG was recorded with the RetiPort/Scan21 system in accordance with the International Society for the
    Clinical Electrophysiology of Vision standards. The target presented to subjects through a 19” CRT monitor was a black
    and white reversing checkerboard with luminance equal to 80 cd/m2
    , contrast 97% and stimulus frequency 2.00 Hz (4
    rev/s). Amplitudes and implicit times of P50 and N95 waves generated by the system were noted and compared between
    the two groups. The results showed no significant difference in the amplitude and implicit times between the right and left
    eyes so only the right eye was used for comparison between the MCI and control groups. The mean amplitude and implicit
    times of the right eye of the MCI and control groups were 1.86±0.65 μV, 56.27±6.20 ms and 1.54±0.74 μV, 56.15±4.98 ms,
    respectively. T-test showed no significant differences in pERG amplitudes and implicit times between MCI and the control
    groups. In conclusion, our results may imply that the inner retina is intact in early MCI elderly subjects.
  17. Zainora Mohammed, Siti Zawiyah Mansor, Saadah Mohamed Akhir, Bariah Mohd-Ali, Norhani Mohidin
    Sains Malaysiana, 2016;45:1393-1398.
    The first aim of this study was to determine the refractive error and visual acuity of Chinese elderly age 60 and above in Selangor and Johor, Malaysia. The second aim was to determine the percentage of elderly with vision impairment. Participants of this study were from the on-going population-based longitudinal study on neuroprotective model for healthy longevity (TUA) among Malaysian older adults using multistage random sampling. A total of 259 Chinese elderly aged 60 and above from state of Selangor and Johor agreed to participate. Refractive error was determined using autorefractometer Retinomax K-plus followed by subjective refraction. Best corrected visual acuity (VA) was measured using logMAR chart. Analysis was performed on data of 202 participants and the remaining 57 were excluded. Overall percentage of refractive error was higher for hyperopia (54%) compared to myopia (23.2%). High percentage of astigmatism was noted for all age groups (> 50%). Both gender showed similar distribution of refractive status. Mean overall VA was 0.24 ± 0.17 logMAR (≅ 6/9-) and mean VA declined with age. Overall, the percentage of elderly having at least mild vision impairment (> 0.3 logMAR or 6/12) was higher (62.9%) compared to normal vision (≤ 0.3 logMAR). However, percentage of vision impairment (VI) was highest in the mild category compared to others and only one participant had severe VI. This study found a high percentage of Chinese elderly with refractive error. The most common type of refractive error was hyperopia. A high proportion of them had mild vision impairment followed by moderate VI even with best correction. Vision impairment could affect daily life functioning and this effect can be further explored in the future.
  18. Nik Nur Izzati Nik Mohd Fakhruddin, Suzana Shahar, Nurul Atiqah Abd Aziz, Roslee Rajikan, Hanis Mastura Yahya
    Sains Malaysiana, 2016;45:1381-1391.
    Older adults quite often had an inadequate diet leading to micronutrient deficiencies and impaired immune response with subsequent development of degenerative diseases. This study aimed to determine the adequacy of energy and nutrient intake and its distribution among three aging groups i.e. successful aging (SA), usual aging (UA) and mild cognitive impairment (MCI). This is a cross-sectional study involving a large sample size (n = 2322) of older adults recruited through multistage random sampling from four states of Malaysia. An interview was conducted to measure dietary intake, neurocognitive status and functional status by using the Diet History Questionnaire (DHQ), Mini-Mental State Examination (MMSE), Rey Auditory Learning Test (RAVLT), Geriatric Depression Scale (GDS), Instrumental Activity of Daily Living (IADL) and Quality of Life Questionnaire. For comparison of dietary intake, a sub-sample of 173 respondents from each aging groups were matched and selected using a comparative cross-sectional approach. Women in SA group had the highest mean intake of vitamin A, calcium (p <0.05), vitamin C, riboflavin and iron (p<0.001). The same aging group also achieved the highest RNI percentage for the same nutrients. More than 80% of respondents for all aging groups did not met the recommended nutrient intake (RNI) for vitamin E, thiamin, niacin, folate, calcium and zinc. In women, MCI respondents were more likely to have an inadequate intake of vitamin A, C, riboflavin and iron followed by UA and SA. Inadequate vitamin E, niacin, folate and calcium were prevalent among all gender and aging groups. There is a need to further distinguish specific dietary patterns associated with these three aging groups to promote optimal nutrient intake for cognitive health.
    MeSH terms: Adult; Aging; Ascorbic Acid; Energy Intake; Cognition; Cross-Sectional Studies; Depression; Female; Folic Acid; Humans; Iron; Malaysia; Niacin; Nutritional Requirements; Quality of Life; Surveys and Questionnaires; Riboflavin; Thiamine; Vitamin A; Vitamin E; Vitamins; Zinc; Sample Size
  19. Amir Hamzah A, Abu Bakar Z, Abdul Sani N, Tan JK, Ahmad Damanhuri M, Makpol S, et al.
    Sains Malaysiana, 2016;45:1371-1380.
    Higher level of education is associated with better cognitive performance and lower risk of developing dementia. However, the effect of education on cognitive performance varies across different cognitive domains and in different populations. The aim of this study was to determine the relationship between education and performance of different cognitive domains among healthy Malay adults. A total of 53 individuals aged 29 to 77 years participated in a battery of neurophysiological tests consisting of Mini-Mental State Examination, Montreal Cognitive Assessment, digit span, visual reproduction and digit symbol speed test (DSST). Blood test was performed for each participant to obtain their biochemical profile. Educational level was divided into level 1 (PMR), level 2 (SPM), level 3 (STPM), level 4 (Diploma) and level 5 (Degree). Simple linear regression indicated that years of education was positively associated with scores of delayed visual reproduction (b=1.348, p=0.002) and DSST (b=3.257, p=0.012). However, scores of all the tests were not significantly different among different levels of education after controlling for age, gender and blood test profile by ANCOVA. Multiple linear regression analysis showed that MMSE score was associated with red cell distribution width (b=-0.628, p=0.005), age (b=-0.119, p<0.001) and there was interaction between high density lipoprotein (HDL) with age (b=0.047, p<001). MoCA score was associated with age (b=-0.121, p<0.001), gender (male compared to female, b=1.870, p=0.020) and HDL (b=1.681, p=0.047). Age was associated with backward digit span (b=-0098, p<0.001) and immediate visual reproduction (b=-0.348, p<0.001), resp. Delayed visual reproduction was associated with age (b=-0.323, p<0.001) and potassium level (b=-4.471, p=0.016). DSST was associated with age (b=-0.911, p<0.001) and alanine aminotransferase (b=-0.754, p=0.002). The lack of association between educational level and cognitive performance after adjusting for confounders in this study maybe due to multiple factors influencing cognitive performance and further studies with a larger sample size are needed to further identify the factors involved.
    Keywords: Cognitive performance; education; healthy Malay adults
    Tahap pendidikan yang tinggi telah dikaitkan dengan prestasi kognitif yang lebih baik dan risiko perkembangan dementia yang lebih rendah. Namun, kesan pendidikan terhadap prestasi kognitif berbeza antara domain kognitif dan populasi yang berlainan. Kajian ini bertujuan untuk menentukan hubungan antara pendidikan dengan prestasi pada domain kognitif yang berlainan pada individu dewasa Melayu yang sihat. Seramai 53 individu yang berumur antara 29 hingga 77 tahun telah menyertai ujian neuropsikologi yang terdiri daripada Pemeriksaan Keadaan Mental Mini, Penilaian Kognitif Montreal, digit span, penghasilan semula visual dan ujian kelajuan simbol digit (DSST). Tahap pendidikan dibahagikan kepada tahap 1 (PMR), tahap 2 (SPM), tahap 3 (STPM), tahap 4 (Diploma) dan tahap 5 (Ijazah Sarjana Muda). Regresi linear mudah menunjukkan bahawa tahap pendidikan berhubung kait secara positif dengan penghasilan semula visual tertunda (b=1.348, p=0.002) dan DSST (b=3.257, p=0.012). Namun, semua skor ujian menjadi tidak berbeza antara tahap pendidikan yang berbeza selepas mengambil kira kesan konpengasas dengan menggunakan ANCOVA. Regresi linear berganda menunjukkan bahawa skor MMSE berhubung kait dengan lebar taburan sel merah (b=-0.628, p=0.005), umur (b=-0.119, p<0.001) dan interaksi antara lipoprotein ketumpatan tinggi (HDL) dan umur (b=0.047, p<001). MoCA didapati berhubung kait dengan umur (b=-0.121, p<0.001), jantina (lelaki berbanding perempuan, b=1.870, p=0.020) dan HDL (b=1.681, p=0.047). Umur juga berhubung kait dengan digit span ke belakang (b=-0098, P<0.001) dan penghasilan semula visual segera (b=-0.348, p<0.001). Penghasilan semula visual tertunda berhubung kait dengan umur (b=-0.323, p<0.001) dan tahap kalium (b=-4.471, p=0.016). DSST berhubung kait dengan umur (b=-0.911, p<0.001) dan alanin aminotransferase (b=-0.754, p=0.002). Hubungan antara tahap pendidikan dan prestasi kognitif tidak dikesan selepas mengambil kira kesan konpengasas yang mencadangkan bahawa prestasi kognitif mungkin dipengaruhi oleh pelbagai faktor dan kajian lanjut dengan bilangan sampel yang lebih besar diperlukan untuk mengenal pasti faktor ini.
    MeSH terms: Adult; Alanine Transaminase; Cognition; Dementia; Educational Status; Erythrocyte Indices; Female; Humans; Lipoproteins, HDL; Malaysia; Male; Potassium; Regression Analysis; Linear Models; Sample Size; D-Alanine Transaminase
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