Browse publications by year: 2016

  1. Iomdina EN, Goltsman GN, Seliverstov SV, Sianosyan AA, Teplyakova KO, Rusova AA
    J Biomed Opt, 2016 09 01;21(9):97002.
    PMID: 27626901 DOI: 10.1117/1.JBO.21.9.097002
    An adequate water balance (hydration extent) is one of the basic factors of normal eye function, including its external shells: the cornea and the sclera. Adequate control of corneal and scleral hydration is very important for early diagnosis of a variety of eye diseases, stating indications for and contraindications against keratorefractive surgeries and the choice of contact lens correction solutions. THz systems of creating images in reflected beams are likely to become ideal instruments of noninvasive control of corneal and scleral hydration degrees. This paper reports on the results of a study involving transmittance and reflectance spectra for the cornea and the sclera of rabbit and human eyes, as well as those of the rabbit eye, in the frequency range of 0.13 to 0.32 THz. The dependence of the reflectance coefficient of these tissues on water mass percentage content was determined. The experiments were performed on three corneas, three rabbit scleras, two rabbit eyes, and three human scleras. The preliminary results demonstrate that the proposed technique, based on the use of a continuous THz radiation, may be utilized to create a device for noninvasive control of corneal and scleral hydration, which has clear potential of broad practical application.
    MeSH terms: Animals; Cornea/physiology; Equipment Design; Humans; Rabbits; Sclera/physiology; Terahertz Imaging/instrumentation; Terahertz Imaging/methods*
  2. Li H, Turkoz I, Zhang F
    Neuropsychiatr Dis Treat, 2016;12:15-24.
    PMID: 26730193 DOI: 10.2147/NDT.S83651
    INTRODUCTION: This single-group, open-label, prospective, noncomparative, multicenter, Phase IV study explored the efficacy and tolerability of paliperidone palmitate (PP) in hospitalized patients with acute exacerbation of schizophrenia.

    METHODS: Asian patients of either sex, between 18 and 65 years of age, diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) with acute exacerbations within the previous 4 weeks, were enrolled. Intramuscular PP was initiated at doses of 150 milligram equivalent (mg eq) (day 1) and 100 mg eq (day 8), followed by a monthly maintenance dose between 75 mg eq and 150 mg eq (days 36 and 64). Primary efficacy endpoint was the change from baseline in the Positive and Negative Syndrome Scale (PANSS) total score (last-observation-carried-forward) at week 13.

    RESULTS: Of the 212 enrolled patients, 152 (71.7%) completed the 13-week treatment; withdrawal of consent (24 [11.3%] patients) was the most common reason for study discontinuation. Mean (standard deviation) PANSS total score from baseline (90.0 [17.41]) improved significantly at day 4 (-6.1 [9.27]; 95% confidence interval: -7.38, -4.85; P<0.001) and week 13 endpoint (-23.9 [23.24]; 95% confidence interval: -27.10, -20.78; P<0.001). Similarly, the secondary endpoints (Clinical Global Impression-Severity, Physical and Social Performance, each PANSS subscale, and Marder factor scores) improved significantly from baseline to week 13 endpoint (P<0.001 for all). At week 13, 112/210 (53.3%) patients had a 40% improvement in the PANSS total score (responder rate), and 133/212 (62.7%) patients were ready for hospital discharge. Overall, 139 (65.6%) patients experienced at least one treatment-emergent adverse event (TEAE). Most common (>5%) TEAEs were hyperprolactinemia, constipation, nasopharyngitis, insomnia, increased weight, and tremor. Worsening of schizophrenia (3.3%) and sinus bradycardia (2.0%) were serious TEAEs; no deaths were reported.

    CONCLUSION: PP was generally tolerable and efficacious in a hospital setting for the treatment of acute exacerbated schizophrenia with significant improvements in psychotic symptoms, social functioning, and severity of illness.
    MeSH terms: Adult; China; Humans; Korea; Malaysia
  3. Barber BE, William T, Grigg MJ, Piera KA, Chen Y, Wang H, et al.
    J. Infect. Dis., 2016 11 15;214(10):1557-1564.
    PMID: 27630198 DOI: 10.1093/infdis/jiw427
    BACKGROUND: Pathogenesis of severe Plasmodium vivax malaria is poorly understood. Endothelial dysfunction and reduced nitric oxide (NO) bioavailability characterize severe falciparum malaria, but have not been assessed in severe vivax malaria.
    METHODS: In patients with severe vivax malaria (n = 9), patients with nonsevere vivax malaria (n = 58), and healthy controls (n = 79), we measured NO-dependent endothelial function by using reactive hyperemia-peripheral arterial tonometry (RH-PAT) and assessed associations with arginine, asymmetric dimethylarginine (ADMA), and hemolysis.
    RESULTS: The L-arginine level and the L-arginine to ADMA ratio (a measure of L-arginine bioavailability) were reduced in patients with severe vivax malaria and those with nonsevere vivax malaria, compared with healthy controls (median L-arginine level, 65, 66, and 98 µmol/mL, respectively [P = .0001]; median L-arginine to ADMA ratio, 115, 125, and 187, respectively [P = .0001]). Endothelial function was impaired in proportion to disease severity (median RH-PAT index, 1.49, 1.73, and 1.97 in patients with severe vivax malaria, those with nonsevere vivax malaria, and healthy controls, respectively; P = .018) and was associated with the L-arginine to ADMA ratio. While the posttreatment fall in hemoglobin level was greater in severe vivax malaria as compared to nonsevere vivax malaria (2.5 vs 1 g/dL; P = .0001), markers of intravascular hemolysis were not higher in severe disease.
    CONCLUSIONS: Endothelial function is impaired in nonsevere and severe vivax malaria, is associated with reduced L-arginine bioavailability, and may contribute to microvascular pathogenesis. Severe disease appears to be more associated with extravascular hemolysis than with intravascular hemolysis.
    Study site: Hospital Queen Elizabeth II, Sabah, Malaysia
    MeSH terms: Adolescent; Adult; Aged; Arginine/blood*; Biological Availability; Borneo; Female; Hemolysis*; Humans; Malaysia; Male; Middle Aged; Nitric Oxide/metabolism*; Prospective Studies; Epidemiologic Studies; Malaria, Vivax/pathology*; Endothelial Cells/physiology*; Young Adult
  4. Vinoth R, Patil IM, Pandikumar A, Kakade BA, Huang NM, Dionysios DD, et al.
    ACS Omega, 2016 Nov 30;1(5):971-980.
    PMID: 31457177 DOI: 10.1021/acsomega.6b00275
    Nitrogen-doped graphene quantum dots (N-GQDs) were decorated on a three-dimensional (3D) MoS2-reduced graphene oxide (rGO) framework via a facile hydrothermal method. The distribution of N-GQDs on the 3D MoS2-rGO framework was confirmed using X-ray photoelectron spectroscopy, energy dispersive X-ray elemental mapping, and high-resolution transmission electron microscopy techniques. The resultant 3D nanohybrid was successfully demonstrated as an efficient electrocatalyst toward the oxygen reduction reaction (ORR) under alkaline conditions. The chemical interaction between the electroactive N-GQDs and MoS2-rGO and the increased surface area and pore size of the N-GQDs/MoS2-rGO nanohybrid synergistically improved the ORR onset potential to +0.81 V vs reversible hydrogen electrode (RHE). Moreover, the N-GQDs/MoS2-rGO nanohybrid showed better ORR stability for up to 3000 cycles with negligible deviation in the half-wave potential (E1/2). Most importantly, the N-GQDs/MoS2-rGO nanohybrid exhibited a superior methanol tolerance ability even under a high concentration of methanol (3.0 M) in alkaline medium. Hence, the development of a low-cost metal-free graphene quantum dot-based 3D nanohybrid with high methanol tolerance may open up a novel strategy to design selective cathode electrocatalysts for direct methanol fuel cell applications.
    MeSH terms: Methanol; Electrodes; Graphite; Hydrogen; Metals; Nitric Oxide; Nitrogen; Nitrogen Oxides; Oxides; Oxygen; X-Rays; Quantum Dots; Microscopy, Electron, Transmission; Photoelectron Spectroscopy
  5. Safonova TN, Mordkovich NN, Veiko VP, Okorokova NA, Manuvera VA, Dorovatovskii PV, et al.
    Acta Crystallogr D Struct Biol, 2016 Feb;72(Pt 2):203-10.
    PMID: 26894668 DOI: 10.1107/S2059798315024353
    Uridine phosphorylase (UP; EC, a key enzyme in the pyrimidine-salvage pathway, catalyzes the reversible phosphorolysis of uridine to uracil and ribose 1-phosphate. The structure of the C212S mutant of uridine phosphorylase from the facultatively aerobic Gram-negative γ-proteobacterium Shewanella oneidensis MR-1 (SoUP) was determined at 1.68 Å resolution. A comparison of the structures of the mutant and the wild-type enzyme showed that one dimer in the mutant hexamer differs from all other dimers in the mutant and wild-type SoUP (both in the free form and in complex with uridine). The key difference is the `maximum open' state of one of the subunits comprising this dimer, which has not been observed previously for uridine phosphorylases. Some conformational features of the SoUP dimer that provide access of the substrate into the active site are revealed. The binding of the substrate was shown to require the concerted action of two subunits of the dimer. The changes in the three-dimensional structure induced by the C212S mutation account for the lower affinity of the mutant for inorganic phosphate, while the affinity for uridine remains unchanged.
    MeSH terms: Bacterial Proteins/chemistry*; Hydrogen Bonding; Kinetics; Models, Molecular; Protein Binding; Substrate Specificity; Uridine/chemistry; Uridine Phosphorylase/chemistry*; Protein Structure, Secondary; Crystallography, X-Ray; Catalytic Domain; Shewanella/enzymology*; Protein Structure, Quaternary
  6. Hazlina Y, Marlindawati MA, Shamsuddin K
    BMC Infect. Dis., 2016 Dec 08;16(1):740.
    PMID: 27931192
    BACKGROUND: Malaysia still faces challenges optimizing resources to effectively eliminate measles through high immunization and herd immunity, with sporadic outbreaks of measles as evidence. The objective of this study is to determine the age-specific positive measles antibodies seroprevalence used for assessing the establishment of herd immunity against measles in different age groups. This is useful for identifying vulnerable age groups requiring supplementary immunization.

    METHODS: A seroprevalence study was conducted among respondents aged 6-9 years, 15-24 years and 45-54 years attending government health clinics in Seremban between September 2014 and January 2015. A total of 1541 measles IgG antibody status were determined using ELISA technique (NovaTec Immundiagnostica GMBH) and assessment of establishment of herd immunity was based on indicators developed by Plans. Data on socio-demographic background as well as medical and medication history were also gathered.

    RESULTS: Seropositive rate for all respondents were 87% (95% CI 85-89), while the rest had either indeterminate [6% (95% CI 5-7)] or negative titre [7% (95% CI 6-8)]. None of the factors analyzed except for age were significant predictors of positive measles antibodies. Seropositive rate differed by age with the highest rate seen in adults (94%; CI 92-96), followed by children (90%; 95% CI 87-94) and adolescents, and young adults (74%; 95% CI 70-78). Based on Plans' indicators, herd immunity was established in adults and children, but not in adolescents and young adults.

    CONCLUSIONS: To tackle the most susceptible group in the present study, it is advisable to give booster vaccination to secondary school students and freshmen who enter colleges and universities in Malaysia.
    MeSH terms: Adolescent; Ambulatory Care Facilities; Antibodies, Viral/blood; Child; Female; Humans; Immunization, Secondary; Malaysia; Malaysia/epidemiology; Male; Measles/immunology*; Measles/epidemiology*; Middle Aged; Seroepidemiologic Studies; Immunity, Herd*; Young Adult
  7. 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
  8. 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
  9. 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
  10. 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
  11. ISBN: 978-967-0769-14-1
    Citation: Jadual Pelupusan Rekod Perubatan. Putrajaya: Kementerian Kesihatan Malaysia; 2016
    MeSH terms: Malaysia; Medical Records; Guidelines as Topic
  12. 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
  13. Citation: Management of Type 1 Diabetes Mellitus in Children and Adolescents. Putrajaya: Ministry of Health, Malaysia; 2016
    Quick Reference:
    Training Manual:
    MeSH terms: Adolescent; Child; Diabetes Mellitus, Type 1; Endocrinology; Humans; Malaysia; Guidelines as Topic
  14. MeSH terms: Humans; Psychiatry; Smoking; Tobacco Use Disorder; Guidelines as Topic; Tobacco Use Cessation
  15. MeSH terms: Humans; Malaysia; Nasopharyngeal Neoplasms; Guidelines as Topic
  16. 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*
  17. 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
  18. 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
  19. 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*
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