Browse publications by year: 2017

  1. Ariff HH, Verghese A, Brian CMK
    MyJurnal
    Tetanus is an acute, potentially fatal disease caused by Clostridium tetani. It is characterized by generalized, painful spasms and rigidity of skeletal muscles. We present two fatal cases and discuss the potential causes that lead to mortality in cases of tetanus infection
    MeSH terms: Clostridium tetani; Muscle Rigidity; Spasm; Tetanus; Muscle, Skeletal
  2. Dasrilsyah RA, Ahmad S, Tan GC, Lim PS
    MyJurnal
    Congenital leukemia is an extremely rare disease but frequently fatal. We report a case of intrauterine death (IUD) secondary to congenital erythroid leukaemia associated with maternal Parvovirus B19 infection. Further research is needed to ascertain the association between maternal Parvovirus B19 infection and congenital leukemia.
    MeSH terms: Female; Fetal Death; Leukemia; Pregnancy; Erythema Infectiosum; Rare Diseases; Stillbirth
  3. Abdullah F, Han TM, Mat Nor MB, Mohd Aznan MA, Ismail IZ
    MyJurnal
    Introduction: Hypertension (HPT) is the most common co-morbidity among type-2 diabetes mellitus (T2DM) patients which ominously increased their morbidity and mortality from cardiovascular diseases (CVD). We aimed to determine the prevalence and control status of HPT, and also the glycemic control among T2DM patients in a primary care clinic in Kuantan, Pahang. Methods: It was a retrospective study of 154 T2DM patients’ records, aged ≥18 years selected by random sampling. The statistical analysis is done by using Chisquare test, paired sample “t” test and ANOVA “F” test. Results: Among T2DM patients; 47% were Malay, 45% Chinese and 9% Indian. The prevalence of HPT was 72.1% and majority of T2DM patients were women (60%). Out of 82 T2DM aged >60 years, 80.5% were hypertensive. 67.2% of T2DM patients between the age of 40-60 years and 25% age <40 years were also hypertensive (p= 0.003). BP-controlled status were classified into controlled, uncontrolled, systolic and diastolic HPT. All patients were compared between the last visit and one year before, which reported 55.8% versus 33.1%, 14.9% versus 51.9%, 20.1% versus 10.4% and 9.1% versus 4.5% respectively. There were significant rises in percentage of systolic BP (by 9.7%) and diastolic HPT (by 4.6%) p<0.0001, from the first visit. BP controlled status for aged group >60 years showed increments in systolic HPT and diastolic HPT which were significant (p<0.0001). Regarding glycemic parameters, 71.4% T2DM patients had poor controlled level of Hb1Ac (≥6.5) and only 20.1% remained controlled after one year (p<0.0001). Conclusions: This pilot study found high prevalence of HPT, increasing prevalence of systolic HPT and diastolic HPT in older age group as well as poor glycemic control among T2DM patients.

    KEYWORDS: Controlled blood pressure, systolic hypertension, diastolic hypertension, HbA1C difference, primary care clinic
    MeSH terms: Ambulatory Care Facilities; Blood Glucose; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Humans; Hypertension; Malaysia; Primary Health Care; Cohort Studies; Comorbidity; Prevalence
  4. Adawiyah J, Moonyza AAK, Mohd Rizal AM, Hatta S, Nik Ruzyanei NJ, Marhani M, et al.
    MyJurnal
    Introduction: Psoriasis is a chronic, immune mediated, hyperproliferative skin disease that has substantial impact on the sexual functions. This study aimed to determine the prevalence and associated factors of female sexual dysfunction (FSD) in patients with psoriasis.
    Methods: A cross-sectional study involving 79 women with psoriasis attending two Dermatology Outpatient Clinics were interviewed and assessed for female sexual dysfunction and severity of psoriasis. The socio-demographic and clinical characteristics of the subjects were compared between the women with and without sexual dysfunction. The subjects were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I.) to exclude any existing psychiatric illness. Sexual dysfunction was assessed using a validated questionnaire on sexual function and the severity of psoriasis was assessed using Psoriasis Area and Severity Index (PASI).
    Results: The prevalence of FSD in the patients with psoriasis was 20.3%, with hypoactive sexual desire being the most prevalent problem (44.3%). Sexual dysfunction was associated with older age, menopause, low body mass index, longer duration of marriage and presence of psoriasis in the genital area. Female sexual dysfunction was highly prevalent in patients with psoriasis.
    Conclusion: Management of psoriasis should include assessment in patients’ sexual health. Genital area involvement with psoriasis should not be overlooked as it can cause significant psychosexual distress.
    Keywords: Psoriasis, female, sexual dysfunction, prevalence, risk factor, Malaysia
    Study site: Dermatology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    MeSH terms: Biological Phenomena; Cross-Sectional Studies; Female; Hospitals, University; Humans; Malaysia; Outpatient Clinics, Hospital; Psoriasis; Skin Diseases; Prevalence
  5. Suzanah Abdul Rahman, Nadia Hanis Abdul Samat, Nur Amalina Ahmad, ‘Afif Raihan Abdullah, Syazana Mohamad Zahri, Saheera Kamarzaman
    MyJurnal
    Exposure to cyclophosphamide (CPA) for cancer treatment results in over-production of reactive oxygen species and oxidative stress thus affecting the DNA in male germ cell inducing sperm defects. Our goal is to assess the potential effects of Nigella sativa extract (NSE) and thymoquinone (TQ) on sperm and embryo quality following fertlization of sperm produced from germ cells which have been exposed to the damaging alkylating effects of CPA.
    MeSH terms: Alkylating Agents; Cyclophosphamide; DNA; Goals; Male; Neoplasms; Spermatozoa; Benzoquinones; Reactive Oxygen Species; Oxidative Stress; Nigella sativa
  6. Imad M. Al-Ani, Ahmed N. Abired, Basma E. Mustafa, Emad N. Abdel Wahab, Marwan S. Azzubaidi
    MyJurnal
    Diabetes mellitus has become a serious warning to mankind health all over the world. The management goal of diabetes is to keep blood glucose levels as close as possible to healthy individuals. Medications used to treat diabetes are usually associated with complications and may cause different side effects. Many traditional anti-diabetic plants have become popular in the management of diabetes mellitus. Flaxseed has been used as traditional medicine for centuries.
    MeSH terms: Blood Glucose; Diabetes Mellitus; Goals; Humans; Medicine, Traditional; Plants; Flax
  7. Fakhria Al-Joufi, Anil K. Saxena, Imad M. Al-Ani, Norlelawati A. Talib, Rafidah H. Mokhtar, Norsidah Ku -Zaifah
    MyJurnal
    Atherosclerosis in cardiovascular disease (CVD) is a growing health problem, especially in developing countries. Hyperlipidemia is known as a dominant risk factor for the development of atherosclerosis. This study was designed to investigate the effects of Eurycoma Longifolia (EL) also known as Malaysian Ginseng/ Tongkat Ali on the testosterone level, biochemical changes of lipid profile and intima media thickness (IMT) in rats fed on high-fat diet. Twenty young, adult male Sprague-Dawley (SD) rats were housed for 12 weeks. After one week of acclimatization, they were randomly divided into four groups of 5 animals each and treated for 12 weeks as follow: Group ND was given only normal diet, group NDEL was given normal diet and EL extracts (15mg/kg) dissolved in distilled water, group HFD was given only high fat diet and group HFDEL was given high fat diet and EL extracts (15mg/kg). Rats which were treated with EL (NDEL and HFDEL) showed a significant increase (p
    MeSH terms: Acclimatization; Animals; Biological Phenomena; Developing Countries; Panax; Hyperlipidemias; Lipids; Male; Risk Factors; Testosterone; Rats, Sprague-Dawley; Eurycoma; Atherosclerosis; Rats; Carotid Intima-Media Thickness; Diet, High-Fat
  8. Khadijah Hasanah Abang Abdullah, Suriati Mohamed Saini, Shalisah Sharipb, Mohamed Hatta Shaharom
    MyJurnal
    Traditional medicine which includes Islamic faith healing centre is still an important place to seek treatment whether for psychiatric reasons or others. This study aims to determine the prevalence of psychiatric illness among attenders of an Islamic spiritual healing centre and to understand patients’ illness attribution and their religiosity.
    MeSH terms: Humans; Islam; Medicine, Traditional; Prevalence; Spiritual Therapies; Faith Healing
  9. Norazsida, R., Pakeer, O., Taher, M.
    MyJurnal
    This study was conducted to evaluate the phytochemical contents and antimalarial properties of the oils extracted from the leaves of Malaysian Plectranthus amboinicus in mice infected with Plasmodium berghei. The essential oils were extracted and prepared by using steam distillation technique and subjected to phytochemical screening by using GC-MS. Antimalarial activity of different extract doses of the essential oil was tested in vivo in ICR mice infected with Plasmodium berghei (PZZ1/100) during early, established and residual infections. In all, 5 compounds made up 88.34% of total oil and the major chemical compounds were carvacrol (85.14%), thymoquinone (1.65%), terpinen-4-ol (0.70%), octenol (0.62%) and thymol (0.23%). Antimalarial assay showed this essential oil as a potential prophylactic agent with the percentage chemosuppression of 45.23%, 18.28%, 45.38% and 58.26% while treated with 50, 200, 400 and 1000 µL/kg respectively of essential oil and curative agent with percentage of chemo suppression of 54.10%, 47.35%, 56.75% and 65.38% while treated with the above dose of essential oil. Statistically no reduction of parasitemia was calculated for suppressive test. The extract has prophylactic and curative effects on P.berghei in mice
    MeSH terms: Animals; Antimalarials; Gas Chromatography-Mass Spectrometry; Mice, Inbred ICR; Oils, Volatile; Plasmodium berghei; Steam; Terpenes; Thymol; Benzoquinones; Parasitemia; Plant Leaves; Plectranthus; Monoterpenes; Mice; Distillation; Phytochemicals
  10. Husin H, Sidi H, Baharudin A
    MyJurnal
    Introduction: Anxiety and depression are both associated with increased morbidity in diabetic population, especially those afflicted with foot ulcer, whereas Erectile Dysfunction (“ED”) and Female Sexual Dysfunction (“FSD”) are amongst the common complication found in diabetes. This study aimed to determine the prevalence of anxiety and depression as primary outcome and sexual dysfunction (“SD”) as a secondary outcome in diabetic patients with and without foot ulcer (“DFU”).
    Methods: A cross-sectional study was conducted in Hospital Raja Permaisuri Bainun Ipoh, Perak, where 164 diabetic patients were recruited for the purpose of this study. Hospital Anxiety and Depression Scale (“HADS”) were utilised to measure anxiety and depression. International Index for Erectile Function 5 (“IIEF-5”) and the Malay version of Female Sexual Function Index (“MVFSFI”) were used to detect SD. Simple and multiple logistic regressions were referred to in order to evaluate the factors associated with anxiety, depression and SD.
    Results: In the group with foot ulcer, 36.8% had depressive and anxiety risk respectively compared to without the foot ulcer, 37.5% and 38.5% respectively. Male gender (AOR=6.3,p=0.002,95%CI 1.975, 20.205) and having lower education status (AOR=6.0,p=0.018,95%CI1.36,26.59,) was associated with foot ulcer. High prevalence of SD found in foot ulcer group (52.6%,p=0.006). Those with depression (OR=4.421,95% CI 1.08,18.16,p=0.039) and male gender (OR=18.42,p<0.01,95%CI5.5,-61.62) predicts present of SD.
    Conclusion: Depression and anxiety prevalent were similar for both with and without diabetic foot ulcer. Several significant predictor factors were identified for DFU group, for anxiety and depression risk and for SD in a diabetes patient. Further studies are required to establish the directional nature of this relationship.
    Keywords: Depression, Anxiety, Diabetic food ulcer (DFU), Erectile Dysfunction (ED), Female Sexual Dysfunction (FSD)
    Study site: outpatient clinic of medical and orthopedic departments in Hospital Raja Permaisuri Bainun (HRPB) Ipoh, Perak, Malaysia
    MeSH terms: Anxiety; Anxiety Disorders; Depression; Depressive Disorder; Diabetes Mellitus; Female; Humans; Erectile Dysfunction; Malaysia; Male; Outpatient Clinics, Hospital; Prevalence; Foot Ulcer
  11. Azrina Md Ralib, Mohd Basri Mat Nor
    MyJurnal
    Urine output provides a rapid estimate for kidney function, and its use has been incorporated in the diagnosis of acute kidney injury. However, not many studies had validated its use compared to the plasma creatinine. It has been showed that the ideal urine output threshold for prediction of death or the need for dialysis was 0.3 ml/kg/h. We aim to assess this threshold in our local ICU population.
    MeSH terms: Creatinine; Fluid Therapy; Renal Dialysis; Intensive Care Units; Kidney Function Tests; Urinary Tract Physiological Phenomena; Acute Kidney Injury
  12. Mohamed Faisal AH, Petrick P, Andrea YL Ban, Roslina AM
    MyJurnal
    Pneumococcal pneumonia is the commonest type of bacterial pneumonia worldwide. In Malaysia, the reported incidence of pneumococcal pneumonia is low. This may be due to poor sensitivity of conventional methods. The use of BinaxNOW, a urinary antigen test for Streptococcus pneumoniae can aid in the diagnosis of pneumococcal pneumonia.
    MeSH terms: Immunologic Tests; Malaysia; Pneumonia, Pneumococcal; Streptococcus pneumoniae; Incidence; Pneumonia, Bacterial
  13. AR Siti Nurul Fazlin, H Hairul Aini, HM Hadzri, MM Mohammed Imad
    MyJurnal
    Hepatitis C virus (HCV) genotyping is very important for the clinical management of HCV-infected patients. The aim of this study was to determine the genotypes of HCV-infected patients and to identify their risk factors and comorbidities.
    MeSH terms: Genotype; Hepatitis C; Humans; Risk Factors; Comorbidity; Hepacivirus
  14. A Azizi, HM Rafidah
    MyJurnal
    Individuals with metabolic syndrome are at increased risk for developing cardiovascular disease and diabetes mellitus. This study was carried out to determine the prevalence of metabolic syndrome and clinical characteristics in hypertensive patients according to the criteria of the new International Diabetes Federation (IDF) definition. Hypertensive patients were recruited from the Medical Out-Patient Department, Kuantan Hospital. The five components of metabolic syndrome were examined which included blood pressure (≥130/85 mmHg), fasting glucose (≥5.6mmol/L), fasting triglycerides (≥1.7 mmol/L), high-density lipoprotein (HDL) cholesterol level (80cm). Out of 139 hypertensive patients, there were 113 met all the selection criteria consisted of 61 male and 52 female subjects. The participants’ age ranged from 21 to 91 years (51.9±16.8 years; mean±SD), and body mass index 13.5-42.3 kg/m2 (27.5±4.9 kg/m2). According to the IDF criteria, the prevalence of central obesity was 67.2% in men and 84.6% in women. Among the 113 hypertensive subjects over 21 years of age, 51 subjects or 45.1% had metabolic syndrome. The present data revealed that there was high prevalence of metabolic syndrome in Malaysian hypertensive subjects. This finding was supported by the fact of high prevalence of central obesity among the study subjects.
    Study site: Medical clinic, Hospital Kuantan, Pahang, Malaysia
    MeSH terms: Adult; Aged; Aged, 80 and over; Blood Pressure; Blood Pressure Determination; Cholesterol; Cross-Sectional Studies; Diabetes Mellitus; Fasting; Female; Glucose; Hospitals, General; Humans; Hypertension; Lipoproteins, HDL; Malaysia; Male; Middle Aged; Outpatient Clinics, Hospital; Outpatients; Risk; Triglycerides; Body Mass Index; Prevalence; Patient Selection; Young Adult; Obesity, Abdominal
  15. Kwong QB, Teh CK, Ong AL, Chew FT, Mayes S, Kulaveerasingam H, et al.
    BMC Genet, 2017 Dec 11;18(1):107.
    PMID: 29228905 DOI: 10.1186/s12863-017-0576-5
    BACKGROUND: Genomic selection (GS) uses genome-wide markers as an attempt to accelerate genetic gain in breeding programs of both animals and plants. This approach is particularly useful for perennial crops such as oil palm, which have long breeding cycles, and for which the optimal method for GS is still under debate. In this study, we evaluated the effect of different marker systems and modeling methods for implementing GS in an introgressed dura family derived from a Deli dura x Nigerian dura (Deli x Nigerian) with 112 individuals. This family is an important breeding source for developing new mother palms for superior oil yield and bunch characters. The traits of interest selected for this study were fruit-to-bunch (F/B), shell-to-fruit (S/F), kernel-to-fruit (K/F), mesocarp-to-fruit (M/F), oil per palm (O/P) and oil-to-dry mesocarp (O/DM). The marker systems evaluated were simple sequence repeats (SSRs) and single nucleotide polymorphisms (SNPs). RR-BLUP, Bayesian A, B, Cπ, LASSO, Ridge Regression and two machine learning methods (SVM and Random Forest) were used to evaluate GS accuracy of the traits.

    RESULTS: The kinship coefficient between individuals in this family ranged from 0.35 to 0.62. S/F and O/DM had the highest genomic heritability, whereas F/B and O/P had the lowest. The accuracies using 135 SSRs were low, with accuracies of the traits around 0.20. The average accuracy of machine learning methods was 0.24, as compared to 0.20 achieved by other methods. The trait with the highest mean accuracy was F/B (0.28), while the lowest were both M/F and O/P (0.18). By using whole genomic SNPs, the accuracies for all traits, especially for O/DM (0.43), S/F (0.39) and M/F (0.30) were improved. The average accuracy of machine learning methods was 0.32, compared to 0.31 achieved by other methods.

    CONCLUSION: Due to high genomic resolution, the use of whole-genome SNPs improved the efficiency of GS dramatically for oil palm and is recommended for dura breeding programs. Machine learning slightly outperformed other methods, but required parameters optimization for GS implementation.

    MeSH terms: Plant Breeding/methods*; Bayes Theorem; Chromosome Mapping; Genetic Markers*; Genotype; Phenotype; Selection, Genetic*; Genome, Plant*; Microsatellite Repeats; Polymorphism, Single Nucleotide; Genomics; Arecaceae/genetics*; Arecaceae/growth & development; Chromosomes, Plant
  16. Qie L, Lewis SL, Sullivan MJP, Lopez-Gonzalez G, Pickavance GC, Sunderland T, et al.
    Nat Commun, 2017 12 19;8(1):1966.
    PMID: 29259276 DOI: 10.1038/s41467-017-01997-0
    Less than half of anthropogenic carbon dioxide emissions remain in the atmosphere. While carbon balance models imply large carbon uptake in tropical forests, direct on-the-ground observations are still lacking in Southeast Asia. Here, using long-term plot monitoring records of up to half a century, we find that intact forests in Borneo gained 0.43 Mg C ha-1 per year (95% CI 0.14-0.72, mean period 1988-2010) above-ground live biomass. These results closely match those from African and Amazonian plot networks, suggesting that the world's remaining intact tropical forests are now en masse out-of-equilibrium. Although both pan-tropical and long-term, the sink in remaining intact forests appears vulnerable to climate and land use changes. Across Borneo the 1997-1998 El Niño drought temporarily halted the carbon sink by increasing tree mortality, while fragmentation persistently offset the sink and turned many edge-affected forests into a carbon source to the atmosphere.
    MeSH terms: Atmosphere; Borneo; Carbon Dioxide; Trees; Biomass; Droughts; Carbon Sequestration; El Nino-Southern Oscillation; Forests
  17. Ng BK, Yakob KA, Ng WYL, Lim PS, Abd Rahman R, Abdul Karim AK, et al.
    Case Rep Med, 2017;2017:9016782.
    PMID: 29259630 DOI: 10.1155/2017/9016782
    Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10-20% of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient. We report a case of NTM in abdominopelvic TB. A 37-year-old foreign worker, para 3, presented with a one-week history of suprapubic pain associated with fever. An assessment showed presence of a right adnexal mass. She was treated as tuboovarian abscess with intravenous antibiotics. Unfortunately, she did not respond. She underwent exploratory laparotomy. Intraoperatively, features of the mass were suggestive of a right mature cystic teratoma with presence of slough and cheesy materials all over the abdominal cavity as well as presence of ascites. Diagnosis of NTM was confirmed with PCR testing using the peritoneal fluid. This case was a diagnostic dilemma due to the nonspecific clinical presentation. Management of such rare infection was revisited.
    MeSH terms: Abscess; Anti-Bacterial Agents; Ascites; Ascitic Fluid; Cause of Death; Female; Fever; Humans; Laparotomy; Nontuberculous Mycobacteria; Pain; Teratoma; Tuberculosis; Incidence; Polymerase Chain Reaction; Abdominal Cavity
  18. Mohamad NA, Ramachandran V, Ismail P, Mohd Isa H, Chan YM, Ngah NF, et al.
    Int J Ophthalmol, 2017;10(12):1889-1897.
    PMID: 29259909 DOI: 10.18240/ijo.2017.12.16
    AIM: To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy (PDT) among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang from 2010 to 2014.

    METHODS: Study subjects were recruited retrospectively using the Electronic Medical Record (EMR) database software in Hospital Selayang. Demographic data, medical history, diagnostic procedure, treatments and diagnosis of patients were recorded.

    RESULTS: The five-year analysis included 821 patients with a mean age of 65.9±11.73y. Overall, there were a higher number of males (63.1%) and a higher number of Chinese (47.4%) patients. Among the 821 patients, 62.9% received ranibizumab injection followed by 19.2% PDT therapy and 17.9% had ranibizumab combined with PDT therapy. Age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) were the most common retinal eye diseases reported, recording prevalence of 25.0% and 45.6%, respectively. The trend in ranibizumab treatment was reported to increase while PDT showed a decrease in trend from year 2010 to 2014. In terms of treatment, following multiple logistic regression, AMD was associated with the subjects being more likely to have received ranibizumab monotherapy (P<0.001) while PCV was associated with more likely to have received PDT (P<0.001) and PDT combined with ranibizumab therapy (P<0.001).

    CONCLUSION: The tertiary care setting in Malaysia is consistent with management of patients from other countries whereby ranibizumab is the most common treatment given to patients with AMD, while PCV patients most commonly receive PDT and ranibizumab combined with PDT therapy.

    Study site: Ophthalmology Clinic, Hospital Selayang
    MeSH terms: Ranibizumab*; Hospitals; Humans; Malaysia; Outpatient Clinics, Hospital; Retrospective Studies
  19. Kumbargere Nagraj S, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A
    Cochrane Database Syst Rev, 2017 Dec 20;12(12):CD010470.
    PMID: 29260510 DOI: 10.1002/14651858.CD010470.pub3
    BACKGROUND: The sense of taste is very much essential to the overall health of an individual. It is a necessary component to enjoy one's food, which in turn provides nutrition to an individual. Any disturbance in taste perception can hamper quality of life in such patients by influencing their appetite, body weight and psychological well-being. Taste disorders have been treated using different modalities of treatment and there is no consensus for the best intervention. Hence this Cochrane Review was undertaken. This is an update of the Cochrane Review first published in November 2014.

    OBJECTIVES: To assess the effects of interventions for the management of patients with taste disturbances.

    SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 4 July 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017 Issue 6) in the Cochrane Library (searched 4 July 2017); MEDLINE Ovid (1946 to 4 July 2017); Embase Ovid (1980 to 4 July 2017); CINAHL EBSCO (1937 to 4 July 2017); and AMED Ovid (1985 to 4 July 2017). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for trials. Abstracts from scientific meetings and conferences were searched on 25 September 2017. No restrictions were placed on the language or date of publication when searching the electronic databases.

    SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing any pharmacological agent with a control intervention or any non-pharmacological agent with a control intervention. We also included cross-over trials in the review.

    DATA COLLECTION AND ANALYSIS: Two pairs of review authors independently, and in duplicate, assessed the quality of trials and extracted data. Wherever possible, we contacted trial authors for additional information. We collected adverse events information from the trials.

    MAIN RESULTS: We included 10 trials (581 participants), nine of which we were able to include in the quantitative analyses (566 participants). We assessed three trials (30%) as having a low risk of bias, four trials (40%) at high risk of bias and three trials (30%) as having an unclear risk of bias. We only included studies on taste disorders in this review that were either idiopathic, or resulting from zinc deficiency or chronic renal failure.Of these, nine trials with 544 people compared zinc supplements to placebo for patients with taste disorders. The participants in two trials were children and adolescents with respective mean ages of 10 and 11.2 years and the other seven trials had adult participants. Out of these nine, two trials assessed the patient-reported outcome for improvement in taste acuity using zinc supplements (risk ratio (RR) 1.40, 95% confidence interval (CI) 0.94 to 2.09; 119 participants, very low-quality evidence). We meta-analysed for taste acuity improvement using objective outcome (continuous data) in idiopathic and zinc-deficient taste disorder patients (standardised mean difference (SMD) 0.44, 95% CI 0.23 to 0.65; 366 participants, three trials, very low-quality evidence). We also analysed one cross-over trial separately using the first half of the results for taste detection (mean difference (MD) 2.50, 95% CI 0.93 to 4.07; 14 participants, very low-quality evidence), and taste recognition (MD 3.00, 95% CI 0.66 to 5.34; 14 participants, very low-quality evidence). We meta-analysed taste acuity improvement using objective outcome (dichotomous data) in idiopathic and zinc-deficient taste disorder patients (RR 1.42, 95% 1.09 to 1.84; 292 participants, two trials, very low-quality evidence). Out of the nine trials using zinc supplementation, four reported adverse events like eczema, nausea, abdominal pain, diarrhoea, constipation, decrease in blood iron, increase in blood alkaline phosphatase, and minor increase in blood triglycerides.One trial tested taste discrimination using acupuncture (MD 2.80, 95% CI -1.18 to 6.78; 37 participants, very low-quality evidence). No adverse events were reported in the acupuncture trial.None of the included trials could be included in the meta-analysis for health-related quality of life in taste disorder patients.

    AUTHORS' CONCLUSIONS: We found very low-quality evidence that was insufficient to conclude on the role of zinc supplements to improve taste acuity reported by patients and very low-quality evidence that zinc supplements improve taste acuity in patients with zinc deficiency/idiopathic taste disorders. We did not find any evidence to conclude the role of zinc supplements for improving taste discrimination, or any evidence addressing health-related quality of life due to taste disorders.We found very low-quality evidence that is not sufficient to conclude on the role of acupuncture for improving taste discrimination in cases of idiopathic dysgeusia (distortion of taste) and hypogeusia (reduced ability to taste). We were unable to draw any conclusions regarding the superiority of zinc supplements or acupuncture as none of the trials compared these interventions.

    MeSH terms: Adolescent; Adult; Child; Humans; Quality of Life; Taste Disorders/diagnosis; Taste Disorders/etiology; Taste Disorders/therapy*; Zinc/deficiency; Acupuncture Therapy*; Randomized Controlled Trials as Topic; Zinc Compounds/adverse effects; Zinc Compounds/therapeutic use*; Taste Perception
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