Browse publications by year: 2020

  1. Lim BJV, Wahab SFA, Kueh YC
    Malays J Med Sci, 2020 Mar;27(2):90-100.
    PMID: 32788845 DOI: 10.21315/mjms2020.27.2.10
    Background: The study aimed to examine the reliability and validity of the existing three-tier triaging system and a new five-level emergency triaging system, emergency severity index (ESI), in the Emergency Department (ED) of Hospital Universiti Sains Malaysia (HUSM).

    Methods: This study was conducted in HUSM's ED over two study periods. In the first three months, 300 patients were triaged under the three-tier triaging system, and, in the subsequent three months, 280 patients were triaged under the ESI. The patients were triaged by junior paramedics and the triage records were retained and later re-triaged by senior paramedics. The inter-rater reliability was evaluated using Cohen's Kappa statistics. The acuity ratings of the junior paramedics were compared with those of the expert panel to determine the sensitivity and specificity of each acuity level for both the ESI and the three-tier triaging system. The over-triage rate, under-triage rate, amount of resources used, admission rate and discharge rate were also determined.

    Results: The inter-rater agreement for the three-tier triaging system was 0.81 while that of the ESI was 0.75. The ESI had a higher average sensitivity of 74.3% and a specificity of 94.4% while the three-tier system's average sensitivity was 68.5% and its specificity 87.0%. The average under-triage and over-triage rates for the ESI were 10.7% and 6.2%, respectively, which were lower than the three-tier system's average under-triage rate of 13.1% and over-triage rate of 17.1%. The urgency levels of both the ESI and the three-tier system were associated with increased admission rates and resources used in the ED.

    Conclusion: The ESI's inter-rater reliability was comparable to the three-tier triaging system and it demonstrated better validity than the existing three-tier system.

    MeSH terms: Allied Health Personnel; Emergencies; Emergency Service, Hospital; Humans; Malaysia; Patient Discharge; Sensitivity and Specificity; Triage; Reproducibility of Results
  2. Sha An Ali M, Mohd Nazir NA, Manaf ZA
    Malays J Med Sci, 2020 Mar;27(2):101-111.
    PMID: 32788846 MyJurnal DOI: 10.21315/mjms2020.27.2.11
    Background: The low consumption of fruits and vegetables among children is a global challenge. Foods recognition, nutrition knowledge and attitude are factors that influence children's dietary practices. This study aims to assess the preference, attitude, recognition and knowledge of fruits and vegetables intake among Malay children.

    Methods: A cross-sectional study was conducted among Malay children from five primary schools in Kuala Lumpur using self-administered questionnaires.

    Results: A total of 134 Malay children (70 males and 64 females) with a mean (SD) age of 10.3 (1.0) years were recruited. Majority of the children had a father (61.9%) and a mother (56.0%) with secondary school education and earned below RM3,900 (70.9%) per month. The most preferred fruits and vegetable were bananas (91.9%) and carrots (71.4%), while the most recognised was oranges (100.0%) and tomatoes (96.3%). The children demonstrated an overall moderate level of attitude, recognition and knowledge with mean (SD) scores of 70.3 (19.9), 76.8 (18.1) and 73.6 (17.5), respectively, towards fruits and vegetables intake. Majority of the children (53.0%) were not aware of the daily recommended servings of fruits and vegetables, while 40.0% of children expressed a low attitude towards eating a variety of fruits and vegetables. The willingness to try a new type of vegetables and consume more vegetables was lower (68.7%) compared to fruits (75.4%).

    Conclusion: The preferences and recognition of fruits were higher compared to vegetables among the children. The children demonstrated a moderate level of attitude, recognition and knowledge towards fruits and vegetables consumption. Efforts to educate children on the recommended number of servings per day and improve their acceptability of vegetables should be implemented to promote the increase in fruits and vegetables consumption among children.

    MeSH terms: Awareness; Child; Cross-Sectional Studies; Fathers; Female; Fruit; Humans; Malaysia; Male; Mothers; Surveys and Questionnaires; Schools; Vegetables; Lycopersicon esculentum; Daucus carota; Musa; Citrus sinensis
  3. Farid H, Pasha L, Majeed M
    Malays J Med Sci, 2020 Mar;27(2):112-119.
    PMID: 32788847 DOI: 10.21315/mjms2020.27.2.12
    Background: The objective of the current study was to adapt the Index of Dental Anxiety and Fear (IDAF-4C) in the Urdu language and measure its validity and reliability.

    Methods: Original English questionnaire of IDAF-4C was translated into Urdu language by a panel of dentists and language experts (Urdu and English) followed by critical evaluation, modification and back translation into English language. A final Urdu questionnaire was distributed among 250 patients visiting the Endodontics section at Margalla Institute of Health Sciences (MIHS), Rawalpindi, Pakistan. Cronbach's alpha was used to determine the reliability of the Index whereas validity was assessed by exploratory factor analysis (EFA). Mean rank scores of IDAF-4C for male and female participants were evaluated using Mann-Whitney U tests (P < 0.05).

    Results: Of 250 questionnaires, 209 were returned with a response rate of 84%. Cronbach's alpha for the Urdu version of IDAF-4C was 0.88. Exploratory factor analysis of the IDAF-4C revealed one factor explaining 55.55% of the common variance (Eigenvalue = 4.5). The mean rank scores of all eight items of IDAF-4C were greater for female participants as compared to male participants with a statistically significant association (P < 0.05).

    Conclusion: The psychometric analysis of the Urdu version of IDAF-4C showed good reliability and consistency compared to the original version as well as other translated versions.

    MeSH terms: Dentists; Endodontics; Factor Analysis, Statistical; Fear; Female; Humans; Language; Male; Pakistan; Psychometrics; Surveys and Questionnaires; Translating; Translations; Reproducibility of Results; Dental Anxiety; Statistics, Nonparametric
  4. Yap SF, Boo NY, Pramod DS, Thaw Z, Liew SF, Woo LF, et al.
    Malays J Med Sci, 2020 Mar;27(2):120-128.
    PMID: 32788848 MyJurnal DOI: 10.21315/mjms2020.27.2.13
    Background: Studies on sarcopenia among Malaysian older people (OP ≥ 60 years of age) living in the community but not in long-term care (LTC) homes have been reported previously. This study aimed to determine the prevalence of sarcopenia and its risk factors in OP in Malaysian LTC homes.

    Methods: This cross-sectional study was conducted with 202 independently mobile OP (males 32%) in seven LTC homes in the Klang Valley of Malaysia. Trained personnel measured their anthropometrics, body composition, gait speed, hand grip strength and timed up-and-go (TUG) duration. Criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Asian Working Group for Sarcopenia were used to identify the presence of sarcopenia. The mini-nutritional assessment (MNA) was used to determine their nutritional status. Additionally, logistic regression analysis was performed to identify significant risk factors associated with pre-sarcopenia/sarcopenia.

    Results: Pre-sarcopenia/sarcopenia was detected in 103 (51%) OP. The significant risk factors were body mass index (BMI, weight/height2; adjusted odds ratio [AOR] = 0.44, P < 0.001), percentage of body fat (PBF; AOR = 1.26, P < 0.001), age group (≥ 80 years; AOR = 3.63, P = 0.025) and 'at risk of malnutrition' status (AOR = 2.63, P = 0.049).

    Conclusion: Sarcopenia is common among OP in LCT homes. The risk increases with decreasing BMI, increasing PBF, age ≥ 80 years and suboptimal nutrition status.

    MeSH terms: Aged; Aged, 80 and over; Body Composition; Body Weight; Cross-Sectional Studies; Humans; Long-Term Care; Malaysia; Male; Middle Aged; Nutritional Status; Risk Factors; Nutrition Assessment; Body Mass Index; Prevalence; Logistic Models; Odds Ratio; Hand Strength; Sarcopenia; Walking Speed
  5. Rahman AA, Ibrahim MI, Rahman RA, Arifin WN, Ahmad M
    Malays J Med Sci, 2020 Mar;27(2):129-150.
    PMID: 32788849 MyJurnal DOI: 10.21315/mjms2020.27.2.14
    Background: The aim of the study is to develop and validate the Malay version of the questionnaire assessing the extent of pornography exposure (PORQUE) among youth in Kelantan.

    Methods: 'Youth' was defined as a person aged between 15 and 24 years, while 'pornography' refers to any material that depicts sexual activity or erotic behaviour. The development phase consisted of a literature review, an expert panel review, face validation and a pre-test. Fifty college students from a randomly selected higher learning institutions were invited to participate in the pilot test, whereas 150 and 198 different students from the same institutions participated in exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively.

    Results: EFA suggested a five-factor solution with factor loadings ranging from 0.449 to 0.891 and a Cronbach's alpha ranging from 0.904 to 0.966. The CFA of the attitude questions also proved a good fitting model with good fit indices: comparative fit index (CFI) robust = 0.907; Tucker-Lewis fit index (TLI) robust = 0.901; root mean square error of approximation (RMSEA) robust = 0.073; standardised root mean square residual (SRMR) = 0.060. The factor loadings ranged from 0.544 to 0.906, whereas the Raykov's rho ranged from 0.886 - 0.974.

    Conclusion: Based on EFA and CFA, the attitude sections of the newly developed Malay version of the PORQUE were found to be psychometrically valid.

    MeSH terms: Adolescent; Adult; Erotica; Factor Analysis, Statistical; Humans; Malaysia; Surveys and Questionnaires; Students; Young Adult
  6. Hikmah N', Anuar TS
    Malays J Med Sci, 2020 Mar;27(2):151-158.
    PMID: 32788850 MyJurnal DOI: 10.21315/mjms2020.27.2.15
    Background: Mobile phones (MPs) have become one of the most indispensable accessories in social and professional life. Though they offer plenty of benefits, MPs are prolific breeding grounds for infectious pathogens in communities. Thus, the aim of this study was to identify the prevalence of bacterial contamination and determine antimicrobial susceptibility pattern of Staphylococcus aureus (S. aureus) from MPs.

    Methods: A cross-sectional study was conducted from March to July 2019 on 126 students and 37 laboratory staff/clinical instructors' MPs from the Faculty of Health Sciences, Universiti Teknologi MARA, Malaysia by a simple random sampling technique. Along with the questionnaire, a swab sample from each participant's MPs was collected and transported to the microbiology laboratory for bacterial culture as per standard microbiological procedures and antimicrobial susceptibility test by the disc diffusion technique. Data were analysed by the Statistical Package for Social Sciences Programme version 24.

    Results: All of the tested MPs were contaminated with either single or mix bacterial agents. Bacillus spp. (74.8%), coagulase-negative staphylococci (CoNS; 47.9%) and S. aureus (20.9%) were the most predominant bacterial isolates, whilst the least isolate was Proteus vulgaris (P. vulgaris) (2.5%). Oxacillin resistance was seen in 5.9% of S. aureus isolate. A comparison of bacteria type and frequency among gender showed a significant difference with P. vulgaris (P = 0.003) and among profession showed a significant difference with S. aureus (P = 0.004).

    Conclusion: The present study indicates that MPs can serve as a vector for both pathogenic and non-pathogenic organisms. Therefore, full guidelines about restricting the use of MPs in laboratory environments, hand hygiene and frequent decontamination of MPs are recommended to limit the risk of cross-contamination and healthcare-associated infections caused by MPs.

    MeSH terms: Bacillus; Coagulase; Communicable Diseases; Cross Infection; Cross-Sectional Studies; Decontamination; Humans; Malaysia; Microbiological Techniques; Oxacillin; Proteus vulgaris; Staphylococcus aureus; Prevalence; Hand Hygiene; Clinical Laboratory Services
  7. Shakeel S, Ahmed Hassali MA, Abbas Naqvi A
    Malays J Med Sci, 2020 Mar;27(2):159-164.
    PMID: 32788851 MyJurnal DOI: 10.21315/mjms2020.27.2.16
    The World Health Organization (WHO) has termed the novel coronavirus infection a pandemic based on number of confirmed cases in more than 195 countries and with risk of further spread. The infection has had drastic impact on global trade and stock markets. The Malaysian authorities realised the need to ensure availability of health resources and facilities in the country so that the healthcare professionals could treat serious cases on priority basis. Steps have been taken to ensure that health facilities are not overwhelmed with cases and do not become the source of virus spread to other healthcare staff and patients.
    MeSH terms: Delivery of Health Care; Health Facilities; Health Resources; Humans; World Health Organization; Coronavirus Infections; Pandemics
  8. Chang YHR
    Chem Commun (Camb), 2020 Sep 17;56(74):10962-10965.
    PMID: 32789397 DOI: 10.1039/d0cc04123h
    While lab-scale synthesis of trigonal-Zr2N2S, hexagonal-Zr2N2S and hexagonal-Zr2N2Se has been reported, meaningful data on the photophysical properties of IV-nitride chalcogenides in general are scarcely available. The first-principles calculations and genetic algorithm modeling in our work reveal the existence of remarkably stable, indirect gap trigonal-Zr2N2Se and trigonal-Hf2N2Se phases, which progress to direct gap, monoclinic materials in monolayer form. These structures display the desired optoelectronic properties, such as exceptionally high visible-UV absorption spectra (105-106 cm-1) and exciton binding energy below 0.02 eV. Strong hybridization between the Zr-d, N-p and Se-p orbitals is accounted for by the polysilicon comparable Vickers hardness (10.64-12.77 GPa), while retaining ductile nature.
    MeSH terms: Algorithms; Hardness; Hybridization, Genetic; Nucleic Acid Hybridization; Physical Phenomena
  9. Awan AM, Azam M, Saeed IU, Bakhtyar B
    Environ Sci Pollut Res Int, 2020 Dec;27(36):45405-45418.
    PMID: 32789804 DOI: 10.1007/s11356-020-10445-4
    The broad purpose of this study is to empirically explore the impact of globalization and financial development on environmental pollution by carbon (CO2) emissions in the six Middle East and North Africa (MENA) countries using balanced panel data from 1971 to 2015. We also aimed to test the legitimacy of the environmental Kuznets curve (EKC) hypothesis for this region. The fixed-effects approach preferred by the Hausman specification test is used to estimate the empirical model, and the feasible generalized least squares (F.G.L.S.) estimator is employed to cope with any issue of heteroscedasticity and serial correlation. This study found that globalization and financial development have adverse and significant effects on environmental degradation and affirm the legitimacy of the EKC hypothesis for these countries. The finding of this study suggests that the governments of MENA countries should design and implement appropriate policies for strengthening the renewable sources of energy like wind, solar, bio-fuel, and thermal to decrease CO2 emissions and boost sustainable economic development. The policymakers should focus on the efficiency of institutions and enhancement of energy-saving projects in this region.
    MeSH terms: Africa, Northern; Middle East; Internationality; Economic Development*; Renewable Energy
  10. Kow CS, Hasan SS
    Headache, 2020 10;60(9):2085-2086.
    PMID: 32790208 DOI: 10.1111/head.13945
    MeSH terms: Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Headache; Humans; Migraine Disorders*; Pneumonia, Viral*; Weight Gain/drug effects; Coronavirus*; Coronavirus Infections*; Pandemics*
  11. Tanil CT, Yong MH
    PLoS One, 2020;15(8):e0219233.
    PMID: 32790667 DOI: 10.1371/journal.pone.0219233
    Our aim was to examine the effect of a smartphone's presence on learning and memory among undergraduates. A total of 119 undergraduates completed a memory task and the Smartphone Addiction Scale (SAS). As predicted, those without smartphones had higher recall accuracy compared to those with smartphones. Results showed a significant negative relationship between phone conscious thought, "how often did you think about your phone", and memory recall but not for SAS and memory recall. Phone conscious thought significantly predicted memory accuracy. We found that the presence of a smartphone and high phone conscious thought affects one's memory learning and recall, indicating the negative effect of a smartphone proximity to our learning and memory.
    MeSH terms: Smartphone; Learning; Memory; Mental Recall; Behavior, Addictive
  12. Vijayasarveswari V, Andrew AM, Jusoh M, Sabapathy T, Raof RAA, Yasin MNM, et al.
    PLoS One, 2020;15(8):e0229367.
    PMID: 32790672 DOI: 10.1371/journal.pone.0229367
    Breast cancer is the most common cancer among women and it is one of the main causes of death for women worldwide. To attain an optimum medical treatment for breast cancer, an early breast cancer detection is crucial. This paper proposes a multi- stage feature selection method that extracts statistically significant features for breast cancer size detection using proposed data normalization techniques. Ultra-wideband (UWB) signals, controlled using microcontroller are transmitted via an antenna from one end of the breast phantom and are received on the other end. These ultra-wideband analogue signals are represented in both time and frequency domain. The preprocessed digital data is passed to the proposed multi- stage feature selection algorithm. This algorithm has four selection stages. It comprises of data normalization methods, feature extraction, data dimensional reduction and feature fusion. The output data is fused together to form the proposed datasets, namely, 8-HybridFeature, 9-HybridFeature and 10-HybridFeature datasets. The classification performance of these datasets is tested using the Support Vector Machine, Probabilistic Neural Network and Naïve Bayes classifiers for breast cancer size classification. The research findings indicate that the 8-HybridFeature dataset performs better in comparison to the other two datasets. For the 8-HybridFeature dataset, the Naïve Bayes classifier (91.98%) outperformed the Support Vector Machine (90.44%) and Probabilistic Neural Network (80.05%) classifiers in terms of classification accuracy. The finalized method is tested and visualized in the MATLAB based 2D and 3D environment.
    MeSH terms: Machine Learning; Algorithms; Bayes Theorem; Female; Forecasting/methods*; Humans; Models, Theoretical; Pattern Recognition, Automated/methods; Neural Networks (Computer); Support Vector Machine
  13. Raouf MA, Hashim F, Liew JT, Alezabi KA
    PLoS One, 2020;15(8):e0237386.
    PMID: 32790697 DOI: 10.1371/journal.pone.0237386
    The IEEE 802.11ah standard relies on the conventional distributed coordination function (DCF) as a backoff selection method. The DCF is utilized in the contention-based period of the newly introduced medium access control (MAC) mechanism, namely restricted access window (RAW). Despite various advantages of RAW, DCF still utilizes the legacy binary exponential backoff (BEB) algorithm, which suffers from a crucial disadvantage of being prone to high probability of collisions with high number of contending stations. To mitigate this issue, this paper investigates the possibility of replacing the existing exponential sequence (i.e., as in BEB) with a better pseudorandom sequence of integers. In particular, a new backoff algorithm, namely Pseudorandom Sequence Contention Algorithm (PRSCA) is proposed to update the CW size and minimize the collision probability. In addition, the proposed PRSCA incorporates a different approach of CW freezing mechanism and backoff stage reset process. An analytical model is derived for the proposed PRSCA and presented through a discrete 2-D Markov chain model. Performance evaluation demonstrates the efficiency of the proposed PRSCA in reducing collision probability and improving saturation throughput, network throughput, and access delay performance.
    MeSH terms: Algorithms*; Automation; Markov Chains; Wireless Technology
  14. Teo HL, Wahab RA
    Int J Biol Macromol, 2020 Oct 15;161:1414-1430.
    PMID: 32791266 DOI: 10.1016/j.ijbiomac.2020.08.076
    There is an array of methodologies to prepare nanocellulose (NC) and its fibrillated form (CNF) with enhanced physicochemical characteristics. However, acids, bases or organosolv treatments on biomass are far from green, and seriously threaten the environment. Current approach to produce NC/CNF from biomass should be revised and embrace the concept of sustainability and green chemistry. Although hydrothermal process, high-pressure homogenization, ball milling technique, deep eutectic solvent treatment, enzymatic hydrolysis etc., are the current techniques for producing NC, the route designs remain imperfect. Herein, this review highlights the latest methodologies in the pre-processing and isolating of NC/CNF from lignocellulose biomass, by largely focusing on related papers published in the past two years till date. This article also explores the latest advancements in environmentally friendly NC extraction techniques that cooperatively use ball milling and enzymatic hydrolytic routes as an eco-efficient way to produce NC/CNF, alongside the potential applications of the nano-sized celluloses.
    MeSH terms: Agriculture; Biodegradation, Environmental*; Cell Wall/chemistry; Cellulose/isolation & purification; Cellulose/chemistry*; Hydrolysis; Industry; Lignin/chemistry; Solvents; Biomass*; Nanostructures/chemistry*; Chemical Phenomena
  15. Abdul Khalil HPS, Adnan AS, Yahya EB, Olaiya NG, Safrida S, Hossain MS, et al.
    Polymers (Basel), 2020 Aug 06;12(8).
    PMID: 32781602 DOI: 10.3390/polym12081759
    Cellulose nanomaterials from plant fibre provide various potential applications (i.e., biomedical, automotive, packaging, etc.). The biomedical application of nanocellulose isolated from plant fibre, which is a carbohydrate-based source, is very viable in the 21st century. The essential characteristics of plant fibre-based nanocellulose, which include its molecular, tensile and mechanical properties, as well as its biodegradability potential, have been widely explored for functional materials in the preparation of aerogel. Plant cellulose nano fibre (CNF)-based aerogels are novel functional materials that have attracted remarkable interest. In recent years, CNF aerogel has been extensively used in the biomedical field due to its biocompatibility, renewability and biodegradability. The effective surface area of CNFs influences broad applications in biological and medical studies such as sustainable antibiotic delivery for wound healing, the preparation of scaffolds for tissue cultures, the development of drug delivery systems, biosensing and an antimicrobial film for wound healing. Many researchers have a growing interest in using CNF-based aerogels in the mentioned applications. The application of cellulose-based materials is widely reported in the literature. However, only a few studies discuss the potential of cellulose nanofibre aerogel in detail. The potential applications of CNF aerogel include composites, organic-inorganic hybrids, gels, foams, aerogels/xerogels, coatings and nano-paper, bioactive and wound dressing materials and bioconversion. The potential applications of CNF have rarely been a subject of extensive review. Thus, extensive studies to develop materials with cheaper and better properties, high prospects and effectiveness for many applications are the focus of the present work. The present review focuses on the evolution of aerogels via characterisation studies on the isolation of CNF-based aerogels. The study concludes with a description of the potential and challenges of developing sustainable materials for biomedical applications.
  16. Siriwardena BSMS, Udagama MNGP, Tennakoon TMPB, Athukorala DAADW, Jayasooriya PR, Tilakaratne WM
    PMID: 32782125 DOI: 10.1016/j.bjorl.2020.06.004
    INTRODUCTION: The adenomatoid odontogenic tumor is a relatively uncommon odontogenic neoplasm representing about 4.7% of all odontogenic tumors.

    OBJECTIVE: The aim of this study was to determine the demographic and clinical profile of the adenomatoid odontogenic tumors in a Sri Lankan population.

    METHODS: Data gathered from the cases received for a period of 38 years from the Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya. Request forms, biopsy reports and electronic data base of the department were used to obtain relevant information. Demographic data including age, gender and location of the tumor were included in the analysis.

    RESULTS: Out of 116 cases of adenomatoid odontogenic tumor, the mean age was 21.02 ± 11.24. It occurs more fre quently in the second decade of life, more prevalent in females, most often associated with the maxilla, predominantly affecting anterior jaw bones and presenting mostly in the right side of the jaw bone. The results from the present study showed the statistically significant relationship with site of occurrence (maxilla/mandible) and age (p  0.05).

    CONCLUSIONS: Adenomatoid odontogenic tumor occurs more frequently in the second decade of life with a significant female predominance and the commonest site is anterior maxilla. This study revealed few differences on demographic and clinical presentations of adenomatoid odontogenic tumor from some regions of the world.

    MeSH terms: Adolescent; Adult; Ameloblastoma; Biopsy; Child; Faculty; Female; Humans; Mandible; Maxilla; Odontogenic Tumors; Pathology, Oral; Prevalence; Young Adult
  17. Cheah YK, Azahadi M, Mohamad Nor NS, Phang SN, Abd Manaf NH
    Obes Res Clin Pract, 2020 08 09;14(5):428-436.
    PMID: 32782176 DOI: 10.1016/j.orcp.2020.07.008
    The objective of the present study is to examine sociodemographic factors associated with consumption of confectionery among obese and non-obese adults in Malaysia. Secondary analysis of the Malaysian Adult Nutrition Survey (MANS) 2014 was performed. The survey was conducted in urban and rural areas in the 14 states of Malaysia, including the Federal Territory of Kuala Lumpur. Adults aged 18 years and above (n = 2696) were interviewed. The dependent variable was the total servings of confectionery consumed per week. An ordered logistic regression model was used to examine the associated sociodemographic factors in the decision of people to consume 0, 1-2, 3-5 and ≥6 servings of confectionery. Marginal effects of sociodemographic variables on confectionery consumption were calculated. Analyses stratified by bodyweight group were conducted. The results showed that income, education, gender, ethnicity, and employment status were significantly associated with consumption of confectionery. In particular, income, education, gender, ethnicity and employment status affected confectionery consumption, but not the other way around. However, no relationship was evidenced between age, marital status, household location and confectionery consumption. In conclusion, sociodemographic factors were related to consumption of confectionery. Policies aimed at discouraging consumption of confectionery should focus primarily on high income earners, well-educated individuals and Bumiputera.
    MeSH terms: Adult; Body Weight; Candy*; Consumer Behavior*; Cross-Sectional Studies; Humans; Malaysia; Male; Nutrition Surveys; Obesity*; Socioeconomic Factors*
  18. Murugesu S, Okayama K, Yamamoto Y, Terada K, Takahashi Y
    Epileptic Disord, 2020 Aug 01;22(4):455-461.
    PMID: 32782230 DOI: 10.1684/epd.2020.1182
    To evaluate changes in the pharmacokinetics of perampanel after discontinuation of carbamazepine. We enrolled 13 patients receiving perampanel who discontinued carbamazepine therapy between June 2016 and December 2018. Data on serum concentrations were obtained from the therapeutic drug monitoring database of the National Epilepsy Center (Shizuoka, Japan). To compare the pharmacokinetics of perampanel before and after discontinuation of carbamazepine, we determined the concentration/dose (CD) ratio of perampanel (serum level [ng/mL] divided by the dose [mg/kg]). The follow-up period was set to eight weeks following the discontinuation of carbamazepine therapy. The mean baseline CD ratio of perampanel was 1,247 ng/mL/mg/kg which increased markedly over time after discontinuation of carbamazepine, with a mean CD ratio at Weeks 1-2, Weeks 3-4, and Weeks 5-8 of 2,683, 3,914, and 4,220, respectively. At eight weeks, the mean CD ratio of perampanel had increased by 276%. Eleven patients developed adverse events, including dizziness, somnolence, irritability, and ataxia. Five of these 11 patients required perampanel dose reduction within eight weeks after discontinuation of carbamazepine. Two patients achieved seizure-free status at Weeks 5-8. The serum perampanel concentration began to increase from one week after discontinuation of carbamazepine, and continued to rise for eight weeks. Based on these findings, we recommend frequent monitoring of serum perampanel concentration for at least eight weeks after stopping carbamazepine therapy. Monitoring is required as a guide for dose adjustment in order to achieve a safe and effective therapeutic dose of perampanel.
    MeSH terms: Adolescent; Adult; Anticonvulsants/administration & dosage; Anticonvulsants/adverse effects; Anticonvulsants/blood*; Carbamazepine/administration & dosage; Female; Follow-Up Studies; Humans; Male; Pyridones/administration & dosage; Pyridones/adverse effects; Pyridones/blood*; Retrospective Studies; Drug Monitoring; Young Adult
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