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Driver characteristics associated with child safety seat usage in Malaysia: a cross-sectional study

Kulanthayan S, Razak A, Schenk E

Accid Anal Prev, 2010 Mar;42(2):509-14.
PMID: 20159074 DOI: 10.1016/j.aap.2009.09.015

The rapidly motorizing environment in Malaysia has made child occupant safety a current public health concern. The usage of child safety seats (CSS) is a widely regarded intervention to enhance child occupant safety, yet no study has been conducted on CSS in Malaysia. This study aims to determine the CSS usage rates in Malaysia and to assess driver characteristics that are associated with CSS usage.
Prevalence of asthma, rhinitis and eczema among schoolchildren in Kelantan, Malaysia

Quah BS, Razak AR, Hassan MH

Acta Paediatr Jpn, 1997 Jun;39(3):329-35.
PMID: 9241894

The prevalence and severity of asthma, rhinitis and eczema in Kelantanese schoolchildren were determined as part of an international study of the epidemiology of asthma and allergic diseases. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 7055 schoolchildren from February 1995 to August 1995. The respondents were parents or guardians of 5- to 7-year-old children (n = 3939), and schoolchildren aged 12-14 years (n = 3116). The ISAAC video questionnaire (AVQ3.0) was shown to children aged 12-14 years after the written questionnaire. The overall prevalences of 'ever wheezed' and 'wheezing in last 12 months' were 9.4 and 6.0% respectively. The prevalence of 'ever diagnosed with asthma' was 9.4%. Both 'ever wheezed' and 'wheezing in the last 12 months' were significantly higher in 12- to 14-year-old children than in 5- to 7-year-old children, with P values of 0.0006 and 0.014 respectively. No gender differences in the prevalences were observed. For the complete study group, 4.7% of children had sleep disturbed by wheezing but only 1.1% had a severe attack limiting speech in the preceding 12 months. Sleep disturbance was more common in the 12- to 14-year-old children than in 5- to 7-year-old children (P = 0.006). There was no difference between the age groups for severe attacks limiting speech. The overall prevalence of rhinitis and eczema symptoms were 27 and 12%, respectively. The prevalence of rhinitis in the 12-14 year age group (38.2%) was significantly higher (P < 0.0001) than in the 5-7 year age group (18.2%). The prevalence of eczema in the 5-7 year age group (13.7%) was significantly higher (P = < 0.0001) than in the 12-14 year age group (9.9%). These prevalence data are comparable with previous reports in Malaysian children, but are considerably lower than those reported for most developed countries.
Contributory Factors for Severe Maternal Morbidity: A 10-Year Review of the Literature

Noor NM, Nik Hussain NH, Sulaiman Z, Abdul Razak A

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):9S-18S.
PMID: 26069164 DOI: 10.1177/1010539515589811

Maternal morbidity is a concept of increasing interest in maternal health. This review aims to assess the contributory factors for severe maternal morbidity over the past one decade worldwide. A comprehensive electronic search was conducted. The search was restricted to articles written in the English language published from 2004 to 2013. Qualitative studies were excluded. A total of 24 full articles were retrieved of which 9 cohort, 7 case-control, 3 cross-sectional studies, and 5 unmentioned designs were included. The contributory factors were divided into 3 components: (a) sociodemographic characteristics, (b) medical and gynecological history, and (c) past and present obstetric performance. This review informs emerging knowledge regarding contributory factors for severe maternal morbidity and has implications for education, clinical practice and intervention. It enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy for maternal morbidity and mortality.
Fulltext Numb chin syndrome: an ominous sign of mandibular metastasis

Razak A, Goh BS, Rajaran JR, Nazimi AJ

BMJ Case Rep, 2018 May 14;2018.
PMID: 29764822 DOI: 10.1136/bcr-2017-223586

A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton. In the head and neck region, left mandibular foramen and oropharynx bilaterally showed increased metabolism suggestive of tumour metastasis. The diagnosis was numb chin syndrome secondary to mandibular metastasis. Apart from supportive treatment, she was started on palliative chemotherapy and radiotherapy. At the time of discharge, there were no active complaints other than the aforementioned hypoesthesia.
Benzodiazepines for Treatment-Resistant Major Depressive Disorder and Obsessive-Compulsive Disorder With Comorbid Mega Cisterna Magna

Ismail A, Ab Razak A, Sayuti KA, Phoa PKA

Cureus, 2023 Oct;15(10):e46670.
PMID: 37942372 DOI: 10.7759/cureus.46670

This article discusses the case of an adult woman with comorbid major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Due to her poor response to initial treatment regimens, a brain computed tomography (CT) was performed, revealing mega cisterna magna (MCM). Subsequently, she responded well to the addition of lorazepam, a benzodiazepine, along with fluvoxamine and quetiapine XR. The clinical significance of MCM and MDD-OCD remains partially understood. Thus, this case report aims to contribute to the literature and review the treatment of benzodiazepines in relation to MCM, MDD, and OCD comorbidities.
Pairing as an instructional strategy to promote soft skills amongst clinical dental students

Abu Kasim NH, Abu Kassim NL, Razak AA, Abdullah H, Bindal P, Che' Abdul Aziz ZA, et al.

Eur J Dent Educ, 2014 Feb;18(1):51-7.
PMID: 24423176 DOI: 10.1111/eje.12058

Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.
The effect of Dermo and Seal-In X5 prosthetic liners on pressure distributions and reported satisfaction during ramp ambulation in persons with transtibial limb loss

Ali S, Osman NA, Razak A, Hussain S, Wan Abas WA

Eur J Phys Rehabil Med, 2015 Feb;51(1):31-7.
PMID: 24963603

Lower limb amputee's are greatly affected in dealing with the environmental barriers such as ramps and stairs and reported high interface pressure between the residual limb and socket/liner. Interface pressure between the residual limb and socket/liner can affect the satisfaction and use of the prosthesis. Until now, little attention has been paid to interface pressure between socket and stump during ramp negotiation and its effect on amputee's satisfaction.
Fulltext The Effect of Channa striatus (Haruan) Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women

Ab Wahab SZ, Abdul Kadir A, Nik Hussain NH, Omar J, Yunus R, Baie S, et al.

Evid Based Complement Alternat Med, 2015;2015:849647.
PMID: 26101537 DOI: 10.1155/2015/849647

Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES), wound cosmetic appearance based on visual analogue scale (VAS) scores and patient satisfaction score (PSS), and safety profiles between C. striatus group and placebo group after six weeks of lower segment caesarean section (LSCS) delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either the C. striatus group (500 mg daily) or placebo group (500 mg of maltodextrin daily). 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain (p = 0.814) and WES (p = 0.160) between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p = 0.014 and p < 0.001, resp.). The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient's satisfaction and is safe for human consumption.
Fulltext Training Characteristics, Personal Factors and Coping Strategies Associated with Burnout in Junior Doctors: A Multi-Center Study

Roslan NS, Yusoff MSB, Ab Razak A, Morgan K, Ahmad Shauki NI, Kukreja A, et al.

Healthcare (Basel), 2021 Sep 14;9(9).
PMID: 34574982 DOI: 10.3390/healthcare9091208

Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor-Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02-2.20), prior work experience (OR: 1.56; 95% CI: 1.05-2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30-2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49-3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15-2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary.
Fulltext Prehypertensive state, mild hypertension, metabolic syndrome and cardiovascular risk factors among young adults in rural Malaysia

Abdullah Aszrin, Shah M. Azarisman, Rahman A. Jamaluddin, Razak A. Tariq, Noor M. Noriah

International Medical Journal Malaysia, 2018;17(1):47-54.
MyJurnal

Introduction: Prehypertension precedes overt hypertension and has been acknowledged by many guidelines.
Hypertension is an important risk factor for cardiovascular disease in Malaysia. Hypertension prevalence is
at 42.6% and population-based control is poor at 26.8%. The objective of the study is to ascertain the
cardiovascular risk profile of prehypertensive and mildly hypertensive young adults against age-matched
controls in rural Malaysia. Methods: 484 (four hundred and eighty four) subjects attending primary care
clinic were screened. 91 (Ninety one) young adults with pre/mild hypertension and normotensive, agematched controls were enrolled. The blood pressure and biochemical profiles for both groups were assessed
and compared. Results: Fifty-four subjects and 37 controls were enrolled. Amongst subjects, 46.3% had
prehypertension and 53.7% had mild hypertension. Mean values compared to age-matched controls for MAP
were 102.68 ± 7.48 vs 83.25 ± 6.08 mmHg (p< 0.001), LDL 3.75 ± 0.95 vs 3.32 ± 0.93 mmol/L (p=0.03), FBG
4.65 ± 0.54 vs 4.33 ± 0.42 mmol/L (p=0.03), BMI 28.81 ± 5.16 vs 24.12 ± 4.91 (p< 0.001). The mean BP was
significantly associated with BMI, FBG, triglycerides, HDL and the TC/HDL ratio. Conclusions: Greater BMI,
FBG, HDL, triglyceride levels and TC/HDL ratio characterised the young adults with pre/mild hypertension.
The data suggests that hypertension in young adults is secondary to metabolic syndrome.
An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students

Kawamura M, Wright FA, Declerck D, Freire MC, Hu DY, Honkala E, et al.

Int Dent J, 2005 Aug;55(4):205-11.
PMID: 16167608

To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students.
Fulltext What Are the Common Themes of Physician Resilience? A Meta-Synthesis of Qualitative Studies

Roslan NS, Yusoff MSB, Morgan K, Ab Razak A, Ahmad Shauki NI

Int J Environ Res Public Health, 2022 Jan 01;19(1).
PMID: 35010729 DOI: 10.3390/ijerph19010469

In the practice of medicine, resilience has gained attention as on of the ways to address burnout. Qualitative studies have explored the concept of physician resilience in several contexts. However, individual qualitative studies have limited generalizability, making it difficult to understand the resilience concept in a wider context. This study aims to develop a concept of resilience in the context of physicians' experience through a meta-synthesis of relevant qualitative studies. Using a predetermined search strategy, we identified nine qualitative studies among 450 participants that reported themes of resilience in developed and developing countries, various specialties, and stages of training. We utilized the meta-ethnography method to generate themes and a line-of-argument synthesis. We identified six key themes of resilience: tenacity, resources, reflective ability, coping skills, control, and growth. The line-of-argument synthesis identified resilient physicians as individuals who are determined in their undertakings, have control in their professional lives, reflect on adversity, utilize adaptive coping strategies, and believe that adversity provides an opportunity for growth. Resilient physicians are supported by individual and organizational resources that include nurturing work culture, teamwork, and support from the medical community and at home. Our findings suggest that resilience in physicians is dynamic and must be supported not only by physician-directed interventions but also by organization-directed interventions.
STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery

Agha R, Abdall-Razak A, Crossley E, Dowlut N, Iosifidis C, Mathew G, et al.

Int J Surg, 2019 Nov 06;72:156-165.
PMID: 31704426 DOI: 10.1016/j.ijsu.2019.11.002

INTRODUCTION: The STROCSS guideline was developed in 2017 to improve the reporting quality of observational studies in surgery. Building on its impact and usefulness, we sought to update the guidelines two years after its publication.
METHODS: A steering group was formed to review the existing guideline and propose amendments to the 17-item checklist. A Delphi consensus exercise was utilised to determine agreement across a list of proposed modifications to the STROCSS 2017 guideline. An expert panel of 46 surgeons were invited to assess the proposed updates via Google Forms.
RESULTS: The response rate was 91% (n = 42/46). High agreement was reached across all the items and the guideline was finalised in the first round. The checklist maintained 17-items, with modifications primarily considered to improve content and readability.
CONCLUSIONS: The STROCSS 2019 guideline is hereby presented as a considered update to improve reporting of cohort, cross-sectional and case-control studies in surgery.
Efficacy of Mosquito Coils: Cross-resistance to Pyrethroids in Aedes aegypti (Diptera: Culicidae) From Indonesia

Amelia-Yap ZH, Chen CD, Sofian-Azirun M, Lau KW, Suana IW, Harmonis, et al.

J Econ Entomol, 2018 12 14;111(6):2854-2860.
PMID: 30265353 DOI: 10.1093/jee/toy296

Aedes aegypti (L.) (Diptera: Culicidae) is the primary vector of several arthropod-borne viral infectious diseases globally. Relentless vector control efforts are performed to curtail disease transmissions, insecticides remain as the first line of defense in Indonesia. With a dearth of publication on the efficacy of mosquito coil in Indonesia, this is the first report related to mosquito coil despite its common use in households. Ae. aegypti mosquitoes were sampled from nine regencies in Indonesia and tested using the glass-chamber method against three commercially available local pyrethroid-based mosquito coils containing d-allethrin, transfluthrin, and metofluthrin. The 50% knockdown time of female Ae. aegypti tested with d-allethrin, transfluthrin, and metofluthrin containing coils ranged from 0.65 to 14.32; 0.8 to 16.4; and 0.78 to 20.57 min, respectively. Mortality rates in accordance with WHO resistance indicators showed that strains from Denpasar, Mataram, Kuningan, Padang, Samarinda, and Sumba Timur were resistant (<80% mortality rate), whereas strains from Manggarai Barat, Dompu, and Pontianak were susceptible (>98% mortality rate) to the active ingredients assayed. Moreover, the knockdown rates between d-allethrin and transfluthrin, d-allethrin and metofluthrin, as well as transfluthrin and metofluthrin displayed significant associations, portraying the presence of cross-resistance within pyrethroid insecticides. The minimal insecticidal effect of mosquito coils against some Indonesian Ae. aegypti also pointed out the development of pyrethroid resistance, prompting a revamping of the vector control system.
Monitoring Insecticide Resistance Profiles of Aedes aegypti (Diptera: Culicidae) in the Sunda Islands of Indonesia Based on Diagnostic Doses of Larvicides

Haziqah-Rashid A, Chen CD, Lau KW, Low VL, Sofian-Azirun M, Suana IW, et al.

J Med Entomol, 2019 02 25;56(2):514-518.
PMID: 30462258 DOI: 10.1093/jme/tjy208

This study was conducted to monitor the susceptibility status of Aedes aegypti (Linnaeus) larvae in the Sunda Islands of Indonesia against various organophosphates and organochlorines. Larval bioassay was performed in accordance with the World Health Organization standard protocol. Field-collected and reference strains of Ae. aegypti larvae were tested against diagnostic doses of eight larvicides belonging to organophosphates and organochlorines, namely bromophos (0.050 mg/liter), chlopyrifos (0.002 mg/liter), fenitrothion (0.020 mg/liter), fenthion (0.025 mg/liter), malathion (0.125 mg/liter), temephos (0.012 mg/liter), DDT (0.012 mg/liter), and dieldrin (0.025 mg/liter). Mortality rates of larvae were recorded at 24-h posttreatment. This study showed that Ae. aegypti larvae from Padang, Samarinda, Manggarai Barat, and South Central Timor were susceptible to both fenitrothion and dieldrin (mortality rates ≥ 98%). About 6 out of 10 field strains of Ae. aegypti larvae were resistant (<80% mortality rates) against fenthion, whereas Ae. aegypti larvae from Kuningan, Samarinda, Sumba, and South Central Timor exhibited some degrees of resistance (mortality rates 80-98%). All field-collected Ae. aegypti larvae were resistant against diagnostic doses of chlorpyrifos, malathion, temephos, and DDT with mortality rates ranging from 0 to 74.67%. Continued insecticide susceptibility studies are essential to identify the efficacy of insecticides for an improved dengue vector control and to delay the development of insecticide resistance.
V1016G Point Mutation: The Key Mutation in the Voltage-Gated Sodium Channel (Vgsc) Gene of Pyrethroid-Resistant Aedes aegypti (Diptera: Culicidae) in Indonesia

Amelia-Yap ZH, Sofian-Azirun M, Chen CD, Lau KW, Suana IW, Syahputra E, et al.

J Med Entomol, 2019 06 27;56(4):953-958.
PMID: 30942885 DOI: 10.1093/jme/tjz035

Resistance to pyrethroid insecticides is widespread in Indonesian Aedes aegypti (Linnaeus), the primary vector of dengue viruses. This study aims to investigate the mutations in the voltage-gated sodium channel (Vgsc) conferring pyrethroid resistance against Ae. aegypti populations from Indonesia. Molecular genotyping of mutations using polymerase chain reaction assay and direct DNA sequencing were performed at positions 989 and 1,016 in IIS6 region, and 1,534 in IIIS6 region of the voltage-gated sodium channel (Vgsc) in nine populations of Indonesian Ae. aegypti. The V1016G and S989P genotyping identified the RR genotype to be predominant in six out of nine populations of Ae. aegypti, whereas the SS genotype occurred only in minority. Interestingly, co-occurrence of the V1016G and S989P mutations was detected in the aforementioned six populations with high frequency. Genotyping of F1534C showed all nine populations exhibited the SS genotype, with merely two individuals from a population were heterozygous (RS). Significant correlations were demonstrated between the allele frequencies of the V1016G mutation and the survivability rates as well as resistance ratios in pyrethroid adult bioassays. This signifies the V1016G can contribute more to the insensitivity of Vgsc than the F1534C. Homozygous 1016G mosquitoes were likelier to survive pyrethroid exposure. Identification of underlying mechanisms resulting in insecticide resistance is advantageous in developing effective mosquito control programs in Indonesia.
Fulltext Evaluation of Retinal Nerve Fiber Layer Thickness, Electroretinogram and Visual Evoked Potential in Patients with Alzheimer's Disease

Ngoo QZ, Wan Hitam WH, Ab Razak A

J Ophthalmol, 2019;2019:6248185.
PMID: 31949951 DOI: 10.1155/2019/6248185

OBJECTIVE: To study the retinal nerve fibre layer (RNFL) thickness and visual electrophysiology testing in patients with Alzheimer's disease (AD).
METHODS: A cross-sectional, hospital-based study: 25 AD subjects and 25 controls were recruited. Candidates who fulfil the criteria with normal ocular examinations were made to proceed with scanning laser polarimetry, pattern electroretinogram (PERG), and pattern visual evoked potential (PVEP) examinations of the right eye. RNFL thickness, PERG, and PVEP readings were evaluated.
RESULTS: In AD, the mean of average RNFL thickness was 45.28 μm, SD = 3.61, P < 0.001 (P < 0.05), while the superior RNFL thickness was 54.44 μm, SD = 2.85, P < 0.001 (P < 0.05) and inferior RNFL thickness was 47.11 μm, SD = 4.52, P < 0.001 (P < 0.05). For PERG, the mean P50 latency was 63.88 ms, SD = 7.94, P < 0.001 (P < 0.05) and the mean amplitudes of P50 waves were 1.79 μV, SD = 0.64, P < 0.001 (P < 0.05) and N95 waves were 2.43 μV, SD = 0.90, P < 0.001 (P < 0.05). For PVEP, the mean latency of P100 was 119.00 ms, SD = 9.07, P < 0.001 (P < 0.05), while the mean latency of N135 was 145.20 ms, SD = 8.53, P < 0.001 (P < 0.05). The mean amplitude of P100 waves was 3.71 μV, SD = 1.60, P < 0.001 (P < 0.05), whereas the mean amplitude of N135 waves was 3.67 μV, SD = 2.02, P < 0.001 (P < 0.05). RNFL thickness strongly correlates with PERG readings, with P50 latency R = 0.582, R2 = 0.339, P=0.002 (P < 0.05), amplitude of P50 wave at R = 0.749, R2 = 0.561, P ≤ 0.001 (P < 0.05), and amplitude of N95 wave at R = 0.500, R2 = 0.250, P=0.011 (P < 0.05). No significant difference and correlation were observed on PVEP readings.
CONCLUSION: The mean of the average, superior and inferior RNFL thickness were significantly lower in the AD group compared with control. There is also significant difference of PERG and PVEP parameters between AD and controls. Regression analysis showed average RNFL thickness having significantly linear relationship with the PERG parameters.
Evaluation of load at fracture of Procera AllCeram copings using different luting cements

Al-Makramani BMA, Razak AAA, Abu-Hassan MI

J Prosthodont, 2008 Feb;17(2):120-124.
PMID: 18047490 DOI: 10.1111/j.1532-849X.2007.00270.x

PURPOSE: The current study investigated the effect of different luting agents on the fracture resistance of Procera AllCeram copings.
METHODS: Six master dies were duplicated from the prepared maxillary first premolar tooth using nonprecious metal alloy (Wiron 99). Thirty copings (Procera AllCeram) of 0.6-mm thickness were manufactured. Three types of luting media were used: zinc phosphate cement (Elite), glass ionomer cement (Fuji I), and dual-cured composite resin cement (Panavia F). Ten copings were cemented with each type. Two master dies were used for each group, and each of them was used to lute five copings. All groups were cemented according to manufacturer's instructions and received a static load of 5 kg during cementation. After 24 hours of distilled water storage at 37 degrees C, the copings were vertically compressed using a universal testing machine at a crosshead speed of 1 mm/min.
RESULTS: ANOVA revealed significant differences in the load at fracture among the three groups (p < 0.001). The fracture strength results showed that the mean fracture strength of zinc phosphate cement (Elite), glass ionomer cement (Fuji I), and resin luting cement (Panavia F) were 1091.9 N, 784.8 N, and 1953.5 N, respectively.
CONCLUSION: Different luting agents have an influence on the fracture resistance of Procera AllCeram copings.
Fulltext Assessment of Glycemic Control Protocol (STAR) Through Compliance Analysis Amongst Malaysian ICU Patients

Abdul Razak A, Abu-Samah A, Abdul Razak NN, Jamaludin U, Suhaimi F, Ralib A, et al.

Med Devices (Auckl), 2020;13:139-149.
PMID: 32607009 DOI: 10.2147/MDER.S231856

Purpose: This paper presents an assessment of an automated and personalized stochastic targeted (STAR) glycemic control protocol compliance in Malaysian intensive care unit (ICU) patients to ensure an optimized usage.
Patients and Methods: STAR proposes 1-3 hours treatment based on individual insulin sensitivity variation and history of blood glucose, insulin, and nutrition. A total of 136 patients recorded data from STAR pilot trial in Malaysia (2017-quarter of 2019*) were used in the study to identify the gap between chosen administered insulin and nutrition intervention as recommended by STAR, and the real intervention performed.
Results: The results show the percentage of insulin compliance increased from 2017 to first quarter of 2019* and fluctuated in feed administrations. Overall compliance amounted to 98.8% and 97.7% for administered insulin and feed, respectively. There was higher average of 17 blood glucose measurements per day than in other centres that have been using STAR, but longer intervals were selected when recommended. Control safety and performance were similar for all periods showing no obvious correlation to compliance.
Conclusion: The results indicate that STAR, an automated model-based protocol is positively accepted among the Malaysian ICU clinicians to automate glycemic control and the usage can be extended to other hospitals already. Performance could be improved with several propositions.
Patterns of tooth vulnerability to caries in 20-24-year-old subjects

Razak IA, Razak AA

Odontostomatol Trop, 1988 Dec;11(4):145-8.
PMID: 3272009

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