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Validity of screening tools for dementia and mild cognitive impairment among the elderly in primary health care: a systematic review

Abd Razak MA, Ahmad NA, Chan YY, Mohamad Kasim N, Yusof M, Abdul Ghani MKA, et al.

Public Health, 2019 Apr;169:84-92.
PMID: 30826688 DOI: 10.1016/j.puhe.2019.01.001

OBJECTIVES: This systematic review aims to provide updated and comprehensive evidence on the validity and feasibility of screening tools for mild cognitive impairment (MCI) and dementia among the elderly at primary healthcare level.
STUDY DESIGN: A review of articles was performed.
METHODS: A search strategy was used by using electronic bibliographic databases including PubMed, Embase and CENTRAL for published studies and reference list of published studies. The articles were exported to a bibliographic database for further screening process. Two reviewers worked independently to screen results and extract data from the included studies. Any discrepancies were resolved and confirmed by the consensus of all authors.
RESULTS: There were three screening approaches for detecting MCI and dementia - screening by a healthcare provider, screening by a self-administered questionnaire and caretaker informant screening. Montreal Cognitive Assessment (MoCA) was the most common and preferable tool for MCI screening (sensitivity [Sn]: 81-97%; specificity [Sp]: 60-86%), whereas Addenbrooke's Cognitive Examination (ACE) was the preferable tool for dementia screening (Sn: 79-100%; Sp: 86%).
CONCLUSION: This systematic review found that there are three screening approaches for detecting early dementia and MCI at primary health care. ACE and MoCA are recommended tools for screening of dementia and MCI, respectively.
Fulltext The results of treatment of dislocation and fracture--dislocation of the elbow--a review of 41 patients

Azmi I, Razak M, Hyzan Y

Med J Malaysia, 1998 Sep;53 Suppl A:59-70.
PMID: 10968184

Forty-one patients with 42 elbow dislocations, of which 13 had acute simple dislocations, 21 had fracture-dislocations and 8 had neglected elbow dislocations, were evaluated with regard to limitation of motion, pain, instability and residual neurovascular deficit. All patients with acute simple dislocation were treated with closed reduction, but the duration of immobilization before commencement of active motion varied. Open-reduction was indicated for failed closed reduction and neglected-dislocations. Internal fixation as a primary procedure was only performed for displaced fracture-dislocation. Excision of radial head or tricepsplasty were performed if the reduction was impossible in neglected elbow dislocation. Despite a good results in acute simple dislocation, 33.07% had flexion contracture of between 5 to 30 degrees. In fracture dislocation, satisfactory results were seen in whom the elbow was immobilized for three weeks or less. Neglected-dislocation is associated with poor functional outcome, 37.5% were good and 62.5% were poor. Prolonged immobilization after injury was strongly associated with an unsatisfactory result. The results indicate that early properly supervised active motion is a key factor in the rehabilitation of elbow dislocation.
Fulltext Contributing factors in non-union of the humeral shaft fracture and the results of treatments

Baba R, Razak M

Med J Malaysia, 1998 Sep;53 Suppl A:42-51.
PMID: 10968182

Out of 218 fractures of humeral shaft treated in the department, 23 (10.5%) of them developed non-union. 14/23 (60.9%) fracture were located in middle third. Transverse (52.2%), short oblique (17.4%) and comminuted fracture (13.0%) constituted about 82% of all initial fracture pattern. Twelve cases (52.5%) were initially treated with hanging cast. Radial nerve palsy occurred in 4/23 (17.4%) of patient and all of them located at lower third of humerus and only one recovered after eight weeks of injury. Factors such as middle third comminuted opened fractures, soft tissue interposition, improper immobilization and poor patient compliance were found to be directly associated with the non-union. All non-unions healed following plating and bone grafting. Overall 17/23 patient (74%) had good results, 4/23 (17%) fair and 2/23 (9%) with poor functional results.
Improved cellulase production by Botryosphaeria rhodina from OPEFB at low level moisture condition through statistical optimization

Bahrin EK, Ibrahim MF, Abd Razak MN, Abd-Aziz S, Shah UK, Alitheen N, et al.

Prep Biochem Biotechnol, 2012;42(2):155-70.
PMID: 22394064 DOI: 10.1080/10826068.2011.585413

The response surface method was applied in this study to improve cellulase production from oil palm empty fruit bunch (OPEFB) by Botryosphaeria rhodina. An experimental design based on a two-level factorial was employed to screen the significant environmental factors for cellulase production. The locally isolated fungus Botryosphaeria rhodina was cultivated on OPEFB under solid-state fermentation (SSF). From the analysis of variance (ANOVA), the initial moisture content, amount of substrate, and initial pH of nutrient supplied in the SSF system significantly influenced cellulase production. Then the optimization of the variables was done using the response surface method according to central composite design (CCD). Botryosphaeria rhodina exhibited its best performance with a high predicted value of FPase enzyme production (17.95 U/g) when the initial moisture content was at 24.32%, initial pH of nutrient was 5.96, and 3.98 g of substrate was present. The statistical optimization from actual experiment resulted in a significant increment of FPase production from 3.26 to 17.91 U/g (5.49-fold). High cellulase production at low moisture content is a very rare condition for fungi cultured in solid-state fermentation.
Fulltext Multiphasic strain differentiation of atypical mycobacteria from elephant trunk wash

Chan KG, Loke MF, Ong BL, Wong YL, Hong KW, Tan KH, et al.

PeerJ, 2015;3:e1367.
PMID: 26587340 DOI: 10.7717/peerj.1367

Background. Two non-tuberculous mycobacterial strains, UM_3 and UM_11, were isolated from the trunk wash of captive elephants in Malaysia. As they appeared to be identical phenotypes, they were investigated further by conventional and whole genome sequence-based methods of strain differentiation. Methods. Multiphasic investigations on the isolates included species identification with hsp65 PCR-sequencing, conventional biochemical tests, rapid biochemical profiling using API strips and the Biolog Phenotype Microarray analysis, protein profiling with liquid chromatography-mass spectrometry, repetitive sequence-based PCR typing and whole genome sequencing followed by phylogenomic analyses. Results. The isolates were shown to be possibly novel slow-growing schotochromogens with highly similar biological and genotypic characteristics. Both strains have a genome size of 5.2 Mbp, G+C content of 68.8%, one rRNA operon and 52 tRNAs each. They qualified for classification into the same species with their average nucleotide identity of 99.98% and tetranucleotide correlation coefficient of 0.99999. At the subspecies level, both strains showed 98.8% band similarity in the Diversilab automated repetitive sequence-based PCR typing system, 96.2% similarity in protein profiles obtained by liquid chromatography mass spectrometry, and a genomic distance that is close to zero in the phylogenomic tree constructed with conserved orthologs. Detailed epidemiological tracking revealed that the elephants shared a common habitat eight years apart, thus, strengthening the possibility of a clonal relationship between the two strains.
Ascorbic acid induces osteoblast differentiation of human suspension mononuclear cells

Hadzir SN, Ibrahim SN, Abdul Wahab RM, Zainol Abidin IZ, Senafi S, Ariffin ZZ, et al.

Cytotherapy, 2014 May;16(5):674-82.
PMID: 24176546 DOI: 10.1016/j.jcyt.2013.07.013

Suspension mononuclear cells (MNCs) can be differentiated into osteoblasts with the induction of ascorbic acid and β-glycerophosphate. The aim of this study was to determine the ability of suspension MNCs to differentiate into osteoblasts using ascorbic acid only.
Vanadia as an electron-hole recombination inhibitor on fibrous silica-titania for selective hole oxidation of ciprofloxacin and Congo red photodegradation

Hassan NS, Jalil AA, Fei ICM, Razak MTA, Khusnun NF, Bahari MB, et al.

Chemosphere, 2023 Oct;338:139502.
PMID: 37453521 DOI: 10.1016/j.chemosphere.2023.139502

Vanadia (V2O5)-incorporated fibrous silica-titania (V/FST) catalysts, which were successfully synthesized using a hydrothermal method followed by the impregnation of V2O5. The catalysts were then characterized using numerous techniques, including X-ray diffraction, field emission scanning electron microscopy, transmission electron microscopy, nitrogen adsorption-desorption analyses, ultraviolet-visible diffuse reflectance spectroscopy, Fourier-transform infrared, X-ray photoelectron spectroscopy, and photoluminescence (PL) analyses. The study found that varying the amount of V2O5 (1-10 wt%) had a significant impact on the physicochemical properties of the FST, which in turn improved the photodegradation efficiency of two organic compounds, ciprofloxacin (CIP) and congo red (CR). 5V/FST demonstrated the best performance in degrading 10 mg L-1 of CIP (83%) and CR (100%) at pH 3 using 0.375 g L-1 catalyst under visible light irradiation within 180 min. The highest photoactivity of 5V/FST is mainly due to higher crystallinity and the highest number of V2O5-FST interactions. Furthermore, as demonstrated by PL analysis, the 5V/FST catalyst has the most significant impact on interfacial charge transfer and reduces electron-hole recombination. The photodegradation of both contaminants follows the Langmuir-Hinshelwood pseudo-first-order model, according to the kinetic study. The scavenger investigation demonstrated that hydroxyl radicals and holes dominated species in the system, indicating that the catalyst effectively generated reactive species for pollutant degradation. A possible mechanism was also identified for FST and 5V/FST. Interestingly, V2O5 acts as an electron-hole recombination inhibitor on FST for selective hole oxidation of ciprofloxacin and congo red photodegradation. Finally, the degradation efficiency of the catalyst remained relatively stable even after five cyclic experiments, indicating its potential for long-term use in environmental remediation.
Fulltext Pollination Services of Mango Flower Pollinators

Huda AN, Salmah MR, Hassan AA, Hamdan A, Razak MN

J Insect Sci, 2015;15.
PMID: 26246439 DOI: 10.1093/jisesa/iev090

Measuring wild pollinator services in agricultural production is very important in the context of sustainable management. In this study, we estimated the contribution of native pollinators to mango fruit set production of two mango cultivars Mangifera indica (L). cv. 'Sala' and 'Chok Anan'. Visitation rates of pollinators on mango flowers and number of pollen grains adhering to their bodies determined pollinator efficiency for reproductive success of the crop. Chok Anan failed to produce any fruit set in the absence of pollinators. In natural condition, we found that Sala produced 4.8% fruit set per hermaphrodite flower while Chok Anan produced 3.1% per flower. Hand pollination tremendously increased fruit set of naturally pollinated flower for Sala (>100%), but only 33% for Chok Anan. Pollinator contribution to mango fruit set was estimated at 53% of total fruit set production. Our results highlighted the importance of insect pollinations in mango production. Large size flies Eristalinus spp. and Chrysomya spp. were found to be effective pollen carriers and visited more mango flowers compared with other flower visitors.
Crude cellulase from oil palm empty fruit bunch by Trichoderma asperellum UPM1 and Aspergillus fumigatus UPM2 for fermentable sugars production

Ibrahim MF, Razak MN, Phang LY, Hassan MA, Abd-Aziz S

Appl Biochem Biotechnol, 2013 Jul;170(6):1320-35.
PMID: 23666614 DOI: 10.1007/s12010-013-0275-2

Cellulase is an enzyme that converts the polymer structure of polysaccharides into fermentable sugars. The high market demand for this enzyme together with the variety of applications in the industry has brought the research on cellulase into focus. In this study, crude cellulase was produced from oil palm empty fruit bunch (OPEFB) pretreated with 2% NaOH with autoclave, which was composed of 59.7% cellulose, 21.6% hemicellulose, and 12.3% lignin using Trichoderma asperellum UPM1 and Aspergillus fumigatus UPM2. Approximately 0.8 U/ml of FPase, 24.7 U/ml of CMCase and 5.0 U/ml of β-glucosidase were produced by T. asperellum UPM1 at a temperature of 35 °C and at an initial pH of 7.0. A 1.7 U/ml of FPase, 24.2 U/ml of CMCase, and 1.1 U/ml of β-glucosidase were produced by A. fumigatus UPM2 at a temperature of 45 °C and at initial pH of 6.0. The crude cellulase was best produced at 1% of substrate concentration for both T. asperellum UPM1 and A. fumigatus UPM2. The hydrolysis percentage of pretreated OPEFB using 5% of crude cellulase concentration from T. asperellum UPM1 and A. fumigatus UPM2 were 3.33% and 19.11%, with the reducing sugars concentration of 1.47 and 8.63 g/l, respectively.
Fulltext Proximal third femoral shaft fractures in children: prevention of angular deformities using bilateral Thomas splints

Kamal MH, Razak M, Ibrahim S, Lim A

Med J Malaysia, 2000 Sep;55 Suppl C:68-73.
PMID: 11200047

This is a prospective study to look at the outcome of unilateral proximal third femoral shaft fractures in children treated with a bilateral Thomas splint in the Department of Orthopaedic Surgery Universiti Kebangsaan Malaysia between the period of January 1996 and June 1998. Eighteen children aged between 2 years and 12 years old with unilateral proximal third fractures of the femoral shaft were treated using a bilateral Thomas splint. Angular deformities were measured using a goniometer metric scale before and after Thomas splints. The percentage of varus tilt corrected ranged from 17% to 72% with an average correction of 29% from the initial deformity and the difference was statistically significant (p < 0.05). The percentage of posterior tilt corrected ranged from 19% to 60% with the average correction of 20% from the initial deformity. The difference was statistically significant (p < 0.05). From this study, we conclude that bilateral Thomas splints can give a better correction of angular deformity for proximal third femoral shaft fractures in children below twelve years of age.
Fulltext Conservative management of femoral shaft fractures in children

Moses T, Pan KL, Razak M

Med J Malaysia, 1998 Sep;53 Suppl A:22-6.
PMID: 10968179

Thirty-two children with femoral shaft fractures were treated conservatively with initial skin traction followed by an additional period in a spica cast. After 12 to 20 months of follow up, none had any pain and all of them were attending school without problems. Shortening of more than 2 cm occurred in 6 (19%) of the 32 patients. The most important factor associated with shortening was an overlap of more than 2 cm of shortening of the fracture ends at the time of cast fitting. The average compensatory overgrowth at final assessment was 7 mm. Angular deformity did not pose a problem. This is a safe, simple and practical method to treat childhood femoral shaft fractures.
Barriers to implementing a national health screening program for men in Malaysia: An online survey of healthcare providers

Ng CJ, Teo CH, Ang KM, Kok YL, Ashraf K, Leong HL, et al.

Malays Fam Physician, 2020;15(1):6-14.
PMID: 32284799

Introduction: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia.
Methods: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants' socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool.
Results: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a "top-down decision." Although 37.44% found the screening tool for adult men "useful," some felt that it was "time consuming" to fill out (38.2%) and "lengthy" (28.3%). In addition, 'adult men refuse to answer' (24.1%) was cited as the most common patient-related barrier.
Conclusions: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.
Fulltext Lingual thyroid--a lesson to learn (letter)

Ng CS, Mohd Razak MS

Med J Malaysia, 2005 Mar;60(1):115.
PMID: 16250296

Comment on: Ramzisham AR, Somasundaram S, Nasir ZM. Lingual thyroid--a lesson to learn. Med J Malaysia. 2004 Oct;59(4):533-4
Tuberculosis in captive Asian elephants (Elephas maximus) in Peninsular Malaysia

Ong BL, Ngeow YF, Razak MF, Yakubu Y, Zakaria Z, Mutalib AR, et al.

Epidemiol Infect, 2013 Jul;141(7):1481-7.
PMID: 23414617 DOI: 10.1017/S0950268813000265

A cross-sectional study was conducted from 10 January to 9 April 2012, to determine the seroprevalence of tuberculosis (TB) of all captive Asian elephants and their handlers in six locations in Peninsular Malaysia. In addition, trunk-wash samples were examined for tubercle bacillus by culture and polymerase chain reaction (PCR). For 63 elephants and 149 elephant handlers, TB seroprevalence was estimated at 20.4% and 24.8%, respectively. From 151 trunkwash samples, 24 acid-fast isolates were obtained, 23 of which were identified by hsp65-based sequencing as non-tuberculous mycobacteria. The Mycobacterium tuberculosis-specific PCR was positive in the trunk-wash samples from three elephants which were also seropositive. Conversely, the trunk wash from seven seropositive elephants were PCR negative. Hence, there was evidence of active and latent TB in the elephants and the high seroprevalence in the elephants and their handlers suggests frequent, close contact, two-way transmission between animals and humans within confined workplaces.
Fulltext Cutaneous side-effects of epidermal growth factor receptor-tyrosine kinase inhibitor (TKI) in the treatment of lung cancer: description and its management

Ong CK, Tan WC, Chan LC, Abdul Razak M

Med J Malaysia, 2012 Apr;67(2):222-3.
PMID: 22822651 MyJurnal

Epidermal growth factor receptor (EGFR)--tyrosine kinase inhibitors (TKI) like erlotinib and gefitinib have been approved as monotherapy for the treatment of patients with locally advanced or metastatic non small cell lung cancer (NSCLC) after failure of at least one prior chemotherapy regimen. The use of EGFR-TKI is associated with unique and dramatic dermatologic side effects. We report 2 patients with NSCLC developing a typical acneiform (papulo-pustular) eruption shortly after initiation of EGFR-TKI.
Fulltext Late reconstruction of the patellar tendon

Pan KL, Masbah O, Razak M

Med J Malaysia, 2001 Jun;56 Suppl C:73-5.
PMID: 11814255

A case of late reconstruction of the patellar tendon is reported. Besides partial loss of the tendon, the patient also had loss of the distal third of the patella. A rolled strip of fascia lata was used to reconstruct the tendon with tunnels through the patella. At the tenth month of follow-up, the result was deemed successful.
Fulltext Rare combination of seven fractures in the same forearm and wrist

Pan KL, Masbah O, Razak M

Med J Malaysia, 2000 Jun;55(2):268-70.
PMID: 19839159

A rare combination of a segmental ulnar fracture with fracture dislocation of the head of the radius and intraarticular fracture of the distal radius concomitant with an ipsilateral scaphoid, lunate and coronoid process fractures is presented. The mechanism of injury could possibly be a tremendous impact on the outstretched hand with a dorsiflexed wrist, fracturing the carpal bones and the distal radius. Transmitted axial forces on the ulna in a pronating forearm resulted in the other fractures. To the best of our knowledge, no such case has been reported. Open reduction with screw fixation of the scaphoid, plating of the proximal ulna and Kirschner wiring of the distal radius and radial head dislocation were done.
Fulltext The pattern of spinal tuberculosis in Sarawak General Hospital

Rasit AH, Razak M, Ting FSS

Med J Malaysia, 2001 Jun;56(2):143-50.
PMID: 11771073

This is a retrospective study of 53 patients with spinal tuberculosis treated in Sarawak General Hospital from 1994 until 1998. The study showed that the mean age in patients with spinal tuberculosis was 40.2 years, and was more common in male (70%) and in Iban population (50%). The clinical presentation included backache (94%); abscess (45%); neurological deficit (44%); and gibbus deformity (22%). The percentage of patient without BCG scar was 82% and 18% had evidence of pulmonary tuberculosis. The most common vertebra involved was the ninth thoracic vertebra and the least common was the third cervical vertebra. The average number of vertebra affected per patient was three. The most common radiological type of lesion was paradiscal (47%). The percentage of patients diagnosed by histological examination was 44%. All patients were given chemotherapy for 12 months' duration; 57% were treated surgically and 43% were treated conservatively. Twenty-four of patients (40%) had an excellent and good results and 28 of patients had a fair result and only one patient had poor result. In 23 of patients treated conservatively showed increment of 8 degrees of kyphosis angle and 22 of patients had a fair result and only one patient had poor outcome after 6 months of treatment. In 30 of patients treated surgically showed correction of 4 degrees of kyphosis angle and 24 of them had excellent and good outcome, where 6 of them had fair outcome after 6 months of treatment.
Fulltext Anterior cruciate ligament reconstruction using the patellar ligament

Rauf A, Razak M, Ismail M

Med J Malaysia, 1998 Sep;53 Suppl A:107-14.
PMID: 10968192

From January 1992 to January 1996, thirty-three patients with persistent clinical and functional knee instability due to anterior cruciate insufficiency underwent ACL reconstruction using central third of the bone-patellar ligament-bone graft. An early experience was presented with average follow-up of 9.8 months (range six to thirty-three months). There thirty-two male and two females. The average age was twenty-four months. Eighty-three percent were involved in football injury. The average time interval from initial injury to operation was twenty-five months. Majority presented with knee pain and giving way. Meniscal tear was the commonest associated injury in more than 70 percent; the lateral meniscus being more frequently injured (42 percent) than the medial meniscus (15 percent). Using modified criteria by Paterson and Trickey (1986), nine patients (27 percent) had good results and twenty-two (67 percent) has satisfactory results. Two patients (6 percent) who had post-operative infection were graded as poor. Functional stability was achieved in twenty-eight (85 percent) and instability persisted in five (15 percent). There were marked clinical improvement in the Lachman and anterior drawer grading post-operatively. The accelerated rehabilitation programme was effective in obtaining early clinical improvement and in reducing post-operative knee stiffness.
Fulltext Neurological recovery following posterior decompression of spinal secondaries

Razak M, Sappani K

Med J Malaysia, 1998 Sep;53 Suppl A:6-11.
PMID: 10968177

This is a retrospective study comprising 45 patients who underwent decompressive laminectomy due to secondary malignancy in the spine. There were 31 males and 14 females. Two of them had no weakness, one was treated for radicular pain and the other for severe intractable back pain. Forty-three patients presented with weakness of the limb of which six patients were able to walk unaided, four with an aid, twenty four were unable to walk of which eleven of them were completely paralysed. Nineteen of the patients had urinary incontinence. Out of 10 patients in Frankel's D, 3 of them regained almost normal power post operatively and were able to walk without any aids at the time of discharge. There were 6 patients in Frankel's C and 2 improved. Of 17 patients in Frankel's B, 6 of them improved and were able to walk with walking aids. Only one out of ten patient from Frankel's A had showed an improvement. A total of three patients deteriorated post operatively and all of them presented with multiple level involvement. There was no change in the post operative status of the two patients who did not have weakness. Overall only 27% of the patient showed improvement following decompressive laminectomy.

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