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Moderating effect of emotional support on the relationship between disability and life satisfaction in older adults

Haron SA, Foong HF, Hamid TA

Geriatr Gerontol Int, 2018 Sep;18(9):1361-1365.
PMID: 30044041 DOI: 10.1111/ggi.13490

AIM: Disability is strongly linked to poorer life satisfaction among older persons. Such close correlations warrant better understanding of the underlying moderator in which negative effects of the former on the latter can be reduced. More specifically, it is the aim of this study to examine the moderating effect of emotional support on the relationship between disability and life satisfaction.
METHODS: The study included 2322 nationally represented community-dwelling older persons in Malaysia who participated in the baseline study of Neuroprotective Model for Healthy Longevity. In order to test the moderating effect of emotional support on the association between disability and life satisfaction, a series of hierarchical multiple linear regression models were utilized, after controlling for potential covariates associated with life satisfaction.
RESULTS: Bivariate analyses showed that disability negatively predicted life satisfaction, whereas emotional support positively predicted life satisfaction. Furthermore, the moderated hierarchical regression analysis showed that emotional support moderated the association between disability and life satisfaction, after controlling for potential covariates, such that the negative relationship between disability and life satisfaction was stronger for individuals with lower levels of emotional support.
CONCLUSIONS: The presence of emotional support might reduce the negative effects of disability on life satisfaction. These findings have important clinical implications, especially in developing better strategies to help disabled older persons to cope with their disabilities; with the hope that in the long term, a society with healthy longevity can be established. Geriatr Gerontol Int 2018; 18: 1361-1365.
Fulltext A new method of mark detection for software-based optical mark recognition

Loke SC, Kasmiran KA, Haron SA

PLoS One, 2018;13(11):e0206420.
PMID: 30412588 DOI: 10.1371/journal.pone.0206420

Software optical mark recognition (SOMR) is the process whereby information entered on a survey form or questionnaire is converted using specialized software into a machine-readable format. SOMR normally requires input fields to be completely darkened, have no internal labels, or be filled with a soft pencil, otherwise mark detection will be inaccurate. Forms can also have print and scan artefacts that further increase the error rate. This article presents a new method of mark detection that improves over existing techniques based on pixel counting and simple thresholding. Its main advantage is that it can be used under a variety of conditions and yet maintain a high level of accuracy that is sufficient for scientific applications. Field testing shows no software misclassification in 5695 samples filled by trained personnel, and only two misclassifications in 6000 samples filled by untrained respondents. Sensitivity, specificity, and accuracy were 99.73%, 99.98%, and 99.94% respectively, even in the presence of print and scan artefacts, which was superior to other methods tested. A separate direct comparison for mark detection showed a sensitivity, specificity, and accuracy respectively of 99.7%, 100.0%, 100.0% (new method), 96.3%, 96.0%, 96.1% (pixel counting), and 99.9%, 99.8%, 99.8% (simple thresholding) on clean forms, and 100.0%, 99.1%, 99.3% (new method), 98.4%, 95.6%, 96.2% (pixel counting), 100.0%, 38.3%, 51.4% (simple thresholding) on forms with print artefacts. This method is designed for bubble and box fields, while other types such as handwriting fields require separate error control measures.
Fulltext Cor triatriatum dexter: A rare cause of childhood cyanosis

Zainudin AR, Tiong KG, Mokhtar SA

Ann Pediatr Cardiol, 2012 Jan;5(1):92-4.
PMID: 22529613 DOI: 10.4103/0974-2069.93725

Cor triatriatum dexter is a rare congenital heart anomaly where the right atrium is divided into two chambers by a membrane. We report a boy who had persistent mild cyanosis and diagnosed to have cor triatriatum dexter with secundum atrial septal defect by transoesophageal echocardiography. Interestingly, he had persistent mild cyanosis despite insignificant obstruction to the right ventricular inflow and normal pulmonary artery pressure. The pathophysiology, approach to the diagnosis, and mode of treatment are also discussed.
Ossified lumbar pseudomeningocele: imaging findings

Al-Edrus SA, Mohamed Mukari SA, Ganesan D, Ramli N

Spine J, 2011 Aug;11(8):796-7.
PMID: 21724472 DOI: 10.1016/j.spinee.2011.05.013
The association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity: a gender perspective in Malaysia

Foong HF, Hamid TA, Ibrahim R, Haron SA

Psychogeriatrics, 2020 Nov;20(6):891-899.
PMID: 32985044 DOI: 10.1111/psyg.12614

BACKGROUND: Little is known about gender differences in the relationship between religious orientation and life satisfaction in older adults living with chronic disease(s). Therefore, the purpose of this article was to examine the moderating effect of gender on the association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity.
METHODS: The study involved 1790 community-dwelling older adults aged 60 and above living with at least one chronic medical condition. The Satisfaction with Life Scale and Revised Intrinsic/Extrinsic Religious Orientation Scale were used to measure life satisfaction and religious orientation. Moderated hierarchical multiple regression was used to test the moderation effect.
RESULTS: Results showed that while intrinsic religiosity was positively associated with life satisfaction, extrinsic religiosity was found to have a negative relationship with life satisfaction. Gender moderated the association between intrinsic religiosity and life satisfaction.
CONCLUSIONS: The findings suggested that the positive impact of intrinsic religiosity on life satisfaction was stronger in older women living with morbidity and multimorbidity. Healthcare practitioners can help disadvantaged older women in identifying their religious values and practices to improve their subjective wellbeing.
Fulltext TRPM2 Channel in Microglia as a New Player in Neuroinflammation Associated With a Spectrum of Central Nervous System Pathologies

Malko P, Syed Mortadza SA, McWilliam J, Jiang LH

Front Pharmacol, 2019;10:239.
PMID: 30914955 DOI: 10.3389/fphar.2019.00239

Microglial cells in the central nervous system (CNS) are crucial in maintaining a healthy environment for neurons to function properly. However, aberrant microglial cell activation can lead to excessive generation of neurotoxic proinflammatory mediators and neuroinflammation, which represents a contributing factor in a wide spectrum of CNS pathologies, including ischemic stroke, traumatic brain damage, Alzheimer's disease, Parkinson's disease, multiple sclerosis, psychiatric disorders, autism spectrum disorders, and chronic neuropathic pain. Oxidative stress is a salient and common feature of these conditions and has been strongly implicated in microglial cell activation and neuroinflammation. The transient receptor potential melastatin-related 2 (TRPM2) channel, an oxidative stress-sensitive calcium-permeable cationic channel, is highly expressed in microglial cells. In this review, we examine the recent studies that provide evidence to support an important role for the TRPM2 channel, particularly TRPM2-mediated Ca2+ signaling, in mediating microglial cell activation, generation of proinflammatory mediators and neuroinflammation, which are of relevance to CNS pathologies. These findings lead to a growing interest in the TRPM2 channel, a new player in neuroinflammation, as a novel therapeutic target for CNS diseases.
Information processing speed as a mediator between psychosocial stress and global cognition in older adults

Foong HF, Hamid TA, Ibrahim R, Haron SA

Psychogeriatrics, 2018 Jan;18(1):21-29.
PMID: 29372603 DOI: 10.1111/psyg.12279

BACKGROUND: The link between psychosocial stress and cognitive function is complex, and previous studies have indicated that it may be mediated by processing speed. Therefore, the main aim of this study was to examine whether processing speed mediates the association between psychosocial stress and global cognition in older adults. Moreover, the moderating role of gender in this model is examined as well.
METHODS: The study included 2322 community-dwelling older adults in Malaysia who were randomly selected through a multistage proportional cluster random sampling technique. Global cognition construct was measured by the Mini-Mental State Examination and Montreal Cognitive Assessment; psychosocial stress construct was measured by perceived stress, depression, loneliness, and neuroticism; and processing speed was assessed by the Digit Symbol Substitution Test. Structural equation modelling was used to analyze the mediation and moderation tests.
RESULTS: Processing speed was found to partially mediate the relationship between psychosocial stress and global cognition (β in the direct model = -0.15, P
Fulltext Pulmonary arteriovenous malformation: a rare cause of cyanosis in a child

Sharifah AI, Jasvinder K, Rus AA

Singapore Med J, 2009 Apr;50(4):e127-9.
PMID: 19421665

Pulmonary arteriovenous malformations are rare vascular anomalies. We report a 12-year-old girl who presented with exertional dyspnoea, cyanosis and clubbing since the age of five years, and multiple pulmonary arteriovenous malformations. Computed tomography pulmonary angiogram showed a large pulmonary arteriovenous malformation at the lower lobe of the right lung. Pulmonary angiogram showed a large right lung arteriovenous malformation and two small left lung arteriovenous malformations. The multiple arteriovenous malformations were occluded with Gianturco coils. She is now asymptomatic and on regular follow-up.
Fulltext Generalised lipodystrophy

Choo KE, Sharifah A, Ariffin WA, Mafauzy M

Singapore Med J, 1990 Jun;31(3):289-92.
PMID: 2392709

We report a Malay girl suffering from generalised lipodystrophy, with clinical features of absence of body adipose tissue, hepatomegaly, hyperpigmentation and muscular hypertrophy. She also had hyperlipaemia, hypercholesterolemia and non-ketotic insulin-resistant diabetes mellitus. The possibility of malnutrition-related diabetes mellitus was excluded because of (a) no personal or family history of malnutrition (b) no pancreatic calcification (c) total loss of subcutaneous fat and (d) her requirement for insulin was more than 21.2 units/kg body weight which would be too high even for malnutrition-related diabetes mellitus. Attempts were made to control her diabetes initially with subcutaneous boluses insulin, then continuous intravenous insulin infusion (CIVII) and finally orally with fenfluramine and chlorpropamide.
Food variety and dietary diversity scores to understand the food-intake pattern among selected Malaysian households

Zainal Badari SA, Arcot J, Haron SA, Paim L, Sulaiman N, Masud J

Ecol Food Nutr, 2012;51(4):265-99.
PMID: 22794127 DOI: 10.1080/03670244.2012.674445

Food variety scores (FVS) and dietary diversity scores (DDS) were estimated based on foods consumed weekly by 285 Malaysian households using a food frequency questionnaire. The scoring system of FVS and DDS was based on a scale of 0-7 and 0-6 respectively. The mean household FVS and DDS was 164.1 ± 93 and 6 ± 0.4. The age of respondents (husbands or wives; p < .01), sex (p < .05), and household food expenditure (p < .01) had a significant influence on both FVS and DDS. The food-intake pattern of Malaysian households showed that their typical diets had high protein and energy-based foods.
Articular cartilage regeneration with autologous peripheral blood stem cells versus hyaluronic acid: a randomized controlled trial

Saw KY, Anz A, Jee CSY, Merican S, Ching-Soong Ng R, Roohi SA, et al.

Arthroscopy, 2013 Apr;29(4):684-94.
PMID: 23380230 DOI: 10.1016/j.arthro.2012.12.008

PURPOSE: The purpose of this study was to compare histologic and magnetic resonance imaging (MRI) evaluation of articular cartilage regeneration in patients with chondral lesions treated by arthroscopic subchondral drilling followed by postoperative intra-articular injections of hyaluronic acid (HA) with and without peripheral blood stem cells (PBSC).
METHODS: Fifty patients aged 18 to 50 years with International Cartilage Repair Society (ICRS) grade 3 and 4 lesions of the knee joint underwent arthroscopic subchondral drilling; 25 patients each were randomized to the control (HA) and the intervention (PBSC + HA) groups. Both groups received 5 weekly injections commencing 1 week after surgery. Three additional injections of either HA or PBSC + HA were given at weekly intervals 6 months after surgery. Subjective IKDC scores and MRI scans were obtained preoperatively and postoperatively at serial visits. We performed second-look arthroscopy and biopsy at 18 months on 16 patients in each group. We graded biopsy specimens using 14 components of the International Cartilage Repair Society Visual Assessment Scale II (ICRS II) and a total score was obtained. MRI scans at 18 months were assessed with a morphologic scoring system.
RESULTS: The total ICRS II histologic scores for the control group averaged 957 and they averaged 1,066 for the intervention group (P = .022). On evaluation of the MRI morphologic scores, the control group averaged 8.5 and the intervention group averaged 9.9 (P = .013). The mean 24-month IKDC scores for the control and intervention groups were 71.1 and 74.8, respectively (P = .844). One patient was lost to follow-up. There were no notable adverse events.
CONCLUSIONS: After arthroscopic subchondral drilling into grade 3 and 4 chondral lesions, postoperative intra-articular injections of autologous PBSC in combination with HA resulted in an improvement of the quality of articular cartilage repair over the same treatment without PBSC, as shown by histologic and MRI evaluation.
LEVEL OF EVIDENCE: Level II, randomized controlled trial (RCT).
Body Mass Index (BMI) and Cognitive Functions in Later Life

Momtaz YA, Haron SA, Hamid TA, Ibrahim R, Tanjani PT

Curr Alzheimer Res, 2018;15(2):195-200.
PMID: 28982334 DOI: 10.2174/1567205014666171004114246

BACKGROUND: The findings from previous studies exploring the association between BMI and cognitive function in the elderly are conflicting. The purpose of the present study is twofold; to verify the association between BMI and cognitive functions and examine whether this association is impacted by height, when adjusted for possible covariates.
METHODS: The data for this study, consisted of 2287 older adults aged 60 years and above, drawn from a nationally representative population-based survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2009.
RESULTS: The mean age of the respondents was 68.7 (SD=6.6) years. The average score of cognitive function, measured by MMSE was 24.5 (SD=5.6). About 40% of the respondents were classified as overweight. Results of the multiple linear regression analysis revealed a significant association between BMI and cognitive function (Beta=.10, p
Fulltext Transcatheter Closure of Patent Ductus Arteriosus: The Penang Hospital's Experience

Amir Hamzah AR, Tiow CA, Koh GT, Sharifah AM

Med J Malaysia, 2011 Mar;66(1):19-21.
PMID: 23765137

Transcatheter closure of small and moderate sizes of Patent Ductus Arteriosus (PDA) is a standard and well accepted form of treatment. The aim of this study is to describe the experience of transcatheter closure of PDA in Penang Hospital. All patients who underwent transcatheter closure of PDA at our institution between 20th January 2006 and 27th June 2008 were retrospectively identified and studied. There were a total of 66 patients who had undergone transcatheter closure of PDA during this period which comprised of 24 male and 42 female. The PDA was closed by Amplatzer Duct Occluder (ADO) in 31 patients, Gianturco coil in 29 patients and other types of devices in 6 patients. There were 4 patients (6%) who had developed acute complication during the procedure (3 of them developed coil embolization and 1 had bleeding from puncture site). The PDA was successfully close in 95.5% of the study population without any residual PDA shunting. All the patients were alive but 5 of them (4.5%) have some abnormalities (2 has mild left pulmonary stenosis, 3 has small residual). Comparison between ADO and Gianturco coil revealed no significant difference in the outcome. Transcatheter closure of PDA has proven to be safe and effective with good midterm outcome. There was no significant difference between Amplatzer Ductal Occluder and Gianturco coil in term of the outcome.
Fulltext A clinical, laboratory and echocardiographic profile of children with acute rheumatic fever

Gururaj AK, Choo KE, Ariffin WA, Sharifah A

Singapore Med J, 1990 Aug;31(4):364-7.
PMID: 2255935

A retrospective study of 42 children with acute rheumatic fever admitted to Hospital Universiti Sains Malaysia from April 1985 to March 1989 was undertaken to assess the clinical, laboratory, echocardiographic aspects and outcome. The ages of the children ranged from 5 years 9 months to 11 years 11 months. There was no significant sex difference. 69.4% were admitted between November and April with a seasonal low between May and August. Sixteen children (38.1%) were hospitalised for recurrence of rheumatic fever. Carditis was the commonest manifestation and was seen in 28 (66.6%) children, followed by arthritis in 24 (57.1%), and chorea in 3 (7.1%). Echocardiography detected abnormalities in 24 out of 35 cases and the most common echocardiographic findings were poor coaptation of mitral valve (ten) left ventricular dilatation (ten), thickened mitral valve cusps (seven) and pericardial effusion (seven). In those children followed up, there were 2 recurrences while on secondary prophylaxis and complete recovery was seen only in 11 (26.9%).
Fulltext Predisposition to Alzheimer's and Age-Related Brain Pathologies by PM2.5 Exposure: Perspective on the Roles of Oxidative Stress and TRPM2 Channel

Wang L, Wei LY, Ding R, Feng Y, Li D, Li C, et al.

Front Physiol, 2020;11:155.
PMID: 32174842 DOI: 10.3389/fphys.2020.00155

Accumulating epidemiological evidence supports that chronic exposure to ambient fine particular matters of <2.5 μm (PM2.5) predisposes both children and adults to Alzheimer's disease (AD) and age-related brain damage leading to dementia. There is also experimental evidence to show that PM2.5 exposure results in early onset of AD-related pathologies in transgenic AD mice and development of AD-related and age-related brain pathologies in healthy rodents. Studies have also documented that PM2.5 exposure causes AD-linked molecular and cellular alterations, such as mitochondrial dysfunction, synaptic deficits, impaired neurite growth, neuronal cell death, glial cell activation, neuroinflammation, and neurovascular dysfunction, in addition to elevated levels of amyloid β (Aβ) and tau phosphorylation. Oxidative stress and the oxidative stress-sensitive TRPM2 channel play important roles in mediating multiple molecular and cellular alterations that underpin AD-related cognitive dysfunction. Documented evidence suggests critical engagement of oxidative stress and TRPM2 channel activation in various PM2.5-induced cellular effects. Here we discuss recent studies that favor causative relationships of PM2.5 exposure to increased AD prevalence and AD- and age-related pathologies, and raise the perspective on the roles of oxidative stress and the TRPM2 channel in mediating PM2.5-induced predisposition to AD and age-related brain damage.
Fulltext ATP-activated P2X7 receptor in the pathophysiology of mood disorders and as an emerging target for the development of novel antidepressant therapeutics

Wei L, Syed Mortadza SA, Yan J, Zhang L, Wang L, Yin Y, et al.

Neurosci Biobehav Rev, 2018 Apr;87:192-205.
PMID: 29453990 DOI: 10.1016/j.neubiorev.2018.02.005

Mood disorders are a group of psychiatric conditions that represent leading global disease burdens. Increasing evidence from clinical and preclinical studies supports that innate immune system dysfunction plays an important part in the pathophysiology of mood disorders. P2X7 receptor, belonging to the ligand-gated ion channel P2X subfamily of purinergic P2 receptors for extracellular ATP, is highly expressed in immune cells including microglia in the central nervous system (CNS) and has a vital role in mediating innate immune response. The P2X7 receptor is also important in neuron-glia signalling in the CNS. The gene encoding human P2X7 receptor is located in a locus of susceptibility to mood disorders. In this review, we will discuss the recent progress in understanding the role of the P2X7 receptor in the pathogenesis and development of mood disorders and in discovering CNS-penetrable P2X7 antagonists for potential uses in in vivo imaging to monitor brain inflammation and antidepressant therapeutics.

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