Displaying publications 201 - 220 of 1049 in total

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  1. Design of a fuzzy-based decision support system for coronary heart disease diagnosis
    Lahsasna A, Ainon RN, Zainuddin R, Bulgiba A
    J Med Syst, 2012 Oct;36(5):3293-306.
    PMID: 22252606 DOI: 10.1007/s10916-012-9821-7
    In the present paper, a fuzzy rule-based system (FRBS) is designed to serve as a decision support system for Coronary heart disease (CHD) diagnosis that not only considers the decision accuracy of the rules but also their transparency at the same time. To achieve the two above mentioned objectives, we apply a multi-objective genetic algorithm to optimize both the accuracy and transparency of the FRBS. In addition and to help assess the certainty and the importance of each rule by the physician, an extended format of fuzzy rules that incorporates the degree of decision certainty and importance or support of each rule at the consequent part of the rules is introduced. Furthermore, a new way for employing Ensemble Classifiers Strategy (ECS) method is proposed to enhance the classification ability of the FRBS. The results show that the generated rules are humanly understandable while their accuracy compared favorably with other benchmark classification methods. In addition, the produced FRBS is able to identify the uncertainty cases so that the physician can give a special consideration to deal with them and this will result in a better management of efforts and tasks. Furthermore, employing ECS has specifically improved the ability of FRBS to detect patients with CHD which is desirable feature for any CHD diagnosis system.
    Matched MeSH terms: Age Factors
  2. Fulltext The contribution of reproductive factors and family history towards premenopausal breast cancer risk in Kuala Lumpur, Malaysia
    Razif SM, Sulaiman S, Hanie SS, Aina EN, Rohaizak M, Fuad I, et al.
    Med J Malaysia, 2011 Aug;66(3):220-6.
    PMID: 22111444 MyJurnal
    Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer.
    Matched MeSH terms: Age Factors
  3. Fulltext Fundamentals in the management of multiple myeloma
    Fadilah SA
    Med J Malaysia, 2010 Sep;65(3):231-9.
    PMID: 21939177
    Progress in our understanding of multiple myeloma and its treatment has resulted in a more tailored approach to patient management, with different therapeutics regimens for different patient populations. The decision to initiate therapy depends primarily on the presence of symptoms which has to balance the chance of tumor clearance and against the risks of treatment related mortality. Selection of appropriate initial treatment should be based primarily on patient's characteristics (biologic age, co-morbidities), the disease characteristics (tumor burden and genetic risk profile) and the expected toxicity profile of the different regimens. When treatment begins, in younger transplant eligible patients the goal is to achieve high quality responses with intensive therapies as the quality of response appears to be important surrogates for long-term outcome. In the majority of myeloma patients in whom intensive treatment is not an option due to advanced age and co-morbidities, treatment should emphasize on optimal disease control to obtain symptomatic relief and to maintain a satisfactory quality of life. The introduction of novel agents has substantially changed the treatment paradigm of this otherwise incurable disease. The utilization of these drugs has moved from relapse setting to the front line setting and has benefited all patient groups. Because of these rapid developments and many treatment options we need good quality clinical studies to guide clinical practice in the management of patients with multiple myeloma. This review presents an update on current concepts of diagnosis and treatment of patients with multiple myeloma and provides recommendations on tailored therapies with particular reference to the local practice. The information presented herein may be used by the health care providers caring for myeloma patients as a guideline to counsel patients to understand their disease and the treatment better.
    Matched MeSH terms: Age Factors
  4. Motorcyclist rear brake simple perception-response times in rear-end collision situations
    Davoodi SR, Hamid H, Arintono S, Muniandy R, Faezi SF
    Traffic Inj Prev, 2011 Apr;12(2):174-9.
    PMID: 21469025 DOI: 10.1080/15389588.2010.533314
    The purpose of this study was to determine the baseline motorcycle riders' perception-response times (PRTs) in an expected object braking task and to determine the significant difference between PRTs of older and younger riders.
    Matched MeSH terms: Age Factors
  5. Changes over time in the relationship between symptoms of asthma, rhinoconjunctivitis and eczema: a global perspective from the International Study of Asthma and Allergies in Childhood (ISAAC)
    Asher MI, Stewart AW, Wong G, Strachan DP, García-Marcos L, Anderson HR, et al.
    Allergol Immunopathol (Madr), 2012 Sep-Oct;40(5):267-74.
    PMID: 22297190 DOI: 10.1016/j.aller.2011.11.004
    BACKGROUND: The International Study of Asthma and Allergies in Childhood (ISAAC) identified trends in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema over a seven-year period. We hypothesised that environmental influences on the three diseases are different and therefore investigated the correlation over time between trends in the prevalence of these diseases and their combinations at centre and individual level.
    METHODS: Centre level analyses were correlations between time trends in the prevalence of symptoms. At an individual level, odds ratios were calculated for associations between symptoms between Phases One and Three. We also investigated potential effect modification in the younger versus older age group; male versus female; and by average Gross National Income per capita (GNI).
    RESULTS: Both phases were completed in 66 centres in 37 countries for the 6-7 year age group and in 106 centres in 56 countries for the 13-14 year age group. We found that the correlations in time trends were stronger for the older age group than the younger one. Between symptoms of diseases, correlations of time trends were the strongest for rhinoconjunctivitis with eczema and weakest for eczema with asthma. The relationship between the three diseases was generally consistent over the seven-year period, and there was little association found with average GNI.
    CONCLUSIONS: Despite some increase in the proportion of children with symptoms of asthma, rhinoconjunctivitis and eczema, the pattern between the three diseases has not changed much, suggesting that similar factors may be affecting them at a global level.
    Matched MeSH terms: Age Factors
  6. Health-related quality of life (HRQOL) among pediatric leukemia patients in Malaysia
    Hamidah A, Wong CY, Tamil AM, Zarina LA, Zulkifli ZS, Jamal R
    Pediatr Blood Cancer, 2011 Jul 15;57(1):105-9.
    PMID: 21465639 DOI: 10.1002/pbc.23125
    Health-Related Quality of Life (HRQOL) in pediatric leukemia patients in Malaysia has not been studied before. This was mainly due to a lack of databases on patients in the past. Many patients abandoned treatment or were lost to follow up. With more children now fully compliant and completing treatment nowadays, with higher cure rate, HRQOL has become important for our patients. The purpose of the current study was to determine the HRQOL scores in children with acute leukemia and to compare the scores for those on maintenance chemotherapy with those off-treatment as well as to determine factors which might affect HRQOL.
    Matched MeSH terms: Age Factors
  7. Ageing modifies the fibre angle and biomechanical function of the lumbar extensor muscles
    Singh DK, Bailey M, Lee RY
    Clin Biomech (Bristol, Avon), 2011 Jul;26(6):543-7.
    PMID: 21392870 DOI: 10.1016/j.clinbiomech.2011.02.002
    Ageing is associated with geometrical changes in muscle fascicles that may lead to deteriorations in physical functions. The purpose of this study was to study the effects of ageing on fibre orientation and strength of the lumbar extensor muscles.
    Matched MeSH terms: Age Factors
  8. Age at menarche of university students in Bangladesh: secular trends and association with adult anthropometric measures and socio-demographic factors
    Hossain MG, Islam S, Aik S, Zaman TK, Lestrel PE
    J Biosoc Sci, 2010 Sep;42(5):677-87.
    PMID: 20529410 DOI: 10.1017/S0021932010000210
    Age at menarche has been shown to be an important indicator for diseases such as breast cancer and ischaemic heart disease. The aim of the present study was to document secular trends in age at menarche and their association with anthropometric measures and socio-demographic factors in university students in Bangladesh. Data were collected from 995 students from Rajshahi University using a stratified sampling technique between July 2004 and May 2005. Trends in age at menarche were examined by linear regression analysis. Multiple regression analysis was used to assess the association of age at menarche with adult anthropometric measures and various socio-demographic factors. The mean and median age of menarche were 13.12+/-1.16 and 13.17 years, respectively, with an increasing tendency among birth-year cohorts from 1979 to 1986. Menarcheal age was negatively associated with BMI (p<0.01), but positively associated with height (p<0.05). Early menarche was especially pronounced among students from urban environments, Muslims and those with better educated mothers. Increasing age at menarche may be explained by improved nutritional status among Bangladeshi populations. Early menarche was associated with residence location at adolescence, religion and mother's education.
    Matched MeSH terms: Age Factors
  9. Accurate prediction of the needle depth required for successful lumbar puncture
    Chong SY, Chong LA, Ariffin H
    Am J Emerg Med, 2010 Jun;28(5):603-6.
    PMID: 20579557 DOI: 10.1016/j.ajem.2009.02.006
    The aim of this study is to formulate an accurate estimate of the spinal needle depth for a successful lumbar puncture in pediatric patients.
    Matched MeSH terms: Age Factors
  10. Normal motor nerve conduction studies using surface electrode recording from the supraspinatus, infraspinatus, deltoid, and biceps
    Buschbacher RM, Weir SK, Bentley JG, Cottrell E
    PM R, 2009 Feb;1(2):101-6.
    PMID: 19627883 DOI: 10.1016/j.pmrj.2008.08.002
    Proximal peripheral nerve conduction studies can provide useful information to the clinician. The difficulty of measuring the length of the proximal nerve as well as a frequent inability to stimulate at 2 points along the nerve adds a challenge to the use of electrodiagnosis for this purpose. The purpose of this article is to present normal values for the suprascapular, axillary, and musculocutaneous nerves using surface electrodes while accounting for side-to-side variability.
    Matched MeSH terms: Age Factors
  11. Fulltext Outcome of patients presenting with idiopathic facial nerve paralysis (Bell's palsy) in a tertiary centre--a five year experience
    Tang IP, Lee SC, Shashinder S, Raman R
    Med J Malaysia, 2009 Jun;64(2):155-8.
    PMID: 20058577
    This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.
    Matched MeSH terms: Age Factors
  12. 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.
    Matched MeSH terms: Age Factors
  13. Morphological comparison between adolescent and adult lumbar pedicles using computerised tomography scanning
    Mughir AM, Yusof MI, Abdullah S, Ahmad S
    Surg Radiol Anat, 2010 Jul;32(6):587-92.
    PMID: 20047027 DOI: 10.1007/s00276-009-0612-x
    To study the morphological difference between the lumbar pedicle in adolescent and adult groups as only less information is known about their pedicle morphology, especially in Malaysian population.
    Matched MeSH terms: Age Factors
  14. A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups
    Ngeow WC, Dionysius DD, Ishak H, Nambiar P
    J Oral Sci, 2009 Jun;51(2):231-7.
    PMID: 19550091
    The anterior loop is defined as where the mental neurovascular bundle crosses anterior to the mental foramen then doubles back to exit the mental foramen. It cannot be seen clinically but can be detected in 11-60% of panoramic radiographs. As this anatomical structure is important in determining the placement position of endosseous implants in the mandibular premolar region, a pilot study was undertaken to determine its visibility on dental panoramic radiographs in dentate subjects of various age groups. One or more anterior loops were visible in 39 (40.2%) radiographs encompassing 66 sites (34.4%). Interestingly, anterior loops were most commonly observed bilaterally, followed by on the right side of the mandible only. An anterior loop on the left side only was observed in just 1 radiograph. Visibility of anterior loops reduced as the age of subjects increased. More than half (58.1%) of subjects aged 20-29 years exhibited at least one anterior loop; this gradually reduced to only 15 percent of subjects aged 50 and older. There was no association between visualization of the anterior loop and subject gender.
    Matched MeSH terms: Age Factors
  15. Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia
    Ibrahim NM, Shohaimi S, Chong HT, Rahman AH, Razali R, Esther E, et al.
    Dement Geriatr Cogn Disord, 2009;27(3):247-53.
    PMID: 19246909 DOI: 10.1159/000203888
    BACKGROUND/AIMS: In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics).
    METHODS: Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell 'dunia' backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves.
    RESULTS: Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders.
    CONCLUSION: All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied.
    Study site: Community, neurology and dementia outpatient clinics, Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Age Factors
  16. Fulltext Gender and ethnic differences in cardiovascular risks in Songkhla province, Thailand: the interASIA-south
    Chongsuvivatwong V, YipIntsoi T, Apakupakul N
    J Med Assoc Thai, 2008 Apr;91(4):464-70.
    PMID: 18556853
    The subset of data on southern Thai InterAsia study conducted in 2000 was revisited in order to document gender and ethnic breakdown of prevalence of risk factors for cardiovascular diseases (CVD). Three hundred and seventy-five men and 630 women with overall mean +/- SD age of 53.2 +/- 11.7 years were recruited. Combined gender prevalences were: 21.1% for smoking, 15.5% for drinking, 21.8% for hypertension (systemic blood pressure > or = 140/90 mmHg), 49.8% for impaired fasting plasma glucose (FPG 110-125 mg/dl), 9.9% for diabetes mellitus (FPG > or = 126 mg/dl), 10% for body mass index > or = 30 kg/m2, 43.5% for large waist circumference (WC > or = 90 cm in men and > or = 80 in women), 62.8% for total serum cholesterol (TC), > 200 mg/dl, 38.5% for TC divided by high density lipoprotein cholesterol (HDL-C) > or = 5 and 61.6% for low-density-lipoprotein cholesterol (LDL-C), > or = 130 mg/dl. After using logistic regression, adjusting the effects of age and community of residence, women were less likely than men to be smokers, drinkers, or showed impaired FPG but significantly more likely to have large WC, TC > or = 200 mg/dl and LDL-C > or = 130 mg/dl. Muslims showed significantly lower risk for drinking and large WC but higher risk for low HDL-C. The differences require further research. In conclusion, gender and age have stronger association with various risk factors than ethnicity in this selected population.
    Matched MeSH terms: Age Factors
  17. Perceived vaccination status in ecotourists and risks of anthropozoonoses
    Muehlenbein MP, Martinez LA, Lemke AA, Ambu L, Nathan S, Alsisto S, et al.
    Ecohealth, 2008 Sep;5(3):371-8.
    PMID: 18810550 DOI: 10.1007/s10393-008-0192-y
    Anthropozoonotic (human to nonhuman animal) transmission of infectious disease poses a significant threat to wildlife. A large proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses, and a majority of these travelers demonstrate poor recall of actual vaccination status. Here we characterize self-perceived vaccination status among a large sample of ecotourists at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. Despite their recognized travel itinerary to view endangered animals, tourists at wildlife sanctuaries are not adequately protected against vaccine-preventable illnesses. Of 633 surveys, over half reported being currently vaccinated against tuberculosis, hepatitis A, hepatitis B, polio, and measles. Fewer participants reported current vaccination status for influenza, rabies, and chickenpox. Despite the fact that the majority of visitors to Sepilok are from temperate regions where influenza is relatively more prevalent, 67.1% of those surveyed with medical-related occupations reported not being currently vaccinated for influenza. Ecotourists concerned about environmental protection are themselves largely unaware of their potential contribution to the spread of diseases to animals. The risks of negatively affecting animal populations must be communicated to all concerned parties, and this may begin by urging travelers to examine their actual vaccination status, particularly as the ecotourism industry continues its rapid expansion, and is seen increasingly as a possible tool to save great ape populations from extinction.
    Matched MeSH terms: Age Factors
  18. Pay attention to radiation doses
    Shulman ST
    Pediatr Ann, 2008 Jun;37(6):368-9.
    PMID: 18616187
    Matched MeSH terms: Age Factors
  19. Oral cancer presentation among Malay patients in hospital Universiti Sains Malaysia, Kelantan
    Razak AA, Saddki N, Naing NN, Abdullah N
    Asian Pac J Cancer Prev, 2009;10(6):1131-6.
    PMID: 20192598
    OBJECTIVE: The objective of this study was to identify the characteristics of oral cancer among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan.

    METHODS: A retrospective record review was conducted from August to December 2006 in HUSM. Of 133 patients with oral cancer diagnosed from 1986 to 2005, 118 were Malay. Data on socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients were obtained.

    RESULTS: Malay patients with oral cancer were predominantly elderly, aged 60 years old and above (51.7%) at the time of diagnosis, with a mean age of 58.1 years (SD 16.81). Most patients were males (64.4%) and the majority of them were married (83.9%). More than half (58.5%) had been smokers, and of those who smoked, 89.9% were males. Some had a betel quid chewing habit (22.9%) but none ever consumed alcohol. The majority of the patients (77.1%) were diagnosed at stage IV. The tongue was the most usual site involved (37.3%) and squamous cell carcinoma was the most common histological type seen (75.4%).

    CONCLUSIONS: The prevalence of oral cancer among Malay patients in HUSM is high (88.7%). It is predominantly found in elderly males and the majority of cases present at advanced stage.

    Matched MeSH terms: Age Factors
  20. Fulltext Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination
    Tay PY, Raj VR, Kulenthran A, Sitizawiah O
    Med J Malaysia, 2007 Oct;62(4):286-9.
    PMID: 18551930 MyJurnal
    To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) < or = 20 million/ml compared to those with TMSC >20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.
    Matched MeSH terms: Age Factors
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