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A case of sexual abuse by a traditional faith healer: are there potential preventions?

Chan LF, Tan SM, Ang JK, Kamal Nor N, Sharip S

J Child Sex Abus, 2012;21(6):613-20.
PMID: 23194137 DOI: 10.1080/10538712.2012.719597

Adolescent sexual abuse is not an uncommon phenomenon in Malaysia. It is a traumatic experience that complicates the psychosocial development of young people on the threshold of adulthood. This case report highlights the psychosocial sequelae of adolescent sexual abuse by a traditional healer and discusses management issues in the context of unique cultural and belief systems.
STR data for the 13 CODIS loci in Singapore Malays

Ang HC, Sornarajah R, Lim SE, Syn CK, Tan-Siew WF, Chow ST, et al.

Forensic Sci Int, 2005 Mar 10;148(2-3):243-5.
PMID: 15639622

Allele frequencies for the 13 CODIS (Combined DNA Index System, USA) STR loci included in the AmpFISTR Profiler Plus and AmpFISTR Cofiler kits (Applied Biosystems, Foster City, USA) were determined in a sample of 197 unrelated Malays in Singapore.
Fulltext Antidiabetic properties and mechanism of action of Orthosiphon stamineus Benth bioactive sub-fraction in streptozotocin-induced diabetic rats

Mohamed EA, Yam MF, Ang LF, Mohamed AJ, Asmawi MZ

J Acupunct Meridian Stud, 2013 Feb;6(1):31-40.
PMID: 23433053 DOI: 10.1016/j.jams.2013.01.005

Orthosiphon stamineus is a popular folk medicine widely used to treat many diseases including diabetes. Previous studies have shown that the sub-fraction of chloroform extract was able to inhibit the rise of blood glucose levels in a glucose tolerance test. This study was carried out to evaluate the chronic effect and possible mechanism of action of the bioactive chloroform sub-fraction of O. stamineus using streptozotocin-induced diabetic rats and in vitro methods. Administration of the chloroform extract sub-fraction 2 (Cƒ2-b) at a dose of 1 g/kg twice daily on diabetic rats for 14 days showed a significant lowering (p < 0.05) of the final blood glucose level compared to the pretreatment level. However, there were no significant differences in the plasma insulin levels post-treatment compared to the pretreatment levels for all doses of Cƒ2-b. Conversely, Cƒ2-b at a concentration of 2 mg/mL significantly increased (p < 0.001) the glucose uptake by the rat diaphragm muscle. The increase in glucose uptake was also shown when the muscle was incubated in a solution containing 1 IU/mL of insulin or 1 mg/mL of metformin. Furthermore, the effect of this sub-fraction on glucose absorption in the everted rat jejunum showed that Cƒ2-b at concentrations of 0.5 mg/mL, 1 mg/mL and, 2 mg/mL significantly reduced the glucose absorption of the jejunum (p < 0.05-0.001). Similarly, the absorption of glucose was also inhibited by 1 mg/mL and 2 mg/mL of metformin (p < 0.001). These results suggest that the effect of Cƒ2-b may be due to extra-pancreatic mechanisms. There was no evidence that the plant extract stimulated the release of insulin in order to lower the blood glucose level.
Racial differences in Helicobacter pylori, serum pepsinogen and gastric cancer incidence in an urban Asian population

Ang TL, Fock KM, Dhamodaran S, Teo EK, Tan J

J Gastroenterol Hepatol, 2005 Oct;20(10):1603-9.
PMID: 16174081

In Singapore, the highest incidence of gastric cancer occurs in the Chinese (C), with lower rates among Malay (M) and Indian (I) subjects. The purpose of the present paper was to examine whether racial differences in the prevalence of Helicobacter pylori and serum pepsinogen (PG) could account for this difference.
The relationship of hostility, negative affect and ethnicity to cardiovascular responses: an ambulatory study in Singapore

Enkelmann HC, Bishop GD, Tong EM, Diong SM, Why YP, Khader M, et al.

Int J Psychophysiol, 2005 May;56(2):185-97.
PMID: 15804452

This study tested the hypotheses that ambulatory heart rate and blood pressure would be higher for individuals high but not low in hostility when they experienced negative affect or social stress and that this interaction would be stronger for Indians compared with other Singapore ethnic groups. Ambulatory blood pressure monitoring was done on 108 male Singapore patrol officers as they went about their daily duties. After each BP measurement participants completed a computerized questionnaire including items on emotional experience. Individuals high in hostility showed higher systolic blood pressure when reporting negative affect whereas this was not true for those low in hostility. Ethnic differences were obtained such that Indians showed an increase in mean arterial pressure when angered whereas MAP was negatively related to anger for Malays and unrelated for Chinese. Also a three-way interaction between ethnicity, hostility, and social stress indicated that hostility and social stress interacted in their effects on DBP for Indian participants but not for Chinese or Malays. Finally, a three-way interaction was obtained between ethnicity, hostility and negative affect for heart rate in which heart rate increased with increasing levels of negative affect for Chinese high in hostility and Malays low in hostility but decreased with increasing negative affect for all other participants. These data are consistent with higher CHD rates among individuals high in hostility and also provide additional evidence on ethnic differences in cardiovascular reactivity in Singapore.
Craniofacial morphology, head posture, and nasal respiratory resistance in obstructive sleep apnoea: an inter-ethnic comparison

Wong ML, Sandham A, Ang PK, Wong DC, Tan WC, Huggare J

Eur J Orthod, 2005 Feb;27(1):91-7.
PMID: 15743868

The aim of this study was to measure craniofacial morphology and nasal respiratory resistance (NRR) in Malay, Indian and Chinese subjects with obstructive sleep apnoea (OSA). The sample consisted of 34 male subjects, 27-52 years of age (Malay n = 11, which included five mild and six moderate-severe OSA; Indian n = 11, which included six mild and five moderate-severe OSA; and Chinese n = 12, which included six mild and six moderate-severe OSA) diagnosed using overnight polysomnography. After use of a decongestant, NRR was recorded using anterior and posterior rhinomanometry. Standardized lateral cephalometric radiographs were used to record linear and angular dimensions. Malay subjects with moderate-severe OSA had a shorter maxillary (sp-pm) and mandibular (gn-go) length when compared with a mild OSA reference sample (P < 0.05). The hyoid bone was located more caudally in the Chinese moderate-severe subjects (hy-NL, hy-ML)(P < 0.05), and may be a useful diagnostic indicator for severity in this racial group. No pattern of differences for NRR was seen between the moderate-severe and mild OSA subjects. The consistently lower values for nasopharyngeal resistance in all the moderate-severe subjects when compared with the mild group may indicate that some compensation at this level of the airway had taken place. Strong positive correlations between craniocervical angulation (NL/OPT) and total airway resistance and the turbulent component of flow (k(2)) suggest that head posture is sensitive to fluctuations in airway resistance (P < 0.01).
Development of a dry-reagent-based nucleic acid-sensing platform by coupling thermostabilised LATE-PCR assay to an oligonucleotide-modified lateral flow biosensor

Ang GY, Yu CY, Chan KG, Singh KK, Chan Yean Y

J Microbiol Methods, 2015 Nov;118:99-105.
PMID: 26342435 DOI: 10.1016/j.mimet.2015.08.024

In this study, we report for the first time the development of a dry-reagent-based nucleic acid-sensing platform by combining a thermostabilised linear-after-the-exponential (LATE)-PCR assay with a one-step, hybridisation-based nucleic acid lateral flow biosensor. The nucleic acid-sensing platform was designed to overcome the need for stringent temperature control during transportation or storage of reagents and reduces the dependency on skilled personnel by decreasing the overall assay complexity and hands-on time. The platform was developed using toxigenic Vibrio cholerae as the model organism due to the bacterium's propensity to cause epidemic and pandemic cholera. The biosensor generates result which can be visualised with the naked eyes and the limit of detection was found to be 1pg of pure genomic DNA and 10CFU/ml of toxigenic V. cholerae. The dry-reagent-based nucleic acid-sensing platform was challenged with 95 toxigenic V. cholerae, 7 non-toxigenic V. cholerae and 66 other bacterial strains in spiked stool sample and complete agreement was observed when the results were compared to that of monosialoganglioside (GM1)-ELISA. Heat-stability of the thermostabilised LATE-PCR reaction mixes at different storage temperatures (4-56°C) was investigated for up to 90days. The dry-reagent-based genosensing platform with ready-to-use assay components provides an alternative method for sequence-specific detection of nucleic acid without any cold chain restriction that is associated with conventional molecular amplification techniques.
Fulltext Draft genome sequence of a multidrug-resistant Chryseobacterium indologenes isolate from Malaysia

Yu CY, Ang GY, Cheng HJ, Cheong YM, Yin WF, Chan KG

Genom Data, 2016 Mar;7:185-6.
PMID: 26981402 DOI: 10.1016/j.gdata.2015.12.024

Chryseobacterium indologenes is an emerging pathogen which poses a threat in clinical healthcare setting due to its multidrug-resistant phenotype and its common association with nosocomial infections. Here, we report the draft genome of a multidrug-resistant C. indologenes CI_885 isolated in 2014 from Malaysia. The 908,704-kb genome harbors a repertoire of putative antibiotic resistance determinants which may elucidate the molecular basis and underlying mechanisms of its resistant to various classes of antibiotics. The genome sequence has been deposited in DDBJ/EMBL/GenBank under the accession number LJOD00000000.
Fulltext Comparative Genomic Analysis Reveals a Possible Novel Non-Tuberculous Mycobacterium Species with High Pathogenic Potential

Choo SW, Dutta A, Wong GJ, Wee WY, Ang MY, Siow CC

PLoS One, 2016;11(4):e0150413.
PMID: 27035710 DOI: 10.1371/journal.pone.0150413

Mycobacteria have been reported to cause a wide range of human diseases. We present the first whole-genome study of a Non-Tuberculous Mycobacterium, Mycobacterium sp. UM_CSW (referred to hereafter as UM_CSW), isolated from a patient diagnosed with bronchiectasis. Our data suggest that this clinical isolate is likely a novel mycobacterial species, supported by clear evidence from molecular phylogenetic, comparative genomic, ANI and AAI analyses. UM_CSW is closely related to the Mycobacterium avium complex. While it has characteristic features of an environmental bacterium, it also shows a high pathogenic potential with the presence of a wide variety of putative genes related to bacterial virulence and shares very similar pathogenomic profiles with the known pathogenic mycobacterial species. Thus, we conclude that this possible novel Mycobacterium species should be tightly monitored for its possible causative role in human infections.
Acoustically enhanced heat transport

Ang KM, Yeo LY, Friend JR, Hung YM, Tan MK

Rev Sci Instrum, 2016 Jan;87(1):014902.
PMID: 26827343 DOI: 10.1063/1.4939757

We investigate the enhancement of heat transfer in the nucleate boiling regime by inducing high frequency acoustic waves (f ∼ 10(6) Hz) on the heated surface. In the experiments, liquid droplets (deionized water) are dispensed directly onto a heated, vibrating substrate. At lower vibration amplitudes (ξs ∼ 10(-9) m), the improved heat transfer is mainly due to the detachment of vapor bubbles from the heated surface and the induced thermal mixing. Upon increasing the vibration amplitude (ξs ∼ 10(-8) m), the heat transfer becomes more substantial due to the rapid bursting of vapor bubbles happening at the liquid-air interface as a consequence of capillary waves travelling in the thin liquid film between the vapor bubble and the air. Further increases then lead to rapid atomization that continues to enhance the heat transfer. An acoustic wave displacement amplitude on the order of 10(-8) m with 10(6) Hz order frequencies is observed to produce an improvement of up to 50% reduction in the surface temperature over the case without acoustic excitation.
Enzymatic electrochemical detection of epidemic-causing Vibrio cholerae with a disposable oligonucleotide-modified screen-printed bisensor coupled to a dry-reagent-based nucleic acid amplification assay

Yu CY, Ang GY, Chan KG, Banga Singh KK, Chan YY

Biosens Bioelectron, 2015 Aug 15;70:282-8.
PMID: 25835520 DOI: 10.1016/j.bios.2015.03.048

In this study, we developed a nucleic acid-sensing platform in which a simple, dry-reagent-based nucleic acid amplification assay is combined with a portable multiplex electrochemical genosensor. Preparation of an amplification reaction mix targeting multiple DNA regions of interest is greatly simplified because the lyophilized reagents need only be reconstituted with ultrapure water before the DNA sample is added. The presence of single or multiple target DNAs causes the corresponding single-stranded DNA (ssDNA) amplicons to be generated and tagged with a fluorescein label. The fluorescein-labeled ssDNA amplicons are then analyzed using capture probe-modified screen-printed gold electrode bisensors. Enzymatic amplification of the hybridization event is achieved through the catalytic production of electroactive α-naphthol by anti-fluorescein-conjugated alkaline phosphatase. The applicability of this platform as a diagnostic tool is demonstrated with the detection of toxigenic Vibrio cholerae serogroups O1 and O139, which are associated with cholera epidemics and pandemics. The platform showed excellent diagnostic sensitivity and specificity (100%) when challenged with 168 spiked stool samples. The limit of detection was low (10 colony-forming units/ml) for both toxigenic V. cholerae serogroups. A heat stability assay revealed that the dry-reagent amplification reaction mix was stable at temperatures of 4-56 °C, with an estimated shelf life of seven months. The findings of this study highlight the potential of combining a dry-reagent-based nucleic acid amplification assay with an electrochemical genosensor in a more convenient, sensitive, and sequence-specific detection strategy for multiple target nucleic acids.
Fulltext HPLC method for simultaneous quantitative detection of quercetin and curcuminoids in traditional chinese medicines

Ang LF, Yam MF, Fung YT, Kiang PK, Darwin Y

J Pharmacopuncture, 2014 Dec;17(4):36-49.
PMID: 25780718 DOI: 10.3831/KPI.2014.17.035

OBJECTIVES: Quercetin and curcuminoids are important bioactive compounds found in many herbs. Previously reported high performance liquid chromatography ultraviolet (HPLC-UV) methods for the detection of quercetin and curcuminoids have several disadvantages, including unsatisfactory separation times and lack of validation according the standard guidelines of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use.
METHODS: A rapid, specific, reversed phase, HPLC-UV method with an isocratic elution of acetonitrile and 2% v/v acetic acid (40% : 60% v/v) (pH 2.6) at a flow rate of 1.3 mL/minutes, a column temperature of 35°C, and ultraviolet (UV) detection at 370 nm was developed. The method was validated and applied to the quantification of different types of market available Chinese medicine extracts, pills and tablets.
RESULTS: The method allowed simultaneous determination of quercetin, bisdemethoxycurcumin, demethoxycurcumin and curcumin in the concentration ranges of 0.00488 ─ 200 μg/mL, 0.625 ─ 320 μg/mL, 0.07813 ─ 320 μg/mL and 0.03906 ─ 320 μg/mL, respectively. The limits of detection and quantification, respectively, were 0.00488 and 0.03906 μg/mL for quercetin, 0.62500 and 2.50000 μg/mL for bisdemethoxycurcumin, 0.07813 and 0.31250 μg/mL for demethoxycurcumin, and 0.03906 and 0.07813 μg/mL for curcumin. The percent relative intra day standard deviation (% RSD) values were 0.432 ─ 0.806 μg/mL, 0.576 ─ 0.723 μg/mL, 0.635 ─ 0.752 μg/mL and 0.655 ─ 0.732 μg/mL for quercetin, bisdemethoxycurcumin, demethoxycurcumin and curcumin, respectively, and those for intra day precision were 0.323 ─ 0.968 μg/mL, 0.805 ─ 0.854 μg/mL, 0.078 ─ 0.844 μg/mL and 0.275 ─ 0.829 μg/mL, respectively. The intra day accuracies were 99.589% ─ 100.821%, 98.588% ─ 101.084%, 9.289% ─ 100.88%, and 98.292% ─ 101.022% for quercetin, bisdemethoxycurcumin, demethoxycurcumin and curcumin, respectively, and the inter day accuracy were 99.665% ─ 103.06%, 97.669% ─ 103.513%, 99.569% ─ 103.617%, and 97.929% ─ 103.606%, respectively.
CONCLUSION: The method was found to be simple, accurate and precise and is recommended for routine quality control analysis of commercial Chinese medicine products containing the flour flavonoids as their principle components in the extracts.
Oxidative hydrothermal surface modification of activated carbon for sevoflurane removal

Ang TN, Young BR, Burrell R, Taylor M, Aroua MK, Baroutian S

Chemosphere, 2021 Feb;264(Pt 2):128535.
PMID: 33045509 DOI: 10.1016/j.chemosphere.2020.128535

The emission of waste anaesthetic gas is a growing contributor to global warming and remains a factor in atmospheric ozone depletion. Volatile anaesthetics in medical waste gases could be removed via adsorption using suitable activated carbon materials possessing an enhanced affinity to anaesthetic molecules. In this work, the effects of surface physical and chemical properties on sevoflurane adsorption were investigated by oxidative hydrothermal surface modification of a commercial activated carbon using only distilled water. The hydrothermal surface modification was carried out at different treatment temperatures (150-300 °C) for varying durations (10-30 min), and adsorption was conducted under fixed conditions (bed depth = 10 cm, inlet concentration = 528 mg/L, and flow rate = 3 L/min). The hydrothermal treatment generally increased the BET surface area of the activated carbons. At oxidation temperatures above 200 °C, the micropore volume of the samples diminished. The relative amount of surface oxygen was enriched as the treatment temperature increased. Treatment duration did not significantly affect the introduction of relative amount of surface oxygen, except at higher temperatures. There were no new types of functional groups introduced. However, disappearance and re-formation of oxygen functional groups containing C-O structures (as in hydroxyl and ether groups) occurred when treatment temperature was increased from 150 to 200 °C, and when treatments were conducted above 200 °C, respectively. The ester/acetal groups were enriched under the temperature range studied. The findings suggested that the re-formation of surface oxygen functionalities might lead to the development of functional groups that improve sevoflurane adsorption.
Parental preferences in treatment of acute uncomplicated appendicitis comparing surgery to conservative management with antibiotics and their views on research participation

Kyaw L, Pereira NK, Ang CX, Choo CSC, Nah SA

Eur J Pediatr, 2020 May;179(5):735-742.
PMID: 31897841 DOI: 10.1007/s00431-019-03555-w

Studies show that conservative management in acute uncomplicated appendicitis (AUA) is an alternative to surgery. This study aims to determine factors affecting parental preference in management of AUA and their decision for research participation. We conducted surveys on parents whose children were admitted with suspicion of appendicitis but later confirmed not to have appendicitis. Information on appendicectomy versus conservative treatment with antibiotics was provided using a fixed script and standard information leaflet. Questionnaires covered factors influencing decisions, opinions regarding research, treatment preference and demographic data. We excluded parents not fluent in English. Of 113 respondents, 71(62.8%) chose antibiotics, 39(34.5%) chose appendicectomy, and 3(2.7%) had no preference. Reasons given for choosing antibiotics were fear of surgical risks and preferring less invasive treatment. Those choosing appendicectomy expressed preference for definitive treatment and fear of recurrence. Majority were against randomisation (n = 89, 78.8%) and blinding (n = 90, 79.7%). Over half found difficulty involving their child in research (n = 65, 57.5%). Most thought that research is important (66.4%) and beneficial to others (59.3%). Parents who perceived their child as healthy found research riskier (p = 0.039). Educated parents were more likely to find research beneficial to others (p = 0.012) but less accepting of randomisation (p = 0.001).Conclusion: More parents appear to prefer conservative treatment for acute uncomplicated appendicitis. Researchers must consider parental concerns regarding randomisation and blinding.What is Known:• Conservative management of acute uncomplicated appendicitis in paediatric patients is safe and effective, sparing the child the need for an operation; however, neither conservative nor surgical management is proven to be superior.• Randomised controlled trials provide the highest level of evidence, but it is challenging to recruit paediatric patients as participants in such clinical trials.What is New:• More parents prefer conservative management of uncomplicated appendicitis over surgical management for their children due to fear of surgical risks and complications• Randomisation in trial design is significantly associated with a parent's decision to reject their child's participation in a clinical trial.
Diversity and characterization of lignocellulolytic fungi isolated from oil palm empty fruit bunch, and identification of influencing factors of natural composting process

Md Tahir P, Liew WP, Lee SY, Ang AF, Lee SH, Mohamed R, et al.

Waste Manag, 2019 Dec;100:128-137.
PMID: 31536923 DOI: 10.1016/j.wasman.2019.09.002

Oil palm empty fruit bunch (EFB) is the most significant waste generated from the agricultural industry in Malaysia. Composting is one of the potential approaches to utilize EFB. However, composting of EFB is a time-consuming process, thus impractical for industrial application. The composting process can be shortened by introducing competent fungi into an optimal EFB composting system. This study was conducted to isolate and identify competent fungi that can naturally compost EFB. Samplings were carried out at eight different time points over a 20-weeks experimental period. The physical properties of EFB samples such as pH, residual oil content, and moisture content were measured and the EFB composting process that was indicated by the contents of cellulose, hemicellulose, and lignin were assessed. The fungal growth, distribution, and lignocellulolytic enzyme activities were evaluated. The results indicated that the changes in physical properties of EFB were correlated to the fungal growth. The gradual reduction in moisture content and residual oil, and the increment in pH values in EFB samples throughout the experimental period resulted in reduced fungal growth and diversity. Such phenomenon delayed EFB composting process as revealed by the changes in EFB lignin, hemicellulose, and cellulose contents. The most dominant and resilient fungi (Lichtheimia ramosa and Neurospora crassa) survived up to 16 weeks and were capable of producing various lignocellulolytic enzymes. Further understanding of these factors that would contribute to effective EFB composting could be useful for future industrial applications.
Infolding of the Venus P-Valve After Transcatheter Pulmonary Valve Implantation

Riahi M, Ang HL, Jones M, Prachasilchai P, Baruteau AE, Promphan W, et al.

Circ Cardiovasc Interv, 2018 04;11(4):e005923.
PMID: 29618579 DOI: 10.1161/CIRCINTERVENTIONS.117.005923
Adsorption study of methyl orange by chitosan/polyvinyl alcohol/zeolite electrospun composite nanofibrous membrane

Habiba U, Siddique TA, Li Lee JJ, Joo TC, Ang BC, Afifi AM

Carbohydr Polym, 2018 Jul 01;191:79-85.
PMID: 29661324 DOI: 10.1016/j.carbpol.2018.02.081

The chitosan/polyvinyl Alcohol/zeolite electrospun composite nanofibrous membrane was fabricated for adsorption of methyl orange. The EDX, TGA and tensile test were carried out for the characterization of the membrane. The Young's Modulus of the nanofibrous membranes increased by more than 100% with the addition of zeolite to chitosan/PVA. The batch adsorption tests were conducted by varying the initial concentration of methyl orange, contact time and pH of the dye solution. UV-vis results showed that most of the dye was adsorbed within 6 min. An adsorption kinetic study was carried out using the pseudo-second-order kinetic model, Lagergren-first-order model and intra particle diffusion model. The adsorption kinetics obeyed the Pseudo second order model. The adsorption mechanism was analyzed using the Langmuir and Freundlich isotherm model. The experimental data fits well with the Freundlich model. The adsorption capacity of the membrane was 153 mg/g. Adsorption capacity was decreased with increasing pH value. The resulting nanofiber became less active over methyl orange after several runs.
Depressive symptoms in adolescents in Kuching, Malaysia: Prevalence and associated factors

Ang AL, Wahab S, Abd Rahman FN, Hazmi H, Md Yusoff R

Pediatr Int, 2019 Apr;61(4):404-410.
PMID: 30597707 DOI: 10.1111/ped.13778

BACKGROUND: The trend of depression is rising worldwide. There are limited studies on depression in adolescents. The aim of this study was to estimate the prevalence of and identify the factors associated with depressive symptoms in adolescents in Kuching, Malaysia, and to analyze the relationship between depressive symptoms and suicidal ideation.
METHODS: A cross-sectional study was conducted in 320 students from urban and rural secondary schools. The participants were randomly selected via multi-stage sampling. They completed the Malay versions of the Children's Depression Inventory (CDI) and Beck Scale for Suicide Ideation (BSS).
RESULTS: The prevalence of depressive symptoms was 26.2%. On binary logistic regression analysis, variables with significant association with depressive symptoms were race (P = 0.028), type of class (P < 0.001), mother's education level (P = 0.036), type of housing (P = 0.036), parents' marital status (P = 0.012), alcohol intake (P = 0.005), stealing (P < 0.001) and history of disciplinary record (P = 0.005). Variables that remained significant on multivariable logistic regression were type of class (P = 0.004), parents' marital status (P = 0.017) and stealing (P < 0.001). Students from the Arts stream (OR, 2.43) with parents who were separated, divorced or widowed (OR, 3.13) and who had experience of stealing (OR, 3.27) were predicted to be at risk of developing depressive symptoms. There was a significant correlation between total CDI score and total BSS score (P < 0.001).
CONCLUSIONS: The prevalence of depressive symptoms in adolescents was high. Depressive symptoms are significantly correlated with suicidal ideation. Greater collaboration between the education and health agencies is essential for mental health promotion in schools and early detection of depression, especially in at-risk adolescents.
Fulltext Evaluation of vascular endothelial growth factor levels in tears and serum among diabetic patients

Ang WJ, Zunaina E, Norfadzillah AJ, Raja-Norliza RO, Julieana M, Ab-Hamid SA, et al.

PLoS One, 2019;14(8):e0221481.
PMID: 31437234 DOI: 10.1371/journal.pone.0221481

OBJECTIVE: Detection of vascular endothelial growth factor (VEGF) levels in ocular tissue may perhaps provide insight into the role of VEGF in the pathogenesis and progression of diabetic retinopathy (DR). The aim of this study was to evaluate the levels of VEGF in tears and serum amongst type 2 diabetes mellitus (DM) patients.
METHODS: A comparative cross-sectional study was conducted between August 2016 and May 2018 involving type 2 DM patients with no DR, non-proliferative DR (NPDR), and proliferative DR (PDR). Tear samples were collected using no.41 Whatman filter paper (Schirmer strips) and 5 mL blood samples were drawn by venous puncture. VEGF levels in tears and serum were measured by enzyme-linked immunosorbent assay.
RESULTS: A total of 88 type 2 DM patients (no DR: 30 patients, NPDR: 28 patients, PDR: 30 patients) were included in the study. Mean tear VEGF levels were significantly higher in the NPDR and PDR groups (114.4 SD 52.5 pg/mL and 150.8 SD 49.7 pg/mL, respectively) compared to the no DR group (40.4 SD 26.5 pg/mL, p < 0.001). There was no significant difference in the mean serum VEGF levels between the three groups. There was a fair correlation between serum and tear VEGF levels (p = 0.015, r = 0.263).
CONCLUSION: VEGF levels in tears were significantly higher amongst diabetic patients with DR compared to those without DR and were significantly associated with the severity of DR. There was a fair correlation between serum and tear VEGF levels. Detection of VEGF in tears is a good non-invasive predictor test for the severity of DR. A large cohort study is needed for further evaluation.
Fulltext Prevalence of Drug-Related Problems and Complementary and Alternative Medicine Use in Malaysia: A Systematic Review and Meta-Analysis of 37,249 Older Adults

Chang CT, Ang JY, Islam MA, Chan HK, Cheah WK, Gan SH

Pharmaceuticals (Basel), 2021 Feb 25;14(3).
PMID: 33669084 DOI: 10.3390/ph14030187

Drug-related problems (DRPs) in the elderly include polypharmacy, potentially inappropriate medications, nonadherence, and drug-related falls. In this systematic review and meta-analysis, the prevalence of DRPs and complementary and alternative medicine (CAM) use among the Malaysian elderly was estimated. PubMed, Scopus, Web of Science, and Google Scholar databases were searched to identify studies published since their inception up to 24 August 2020. A random-effects model was used to generate the pooled prevalence of DRPs along with its corresponding 95% confidence interval (CI). The heterogeneity of the results was estimated using the I2 statistics, and Cochran's Q test and sensitivity analyses were performed to confirm the robustness of the results. We identified 526 studies, 23 of which were included in the meta-analysis. (n = 29,342). The pooled prevalence of DRPs among Malaysian elderly was as follows: (1) polypharmacy: 49.5% [95% CI: 20.5-78.6], (2) potentially inappropriate medications: 28.9% [95% CI: 25.4-32.3], (3) nonadherence to medications: 60.6% [95% CI: 50.2-70.9], and (4) medication-related falls 39.3% [95% CI: 0.0-80.8]. Approximately one in two Malaysian elderly used CAM. The prevalence of polypharmacy and potentially inappropriate medications among the Malaysian elderly population was high, calling for measures and evidence-based guidelines to ensure the safe medication use.

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