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Fulltext Identification of Cultivable Bacteria from Tropical Marine Sponges and Their Biotechnological Potentials

Amelia TSM, Amirul AA, Saidin J, Bhubalan K

Trop Life Sci Res, 2018 Jul;29(2):187-199.
PMID: 30112149 MyJurnal DOI: 10.21315/tlsr2018.29.2.13

Marine sponges are acknowledged as bacterial hotspots in the oceanic biome. Aquatic bacteria are being investigated comprehensively for bioactive complexes and secondary metabolites. Cultivable bacteria associated with different species of sea sponges in South China Sea waters adjacent to Bidong Island, Terengganu were identified. Molecular identification was accomplished using 16S rRNA gene cloning and sequencing. Fourteen bacterial species were identified and their phylogenetic relationships were analysed by constructing a neighbour-joining tree with Molecular Evolutionary Genetics Analysis 6. The identified species encompassed four bacterial classes that were Firmicutes, Actinobacteria, Alphaproteobacteria and Gammaproteobacteria known to have been associated with sponges. The potential biotechnological applications of the identified bacteria were compared and reviewed based on relevant past studies. The biotechnological functions of the 14 cultivable isolates have been previously reported, hence reinforcing that bacteria associated with sponges are an abundant resource of scientifically essential compounds. Resilience of psychrotolerant bacteria, Psychrobacter celer, in warm tropical waters holds notable prospects for future research.
Fulltext Probiotic potentials of Lactobacillus plantarum isolated from fermented durian (Tempoyak), a Malaysian traditional condiment

Ahmad A, Yap WB, Kofli NT, Ghazali AR

Food Sci Nutr, 2018 Sep;6(6):1370-1377.
PMID: 30258578 DOI: 10.1002/fsn3.672

Lactic acid bacterium isolated from fermented durian (tempoyak) was investigated for its potentials as a probiotic strain. Bacterial tolerance toward gastrointestinal environment, adhesion, and cytotoxic activity in human colon adenocarcinoma cell line HT-29 was evaluated. 16S rRNA sequencing identified the lactic acid bacterium as Lactobacillus plantarum. The bacterium demonstrated good tolerance toward gastrointestinal pH 2.0 and 0.3% bile salts. It showed strong adhesive capacity in human intestinal cell line, HT-29, with an adhesion index of 159 ± 10. Cytotoxicity of L. plantarum was investigated using both live bacterial cells (BC) and cell-free supernatant (CFS). Findings showed that both BC and CFS of L. plantarum reduced proliferation of HT-29 colon adenocarcinoma cells using MTT assay. The results imply potential probiotic properties of L. plantarum isolated from tempoyak.
Fulltext Efficient and High-Quality RNA Isolation from Metabolite-Rich Tissues of Stevia rebaudiana, an Important Commercial Crop

Leh TY, Yong CSY, Nulit R, Abdullah JO

Trop Life Sci Res, 2019 Jan;30(1):149-159.
PMID: 30847038 MyJurnal DOI: 10.21315/tlsr2019.30.1.9

Stevia rebaudiana, a perennial herb native to northeastern Paraguay, has gained immense attention globally over the recent decades due to the natural sweetness of its leaves. Like in most plants, this particular species contains high amount of secondary metabolites, thus rendering the isolation of high quality and quantity RNA extract for molecular applications rather challenging. An effective, high-yield and high-quality RNA isolation protocol for this economically important plant species was devised here based on the cetyltrimethylammonium bromide (CTAB) extraction method, with an additional genomic DNA (gDNA) removal step. DNA and other contaminants that may affect downstream applications were effectively removed. Our results exhibited that RNA samples isolated from the leaves and stems of Stevia rebaudiana using this improvised method are high in integrity and quality with RNA integrity number (RIN) of more than 8 and low in contaminants.
Fulltext Hemolyzed Specimens: Major Challenge for Identifying and Rejecting Specimens in Clinical Laboratories

Wan Azman WN, Omar J, Koon TS, Tuan Ismail TS

Oman Med J, 2019 Mar;34(2):94-98.
PMID: 30918601 DOI: 10.5001/omj.2019.19

Pre-analytical quality in clinical chemistry testing is as important as analytical and post-analytical quality. The most prevalent pre-analytical interference and a major source of error producing unreliable laboratory test results is hemolysis of blood samples. In vitro hemolysis may be due to the blood withdrawal technique or sample handling whereas in vivo hemolysis can originate from acquired, hereditary, or iatrogenic conditions and is not technique dependent. Interpreting in vivo or in vitro hemolysis requires clinicians to supply reliable clinical history and findings. Even then, to reject or release the result with interpretation is still under debate. Thus, hemolyzed specimens are a serious pre-analytical problem calling for well-designed and strictly implemented laboratory guidelines. The aim of this non-systematic review (addressed to healthcare professionals) was to highlight the challenges in identifying and rejecting hemolysis specimens.
Prevalence of parasites in working pig-tailed Macaques (Macaca nemestrina) in Kelantan, Malaysia

Choong SS, Mimi Armiladiana M, Ruhil HH, Peng TL

J Med Primatol, 2019 08;48(4):207-210.
PMID: 31025372 DOI: 10.1111/jmp.12416

BACKGROUND: Coconut is an important commodity in Kelantan, and pig-tailed macaques (Macaca nemestrina) have been traditionally used for coconut-plucking for over a century. Most of these animals were sourced from the wild population, and the parasitic status of these macaques is unknown, plus the impacts caused by these parasites are usually underestimated by the owners.
METHODS: A total of 30 macaques were sampled for blood, faeces and hair plucks to detect parasite.
RESULTS: Out of 21 faecal samples examined, 11 (52%) were determined positive for one or more gastrointestinal parasites, namely Trichostrongylus spp., Strongyloides spp., Anatrichosoma spp., Capillaria spp., Trichuris spp. and Paramphisotomum spp. Filaria was detected in one (3%) of the blood samples. For ectoparasites, only lice, Pedicinus sp., were found in 9 (30%) macaques.
CONCLUSIONS: It is imperative that the parasitic status of these animals be determined so that necessary actions and preventive measures can be implemented to prevent zoonotic transmissions.
Fulltext Effect of Indirect Neural Decompression with Oblique Lateral Interbody Fusion Was Influenced by Preoperative Lumbar Lordosis in Adult Spinal Deformity Surgery

Beng TB, Kotani Y, Sia U, Gonchar I

Asian Spine J, 2019 10;13(5):809-814.
PMID: 31154702 DOI: 10.31616/asj.2018.0283

Study Design: Retrospective clinical study on the indirect decompressive effect of oblique lateral interbody fusion (OLIF) for adult spinal deformity.
Purpose: To evaluate the effect of interbody distraction by OLIF for the treatment of adult spinal deformity.
Overview of Literature: Adult spinal deformity with symptomatic stenosis has been addressed conventionally using a direct posterior decompression approach with fusion. However, stenotic symptoms can also be alleviated indirectly through restoration of intervertebral and foraminal heights and correction of spinal alignment.
Methods: Twenty-eight patients with adult spinal deformity underwent OLIF combined with modified cortical bone trajectory screws at 94 lumbar levels with neuromonitoring. The patients were divided into three groups based on their preoperative lumbar lordosis: group A, <0°; group B, 0°-20°; and group C, >20°. The cross-sectional area (CSA) of the thecal sac was measured preoperatively and postoperatively on axial magnetic resonance images. Differences in CSA were evaluated, and the relationship between the CSA extension ratio and preoperative CSA was assessed. Changes in disc height and segmental disc angle were measured from plain radiographs.
Results: OLIFs were performed successfully without neural complications. In group A, the mean CSA increased from 120.6 mm2 preoperatively to 148.5 mm2 postoperatively (p <0.001). The mean CSA for group B increased from 120.1 mm2 preoperatively to 154.4 mm2 postoperatively (p <0.001). Group C had an increase in mean CSA from 114.7 mm2 preoperatively to 160.7 mm2 postoperatively (p <0.001). The mean CSA enlargement ratio was 27.5%, 32.1%, and 60.4% in groups A, B, and C, respectively. The mean CSA extension ratio was inversely correlated with preoperative CSA.
Conclusions: The effect of indirect neural decompression in adult spinal deformity with OLIF varies with the degree of preoperative lumbar lordosis.
Fulltext Bilateral Inferior Altitudinal Visual Field Defect in Recurrent Intracranial Meningioma: A Case Report

Ghanimi Zamli AK, Chew-Ean T, Wan Hitam WH

Cureus, 2019 Apr 11;11(4):e4436.
PMID: 31245223 DOI: 10.7759/cureus.4436

Altitudinal visual field defect is a rare presentation of retrochiasmal lesion especially when bilateral visual fields were affected. In fact, bilateral inferior altitudinal visual field defect (BIAVFD) usually occurred in patients who survived a gunshot injury to the occipital lobe or as a direct trauma to the brain. We report a rare case of BIAVFD secondary to occipital meningioma. A high index of suspicion enables timely investigation and diagnosis when dealing with atypical presentation of intracranial meningioma.
Fulltext Traumatic transnasal penetrating injury with cerebral spinal fluid leak

Teng TS, Ishak NL, Subha ST, Bakar SA

EXCLI J, 2019;18:223-228.
PMID: 31217785 DOI: 10.17179/excli2018-1971

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.
Characterization of S1 gene sequence variations of attenuated QX-like and variant infectious bronchitis virus strains and the pathogenicity of the viruses in specific-pathogen-free chickens

Ismail MI, Wei TS, Hair-Bejo M, Omar AR

Arch Virol, 2020 Dec;165(12):2777-2788.
PMID: 32964293 DOI: 10.1007/s00705-020-04812-2

Besides the vaccine strains, the Malaysian variant (MV) and QX-like are the predominant IBVs detected on commercial poultry farms. These two virus strains are distinct based on genomic and pathogenicity studies. In this study, we determined the sequence of the S1 gene and compared the pathogenicity of serial passage 70 (P70) of Malaysian QX-like (QX/P70) and MV (MV/P70) strains with that of their respective wild-type viruses. The nucleotide and amino acid sequences of the complete S1 genes of QX/P70 and MV/P70 showed 1.4 to 1.6% and 3.0 to 3.3% variation, respectively, when compared to the wild-type virus. Most of the mutations were insertions and substitutions in the hypervariable regions (HVRs), primarily in HVR 3. Furthermore, selection pressure analysis showed that both viruses are under purifying selection. A pathogenicity study in specific-pathogen-free (SPF) chickens showed a reduction in respiratory and kidney lesions in chickens inoculated with MV/P70, but not with QX/P70, when compared to the respective wild-type viruses. However, MV/P70 is still pathogenic and can cause ciliary damage. In conclusion, the MV IBV strain is more responsive than the QX-like IBV strain following the attenuation process used for the development of a live attenuated IBV vaccine.
E-waste recycling intention paradigm of small and medium electronics store managers in Bangladesh: An S-O-R perspective

Mahmud I, Sultana S, Rahman A, Ramayah T, Cheng Ling T

Waste Manag Res, 2020 Dec;38(12):1438-1449.
PMID: 32364437 DOI: 10.1177/0734242X20914753

Each year Bangladesh produces around 400,000 metric tonnes of e-waste. E-waste accumulation is expected to increase by 20% annually. In order to facilitate e-waste recycling, it is crucial to identify the factors. In this study, building on the stimulus-organism-response framework, we develop a research model to explore the effect of information publicity, ascription of responsibility and convenience of recycling on the recycling attitude, subjective norm, personal norm and perceived behaviour control which lead to recycling intention. Data were gathered from 127 small and medium electronics store managers. The structural equation modelling technique was used to test the paths. The result suggests a significant influence of the element of stimulus (S) on the element of organism (O). The relationship between the element of organism (O) and the element of response (R) is partial. This paper contributes to the body of work dedicated to helping us better understand the recycling behaviour from the stimulus-organism-response perspective. From the viewpoint of practice, this research sheds light on some of the challenges that the implementer might face when making strategy and policy for e-waste management in Bangladesh.
Fulltext Metagenomic data on bacterial diversity profiling of high-microbial-abundance tropical marine sponges Aaptos aaptos and Xestospongia muta from waters off terengganu, South China Sea

Amelia TSM, Lau NS, Amirul AA, Bhubalan K

Data Brief, 2020 Aug;31:105971.
PMID: 32685631 DOI: 10.1016/j.dib.2020.105971

Marine sponges are acknowledged as a bacterial hotspot and resource of novel natural products or genetic material with industrial or commercial potential. However, sponge-associated bacteria are difficult to be cultivated and the production of their desirable metabolites is inadequate in terms of rate and quantity, yet bioinformatics and metagenomics tools are steadily progressing. Bacterial diversity profiles of high-microbial-abundance wild tropical marine sponges Aaptos aaptos and Xestospongia muta were obtained by sample collection at Pulau Bidong and Pulau Redang islands, 16S rRNA amplicon sequencing on Illumina HiSeq2500 platform (250 bp paired-end) and metagenomics analysis using Ribosomal Database Project (RDP) classifier. Raw sequencing data in fastq format and relative abundance histograms of the dominant 10 species are available in the public repository Discover Mendeley Data (http://dx.doi.org/10.17632/zrcks5s8xp). Filtered sequencing data of operational taxonomic unit (OTU) with chimera removed is available in NCBI accession numbers from MT464469 to MT465036.
Fulltext Characterization of salt-tolerant plant growth-promoting rhizobacteria and the effect on growth and yield of saline-affected rice

Shultana R, Kee Zuan AT, Yusop MR, Saud HM

PLoS One, 2020;15(9):e0238537.
PMID: 32886707 DOI: 10.1371/journal.pone.0238537

In this study, we characterized, identified, and determined the effect of salt-tolerant PGPR isolated from coastal saline areas on rice growth and yield. A total of 44 bacterial strains were isolated, and 5 were found to be tolerant at high salt concentration. These isolates were further characterized for salinity tolerance and beneficial traits through a series of quantitative tests. Biochemical characterization showed that bacterial survivability decreases gradually with the increase of salt concentration. One of the strains, UPMRB9, produced the highest amount of exopolysaccharides when exposed to 1.5M of NaCl. Moreover, UPMRB9 absorbed the highest amount of sodium from the 1.5M of NaCl-amended media. The highest floc yield and biofilm were produced by UPMRE6 and UPMRB9 respectively, at 1M of NaCl concentration. The SEM observation confirmed the EPS production of UPMRB9 and UPMRE6 at 1.5M of NaCl concentration. These two isolates were identified as Bacillus tequilensis and Bacillus aryabhattai based on the 16S rRNA gene sequence. The functional group characterization of EPS showed the presence of hydroxyl, carboxyl, and amino groups. This corresponded to the presence of carbohydrates and proteins in the EPS and glucose was identified as the major type of carbohydrate. The functional groups of EPS can help to bind and chelate Na+ in the soil and thereby reduces the plant's exposure to the ion under saline conditions. The plant inoculation study revealed significant beneficial effects of bacterial inoculation on photosynthesis, transpiration, and stomatal conductance of the plant which leads to a higher yield. The Bacillus tequilensis and Bacillus aryabhattai strains showed good potential as PGPR for salinity mitigation practice for coastal rice cultivation.
Fulltext Relationship between sleeping quality and behavioural outcomes of UiTM Seremban 3 students

Abdullah NDT, Radzuwan R, Ab Dini MN

Journal of Academia Universiti Teknologi MARA Negeri Sembilan, 2020;8(2):67-75.
MyJurnal DOI: 10.24191/joa.v8i2.10107

Purpose: To examine the relationship between sleeping quality and behavioural outcomes of UiTM Seremban 3 students.
Methods and sample: A quantitative approach using a modified questionnaire of Pittsburgh Sleep Quality Index Score was employed to examine the sleeping quality and modified version of the Adolescent Behavioral Checklist was used to obtain the response on the behavioural of UiTM Seremban 3, students. 428 respondents from three (3) faculties in the Seremban campus
participated in this study.
Findings: The result shows that there is a significant relationship between sleeping quality and behavioural outcomes of the students (r=.118, p<0.05).
Discussion and Conclusion: This study revealed that there is no significant relationship between sleeping quality and positive behavioural outcomes. However, the result indicated that there is a weak relationship between sleep quality and negative behavioural outcomes. The behaviours of the respondents tend to become
more negative if they were having poor quality of sleep. The results also suggest that poor sleep quality is not only prevalent among college students but are also associated with negative behavioural outcomes. Therefore, sleeping quality should be considered in the management of students’ health and there is a need for an investigation for possible intervention on sleeping quality of the college students.
Keywords: sleeping quality, behavioural outcomes, college students
Study site: University Teknologi MARA (UiTM), Seremban 3, Negeri Sembilan, Malaysia
Fulltext Genotypic and phenotypic variation of CADASIL among Chinese, Indians and Rungus in Malaysia

Toh, Tsun-Haw, Lim, Kheng-Seang, Ng, Ching-Ching, Imran Idris, Sherrini Bazir Ahmad, Lim, Thien-Thien, et al.

Neuroscience Research Notes, 2019;2(3):1-11.
MyJurnal

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary disease of small cerebral arteries. This case series aims to describe the mutations in NOTCH3and their phenotypes in Malaysia. We includedpatients who were genetically confirmed to have CADASIL, diagnosed at the University of Malaya Medical Centre, Malaysia. Family members who fulfilled clinical or imaging criteria, and patients from two previous published Malaysian families were also included. Six families (eleven cases) were included in this series. Genetic testing revealed NOTCH3 mutations in c.328C>T (p.Arg110Cys, R110C), c.553T>G (p.Cys185Gly, C185G), c.1630C>T (p.Arg544Cys, R544C) and c.160C>T (p.Arg54Cys, R54C). Two out of four Chinese families had R544C mutation in exon 11, with a later age of onset, absence of migraine and lack of anterior temporal pole involvement on MRI. One family with mixed Indian and Chinese ancestry had a mutation in exon 3 with R110C and another Indian family exon 4 with C185G mutation. This case series highlights the genotypic and phenotypic variability of CADASIL in a multi-ethniccountry. The finding of p.Arg544Cys mutation among the older Chinese families, similar to those reported in Jeju Island and Taiwan, suggest the need to screen the older Chinese stroke patients with typical MRI changes.
Fulltext Functional outcome of proximal humeral fractures

Yeap JS, Noor Zehan AR, Ezlan S, Borhan Tan A, Harwant S

Med J Malaysia, 2001 Jun;56 Suppl C:13-8.
PMID: 11814242

The functional outcome of 27 patients (16 males, 11 females) with a proximal humeral fracture was evaluated using the Simple Shoulder Test. Fifteen patients were also assessed using the Constant system. The mean age of the patients was 46.3 years (range 16-90 years) and the mean follow-up was 14 months (range 6-29 months). There were ten 2-part fractures, eight minimally displaced fractures, two 3-part fractures, three 4-part fractures, three 1-part fracture-dislocations and one 3 parts fracture-dislocation. Twenty-four fractures were treated conservatively and 3 surgically. Thirteen patients (48%) regained full function on the simple shoulder test and almost all regained range of movement sufficient for activities of daily living. Six patients were not able to return to their previous job. All patients were pain free at rest and were able to sleep on the affected side comfortably, although 9 patients had pain with activity, even though most pain were mild in nature. The mean Constant scores for the fractured arm and the normal arm were 72.5 points and 91 points respectively. The strength of shoulder abduction was reduced by a mean of 34%. Although the outcome was generally satisfactory, there was nevertheless a statistically significant deterioration of function following the fracture.
Lipids and coronary heart disease in Asia

Khoo KL, Tan H, Liew YM, Deslypere JP, Janus E

Atherosclerosis, 2003 Jul;169(1):1-10.
PMID: 12860245

In Western countries, it has been shown that coronary heart disease (CHD) is related to high serum total cholesterol (TC) levels. In less developed continents such as Asia and Africa, serum lipid levels are low and CHD incidence is much lower as compared with Western countries. With growing urbanization and industrialization in Asia, it has been shown that there is a concomitant rise in the level of serum TC and with it a rise in CHD. In all the Asian countries, serum TC levels are also higher in the urban compared with the rural population. Singapore, the only Asian country which is 100% urbanized since 1980, showed a rise of serum TC similar to that seen in the US and UK from the 1950s to the 1980s followed thereafter by a fall. This is reflected in the trend (rise followed by a fall) of CHD morbidity and mortality as well. In spite of a declining trend in serum TC level, CHD morbidity and mortality are still high in Singapore and comparable to the Western countries. The rest of the Asian countries show a different pattern from Singapore. In general, there is still a rising trend in serum TC level and in CHD mortality in most Asian countries. However, Japan is considered an exception in having a decreasing CHD mortality in spite of an increasing trend in serum TC. This may be attributed to a better control of other CHD risk factors such as hypertension and smoking. The rising trend in serum TC level remains a cause for concern, as this will emerge as a major problem for CHD morbidity and mortality in the future.
Bone marrow transplantation in Malaysia

Lin HP, Chan LL, Tan A, Ariffin WA, Lam SK

Bone Marrow Transplant, 1994 Jun;13(6):725-9.
PMID: 7920303

The sole BMT centre in Malaysia caters only for children. Since 1987, 89 transplants have been performed using reverse barrier nursing techniques. The overall survival rate is 73% with the majority of survivors leading normal lives. The early and late infection rates of 46% and 13%, respectively, are comparable to those of other centres. Although the early septicaemia rate is 36% the immediate mortality rate is < 10%. GVHD is less frequent and severe and the interstitial pneumonitis rate lower than that in the West. The average cost of US $8000 per transplant is much lower than the cost of a transplant performed overseas. Thus we believe that our paediatric BMT programme is simple and cost-effective.
Kaolin-Carbon Adsorbents for Carotene Removal of Red Palm Oil

Hussein MZ, Kuang D, Zainal Z, Teck TK

J Colloid Interface Sci, 2001 Mar 1;235(1):93-100.
PMID: 11237447

Kaolin-carbon adsorbents were prepared with and without sulfuric acid pretreatment followed by activation-carbonization at 500 degrees C. The total surface area of the resulting kaolin-carbon adsorbents was found to be decreased with the increase in kaolin loading. Sulfuric acid pretreatment of the precursor prior to the carbonization-activation processes resulted in the enhancement of total surface area but reduced the micropore surface area of the resulting adsorbents. At the same time, this improved carotene adsorption capacity from red palm oil. However, recovery of carotene from the carotene-adsorbed adsorbent is only improved when the acid pretreatment of the precursor was done at a high loading percentage of activated carbon. Similarly, the peroxide value (PV) increased. A maximum removal of carotene from red palm oil was obtained at 20% kaolin loading for both adsorbents prepared with and without sulfuric acid pretreatment with about 45 and 65% carotene removal, respectively, from a 30-ppm solution. This indicates that pretreatment with sulfuric acid, prior to the activation-carbonization process, increased the carotene uptake by the resulting adsorbent. However, a further increase in the kaolin loading resulted in the decrease of carotene removal. About 3-4% of carotene adsorbed can be recovered from both types of adsorbents under optimum condition, in which the percentage recovered decreased with the increase in kaolin loading. On the other hand, the PV increased with kaolin loading at around 54-64 mEq/kg for both types of adsorbents. It was also found that carotene uptake by the adsorbents is high if the adsorbent contains a high percentage of activated carbon. Similarly, carotene recovery is high and less oxidation can be observed, as indicated by the lower PV value. Copyright 2001 Academic Press.
Fulltext Health status of senior civil servants in Kuala Lumpur

Liew YM, Zulkifli A, Tan H, Ho YN, Khoo KL

Med J Malaysia, 1997 Dec;52(4):348-66.
PMID: 10968112

733 senior civil servants comprising 520 males and 213 females with a mean age of 44 years (range 25-56 years) were screened for their health status. The sample population comprised of 67.9% Malays, 22.5% Chinese, 9.1% Indians and 0.4% other ethnic origins. The subjects' medical histories were recorded and a full medical examination including anthropometric measurements (weight, height, waist and hip circumference), blood biochemistry and urine analysis, chest X-ray and electrocardiograms were done. The results obtained showed that 36.0% of the study population were overweight with 6.5% being obese. Of this 32.0% had central obesity. 15.2% of the subjects had systolic hypertension (systolic BP > or = 140 mmHg) whilst 27.6% had diastolic hypertension (diastolic BP > or = 90 mmHg). Hyperlipidaemia was common, with 75.2% subjects having raised cholesterol, 19.9% raised triglycerides, 50.2% raised LDL-C, 74.6% raised TC:HDL-C and 26.6% raised LDL:HDL-C. An elevated blood glucose was found in 8.4% subjects, whilst urine sugar was detected in only 2.6%, and a raised uric acid was found in 2.8% subjects. The prevalence of hypertension, raised blood glucose and hyperlipidaemia increased with age with more males affected than females. Although hypercholesterolaemia appeared more frequently amongst the Malays, the Indians, by comparison had the highest prevalence for a raised LDL:HDL-C ratio, a reflection of the increase in LDL-C and a concomitant decrease in HDL-C. The latter findings indicate that the Indians are at greater risk for the development of coronary heart disease than the Chinese and Malays. In addition, the mean levels of serum cholesterol found in this study seemed to have exceeded the levels found in populations in the industrialised countries such as the USA. There is thus an urgent need for more public health campaigns aimed at the reduction and control of such coronary risk factors.
Fulltext Patients' knowledge and attitude towards treatment and control of hypertension: a nation-wide telephone survey conducted in Malaysia

Khoo KL, Liew YM, Tan H, Sambhi JS, Hatijah BA

Med J Malaysia, 1999 Mar;54(1):37-46.
PMID: 10972003

The telephone survey of 2,526 hypertensive subjects showed 94% of the respondents were aware of the importance in controlling hypertension. Among these 504 were not on anti-hypertensive medication while the majority of 2,022 were currently on anti-hypertensive medication. Of those who were not on medication, 80% (n = 403) were found non-hypertensive on follow-up. The remaining 20% (n = 101) were confirmed hypertensive and were offered medication. However, 38 subjects refused to take medication and 63 subjects complied with medication but subsequently gave up. The main reasons for giving up medication included lack of motivation (38%), doctors' advice (20%), side effects (19%) and concern of side effects (10%). Of 2,022 hypertensive respondents who were currently on medication, almost half (44%, n = 890) required a change of medication due to side effects (40%, n = 356) or the blood pressure not controlled with the previous medication (33%, n = 294). Despite the change in medication, 42% (n = 150) still continued to suffer from some form of side effects. The information obtained from this survey suggested it is important to recommend some strategies to improve patient compliance. These strategies comprise of motivating the patient, improving medication with less side effects, improving potency and efficiency of medication, and reduction of cost in medication. In addition, convenient blood pressure monitoring such as home blood pressure monitoring is also encouraged.

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