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Association between functional limitations and depression among community-dwelling older adults in Malaysia

Ahmad NA, Abd Razak MA, Kassim MS, Sahril N, Ahmad FH, Harith AA, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:21-25.
PMID: 33370850 DOI: 10.1111/ggi.14012

AIM: This study aimed to assess the relationship between functional limitations and depression among community-dwelling older adults in Malaysia.
METHODS: Data from a nation-wide community-based cross-sectional study were analyzed. This study was conducted using a two-stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M-GDS-14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables.
RESULTS: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income.
CONCLUSIONS: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21-25.

Matched MeSH terms: Chronic Disease
Fulltext Optimisation of the production of fish gelatine nanoparticles as a carrier for sunflower-derived biopeptide

Akbar, I., Jaswir, I., Jamal, P.

International Food Research Journal, 2020;27(1):171-181.
MyJurnal

Gelatine obtained from fish skin has become a potential source of preparing nanoparticles and
encapsulation of bioactive compounds. Within these fish skin, gelatine nanoparticles show
potent benefits for application in pharmaceutical and cosmetic industry. The encapsulated
bioactive ingredients within nanoparticles have improved bioavailability, delivery properties,
and solubility of the nutraceuticals within the human body and blood stream. Many of such
bioactive peptides (biopeptides) are potent antioxidants; and as oxidative stress is the main
cause of the onset of various chronic diseases, encapsulation of antioxidant biopeptides within
fish gelatine nanoparticles could be a potential remedy to prevent or delay the onset of such
diseases and for better health prospects. The purpose of the present work was to prepare a
simple, safe, and reproducible novel food delivery nanoparticle system encapsulating a desirable antioxidant biopeptide. An optimisation study was conducted to produce a desirable size
of gelatine nanoparticles which showed a higher encapsulation efficiency of an antioxidant
biopeptide. Sunflower biopeptide was chosen as the antioxidant biopeptide, as the activity of
this protein hydrolysate is quite high at DPPH of 89% and FRAP assay of 968 µm/L. Tilapia
fish was used as gelatine source at an average yield of the process at 10% wt/wt. Effects of
parameters such as pH, biopeptide concentration, and cross-linking agent ‘glutaraldehyde’ on
the size, stability, and encapsulation efficiency on the nanoparticles were studied. The average
diameter of the biopeptide loaded gelatine nanoparticle was between 228.3 and 1,305 nm.
Encapsulation efficiency was 76% at an optimal pH of 2, glutaraldehyde concentration of 2
mL, and biopeptide concentration of 0.1 mg/mL exhibited DPPH at 92% and FRAP assay of
978 µm/L. To understand the absorption of sunflower biopeptide in stomach, blood stream,
and biopeptide release of the gelatine nanoparticles, biopeptide loaded gelatine nanoparticles
were subjected to simulated gastrointestinal conditions mimicking human stomach and
intestine; and showed peptide release of 0.1464 and 0.277 mg/mL upon pepsin and pancreatin
digestion, respectively.

Matched MeSH terms: Chronic Disease
Fulltext Comparison of risperidone and other neuroleptics in the management of chronic schizophrenia using cognitive therapy

Azhar MZ

Med J Malaysia, 2000 Mar;55(1):7-13.
PMID: 11072484

A number of psychological approaches to alleviating psychotic symptoms have been reported in the literature. The latest technique among them is cognitive therapy (CT). This paper describes an open trial that makes use of cognitive psychotherapy to treat chronic drug resistant delusions (more than 2 years duration) in 20 patients with schizophrenia. The positive response of all patients with the absence of symptom replacement and maintenance of response at 3 months follow-up, seem to imply that this technique is useful and more effort needs to be invested into this new area of psychotherapy for psychosis. This paper also shows that those patients on risperidone maintenance respond better to CT than those on other neuroleptics.

Matched MeSH terms: Chronic Disease
EEG features of focal malformations of cortical development

Raymond AA, Fish DR

J Clin Neurophysiol, 1996 Nov;13(6):495-506.
PMID: 8978621

Recent advances in neuroimaging have allowed the detection and characterization of focal malformations of cortical developmental in a significant proportion of patients with epilepsy, many of whom were previously labelled as cryptogenic, allowing a better description of the associated electroencephalogram (EEG) features. Alpha activity is usually preserved, although superficial gyral abnormalities are often associated with overlying localized polymorphic delta activity, and occasionally abnormal fast activity. Most affected patients with epilepsy show interictal spikes. These are often broadly concordant with the structural abnormality but may show a wider anatomic distribution and be multifocal, or occasionally appear only in anatomically distant sites. In many patients the spikes are frequent and sometimes they occur continuously or in long trains. EEG findings are often stable over time, but some patients only show the development of slow wave changes or interictal spikes when followed serially for several years. A small proportion of patients with focal malformations of cortical development have EEG features mimicking idiopathic generalized epilepsy, and occasionally patients exhibit continuous generalized spike and slow wave activity in sleep. Electrocorticography studies confirm the often widespread nature of interictal spiking, but may also show highly epileptogenic patterns recorded directly from dysplastic cortex. The intrinsic epileptogenicity of areas of cortical developmental abnormalities has also been demonstrated by chronic intracranial studies and in vitro recordings of slices obtained from resected human dysplastic cortex. In this regard such developmental abnormalities are fundamentally different from acquired lesions such as tumors/vascular anomalies that usually exert their effects through changes in adjacent cortex.

Matched MeSH terms: Chronic Disease
Chronic prostatitis: symptom survey with follow-up clinical evaluation

Cheah PY, Liong ML, Yuen KH, Teh CL, Khor T, Yang JR, et al.

Urology, 2003 Jan;61(1):60-4.
PMID: 12559266

OBJECTIVES: To determine the prevalence of chronic prostatitis/chronic pelvic pain syndrome (National Institutes of Health Category III prostatitis) in Penang, Malaysia and estimate the proportion of cases ascertained by population survey that met consensus clinical criteria for "chronic prostatitis."
METHODS: One percent of 20 to 50-year-old men in Penang, Malaysia were surveyed using the National Institutes of Health Chronic Prostatitis Symptom Index. A clinical evaluation that included lower urinary tract localization studies was recommended for symptomatic subjects who met the survey definition to identify bacterial prostatitis and other diagnoses that would exclude them from the consensus clinical definition for chronic prostatitis (Category III).
RESULTS: Of 3147 subjects surveyed, 275 (8.7%) met the survey criteria for chronic prostatitis. The prevalence of chronic prostatitis was 8.0% among Malays, 8.9% among non-Malays, and 16% among noncitizens (P = 0.025). The prevalence increased with age: 6.3% in 20 to 30-year-old men, 8.9% in 31 to 40-year-old men, and 12.6% in 41 to 50-year-old men (P <0.001). Of 87 subjects evaluated clinically, 65 (75%) met the consensus clinical criteria for chronic prostatitis.
CONCLUSIONS: Chronic prostatitis represents an important, international healthcare problem. A thorough clinical evaluation is necessary to verify that chronic prostatitis is indeed responsible for a patient's pelvic pain and lower urinary tract symptoms.

Matched MeSH terms: Chronic Disease
Terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome: a randomized, placebo controlled trial

Cheah PY, Liong ML, Yuen KH, Teh CL, Khor T, Yang JR, et al.

J Urol, 2003 Feb;169(2):592-6.
PMID: 12544314 DOI: 10.1097/01.ju.0000042927.45683.6c

PURPOSE: We evaluate terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome.
MATERIALS AND METHODS: The study included 100, 20 to-50-year-old subjects who met the consensus criteria for chronic prostatitis/chronic pelvic pain syndrome and had not received previous alpha-blockers. Subjects were randomized to receive terazosin with dose escalation from 1 to 5 mg. daily or placebo for 14 weeks. The primary criterion for response was scoring 2 or less ("delighted-to-mostly satisfied") on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) quality of life item. The secondary criterion for response was greater than 50% reduction in NIH-CPSI pain score at 14 weeks. Other outcomes included total and NIH-CPSI domain scores, International Prostate Symptom Score, peak urinary flow rate, post-void residual urine and adverse effects.
RESULTS: Using the primary criterion 24 of 43 evaluable subjects (56%) responded in the terazosin group compared to 14 of 43 (36%) in the placebo group (p = 0.03). Using the secondary criterion 26 of 43 subjects (60%) responded in the terazosin group compared to 16 of 43 (37%) in the placebo group (p = 0.03). The terazosin group had greater reductions (p <0.05) in NIH-CPSI total score, individual domain scores and International Prostate Symptom Score than the placebo group. There was no difference in peak urinary flow rate or post-void residual. In the terazosin group 18 patients (42%) had side effects compared to 9 (21%) in the placebo group (p = 0.04).
CONCLUSIONS: Terazosin proved superior to placebo for patients with chronic prostatitis/chronic pelvic pain syndrome who had not received alpha-blockers previously.

Matched MeSH terms: Chronic Disease
Quality of life of community-based chronic schizophrenia patients in Penang, Malaysia

Mubarak AR, Baba I, Chin LH, Hoe QS

Aust N Z J Psychiatry, 2003 Oct;37(5):577-85.
PMID: 14511086

This is a study of the quality of life (QOL) of 174 community-based chronic schizophrenia patients in Penang, Malaysia.

Matched MeSH terms: Chronic Disease
Chronic granulomatous mastitis: diagnostic and therapeutic considerations

Azlina AF, Ariza Z, Arni T, Hisham AN

World J Surg, 2003 May;27(5):515-8.
PMID: 12715214 DOI: 10.1007/s00268-003-6806-1

To review the clinical presentation, histopathological features, and optimal treatment of chronic granulomatous mastitis, the authors conducted a retrospective study of 25 women admitted to a teaching hospital in Malaysia between January 1998 and December 2000 who met the required histologic criteria. The primary outcome measures were morbidity and recurrence of the disease. Thirteen patients presented with a breast mass clinically mimicking breast cancer, and 12 patients had breast induration and abscess formation. In addition, 8 of these patients had recurrent breast disease. Clinical and imaging diagnosis has often been difficult and inconclusive, so histopathology remains the optimal diagnostic tool. Of interest, 50% of patients experience recurrences, and long-term follow-up is therefore necessary. The authors concluded that, because chronic granulomatous mastitis is a rare benign breast condition that may be misdiagnosed as breast carcinoma, complete resection should be accomplished whenever possible. Steroid therapy may be an adjuvant for optimal treatment. Awareness among surgeons and pathologists should also be emphasized to avoid unnecessary misdiagnosis and treatment.

Matched MeSH terms: Chronic Disease
A comparative study of thought disorder in acute and chronic schizophrenia

Mazumdar PK, Chaturvedi SK, Gopinath PS

Psychopathology, 1995;28(4):185-9.
PMID: 7480574

A differential phenomenological study of acute and chronic schizophrenia is scanty. Thought disorder was assessed in 22 acute and 23 chronic schizophrenics. The scale for the assessment of thought, language and communication was used. Poverty of speech was significantly more frequent in acute schizophrenia. Positive formal thought disorder was unusually found to be severer in chronic schizophrenia. No other significant difference was found. From the perspective of thought disorder, acute and chronic forms of schizophrenia seem to be in a continuum with minimal difference.

Matched MeSH terms: Chronic Disease
Causative organisms in acute exacerbation of chronic airways disease and response to ofloxacin therapy

Sufarlan AW, Zainudin BM, Pit S, Ishak I

Drugs, 1995;49 Suppl 2:442-5.
PMID: 8549394
Matched MeSH terms: Chronic Disease
Fulltext Chronic pain management--upper visceral malignancies coeliac plexus block with CT scanning--a case report

Choy YC, Puvenesvari S, Samad S

Med J Malaysia, 1998 Sep;53(3):277-9.
PMID: 10968166

Coeliac plexus block has been described more than seventy years ago and is widely used for chronic pain management in upper visceral malignancies. The technique described here is a posterior approach using CT scan guidance with absolute ethyl alcohol. A case illustration of a patient with carcinoma of pancreas managed with coeliac plexus block for pain control is presented.

Matched MeSH terms: Chronic Disease
Cultural formulation of psychiatric diagnosis. Sakit Gila in an Iban longhouse: chronic schizophrenia

Barrett RJ

Cult Med Psychiatry, 1997 Sep;21(3):365-79.
PMID: 9352169
Matched MeSH terms: Chronic Disease
The effect of systemic ibuprofen on gingival inflammation in humans

Taiyeb Ali TB, Waite IM

J Clin Periodontol, 1993 Nov;20(10):723-8.
PMID: 8276982

This clinical trial investigated the influence of short-term ibuprofen therapy on the early phase of the treatment of adult chronic periodontitis. The subjects were 17 patients in good general health referred for specialist periodontal treatment, having moderate chronic adult periodontitis. A series of assessments were made every 2 weeks over an 8-week period, including evaluations of oral hygiene, gingival inflammation and probing pocket depths. All participants received oral hygiene instruction, and following baseline examinations, had half the dentition, chosen at random, treated by scaling and root planing. The patients were randomly distributed into 2 groups, a test group receiving a 14-day course of 800 mg ibuprofen daily, in 4 divided doses, and a control group who did not receive any drug regime. At the 2-week assessment following the drug regime, significantly greater reduction in gingival bleeding, colour and pocketing was detected in the test compared with the control group. The beneficial effects were less evident thereafter. Although clinical application of the regime used in this study would not be justified by these results, further research into anti-inflammatory agents as an adjunct in the treatment of periodontal diseases could be considered, in the light of the beneficial effect on gingivitis in the early phase of periodontal treatment reported.

Matched MeSH terms: Chronic Disease
Polyunsaturated fatty acid levels in red cell membranes of unmedicated schizophrenic patients

Peet M, Shah S, Selvam K, Ramchand CN

World J Biol Psychiatry, 2004 Apr;5(2):92-9.
PMID: 15179668

There are several reports of reduced levels of polyunsaturated fatty acids (PUFA), particularly arachidonic acid (AA) and docosahexaenoic acid (DHA), in membrane phospholipid from various tissues including red blood cells (RBC) taken from schizophrenic patients. However, reports have not been entirely consistent and most studies have been confounded by the potential effects of environmental factors including antipsychotic medication and diet. We measured PUFA levels in RBC from two separate groups of unmedicated patients and control subjects from India and Malaysia, populations which have substantial differences in diet. We found no significant difference in levels of AA between patients and control subjects in either population. Levels of adrenic acid were significantly reduced, and levels of DHA significantly increased in both clinical populations. However, diet-related differences in DHA between the populations from India and Malaysia were much greater than differences between schizophrenic patients and controls. It is concluded that reduced RBC membrane levels of AA and DHA are not pathognomic of schizophrenia but that variations in cell membrane fatty acid levels are an epiphenomenon which may reflect underlying abnormalities of phospholipid and fatty acid metabolism and their interaction with environmental factors including medication and diet.

Matched MeSH terms: Chronic Disease
Interleukin-2 levels in chronic schizophrenia patients

Mahendran R, Mahendran R, Chan YH

Ann Acad Med Singap, 2004 May;33(3):320-3.
PMID: 15175772

INTRODUCTION: Most research in interleukin activity in schizophrenia has been in Caucasian populations. We examined interleukin-2 (IL-2) levels and their relation to the duration of the illness, psychopathology and treatment effects, in chronic schizophrenia patients of Asian origin.
MATERIALS AND METHODS: Thirty chronic schizophrenia patients were recruited for the study and their demographic data and medication dosage were noted. Symptom severity was scored on the Positive And Negative Syndrome scale for Schizophrenia (PANSS) and blood sampling done. Ten healthy Chinese males were recruited as controls. Phytohaemagglutinin-stimulated production of serum levels of IL-2 were measured by enzyme-linked immunosorbent assay.
RESULTS: IL-2 levels (1327 +/- 596.2) of all 30 patients were significantly lower than that of the Chinese controls (2420 +/- 342.5). This effect was noted throughout the entire duration of the illness. Ethnic and age differences in IL-2 levels were not found. There was, however, a negative correlation with the duration of the illness and a positive correlation with the dosage of medication.
CONCLUSIONS: The results of this study of a population of mostly Chinese patients with schizophrenia replicate an important finding. Data such as this has not been reported previously on Asians of this racial group.

Matched MeSH terms: Chronic Disease
Fulltext Physical and mental health problems of the elderly in a rural community of Sepang, Selangor

Mohd Sidik S, Rampal L, Afifi M

Malays J Med Sci, 2004 Jan;11(1):52-9.
PMID: 22977360 MyJurnal

The prevalence of aging population is increasing not only in developed countries, but also in developing countries like Malaysia. The aim of this study was: (1) to determine the prevalence of physical and mental health problems, and (2) to determine the association of these health problems with socio demographic factors among the elderly in a rural community in Sepang, Selangor. A cross sectional study design was used. Five out of nine villages were selected via random sampling. The elderly in the selected villages were interviewed using a pre-tested structured questionnaire which included the GDS-30, ECAQ and Barthel Index. Out of 263 elderly residents (6.2% of the total population), 223 agreed to participate in the study giving a response rate of 84.8%. The mean age of the respondents was 69.7 + 6.8 years with a median of 68 years. The prevalence of physical health problems such as chronic illness and functional dependence were 60.1% and 15.7%, respectively. While the prevalence of mental health problems such as depression and cognitive impairment were 7.6% and 22.4%, respectively. Among the health problems studied, depression was found to be significantly associated with unemployment (p<0.05), where as cognitive impairment was significantly associated with age, gender, ethnicity, marital status and level of education (p<0.05).

Matched MeSH terms: Chronic Disease
Fulltext Food security status: It’s association with inflammatory marker and lipid profile among young adult

Nur Atiqah, A., Norazmir, M.N., Khairil Anuar, M.I., Mohd Fahmi, M., Norazlanshah, H.

International Food Research Journal, 2015;22(5):1855-1863.
MyJurnal

Food insecurity, the inability to have sufficient, safe and nutritious food for an active and healthy life, was found to be closely associated with adverse health outcomes. However, limited studies can be found that clearly explains lipid profile and inflammatory events among food secure and insecure individuals, especially among young adults in university, thus creating the need for further research. This study investigated both groups including their gender distribution to determine lipid profile such as total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) and inflammatory marker, high sensitivity C reactive protein (hs-CRP), with waist circumference (WC), fat mass index (FMI) and waist-to-height-ratio (WHTR). A comparative cross-sectional study was carried out among participants aged between 18 to 25 years old (N=124) who were selected through the Adults Food Security Survey Module (AFSSM) and participated in blood draw procedures. Well-established blood markers of lipid profile and inflammatory marker were measured. Percentage of food secure individuals (56.5%) was slightly higher than food insecure (43.5%). Although mean (M) of Hs-CRP for male and female (M=1.000, M=0.645) was higher in food secure group, all other variables showed higher measurements among the food insecure groups. Lipid profiles, TC (M=5.175, M=5.062) and LDL (M=3.100, M=2.914) were high for both male and female respectively, while TG is high for male (M=0.817) (p=0.037) and HDL for female (M=1.826). For body composition such as FMI (M=4.494, M=5.452), WC (M=77.46, M=76.82) and WHtR (M=0.471, M=0.497), male and female respectively, in food insecure group showed higher results but only FMI showed a significant difference (p = 0.016). Statistics showed an association between food security status and lipid profile (TG) and with FMI. However, no significant association was found with inflammatory marker. This study will continue further in depth in gene expression of peroxisome proliferator activated receptor gamma (PPAR-y) and endothelial dysfunction to better understand this issue. Regardless, current data provides knowledge and understanding of food insecurity experienced by young adults in university campus and may help them in making healthier food choices and be appreciative of the risk of chronic illnesses.

Matched MeSH terms: Chronic Disease
Effectiveness of hyaluronic acid and its derivatives on chronic wounds: a systematic review

Shaharudin A, Aziz Z

J Wound Care, 2016 Oct 02;25(10):585-592.
PMID: 27681589 DOI: 10.12968/jowc.2016.25.10.585

OBJECTIVE: Hyaluronic acid (HA) and its derivatives are used for chronic wounds, but evidence of their effectiveness remains unclear. The aim of this study was to provide more updated evidence for the effectiveness of HA (or its derivatives) compared with placebo or other agents for promoting healing in chronic wounds.
METHOD: The Cochrane Central Register of Controlled Trials, MEDLINE via Ovid Online, CINAHL and the EMBASE via EBSCO host databases were searched. Drug companies and experts in wounds were also contacted. Randomised controlled trials of HA (or its derivatives) compared with control were eligible for inclusion.
RESULTS: We identified nine randomised controlled trials involving 865 participants with chronic wounds were included in the review. The reporting for mixed arterial and venous ulcers seems to be better quality than that for venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). Studies provided little evidence regarding the claimed effects of HA or its derivaties on healing of chronic wounds. However, there is some evidence on their effectiveness for reducing pain intensity for mixed arterial and venous ulcers, which involved 255 patients (MD=-6.78 [95% CI: -11.10 to -2.46]).
CONCLUSION: Evidence to guide decisions regarding the use of HA or its derivatives to promote wound healing is still limited. More good-quality randomised controlled trials are warranted.
KEYWORDS: assessment bias; chronic ulcers; hyaluronan; meta-analysis

Matched MeSH terms: Chronic Disease
Fulltext Tropical calcific pancreatitis

Tan CT, Kannan P, Sng KH

Med J Malaysia, 1980 Dec;35(2):150-4.
PMID: 7266409
Matched MeSH terms: Chronic Disease
Fulltext Hepatitis C: an update

Merican MI

Med J Malaysia, 1992 Sep;47(3):158-69.
PMID: 1283440

The identification of the Hepatitis C virus using molecular cloning techniques, besides making the term Non-A Non-B Hepatitis obsolete, enables the development of specific assays for the detection of antibodies in HCV-infected individuals, thus making it possible to obtain sero-epidemiological data of the disease. The carriage of Hepatitis C antibody varies worldwide. The disease is most prevalent in intravenous drug abusers or haemophiliacs. Parenteral transmission is the most important route of transmission. Sexual, intra-familial and perinatal transmissions are uncommon. About 40% could be community-acquired (sporadic). Diagnostic tests include enzyme-linked immunosorbant (ELISA) anti-HCV assay, recombinant immunoblot assay, HCV-RNA by polymerase chain reaction and HCV-Ag. More than 50% of acute cases becomes chronic and runs a benign and indolent course. About 20% progress to cirrhosis and some of these develop hepatocellular carcinoma. Several published trials have consistently shown that treatment with interferon in some patients is useful. There is however a relapse rate of 50%. Further trials with interferon and other anti-viral agents like ribavirin are awaited for more effective treatment.

Matched MeSH terms: Chronic Disease

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