Displaying publications 21 - 40 of 80 in total

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  1. Zakiah I, Ashikin YN, Aisiah SM, Ismail HI
    PMID: 8629092
    The Malaysian level of health care has greatly improved so that many of the infectious diseases are now under control. However, perinatal death or death due to unknown childhood diseases remains high (10.3%) being second on the list of causes of death amongst Malaysians. Could inborn metabolic diseases be the main cause of death among these children? Recently, with our success in the development of confirmatory techniques for amino acid disorders using high performance liquid chromatography (HPLC), we have examined 404 samples received from all over the country in 1993. Each specimen with abnormal findings from screening tests by one-dimensional thin layer chromatography was confirmed using HPLC. 41% had generalized aminoacidurias and 4.2% had maple syrup urine disease (MSUD). Patients were aged between 11 days to 6 years. Most of them were Malay males and presented with a history suggestive of MSUD. With this preliminary finding, further studies will be carried out in order to have an investigation and management protocol for the diseases and more importantly to formulate a strategy of screening for the country.
  2. Ching BH, Mohamed AR, Khoo TB, Ismail HI
    Mult Scler, 2015 Aug;21(9):1209-11.
    PMID: 26199345 DOI: 10.1177/1352458515593404
    Multiphasic disseminated encephalomyelitis (MDEM) followed by optic neuritis (ON) has been described as a new entity in recent years. Gluten encephalopathy has also been recognized as a neurological manifestation of celiac disease. Accurate diagnosis of both is important due to the therapeutic implications. We report a girl presenting with recurrent encephalopathic polyfocal demyelinating episodes followed by optic neuritis, and a clinical history suggestive of gluten sensitivity. She had persistently high ESR, neutrophilia, and tested positive for anti-MOG (myelin oligodendrocyte glycoprotein) antibody. She responded well to methylprednisolone in each relapse, and achieved remission for a year after azathioprine was added.
  3. Ismail H, Reffin N, Wan Puteh SE, Hassan MR
    PMID: 34682604 DOI: 10.3390/ijerph182010864
    Despite several guidelines published by the World Health Organization (WHO) and national authorities, there is a general increase in the number of healthcare workers (HCWs) contracting tuberculosis. This review sought to evaluate the compliance of the HCWs toward tuberculosis preventive measures (TPMs) in their workplace. Both electronic databases and manual searches were conducted to retrieve articles regarding the compliance of HCWs in the workplace published from 2010 onwards. Independent reviewers extracted, reviewed, and analyzed the data using the mixed methods appraisal tool (MMAT) 2018, comprising 15 studies, 1572 HCWs, and 249 health facilities. The results showed there was low compliance toward TPMs in the workplace among HCWs and health facilities from mostly high-burden tuberculosis countries. The failure to comply with control measures against tuberculosis was mainly reported at administrative levels, followed by engineering and personnel protective control measures. In addition, low managerial support and negative attitudes of the HCWs influenced the compliance. Further studies are needed to elucidate how to improve the compliance of HCWs toward the preventive measures against tuberculosis in order to reduce the disease burden among HCWs worldwide.
  4. Sutan R, Batarfi SA, Ismail H, Bin-Ghouth AS
    BMJ Open, 2022 Feb 17;12(2):e055841.
    PMID: 35177459 DOI: 10.1136/bmjopen-2021-055841
    INTRODUCTION: Although immunisation prevents the death of millions of infants and children each year, the vaccination coverage of routine childhood vaccination does not reach its target. The reasons for low vaccination uptake can be related to both demand and supply side determinants. The prevalence of vaccine hesitancy is increasing globally. However, data on vaccine hesitancy in low-income Arabic countries are scarce. To investigate this issue in Yemen, an Arabic low-income country, we aim to examine the link between vaccine hesitancy and the immunisation status of children living in Costal Hadhramout, Yemen, from the perspective of their parents and healthcare providers.

    METHODS AND ANALYSIS: We will use a mixed-method research design. The study will be conducted in Costal Hadhramout in three phases. Phase 1 will involve a situational analysis using secondary data from records of the national expanded immunisation programme in Costal Hadhramout to examine the trend for previous years. Phase 2 will be a quantitative study aimed at assessing the prevalence of vaccination status of children aged <2 years and the determinants of parental vaccine hesitancy perception through a validated questionnaire. Lastly, phase 3 will be a qualitative study that explores vaccine hesitancy in Yemen using in-depth interviews and focus group discussions with parents and healthcare providers, respectively.

    ETHICS AND DISSEMINATION: The study has been approved by the Research Committee of the Faculty of Medicine, University Kebangsaan Malaysia. The findings will be disseminated via publication in peer-reviewed academic journals, academic conferences and public presentations.

  5. Rahmani M, Ling CY, Sukari MA, Ismail HB, Meon S, Aimi N
    Planta Med, 1998 Dec;64(8):780.
    PMID: 17253329
  6. Rahmani M, Hin TY, Ismail HB, Sukari MA, Manas AR
    Planta Med, 1993 Feb;59(1):93-4.
    PMID: 17230343
  7. Shamsudin R, Abdul Azam F', Abdul Hamid MA, Ismail H
    Materials (Basel), 2017 Oct 17;10(10).
    PMID: 29039743 DOI: 10.3390/ma10101188
    The aim of this study was to prepare β-wollastonite using a green synthesis method (autoclaving technique) without organic solvents and to study its bioactivity. To prepare β-wollastonite, the precursor ratio of CaO:SiO₂ was set at 55:45. This mixture was autoclaved for 8 h and later sintered at 950 °C for 2 h. The chemical composition of the precursors was studied using X-ray fluorescence (XRF), in which rice husk ash consists of 89.5 wt % of SiO₂ in a cristobalite phase and calcined limestone contains 97.2 wt % of CaO. The X-ray diffraction (XRD) patterns after sintering showed that only β-wollastonite was detected as the single phase. To study its bioactivity and degradation properties, β-wollastonite samples were immersed in simulated body fluid (SBF) for various periods of time. Throughout the soaking period, the molar ratio of Ca/P obtained was in the range of 1.19 to 2.24, and the phase detected was amorphous calcium phosphate, which was confirmed by scanning electron microscope with energy dispersive X-ray analysis (SEM/EDX) and XRD. Fourier-transform infrared spectroscopy (FTIR) analysis indicated that the peaks of the calcium and phosphate ions increased when an amorphous calcium phosphate layer was formed on the surface of the β-wollastonite sample. A cell viability and proliferation assay test was performed on the rice husk ash, calcined limestone, and β-wollastonite samples by scanning electron microscope. For heavy metal element evaluation, a metal panel that included As, Cd, Pb, and Hg was selected, and both precursor and β-wollastonite fulfilled the requirement of an American Society for Testing and Materials (ASTM F1538-03) standard specification. Apart from that, a degradation test showed that the loss of mass increased incrementally as a function of soaking period. These results showed that the β-wollastonite materials produced from rice husk ash and limestone possessed good bioactivity, offering potential for biomedical applications.
  8. Ismail H, Aris T, Ambak R, Lim KK
    Int J Public Health Res, 2014;4(2):465-471.
    MyJurnal
    Introduction Healthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur.
    Methods A total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%.
    Results The prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level.
    Conclusions Effective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.
    Study site: Klinik Kesihatan, Kuala Lumpur, Malaysia
  9. Rasi RZ, Ismail H, Shahbaz MS, Kaliani Sundram VP
    Heliyon, 2023 Apr;9(4):e15225.
    PMID: 37089391 DOI: 10.1016/j.heliyon.2023.e15225
    As the circular supply chain (CSC) gains traction in literature and practice, some academic groups are developing new fields that proceed from the CSC as a precisely technical concept. In order to examine the trends of CSC over time, to define how previous researchers have conceptualized the CSC ideology, and to identify the barriers to CSC adoption in businesses operations. This systematic review of the literature (n = 55) examines and discusses the disparate body of knowledge on supply chains (SCs). The paper claims that there are still differences across the circular economy (CE) definitions because of alleged antecedents and scopes, which has led to several research streams. However, CSC's goal remained the same: to encourage sustainable strategies that rejected the traditional linear paradigm that had harmed the environment. In order to be included in future practices and approaches, eight significant, interdisciplinary issues were discovered using SLR, along with the corresponding sub-challenges. These difficulties were discussed in this paper. Aiming to address the current concerns about balancing the environmental and economic perspectives, this study will provide guidelines to future researchers to identify the challenges from a real-world point of view by taking into account the social, environmental, and economic perspectives altogether.
  10. Sofian Azizi DD, Hanafiah MM, Woon KS, Ismail H
    Heliyon, 2023 Jun;9(6):e17244.
    PMID: 37441409 DOI: 10.1016/j.heliyon.2023.e17244
    The disposal practises and preferences of household waste from electrical and electronic equipment disposal (WEEE) are essential components in material flow analysis (MFA). Nevertheless, the synergistic of consumers' behaviours and preferences with the disposal of different WEEE has yet to be investigated in depth. This study examined several consumer features of WEEE management using a quantitative questionnaire survey, including consumers' disposal behaviours and preferences. As a Malaysian federal government administrative centre, and model of a contemporary and sustainable Malaysian city, Putrajaya was chosen as the study area. Using stratified random sampling, the questionnaire was distributed through face-to-face and online surveys among households across 20 precincts within Putrajaya. From June 2021 to January 2022, 500 surveys were distributed over seven months, and IBM SPSS Statistic version 26 was used to analyse the data. The result shows that 80% of respondents have a good knowledge of WEEE management and are fully aware of the dangerous materials they have in their WEEE. 75% said they would recycle their WEEE, but only 44% said they would separate it from other household wastes. It was also shown that 88% of the household were willing to pay a collection fee of at least RM 10 for each collection. This analysis found that Extended Producer Responsibility (EPR) mechanisms can assist in overcoming weaknesses in WEEE management by including beneficial schemes to incentivise consumers to improve current waste policies. In the meantime, governments, media, and local non-governmental organisations may help by increasing awareness of effective and sustainable WEEE management.
  11. Ismail H, Chang YL, Chang SD, Nusee Z
    Malays J Med Sci, 2012 Jul;19(3):69-73.
    PMID: 23785250 MyJurnal
    A 30-years-old Taiwanese female in her second pregnancy spontaneously conceived a monochorionic twin pregnancy. A routine ultrasound at 27 weeks of gestation revealed a selective intrauterine growth restriction (sIUGR) fetus and an appropriate gestational age (AGA) fetus. The AGA fetus was found to have a fetal intra-abdominal umbilical vein (FIUV) varix. Serial ultrasounds showed no changes in the FIUV varix. 2 weeks later, the pregnancy progressed to twin-twin transfusion syndrome (TTTS). Repeated amnioreductions were required at 29 and 30 weeks gestation. The babies were delivered by caesarean section at 31 weeks due to fetal distress in the sIUGR fetus. Both fetuses survived the neonatal period with problems of prematurity. The FIUV varix disappeared a few days after delivery.
  12. Cheng KY, Yusoff DM, Ismail H, Naing NN
    Malays J Med Sci, 2018 Sep;25(5):115-127.
    PMID: 30914868 MyJurnal DOI: 10.21315/mjms2018.25.5.11
    BACKGROUND: The aim of the present study was to determine the validity and reliability of the Malay versions of the Incontinence Praying Ability (I-PA) and the Incontinence Quality of Life (I-QoL) questionnaires among childbearing-aged Muslim women.

    METHODS: This cross-sectional study included 338 childbearing-aged Muslim women (mean age: 31.1 years; SD = 5.57) who attended clinics at Hospital Universiti Sains Malaysia. Confirmatory factor analysis was conducted to determine the construct validity of the Malay versions of the I-PA and the I-QoL, while composite reliability was used to examine their internal consistency reliability.

    RESULTS: The hypothesised models of the I-PA and the I-QoL consisted of 10 items with one latent variable and 22 items with three latent variables, respectively. The hypothesised models of the I-PA and the I-QoL did not have good fit. Modifications included co-varying the residual terms for items within the subscales, which resulted in improved fit indices for the I-PA (CFI = 0.976 TLI = 0.961, RMSEA = 0.068) and the I-QoL (CFI = 0.948, TLI = 0.938, RMSEA = 0.063). The composite reliability of the I-PA was 0.93, and the I-QoL ranged from 0.91 to 0.94.

    CONCLUSION: The Malay versions of the I-PA and I-QoL were considered to be valid, reliable questionnaires measuring incontinence QoL among Muslim women of childbearing age.

  13. Mohd Razib NF, Ismail H, Ibrahim R, Isa ZM
    BMC Public Health, 2024 Jul 05;24(1):1791.
    PMID: 38970028 DOI: 10.1186/s12889-024-19296-x
    BACKGROUND: Orang Asli lifestyle and household setting may influence their health status especially respiratory system and lung functions. This cross-sectional study was carried out to investigate the status of lung functions of Orang Asli community and the associated factors.

    METHODS: Data collection was carried out from November 2017 until May 2018 among 211 Orang Asli respondents aged 18 years old and above, who lived in five villages in Tasik Chini, Pahang. All respondents who fulfilled the inclusion criteria were recruited in this study. Interview-guided questionnaire was administered, and spirometry test that include Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), and Peak Expiratory Flow Rate (PEFR) was carried out. Data were analyzed using SPSS software version 23.0. In the first stage, descriptive analysis was done to describe the characteristics of the respondents. In the second stage, bivariable analysis was carried out to compare proportions. Finally, multiple logistic regression was performed to assess the effects of various independent predictors on spirometry parameters.

    RESULTS: The respondents' age ranged from 18 to 71 years old in which 50.2% of them were female. The majority ethnicity in Tasik Chini was Jakun tribe (94.3%). More than half of the respondents (52.1%) were current smoker, 5.2% were ex-smoker and 41.7% were non-smoker. More than half of them (62.1%) used woodstove for cooking, compared to only 37.9% used cleaner fuel like Liquefied Petroleum Gas (LPG) as a fuel for everyday cooking activity. The lung function parameters (FEV1 and FVC) were lower than the predictive value, whereas the ratio of Forced Expiratory Volume in one second and Forced Vital Capacity (FEV1/FVC) (%) and PEFR were within the predictive value. The FEV1 levels were significantly associated with age group (18-39 years old) (p = 0.002) and presence of woodstove in the house (p = 0.004). FVC levels were significantly associated with presence of woodstove in the house (p = 0.004), whereas there were no significant associations between all factors and FEV1/FVC levels.

    CONCLUSIONS: FEV1 levels were significantly associated with age group 18-39 years old, whereas FVC levels were significantly associated with the presence of woodstove in the house. Thus, environmental interventions such as replacing the use of woodstove with LPG, need to be carried out to prevent further worsening of respiratory health among Orang Asli who lived far from health facilities. Moreover, closer health monitoring is crucial especially among the younger and productive age group.

  14. AbdulQader ST, Rahman IA, Thirumulu KP, Ismail H, Mahmood Z
    J Biomater Appl, 2016 Apr;30(9):1300-11.
    PMID: 26740503 DOI: 10.1177/0885328215625759
    Calcium phosphates (CaP) of different porosities have been widely and successfully used as scaffolds with osteoblast cells for bone tissue regeneration. However, the effects of scaffold porosities on cell viability and differentiation of human dental pulp cells for dentin tissue regeneration are not well known. In this study, biphasic calcium phosphate (BCP) scaffolds of 20/80 hydroxyapatite to beta tricalcium phosphate ratio with a mean pore size of 300 μm were prepared into BCP1, BCP2, BCP3, and BCP4 of 25%, 50%, 65%, and 75% of total porosities, respectively. The extracts of these scaffolds were assessed with regard to cell viability, proliferation, and differentiation of human dental pulp cells. The high alkalinity, and more calcium and phosphate ions release that were exhibited by BCP3 and BCP4 decreased the viability and proliferation of human dental pulp cells as compared to BCP1 and BCP2. BCP2 significantly increased both cell viability and cell proliferation. However, the cells cultured with BCP3 extract revealed high alkaline phosphatase (ALP) activity and high expression of odontoblast related genes, collagen type I alpha 1, dentin matrix protein-1, and dentin sialophosphoprotein as compared to that cultured with BCP1, BCP2, and BCP4 extracts. The results highlight the effect of different scaffold porosities on the cell microenvironment and demonstrate that BCP3 scaffold of 65% porosity can support human dental pulp cells differentiation for dentin tissue regeneration.
  15. AbdulQader ST, Kannan TP, Rahman IA, Ismail H, Mahmood Z
    Mater Sci Eng C Mater Biol Appl, 2015 Apr;49:225-233.
    PMID: 25686943 DOI: 10.1016/j.msec.2014.12.070
    Calcium phosphate (CaP) scaffolds have been widely and successfully used with osteoblast cells for bone tissue regeneration. However, it is necessary to investigate the effects of these scaffolds on odontoblast cells' proliferation and differentiation for dentin tissue regeneration. In this study, three different hydroxyapatite (HA) to beta tricalcium phosphate (β-TCP) ratios of biphasic calcium phosphate (BCP) scaffolds, BCP20, BCP50, and BCP80, with a mean pore size of 300μm and 65% porosity were prepared from phosphoric acid (H2PO4) and calcium carbonate (CaCO3) sintered at 1000°C for 2h. The extracts of these scaffolds were assessed with regard to cell viability and differentiation of odontoblasts. The high alkalinity, more calcium, and phosphate ions released that were exhibited by BCP20 decreased the viability of human dental pulp cells (HDPCs) as compared to BCP50 and BCP80. However, the cells cultured with BCP20 extract expressed high alkaline phosphatase activity and high expression level of bone sialoprotein (BSP), dental matrix protein-1 (DMP-1), and dentin sialophosphoprotein (DSPP) genes as compared to that cultured with BCP50 and BCP80 extracts. The results highlighted the effect of different scaffold ratios on the cell microenvironment and demonstrated that BCP20 scaffold can support HDPC differentiation for dentin tissue regeneration.
  16. Nolan JV, Liang JB, Abdullah N, Kudo H, Ismail H, Ho YW, et al.
    Comp. Biochem. Physiol. A Physiol., 1995 May;111(1):177-82.
    PMID: 7735907
    Voluntary food intake, digestibility and water turnover were determined in adult Malaysian lesser mouse-deer (Tragulus javanicus) given unlimited access to lundai foliage (Sapium baccatum). Daily dry matter (DM) intake was 42.4 g/kg metabolic live mass (M0.73) or 3.7% M. Digestible energy intake was 853 kJ/day (571 kJ metabolisable energy per M0.73), calculated to be used with 79% efficiency. Apparent digestibility (%) of organic matter was 83.8, crude fibre 63.7, acid detergent fibre 60.5, neutral detergent fibre 72.1 and crude protein 65.0. Urinary excretion of the purine derivative, allantoin, was 0.05 mg/g digestible DM intake suggesting rumen microbial yield efficiency may be lower than in other ruminant species. Total water intake was 182 ml/M0.82. The body-water content of the fed mouse-deer, from tritiated water dilution, was 77% M, consistent with a very lean carcass. Turnover of body water was 17% per day. The mouse-deer produced relatively dry, well-defined faecal pellets.
  17. Ismail H, Abdul Manaf MR, Abdul Gafor AH, Mohamad Zaher ZM, Ibrahim AIN
    Kidney Int Rep, 2019 Sep;4(9):1261-1270.
    PMID: 31517145 DOI: 10.1016/j.ekir.2019.05.016
    Introduction: Prevalence of chronic kidney disease (CKD) in Malaysia is 9.07% of the total population, of which 0.36% are at stage 5 CKD or end-stage renal disease (ESRD). Public-private partnership has improved accessibility of renal replacement therapies (RRT), especially dialysis, in Malaysia, but the economic burden of the existing RRT financing mechanism, which is predominantly provided by the public sector, has never been quantified.

    Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure.

    Results: Total annual expenditure of ESRD by the public sector has grown 94% within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95% of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2%. Only 6% of ESRD expenditure was spent on renal transplantation, and the remaining 94% was spent on dialysis.

    Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.

  18. Ibrahim S, Othman N, Sreekantan S, Tan KS, Mohd Nor Z, Ismail H
    Polymers (Basel), 2018 Nov 01;10(11).
    PMID: 30961141 DOI: 10.3390/polym10111216
    Natural rubber is one of the most important renewable biopolymers used in many applications due to its special properties that cannot be easily mimicked by synthetic polymers. To sustain the existence of natural rubber in industries, modifications have been made to its chemical structure from time to time in order to obtain new properties and to enable it to be employed in new applications. The chemical structure of natural rubber can be modified by exposure to ultraviolet light to reduce its molecular weight. Under controlled conditions, the natural rubber chains will be broken by photodegradation to yield low-molecular-weight natural rubber. The aim of this work was to obtain what is known as liquid natural rubber via photodegradation, with titanium dioxide nanocrystals as the catalyst. Titanium dioxide, which was firstly synthesized using the sol⁻gel method, was confirmed to be in the form of an anatase, with a size of about 10 nm. In this work, the photodegradation was carried out in latex state and yielded low-molecular-weight natural rubber latex of less than 10,000 g/mol. The presence of hydroxyl and carbonyl groups on the liquid natural rubber (LNR) chains was observed, resulting from the breaking of the chains. Scanning electron microscopy of the NR latex particles showed that titanium dioxide nanocrystals were embedded on the latex surface, but then detached during the degradation reaction.
  19. Sahril N, Shahein NA, Yoep N, Mahmud NA, Sooryanarayana R, Maw Pin T, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:33-37.
    PMID: 33370863 DOI: 10.1111/ggi.13980
    AIM: Falls are a common problem among older people, leading to major morbidity and increased mortality. The study aimed to determine the prevalence of falls among older persons in Malaysia and its associated factors.

    METHODS: Data were obtained from the National Health and Morbidity Survey 2018 (NHMS 2018), a cross-sectional study using stratified cluster sampling design. Older persons were defined as aged ≥60 years in this study. Descriptive and logistic regression analyses were conducted using SPSS version 25.0.

    RESULTS: Overall, 14.1% (95% confidence interval [CI]: 12.46, 15.84) of older persons reported having experienced at least one fall during the past 12 months. Univariate analyses revealed an association between the history of falls with not being employed (odds ratio [OR]: 1.35 [95% CI: 1.03, 1.77]), diabetes mellitus (OR: 1.65 [95% CI: 1.33, 2.04]), limitation in activities of daily living (ADL) (OR: 1.90 [95% CI: 1.43, 2.54]) or instrumental ADL (OR: 1.47 [95% CI: 1.16, 1.84]). Multiple logistic regression revealed that falls were positively associated with those who had diabetes mellitus (OR: 1.55 [95% CI: 1.23, 1.94]) and limitation in ADL (OR: 1.56 [95% CI: 1.14, 2.15]); 43.9% of falls occurred outdoors.

    CONCLUSION: One in six older Malaysian people experience at least one fall over a 12-month period. Diabetes mellitus and limitation in ADL were the factors associated with falls among older persons. A comprehensive and targeted program designed to reduce risk of falls is urgently needed. Future research should identify suitable programs for our setting to reduce the potential society burden of falls in older Malaysians. Geriatr Gerontol Int 2020; 20: 33-37.

  20. Ab Wahab MK, Mohamad HS, Jayamani E, Ismail H, Wnuk I, Przybył A, et al.
    Materials (Basel), 2021 May 27;14(11).
    PMID: 34071851 DOI: 10.3390/ma14112867
    The preparation of polystyrene/thermoplastic starch (PS/TPS) blends was divided into three stages. The first stage involved the preparation of TPS from sago starch. Then, for the second stage, PS was blended with TPS to produce a TPS/PS blend. The ratios of the TPS/PS blend were 20:80, 40:60, 60:40, and 80:20. The final stage was a modification of the composition of TPS/PS blends with succinic anhydride and ascorbic acid treatment. Both untreated and treated blends were characterized by their physical, thermal, and surface morphology properties. The obtained results indicate that modified blends have better tensile strength as the adhesion between TPS and PS was improved. This can be observed from SEM micrographs, as modified blends with succinic anhydride and ascorbic acid had smaller TPS dispersion in PS/TPS blends. The micrograph showed that there was no agglomeration and void formation in the TPS/PS blending process. Furthermore, modified blends show better thermal stability, as proved by thermogravimetric analysis. Water uptake into the TPS/PS blends also decreased after the modifications, and the structural analysis showed the formation of a new peak after the modification process.
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