MyMedR

Displaying publications 21 - 40 of 842 in total

Abstract:

Sort:

Fulltext Nutritional status and nutritional knowledge of Malay pregnant women in selected private hospitals in Klang Valley

Zahara Abdul Manaf, Nuruljannah Johari, Lee, Yee Mei, Ng, Sim Yee, Chua, Kai Yin, Loke, Wai Teng

Jurnal Sains Kesihatan Malaysia, 2014;12(2):53-62.
MyJurnal

Adequate nutrition is important for mothers and their offspring during and after birth. This cross sectional study was conducted to determine nutritional status and nutritional knowledge of pregnant women from two selected private hospitals in Klang Valley, Malaysia. A total of 236 Malay pregnant women aged between 20 to 45 years old (mean age 31+5 years) were recruited through convenient sampling method. Socio-demographic data, nutritional knowledge and a 24-hours diet recall were obtained through a self-administered questionnaire. Anthropometric and haemoglobin data were obtained from the antenatal records in the respective hospitals. The percentages of participants who were underweight, normal, overweight and obese before pregnancy were 12.7%, 55.1%, 25.0% and 7.2% respectively. Among those who were obese before pregnancy, a total of 59.7% had inadequate weight gain, 24.6% gained adequate weight and 15.7% gained excessive gestational weight. About 33.5% of subjects were anaemic (Hb < 11.0g/dL). The mean daily energy intake of the participants was 1748 ± 526 kcal which was 76% of RNI. Calcium (73% of RNI), folic acid (36% of RNI), niacin (89% of RNI) and vitamin D (40% of RNI). The nutritional knowledge level of subjects was moderate (51.9 ± 13.8%). Lower monthly household income (p < 0.001), educational level (p < 0.001) and gestational stage (p < 0.05) of participants were associated with a lower nutritional knowledge level. Nutritional knowledge score was positively correlated with gestational weight gain (r = 0.166, p < 0.05) and haemoglobin level (r = 0.200, p < 0.05). Subjects who claimed practising food taboos had higher nutritional knowledge score (54.9 ± 12.5%) than those who did not (49.9 ± 14.4%)(p < 0.05). A comprehensive nutrition education should be integrated in the antenatal classes to improve nutritional status of pregnant women.

Matched MeSH terms: Calcium, Dietary
Fulltext Blood-pressure and cholesterol lowering in persons without cardiovascular disease

Yusuf S, Lonn E, Pais P, Bosch J, López-Jaramillo P, Zhu J, et al.

N Engl J Med, 2016 May 26;374(21):2032-43.
PMID: 27039945 DOI: 10.1056/NEJMoa1600177

BACKGROUND: Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially.
METHODS: In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In the analyses reported here, we compared the 3180 participants assigned to combined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years.
RESULTS: The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups.
CONCLUSIONS: The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; ClinicalTrials.gov number, NCT00468923.).
Note: Malaysia is a study site (Author: Yusoff K)

Matched MeSH terms: Rosuvastatin Calcium/administration & dosage*; Rosuvastatin Calcium/adverse effects
Fulltext Cholesterol lowering in intermediate-risk persons without cardiovascular disease

Yusuf S, Bosch J, Dagenais G, Zhu J, Xavier D, Liu L, et al.

N Engl J Med, 2016 May 26;374(21):2021-31.
PMID: 27040132 DOI: 10.1056/NEJMoa1600176

BACKGROUND: Previous trials have shown that the use of statins to lower cholesterol reduces the risk of cardiovascular events among persons without cardiovascular disease. Those trials have involved persons with elevated lipid levels or inflammatory markers and involved mainly white persons. It is unclear whether the benefits of statins can be extended to an intermediate-risk, ethnically diverse population without cardiovascular disease.
METHODS: In one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants in 21 countries who did not have cardiovascular disease and were at intermediate risk to receive rosuvastatin at a dose of 10 mg per day or placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included revascularization, heart failure, and resuscitated cardiac arrest. The median follow-up was 5.6 years.
RESULTS: The overall mean low-density lipoprotein cholesterol level was 26.5% lower in the rosuvastatin group than in the placebo group. The first coprimary outcome occurred in 235 participants (3.7%) in the rosuvastatin group and in 304 participants (4.8%) in the placebo group (hazard ratio, 0.76; 95% confidence interval [CI], 0.64 to 0.91; P=0.002). The results for the second coprimary outcome were consistent with the results for the first (occurring in 277 participants [4.4%] in the rosuvastatin group and in 363 participants [5.7%] in the placebo group; hazard ratio, 0.75; 95% CI, 0.64 to 0.88; P<0.001). The results were also consistent in subgroups defined according to cardiovascular risk at baseline, lipid level, C-reactive protein level, blood pressure, and race or ethnic group. In the rosuvastatin group, there was no excess of diabetes or cancers, but there was an excess of cataract surgery (in 3.8% of the participants, vs. 3.1% in the placebo group; P=0.02) and muscle symptoms (in 5.8% of the participants, vs. 4.7% in the placebo group; P=0.005).
CONCLUSIONS: Treatment with rosuvastatin at a dose of 10 mg per day resulted in a significantly lower risk of cardiovascular events than placebo in an intermediate-risk, ethnically diverse population without cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; HOPE-3 ClinicalTrials.gov number, NCT00468923.).
Note: Malaysia is a study site (Author: Yusoff K)

Matched MeSH terms: Rosuvastatin Calcium/administration & dosage*; Rosuvastatin Calcium/adverse effects
One-step synthesis of chitosan-polyethyleneimine with calcium chloride as effective adsorbent for Acid Red 88 removal

Yusof NH, Foo KY, Hameed BH, Hussin MH, Lee HK, Sabar S

Int J Biol Macromol, 2020 Aug 15;157:648-658.
PMID: 31790734 DOI: 10.1016/j.ijbiomac.2019.11.218

Chitosan-polyethyleneimine with calcium chloride as ionic cross-linker (CsPC) was synthesized as a new kind of adsorbent using a simple, green and cost-effective technique. The adsorption properties of the adsorbent for Acid Red 88 (AR88) dye, as a model analyte, were investigated in a batch system as the function of solution pH (pH 3-12), initial AR88 concentration (50-500 mg L-1), contact time (0-24 h), and temperature (30-50 °C). Results showed that the adsorption process obeyed the pseudo-first order kinetic model and the adsorption rate was governed by both intra-particle and liquid-film mechanism. Equilibrium data were well correlated with the Freundlich isotherm model, with the calculated maximum adsorption capacity (qm) of 1000 mg g-1 at 30 °C. The findings underlined CsPC to be an effective and efficient adsorbent, which can be easily synthesized via one-step process with promising prospects for the removal of AR88 or any other similar dyes from the aqueous solutions.

Matched MeSH terms: Calcium Chloride/chemistry*
Removal of Ca2+ and Zn2+ from aqueous solutions by zeolites NaP and KP

Yusof AM, Malek NA, Kamaruzaman NA, Adil M

Environ Technol, 2010 Jan;31(1):41-6.
PMID: 20232677 DOI: 10.1080/09593330903313794

Zeolites P in sodium (NaP) and potassium (KP) forms were used as adsorbents for the removal of calcium (Ca2+) and zinc (Zn2+) cations from aqueous solutions. Zeolite KP was prepared by ion exchange of K+ with Na+ which neutralizes the negative charge of the zeolite P framework structure. The ion exchange capacity of K+ on zeolite NaP was determined through the Freundlich isotherm equilibrium study. Characterization of zeolite KP was determined using infrared spectroscopy and X-ray diffraction (XRD) techniques. From the characterization, the structure of zeolite KP was found to remain stable after the ion exchange process. Zeolites KP and NaP were used for the removal of Ca and Zn from solution. The amount of Ca2+ and Zn2+ in aqueous solution before and after the adsorption by zeolites was analysed using the flame atomic absorption spectroscopy method. The removal of Ca2+ and Zn2+ followed the Freundlich isotherm rather than the Langmuir isotherm model. This result also revealed that zeolite KP adsorbs Ca2+ and Zn2+ more than zeolite NaP and proved that modification of zeolite NaP with potassium leads to an increase in the adsorption efficiency of the zeolite. Therefore, the zeolites NaP and KP can be used for water softening (Ca removal) and reducing water pollution/toxicity (Zn removal).

Matched MeSH terms: Calcium/isolation & purification*; Calcium/chemistry
Fulltext Recycling of phenolic compounds in Borneo's tropical peat swamp forests

Yule CM, Lim YY, Lim TY

Carbon Balance Manag, 2018 Feb 07;13(1):3.
PMID: 29417248 DOI: 10.1186/s13021-018-0092-6

BACKGROUND: Tropical peat swamp forests (TPSF) are globally significant carbon stores, sequestering carbon mainly as phenolic polymers and phenolic compounds (particularly as lignin and its derivatives) in peat layers, in plants, and in the acidic blackwaters. Previous studies show that TPSF plants have particularly high levels of phenolic compounds which inhibit the decomposition of organic matter and thus promote peat accumulation. The studies of phenolic compounds are thus crucial to further understand how TPSF function with respect to carbon sequestration. Here we present a study of cycling of phenolic compounds in five forests in Borneo differing in flooding and acidity, leaching of phenolic compounds from senescent Macaranga pruinosa leaves, and absorption of phenolics by M. pruinosa seedlings.
RESULTS: The results of the study show that total phenolic content (TPC) in soil and leaves of three species of Macaranga were highest in TPSF followed by freshwater swamp forest and flooded limestone forest, then dry land sites. Highest TPC values were associated with acidity (in TPSF) and waterlogging (in flooded forests). Moreover, phenolic compounds are rapidly leached from fallen senescent leaves, and could be reabsorbed by tree roots and converted into more complex phenolics within the leaves.
CONCLUSIONS: Extreme conditions-waterlogging and acidity-may facilitate uptake and synthesis of protective phenolic compounds which are essential for impeded decomposition of organic matter in TPSF. Conversely, the ongoing drainage and degradation of TPSF, particularly for conversion to oil palm plantations, reverses the conditions necessary for peat accretion and carbon sequestration.

Matched MeSH terms: Calcium Carbonate
Arbuscular mycorrhizal fungal composition affects the growth and nutrient acquisition of two plants from a karst area

Yuejun He, Changhong Jiang, Hao Yang, Yongjian Wang, Zhangcheng Zhong

Sains Malaysiana, 2017;46:1701-1708.

How the composition of the arbuscular mycorrhizal (AM) fungal community affects plant traits of different plant species in karst environments is poorly understood. Broussonetia papyrifera (a woody shrub) and Bidens pilosa (a herbaceous plant) growing in pots in limestone soil were inoculated with an AM fungus, either Funneliformis mosseae (FM), Diversispora versiformis (DV) or Glomus diaphanum (GD) or with an inoculum mixture of all three AM fungi (bn). B. papyrifera and B. pilosa seedlings inoculated with AM fungi showed a significant increase in biomass and nitrogen and phosphorus acquisition compared with the controls, which lacked mycorrhiza. Mixed fungal inoculations significantly enhanced biomass and nitrogen and phosphorus acquisition by B. papyrifera seedlings compared with single fungal inoculations. Nitrogen and phosphorus acquisition by B. papyrifera mycorrhizal seedlings was significantly greater than that of B. pilosa mycorrhizal seedlings. Fungal composition significantly influenced the mycorrhizal benefits of biomass and phosphorus acquisition and mixed fungal inoculations enhanced nitrogen acquisition. Plant species significantly affected nitrogen acquisition but did not have an effect on biomass and phosphorus benefits. We concluded that AM fungal associations increased plant growth and nutrient absorption and that in general a mixed inoculation of AM fungi enhanced biomass and nutrient acquisition more than a single AM fungal inoculation. In addition, a mycorrhizal association was more beneficial for B. papyrifera seedlings in terms of biomass and nutrient acquisition than for B. pilosa seedlings.

Matched MeSH terms: Calcium Carbonate
CmCML11 interacts with CmCAMTA5 to enhance γ-aminobutyric acid (GABA) accumulation by regulating GABA shunt in fresh-cut cantaloupe

You W, Zhang J, Ru X, Xu F, Wu Z, Jin P, et al.

Plant Physiol Biochem, 2024 Jan;206:108217.
PMID: 38039581 DOI: 10.1016/j.plaphy.2023.108217

The effect of calcium chloride (CaCl2) treatment on γ-aminobutyric acid (GABA) accumulation in fresh-cut cantaloupe and the involved mechanisms were investigated. The result showed that 1% (w/v) CaCl2 treatment increased GABA content and activities of glutamate decarboxylase (GAD) and succinate semialdehyde dehydrogenase (SSADH), while decreased glutamate (Glu) content and GABA transaminase (GABA-T) activities in fresh-cut cantaloupe. CmCML11 and CmCAMTA5 expressions of CaCl2-treated fruit increased by 187.4% and 165.6% than control fruit in the initial 6 h. Besides, expressions of GABA shunt genes, including CmGAD1, CmGAD2, CmGABA-T and CmSSADH were also up-regulated by CaCl2 treatment during early storage. Moreover, acting as a transcriptional activator, CmCAMTA5 could bind to the CG-box in promoters of CmGAD1, CmGABA-T and CmSSADH and activate their transcription. Furthermore, the interaction between CmCML11 and CmCAMTA5 could enhance the transcriptional activation on GABA shunt genes which were regulated by CmCAMTA5. Collectively, our findings revealed that CaCl2 treatment promoted GABA accumulation in fresh-cut cantaloupe via the combined effect of CmCML11 and CmCAMTA5 in the regulation of expressions of CmGAD1, CmGABA-T, and CmSSADH in GABA shunt.

Matched MeSH terms: Calcium Chloride
Fulltext Hyperkalaemic periodic paralysis in pregnancy

Yong SL, Sin TH, Tang EB, Chai MC

BMJ Case Rep, 2018 Jun 04;2018.
PMID: 29866669 DOI: 10.1136/bcr-2017-223588

Hyperkalaemic periodic paralysis is a rare skeletal muscle disorder which is characterised by episodic muscle paralysis associated with hyperkalaemia. Although it is an autosomal-dominant disease, cases of de novo mutations have been reported. We report the case of a 30-year-old woman, gravida 5 para 3+1, who was planned for an elective repeated caesarean section at 38 weeks and 3 days of pregnancy. She developed recurrent episodes of hyperkalaemic periodic paralysis after receiving corticosteroids. Intravenous calcium gluconate was administered to normalise potassium levels (from 6.3 mmol/L to 4.1 mmol/L). Extra anaesthetic precautions were taken during the caesarean delivery. Postoperatively, she was well and discharged from the ward. She encountered similar symptoms in her third pregnancy, and there was no family history of muscle weakness which suggested a de novo mutation. Pregnancy seemed to result in vulnerability to hyperkalaemic attacks as she was never symptomatic outside pregnancy.

Matched MeSH terms: Calcium Gluconate/therapeutic use
International evaluation of unrecognizably uglifying human faces in late and severe secondary hyperparathyroidism in chronic kidney disease. Sagliker syndrome. A unique catastrophic entity, cytogenetic studies for chromosomal abnormalities, calcium-sensing receptor gene and GNAS1 mutations. Striking and promising missense mutations on the GNAS1 gene exons 1, 4, 10, 4

Yildiz I, Sagliker Y, Demirhan O, Tunc E, Inandiklioglu N, Tasdemir D, et al.

J Ren Nutr, 2012 Jan;22(1):157-61.
PMID: 22200434 DOI: 10.1053/j.jrn.2011.10.030

Hypotheses explaining pathogenesis of secondary hyperparathyroidism (SH) in late and severe CKD as a unique entity called Sagliker syndrome (SS) are still unclear. This international study contains 60 patients from Turkey, India, Malaysia, China, Romania, Egypt, Tunisia, Taiwan, Mexico, Algeria, Poland, Russia, and Iran. We examined patients and first degree relatives for cytogenetic chromosomal abnormalities, calcium sensing receptor (Ca SR) genes in exons 2 and 3 abnormalities and GNAS1 genes mutations in exons 1, 4, 5, 7, 10, 13. Our syndrome could be a new syndrome in between SH, CKD, and hereditary bone dystrophies. We could not find chromosomal abnormalities in cytogenetics and on Ca SR gene exons 2 and 3. Interestingly, we did find promising missense mutations on the GNAS1 gene exons 1, 4, 10, 4. We finally thought that those catastrophic bone diseases were severe SH and its late treatments due to monetary deficiencies and iatrogenic mistreatments not started as early as possible. This was a sine qua non humanity task. Those brand new striking GNAS1 genes missense mutations have to be considered from now on for the genesis of SS.

Matched MeSH terms: Receptors, Calcium-Sensing/genetics*
Fulltext Vitamin D Deficiency and Janus kinase 2 V617F Mutation Status in Essential Thrombocythemia and Polycythemia Vera

Yikilmaz AŞ, Akinci S, Bakanay ŞM, Dilek İ

Malays J Med Sci, 2020 Feb;27(1):70-77.
PMID: 32158346 DOI: 10.21315/mjms2020.27.1.7

Introduction: Vitamin D, which is known for its effects on calcium and bone metabolism, has recently been associated with haematological malignancies. We aimed to investigate the relationship between disease findings and vitamin D deficiency in essential thrombocythemia (ET) and polycythemia vera (PV).
Material and Methods: This retrospective cohort study conducted in Turkey included 73 patients diagnosed with PV or ET according to WHO criteria between 2012 and 2018. Vitamin D deficiency was defined as 25-OH vitamin D < 20 ng/mL. Polymerase chain reaction (PCR) was used to detect the Janus kinase 2 (JAK2) V617F mutation.
Results: Vitamin D deficiency was found in 66.7% of PV and 74.2% of ET patients. The median follow-up time of ET and PV patients was 48 months and 47 months, respectively. Patients with the JAK2 mutation had a higher prevalence of a history of thrombosis and age older than 65 years. There was a significant relationship between JAK2 positivity and vitamin D deficiency.
Conclusion: There was a remarkably higher prevalence of vitamin D deficiency in JAK2 mutation-positive ET and PV patients. These patients should be carefully evaluated for vitamin D deficiency. More studies are required to further investigate the association between JAK2 and vitamin D.

Matched MeSH terms: Calcium, Dietary
Fulltext Effect of CaCO3 particle size in synthesis of β-TCP powder

Yeong, Meng How, Shah Rizal Kasim, Hazizan Md Akil, Zainal Arifin Ahmad

Journal of Nuclear and Related Technologies, 2009;2009(1):19-24.
MyJurnal

β-tricalcium phosphate (β-TCP) powders were synthesized by using various particles sizes (40 nm – 780 μm) calcium carbonate (CaCO3) and phosphoric acid (H3PO4) at room temperature (25 ˚C). The synthesized powders were characterized by using X-Ray Diffraction (XRD) method. The purity of β-TCP powders were determined from XRD pattern while the crystallite size of β-TCP powders were calculated by using Scherrer equation. Results shows that the purity of β-TCP powders were ranged from 20.33 % to 81.94 % while the crystallite size of β- TCP powders were ranged from 0.04391 μm to 0.06751 μm. From this work, particle size of CaCO3 will influenced the purity but not the mean crystallite size of synthesized β-TCP.

Matched MeSH terms: Calcium Carbonate; Calcium Phosphates
Fulltext Association between anthropometric status, dietary intake and physical activity with bone health status among premenopausal Chinese women in the Klang Valley, Malaysia

Yee, Y.S.S., Zaitun, Y., Chan, Y.M., Norhaizan, M.E.

Malays J Nutr, 2013;19(3):293-302.
MyJurnal

Introduction: There is a lack of information on bone health status of premenopausal women in Malaysia. This study investigated the bone health status of premenopausal women and its associations with anthropometric, dietary and physical activity. Methods: Bone mineral density (BMD) was measured using dual X-ray absorptiometry (DEXA) at the lumbar spine, femoral neck, total hip and total body. Serum osteocalcin, parathyroid hormone (PTH), beta-crosslaps were also determined. Results: A total of 73 Chinese premenopausal women were recruited in the study with a mean age of 39.3 ± 5.0 years. Average BMI, body fat percentage and lean body mass were 22.2 ± 3.4 kg/m2, 33.9 ± 4.6% and 34.5 ± 4.4 kg, respectively. Mean BMD at the spine, total hip, femoral neck, and total body were 1.025 ± 0.118 g/cm2, 0.876 ± 0.109 g/cm2, 0.739 ± 0.110 g/cm2, and 1.061 ± 0.755 g/cm2, respectively. Their serum beta-crosslaps and PTH were within normal range, but serum osteocalcin (8.5 ± 4.2 ng/ ml) was low. On average, calorie intake (1506 ± 427 kcal/ day) was below the Malaysian Recommended Nutrient Intake (RNI) while their calcium intake achieved only 67% of RNI. Their mean metabolic equivalent score (MET) was 771.4 ± 926.1 min/week. Body weight and related indices (BMI, lean mass, fat mass) were significantly positively correlated with BMD at all skeletal sites. Conclusion: The study revealed that Chinese premenopausal women in the Klang Valley have low calcium intake and low level of physical activity.

Matched MeSH terms: Calcium
Vitamin D levels: its relationship to bone mineral density response and disease activity in premenopausal Malaysian systemic lupus erythematosus patients on corticosteroids

Yeap SS, Othman AZ, Zain AA, Chan SP

Int J Rheum Dis, 2012 Feb;15(1):17-24.
PMID: 22324943 DOI: 10.1111/j.1756-185X.2011.01653.x

AIM: To determine if baseline vitamin D levels would influence the gain in bone mineral density (BMD) in female systemic lupus erythematosus (SLE) patients on corticosteroids (CS) taking bone-active medication.

METHOD: Premenopausal SLE patients participating in a trial assessing the efficacy of calcium alone, calcitriol and calcium, and alendronate and calcium, on BMD in patients on CS, were studied. Patients were randomly allocated to the treatment groups at the start of the study and followed up for 2 years. Serum 25-hydroxy vitamin D [25(OH)D] was measured at baseline.

RESULTS: Thirty-eight patients were studied. One (2%) patient had osteoporosis, nine (24%) had osteopenia and all others had normal BMD. The mean baseline 25(OH)D levels were 21.6 ± 4.6 ng/mL (± 1 SD). Twelve (32%) patients had vitamin D deficiency [25(OH)D < 20 ng/mL]. There was a significant negative correlation between SLEDAI scores and 25(OH)D levels, that is, patients with high SLEDAI scores had significantly lower 25(OH)D levels (P = 0.033). Left femoral neck BMD was significantly lower in the deficient compared to insufficient group (P = 0.042). There was a trend toward better BMD gain at 2 years in the vitamin D insufficient compared to the deficient group, which did not reach statistical significance.

CONCLUSION: This study showed that in female SLE patients, low vitamin D levels are associated with higher disease activity and suggests that patients who have higher vitamin D levels have a better BMD response during treatment with bone-active agents.

Matched MeSH terms: Calcium/therapeutic use
The Malaysian Clinical Guidance on the management of postmenopausal osteoporosis, 2012: a summary

Yeap SS, Hew FL, Lee JK, Goh EM, Chee W, Mumtaz M, et al.

Int J Rheum Dis, 2013 Feb;16(1):30-40.
PMID: 23441770 DOI: 10.1111/1756-185x.12037

AIM: This Clinical Guidance is aimed to help practitioners assess, diagnose and manage their patients with osteoporosis (OP), using the best available evidence.
METHODS: A literature search using PubMed (MEDLINE) and The Cochrane Library identified all relevant articles on OP and its assessment, diagnosis and treatment, from 2005, to update from the previous edition published in 2006. The studies were assessed and the level of evidence assigned; for each statement, studies with the highest level of evidence were used to frame the recommendation.
RESULTS: This article summarizes the diagnostic and treatment pathways for OP, highlighting the new data that have changed the way we assess and treat OP. Instead of starting treatment based on bone mineral density alone, there has been a move to assessing 10-year fracture risk before treatment, using tools such as the Fracture Risk Assessment Tool (FRAX). There has been a re-evaluation on calcium supplementation and more emphasis on the importance of vitamin D. There has been concern about the potential adverse effects of the long-term usage of bisphosphonates, which we have discussed fully. New drugs that have been licensed since 2006 in Malaysia have been included.
CONCLUSIONS: Adequate intake of calcium (1000 mg from both diet and supplements) and vitamin D (800 IU) daily remain important in the treatment of OP. However, in confirmed OP, pharmacological therapy with anti-resorptives is the mainstay of treatment. Patients need to be regularly assessed while on medication and treatment adjusted as required.

Matched MeSH terms: Calcium Compounds/administration & dosage
Osteoporosis treatment following a low trauma wrist fracture presenting to the accident and emergency department from 2011 to 2015

Yeap SS, Akhir NSM, Thirunavukkarasu V, Thambiah SC, Samsudin IN, Sham SYZ, et al.

Clin Cases Miner Bone Metab, 2018;15:74-78.
DOI: 10.11138/ccmbm/2017.15.1.074

Objective: The aim of this study was to determine the treatment given to patients following a low trauma wrist fracture presenting to an Accident and Emergency (A&E) Department at a tertiary private hospital in Malaysia. Methods: The records of patients over the age of 50 attending A&E Department from 2011-2015 with a diagnosis of Colles Vdistal radius/wrist fracture were obtained. Information was extracted for those with a low trauma fracture. Data was analysed using IBM SPSS Statistics version 22.0 for Windows. Results: 191 patients presented with a wrist fracture for the years 2011-2015. 57 of these were due to accidents which left 134 (70.2%) low trauma wrist fractures for analysis. The mean age of the patients was 61.75 ± 10.23 [standard deviation (SD)] years. There were 87 (64.9%) females, and 90 (67.2%) were of Chinese ethnicity. Following the index low trauma wrist fracture, 16/134 (11.9%) were given anti-osteoporotic medication. Of those given treatment, 11/16 (68.8%) were given calcium/Vitamin D/activated Vitamin D and only 5/16 (31.2%) were given active anti-osteoporotic treatment. The median duration of prescribed treatment was one month. There was no significant difference in demographic factors between patients who were treated and not treated with anti-osteoporosis medication. Conclusions: Currently, treatment for osteoporosis following low trauma wrist fractures in Malaysia is inadequate with only 11.9% receiving treatment, and in those who are treated, the median duration of treatment was only one month. This represents a missed opportunity for the prevention of future fractures. © 2018 CIC Edizioni Internazionali s.r.l. All rights reserved.

Matched MeSH terms: Calcium
Fulltext An update of the Malaysian Clinical Guidance on the management of glucocorticoid-induced osteoporosis, 2015

Yeap SS, Hew FL, Damodaran P, Chee W, Lee JK, Goh EML, et al.

Osteoporos Sarcopenia, 2017 Mar;3(1):1-7.
PMID: 30775497 DOI: 10.1016/j.afos.2017.01.001

Objectives: This Clinical Guidance is aimed to help practitioners assess, diagnose and manage their patients with glucocorticoid-induced osteoporosis (GIO), using the best available evidence.

Methods: A literature search using PubMed (MEDLINE) and The Cochrane Library identified all relevant articles on GIO and its assessment, diagnosis and treatment, from 2011, to update from the 2012 edition. The studies were assessed and the level of evidence assigned. For each statement, studies with the highest level of evidence were used to frame the recommendation.

Results: Consider treatment early in all patients on glucocorticoids (GC) as fracture risk increases within 3-6 months of starting GC. The decision to start treatment for GIO depends on the presence of prior fracture, category of risk (as calculated using Fracture Risk Assessment Tool), daily dose and duration of GC treatment, age, and menopausal status. General measures include adequate calcium and vitamin D intake and reducing the dose of GC to the minimum required to achieve disease control. In patients on GC with osteoporotic fractures or confirmed osteoporosis on dual-energy X-ray absorptiometry, bisphosphonates are the first-line treatment. Treatment should be continued as long as patients remain on GC. Algorithms for the management of GIO in both pre- and post-menopausal women and men have been updated.

Conclusions: In post-menopausal women and men above 50 years, bisphosphonates remain the mainstay of treatment in GIO. In pre-menopausal women and men below 50 years, bisphosphonates are recommended for those with a prevalent fracture or at very high risk only.

Matched MeSH terms: Calcium, Dietary
Fulltext Trends in post osteoporotic hip fracture care from 2010 to 2014 in a private hospital in Malaysia

Yeap SS, Nur Fazirah MFR, Nur Aisyah C, Zahari Sham SY, Samsudin IN, C Thambiah S, et al.

Osteoporos Sarcopenia, 2017 Jun;3(2):112-116.
PMID: 30775514 DOI: 10.1016/j.afos.2017.05.001

Objective: Following an osteoporotic fracture, pharmacological treatment is recommended to increase bone mineral density and prevent future fractures. However, the rate of starting treatment after an osteoporotic hip fracture remains low. The objective of this study was to survey the treatment rate following a low-trauma hip fracture at a tertiary private hospital in Malaysia over a period of 5 years.

Methods: The computerised hospital discharge records were searched using the terms "hip," "femur," "femoral," "trochanteric," "fracture," or "total hip replacement" for all patients over the age of 50, admitted between 2010 and 2014. The medical charts were obtained and manually searched for demographic data and treatment information. Hip operations done for non-low-trauma-related fracture and arthritis were excluded.

Results: Three hundred seventy patients over the age of 50 years were admitted with a hip fracture, of which 258 (69.7%) were low trauma, presumed osteoporotic, hip fractures. The median age was 79.0 years (interquartile range [IQR], 12.0). Following a hip fracture, 36.8% (95 of 258) of the patients received treatment, but out of these, 24.2% (23 of 95) were on calcium/vitamin D only. The median duration of treatment was 1 month (IQR, 2.5). In 2010, 56.7% of the patients received treatment, significantly more than subsequent years 2011-2014, where approximately only 30% received treatment.

Conclusions: Following a low-trauma hip fracture, approximately 72% of patients were not started on active antiosteoporosis therapy. Of those who were, the median duration of treatment was 1 month. This represents a missed opportunity for the prevention of future fractures.

Matched MeSH terms: Calcium
A comparison of calcium, calcitriol, and alendronate in corticosteroid-treated premenopausal patients with systemic lupus erythematosus

Yeap SS, Fauzi AR, Kong NC, Halim AG, Soehardy Z, Rahimah I, et al.

J Rheumatol, 2008 Dec;35(12):2344-7.
PMID: 19004038 DOI: 10.3899/jrheum.080634

OBJECTIVE: To assess bone mineral density (BMD) changes in patients with systemic lupus erythematosus (SLE) undergoing longterm therapy with corticosteroids (CS) while taking calcium, calcitriol, or alendronate. The primary endpoint was BMD changes at 2 years.
METHODS: Premenopausal SLE patients were randomized into 3 groups according to medication: calcium carbonate 500 mg bd (calcium alone), calcitriol 0.25 microg bd plus calcium carbonate 500 mg bd (calcitriol + calcium), and alendronate 70 mg/week plus calcium carbonate 500 mg bd (alendronate + calcium). BMD was measured at baseline and at the end of the first and second years.
RESULTS: Ninety-eight patients were recruited. There were 33 patients taking calcium alone, 33 calcitriol + calcium, and 32 alendronate + calcium. On randomization, median duration of CS use was 2.5 years (range 0-20 yrs). Seventy-seven patients (78.6%) completed the study (23 taking calcium alone, 27 calcitriol + calcium, 27 alendronate + calcium). There were no significant differences in mean CS dosages among the 3 groups at the time of BMD measurements. After 2 years, there were no significant changes in BMD in the calcium-alone and calcitriol + calcium groups, apart from a 0.93% (p < 0.001) reduction in total hip BMD in the calcium-alone group. In contrast, the alendronate + calcium group showed significant increases in BMD of 2.69% (p < 0.001) in the lumbar spine and 1.41% (p < 0.001) in total hip.
CONCLUSION: Both calcium alone and calcitriol + calcium preserved lumbar spine BMD in premenopausal patients with SLE taking longterm CS at 2 years, whereas alendronate + calcium led to increases in BMD in lumbar spine and total hip. Premenopausal women taking CS should be considered for osteoporosis prophylaxis.
Study site: Outpatient clinics in 2 teaching hospitals in Kuala Lumpur, Malaysia

Matched MeSH terms: Calcium/therapeutic use; Calcium Carbonate/therapeutic use*
Effect of calcium ions on the density of lecithin and its effective molecular volume in lecithin-water dispersions

Yeap PK, Lim KO, Chong CS, Teng TT

Chem Phys Lipids, 2008 Jan;151(1):1-9.
PMID: 17963698

As the packing structure of lipid molecules in the liposomes will vary in the presence of ions, it is expected that the density of lipid and the effective volume of lipid molecules in the dispersions will also vary, albeit minutely. Density measurements of lipid-water dispersions with the addition of Ca(2+) ions were determined accurately. The effect of Ca(2+) ions on the molecular packing structure of the liposomes was elucidated from the results obtained. The results for the density of the lecithin in the dispersions with and without the addition of Ca(2+) ions are, respectively, 1.0782 and 1.0579 g cm(-3) at 25 degrees C; and 1.0048 and 0.9961 g cm(-3) at 50 degrees C. The average values of the effective molecular volume of lecithin in the dispersions with and without the addition of Ca(2+) ions are, respectively, 1.131E-21 and 1.152E-21 cm(3) at 25 degrees C; and 1.213E-21 and 1.224E-21 cm(3) at 50 degrees C.

Matched MeSH terms: Calcium Chloride/pharmacology*

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links