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  1. Bahrom NH, Ramli AS, Isa MR, Baharudin N, Badlishah-Sham SF, Mohamed-Yassin MS, et al.
    Malays Fam Physician, 2020;15(3):22-34.
    PMID: 33329860
    Introduction: The Patient Activation Measure (PAM) is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation levels in self-management. This study aimed to determine the validity and reliability of the PAM-13 Malay version among patients with Metabolic Syndrome (MetS) attending a primary care clinic.
    Methods: This work is a cross-sectional validation study among patients with MetS attending a university primary care clinic in Selangor. The PAM-13 Malay version underwent a validation process and field testing. Psychometric properties were examined using principal component analysis (PCA) with varimax rotation, scree plot, Monte Carlo simulation, internal consistency, and test-retest reliability analyses.
    Results: The content of the PAM-13 Malay version and the original version were conceptually equivalent. The questionnaire was refined after face validation by 10 patients with MetS. The refined version was then field-tested among 130 participants (response rate 89.7%). The Kaiser-Meyer-Olkin test was 0.767, and Bartlett's test of sphericity was ≤0.001, indicating sampling adequacy. Two factors were identified and labeled as (1) Passive and Building Knowledge, and (2) Taking Action and Maintaining Behavior. These labels were chosen as they were conceptually consistent with the items representing the levels of activation in PAM-13. The validated PAM-13 Malay version consisted of 13 items, framed into two domains. The overall Cronbach's α was 0.79, and the intraclass correlation coefficient was 0.45.
    Conclusions: The PAM-13 Malay version is valid, reliable, and fairly stable over time. This questionnaire can be used to evaluate the levels of activation among patients with MetS in primary care in Malaysia.
    Study site: Universiti Teknologi MARA (UiTM) primary care clinic, Sungai Buloh, Selangor, Malaysia
  2. Md Din N, Tomkins-Netzer O, Talat L, Taylor SR, Isa H, Bar A, et al.
    J Glaucoma, 2016 07;25(7):598-604.
    PMID: 26900824 DOI: 10.1097/IJG.0000000000000379
    PURPOSE: To determine risk factors for intraocular pressure (IOP) elevation and glaucoma in children with nonjuvenile idiopathic arthritis-related uveitis and any IOP-related changes in the retinal nerve fiber layer (RNFL) thickness.

    PATIENTS AND METHODS: Clinical data were collected from children attending a tertiary referral uveitis clinic between May 2010 and October 2012. We assigned 206 eyes of 103 children into 32 normal eyes, 108 normotensive uveitics (NU), 41 hypertensive uveitics (HU: raised IOP without glaucomatous disc), and 25 glaucomatous uveitics (GU: raised IOP with glaucomatous disc). Risk factors for raised IOP, glaucoma and steroid response (SR) were evaluated and RNFL thickness across groups was compared with determine changes related to raised IOP.

    RESULTS: IOP elevation occurred in 40 patients (38.8%) or 66/174 eyes with uveitis (37.9%); and SR occurred in 35.1% of all corticosteroid-treated eyes. Chronic uveitis was a significant risk factor for raised IOP [odds ratio (OR)=9.28, P=0.001], glaucoma, and SR (OR=8.4, P<0.001). Higher peak IOP was also a risk factor for glaucoma (OR=1.4, P=0.003). About 70% of SR eyes were high responders (IOP increase >15 mm Hg from baseline), associated with younger age and corticosteroid injections. Although no significant RNFL thinning was detected between HU and NU eyes, significant thinning was detected in the inferior quadrant of GU (121.3±28.9 μm) compared with NU eyes (142.1±32.0 μm, P=0.043).

    CONCLUSIONS: Children with chronic uveitis are at higher risk of raised IOP and glaucoma. Thinning of the inferior RNFL quadrant may suggest glaucomatous changes in uveitic children with raised IOP.

    Study site: Moorfields Eye Hospital, London
  3. Badlishah-Sham SF, Ramli AS, Isa MR, Mohd-Zaki N, Whitford DL
    BMC Fam Pract, 2020 03 11;21(1):50.
    PMID: 32160862 DOI: 10.1186/s12875-020-01121-0
    BACKGROUND: Offspring of type 2 diabetes patients have an absolute risk of 20-40% of developing the condition. Type 2 diabetes patients should be encouraged to speak to their offspring regarding diabetes risk and prevention strategies. The Health Belief Model conceptualises that the higher the perceived risk, the more likely an individual will modify their behaviour. The objectives of this study were to i) determine the distribution of type 2 diabetes patients regarding their willingness to accept training to speak to their offspring, ii) determine the distribution of type 2 diabetes patients regarding their willingness to accept training based on the HBM and iii) to determine the factors associated with their willingness to accept training.

    METHODS: This was a cross-sectional study amongst type 2 diabetes patients attending two primary care clinics in Malaysia. Sociodemographic data and knowledge of diabetes risk factors were collected. The adapted, translated and validated Diabetes Mellitus in the Offspring Questionnaire-Malay version (DMOQ-Malay) was self-administered. Statistical analysis included descriptive statistics, univariate and multiple logistic regression (MLogR).

    RESULTS: A total of 425 participants were recruited. Of these, 61.6% were willing to accept training. In MLogR, six variables were found to be significantly associated with willingness to accept training. These were i) positive family history [Adj. OR 2.06 (95% CI: 1.27, 3.35)], ii) having the correct knowledge that being overweight is a risk factor [Adj. OR 1.49 (95%CI: 1.01, 2.29)], iii) correctly identifying age ≥ 40 years old as a risk factor [Adj. OR 1.88 (95%CI: 1.22, 2.90)], iv) agreeing that speaking to their offspring would help them to prevent type 2 diabetes [Adj. OR 4.34 (95%: 1.07, 17.73)], v) being neutral with the statement 'I do not have much contact with my offspring' [Adj. OR: 0.31 (95% CI: 0.12, 0.810] and vi) being neutral with the statement 'my offspring are not open to advice from me' [Adj. OR: 0.63 (95% CI: 0.31, 0.84].

    CONCLUSION: The majority of type 2 diabetes patients were willing to accept training to speak to their offspring to prevent diabetes. A training module should be designed to enhance their knowledge, attitude and skills to become family health educators.
  4. Ma'pol A, Hashim JH, Norbäck D, Weislander G, Hashim Z, Isa ZM
    J Asthma, 2020 08;57(8):842-849.
    PMID: 31155989 DOI: 10.1080/02770903.2019.1614614
    Background: Almost one third of the world population suffers from allergic conditions. Respiratory symptoms are common in Malaysian children but there are few studies on fractional exhaled nitric oxide (FeNO), inclusive of field clinical test for asthma among children in Malaysia. The aim was to provide insight on factors related to level of FeNO among students in Terengganu, Malaysia.Methods: In total, 487 randomly selected students from eight secondary schools participated (13-14 years old). A Standardized questionnaire was used to obtained information on doctors' diagnosed asthma, current asthma and respiratory symptoms. FeNO measurement and skin prick test (SPT to common allergen) were conducted.Results: The geometric mean FeNO was 16.7 ppb. Totally, 38.4% of students had elevated FeNO level (>20 ppb) and 40.3% had had positive SPT to house dust mites allergens (HDM), Dermatophagoides pteronyssinus (Der p 1), Dermatophagoides farinae (Der f 1) or Felis domisticus (cat). Male gender, height, parental history of allergy, self-reported allergy, and atopy were associated with FeNO. In particular, a combination of sensitization to HDM or cat and elevated FeNO were associated with doctor-diagnosed asthma and self-reported allergy to food, pollen and cat.Conclusion: Asthma, respiratory symptoms and sensitization to HDM and cat are common among students and presence of elevated FeNO levels indicate ongoing airway inflammation.
  5. Venkatachalam K, Vinayagam R, Arokia Vijaya Anand M, Isa NM, Ponnaiyan R
    Toxicol Res (Camb), 2020 Feb;9(1):2-18.
    PMID: 32440334 DOI: 10.1093/toxres/tfaa004
    1,2-dimethylhydrazine (DMH) is a member in the class of hydrazines, strong DNA alkylating agent, naturally present in cycads. DMH is widely used as a carcinogen to induce colon cancer in animal models. Exploration of DMH-induced colon carcinogenesis in rodent models provides the knowledge to perceive the biochemical, molecular, and histological mechanisms of different stages of colon carcinogenesis. The procarcinogen DMH, after a series of metabolic reactions, finally reaches the colon, there produces the ultimate carcinogen and reactive oxygen species (ROS), which further alkylate the DNA and initiate the development of colon carcinogenesis. The preneolpastic lesions and histopathological observations of DMH-induced colon tumors may provide typical understanding about the disease in rodents and humans. In addition, this review discusses about the action of biotransformation and antioxidant enzymes involved in DMH intoxication. This understanding is essential to accurately identify and interpret alterations that occur in the colonic mucosa when evaluating natural or pharmacological compounds in DMH-induced animal colon carcinogenesis.
  6. Anne LJ, Rahim MJC, Ghazali WSW, Ahmed WAW, Isa SAM
    BMC Rheumatol, 2021 Apr 12;5(1):10.
    PMID: 33840385 DOI: 10.1186/s41927-021-00182-7
    BACKGROUND: Psoriatic arthritis (PsA) can manifest in various forms. This includes mimicry of other diseases. We describe an unusual mimicry of PsA.

    CASE PRESENTATION: We report a case of a middle-aged lady who presented with severe pain and morning stiffness over the small joints of the left hand for 3 months and painless deformity of the affected joints 1 year before. She was under treatment for pruritic rash over her ankles and knees for the past 1 year as well. Physical examination revealed a fixed flexion deformity, swelling and tenderness of the left ring and little fingers' distal interphalangeal (DIP) joints. Left hand radiograph showed sclerotic joint margin, narrowed joint space and marginal osteophytes of the affected DIP joints. Dermoscopic examination showed red- violaceous, flat-topped papules and plaques with minimal scales on both ankles; hyperpigmented scaly plaques over both knees and vertical fingernail ridges. Serum autoimmune screening and inflammatory markers were unremarkable. Left ankle skin biopsy showed features consistent of psoriasis. PsA was diagnosed. Weekly titrated oral methotrexate and topical steroid were started. The patient showed significant improvement after 1 month of treatment.

    CONCLUSION: PsA is a great mimicker. Dermoscopy is an accessible and valuable tool to assess skin lesions in greater detail. Clinicians should be aware of coexisting diseases or misdiagnosis when patients do not respond to treatment.

  7. Tamrin NAM, Zainudin R, Esa Y, Alias H, Isa MNM, Croft L, et al.
    Animals (Basel), 2020 Dec 10;10(12).
    PMID: 33321745 DOI: 10.3390/ani10122359
    Taste perception is an essential function that provides valuable dietary and sensory information, which is crucial for the survival of animals. Studies into the evolution of the sweet taste receptor gene (TAS1R2) are scarce, especially for Bornean endemic primates such as Nasalis larvatus (proboscis monkey), Pongo pygmaeus (Bornean orangutan), and Hylobates muelleri (Muller's Bornean gibbon). Primates are the perfect taxa to study as they are diverse dietary feeders, comprising specialist folivores, frugivores, gummivores, herbivores, and omnivores. We constructed phylogenetic trees of the TAS1R2 gene for 20 species of anthropoid primates using four different methods (neighbor-joining, maximum parsimony, maximum-likelihood, and Bayesian) and also established the time divergence of the phylogeny. The phylogeny successfully separated the primates into their taxonomic groups as well as by their dietary preferences. Of note, the reviewed time of divergence estimation for the primate speciation pattern in this study was more recent than the previously published estimates. It is believed that this difference may be due to environmental changes, such as food scarcity and climate change, during the late Miocene epoch, which forced primates to change their dietary preferences. These findings provide a starting point for further investigation.
  8. Rais NNM, Bradley DA, Hashim A, Isa NM, Osman ND, Ismail I, et al.
    J Radiol Prot, 2019 Sep;39(3):N8-N18.
    PMID: 31018196 DOI: 10.1088/1361-6498/ab1c16
    Novel germanium (Ge)-doped silica glass fibres tailor-made in Malaysia are fast gaining recognition as potential media for thermoluminescence (TL) dosimetry, with active research ongoing into exploitation of their various beneficial characteristics. Investigation is made herein of the capability of these media for use in diagnostic imaging dosimetry, specifically at the radiation dose levels typically obtained in conduct of Computed Tomography (CT). As a first step within such efforts, there is need to investigate the performance of the fibres using tightly defined spectra, use being made of a Philips constant potential industrial x-ray facility, Model MG165, located at the Malaysian Nuclear Agency Secondary Standards Dosimetry Lab (SSDL). Standard radiation beam qualities (termed RQT) have been established for CT, in accord with IEC 61267: 2003 and IAEA Technical Reports Series No. 457: 2007. A calibrated ionisation chamber has also been utilised, forming a component part of the SSDL equipment. The fabricated fibres used in this study are 2.3 mol% flat fibre (FF) of dimensions 643 × 356 μm2 and 2.3 mol% cylindrical fibre (CF) of 481 μm diameter, while the commercial fibre used is 4 mol% with core diameter of 50 μm. The dopant concentrations are nominal preform values. The fibres have been irradiated to doses of 20, 30 and 40 milligray (mGy) for each of the beam qualities RQT 8, RQT 9 and RQT 10. For x-rays generated at constant potential values from 100 to 150 kV, a discernible energy-dependent response is seen, comparisons being made with that of lithium fluoride (LiF) thermoluminescence dosimeters (TLD-100). TL yield versus dose has also been investigated for x-ray doses from 2 to 40 mGy, all exhibiting linearity. Compared to TLD-100, greater sensitivity is observed for the fibres.
  9. Mohd Isa SA, Md Salleh MS, Ismail MP, Hairon SM
    Asian Pac J Cancer Prev, 2019 Apr 29;20(4):1081-1087.
    PMID: 31030477
    Background: Cervical cancer is a preventable disease caused by human papillomaviruses. It is the third most
    common cancer to occur in women of reproductive age. The ADAM9 protein plays a role in basement membrane
    degradation and tumour metastasis in certain types of tumour. Thus, it has the potential to become a new targeted
    therapy. The objective of this study was to investigate ADAM9 expression in cervical cancer and to determine the
    factors associated with ADAM9-positive expression. Methods: This cross-sectional study was conducted in Hospital
    Universiti Sains Malaysia (HUSM) Kelantan, Malaysia from December 2010 to December 2012. Histological slides
    obtained from 95 cervical cancer cases diagnosed and/or treated in HUSM from 2000 to 2010 were analysed. The
    ADAM9 immunostain was then performed on the paraffin blocks. The statistical data entry and analysis were done
    using SPSS version 18.0. Multiple logistic regression analysis was performed to determine the factors associated with
    ADAM9-positive expression. Result: Of the 95 cervical cancer patients included in the study, 72 (75.8%) patients showed
    positive ADAM9 expression. The mean age of the patients was 53.89 (10.83) years old. Squamous cell carcinoma was
    the most common type of cervical cancer (n = 67, 70.5%). Factors that showed a statistically significant association
    with ADAM9-positive expression were tumour size (adjusted odds ratio [adj. OR]: 1.08; 95% confidence interval
    [CI]: 1.02, 1.13; p = 0.004), distant metastasis (adj. OR: 12.82; 95% CI: 1.91, 86.13; p = 0.009) and the histological
    type of cervical cancer (i.e. squamous cell carcinoma) (adj. OR: 7.39; 95% CI: 1.42, 38.51; p = 0.017). Conclusion:
    The ADAM9 immunostain was consistently positive in malignant cells. Thus, ADAM9 expression can be used as a
    prognostic/therapeutic indicator in aiding clinician decision-making regarding patient treatment (targeted therapy).
  10. Othman N, Ismail IH, Yip R, Zainuddin Z, Kasim SM, Isa R, et al.
    Pediatr Infect Dis J, 2007 Oct;26(10):960-1.
    PMID: 17901807 DOI: 10.1097/INF.0b013e3181257234
    Two tsunami survivors from Banda Acheh, Sumatra, presented with pyrexia of unknown origin and a nonresolving left-sided empyema, respectively. Both children had mixed infections of tuberculosis and melioidosis; Salmonella typhi was also present in the second patient. Mixed infections are common late sequela complications in post-tsunami victims.
  11. Abdul Mutalib NE, Mat Isa N, Alitheen NB, Song AA, Rahim RA
    Plasmid, 2014 May;73:26-33.
    PMID: 24780699 DOI: 10.1016/j.plasmid.2014.04.003
    Plasmid DNAs isolated from lactic acid bacteria (LAB) such as Lactococcus lactis (L. lactis) has been gaining more interests for its positive prospects in genetic engineering-related applications. In this study, the lactococcal plasmid, pNZ8048 was modified so as to be able to express multiple genes in the eukaryotic system. Therefore, a cassette containing an internal ribosome entry site (IRES) was cloned between VP2 gene of a very virulent infectious bursal disease (vvIBDV) UPM 04190 of Malaysian local isolates and the reporter gene, green fluorescent protein (GFP) into pNZ:CA, a newly constructed derivative of pNZ8048 harboring the cytomegalovirus promoter (Pcmv) and polyadenylation signal. The new bicistronic vector, denoted as pNZ:vig was subjected to in vitro transcription/translation system followed by SDS-PAGE and Western blot analysis to rapidly verify its functionality. Immunoblotting profiles showed the presence of 49 and 29kDa bands that corresponds to the sizes of the VP2 and GFP proteins respectively. This preliminary result shows that the newly constructed lactococcal bicistronic vector can co-express multiple genes in a eukaryotic system via the IRES element thus suggesting its feasibility to be used for transfection of in vitro cell cultures and vaccine delivery.
  12. Isa NM, James DT, Saw TH, Pennisi R, Gough I
    Diagn Cytopathol, 2009 Jun;37(6):427-32.
    PMID: 19306411 DOI: 10.1002/dc.21065
    Angiosarcoma of the thyroid is a rare and aggressive primary malignant tumor of the thyroid originally reported in patients from the Swiss Alpine region. Diagnosis of this tumor rests mainly on characteristic histopathological features of a malignant vascular tumor supported by immunopositivity for vascular markers e.g., CD31, Factor VIII, and CD34. Its cytological features, however, are not well-defined. We describe a case of primary angiosarcoma of the thyroid in a 48-year-old female, who presented with a rapidly enlarging neck mass associated with compressive symptoms. She had a history of hypothyroidism. The initial fine needle aspiration cytology of the neck mass was negative. She then underwent left hemithyroidectomy. Histologically, the tumor showed poorly differentiated malignant cells with eccentrically-placed nuclei, prominent nucleoli, and intracytoplasmic vacuoles admixed with mixed inflammatory cells. These showed immunopositivity for CD31 but were negative for CD34, Factor VIII, CK5/6, EMA, TTF-1, Thyroglobulin, Calcitonin, Melan A, and Calretinin. A diagnosis of poorly differentiated malignant tumor consistent with angiosarcoma was made. The patient was treated with radiation therapy but developed recurrence of the tumor. Second aspiration cytology of the recurrent tumor yielded hypocellular smears containing singularly dispersed atypical cells having eccentrically-placed nuclei with prominent macronucleoli and intracytoplasmic vacuoles within a background of inflammatory cells, consistent with recurrent angiosarcoma. Chemotherapy was started but she succumbed to the disease 7 months after diagnosis. The cytological, histopathological, immunohistochemical findings, and the clinical course are discussed.
  13. Mohamad-Isa MZ, Mohamed-Yassin MS, Badlishah-Sham SF, Baharudin N, Ramli AS
    PMID: 33916335 DOI: 10.3390/ijerph18073778
    Communication is one of the fundamental skills in the medical profession. The Communication Skills Attitude Scale (CSAS) is a widely used questionnaire to measure the attitudes of medical students toward learning communication skills. It has been adapted and translated into many languages. The objective of this study was to adapt and translate the CSAS into the Malay language and determine its psychometric properties in medical students. This is a cross-sectional study involving 218 first-year Universiti Teknologi MARA students. Content validation, cross-cultural adaptation, translation, and face validation of the 26-item CSAS were performed according to established guidelines. Principal component analysis with direct oblimin rotation was used to determine the underlying structure of the CSAS-Malay. The reliability was assessed using Cronbach's α coefficient for internal consistency and using the intraclass correlation coefficient for the test-retest reliability. Although the contents of the CSAS-Malay and the original version were conceptually equivalent, item 11 was removed during the content validation stage due to a low item content validity index (I-CVI < 1.00). Two subscales were derived from the remaining 25 items, which were the Positive Attitude Scale and the Negative Attitude Scale. Items 1 and 15 were removed due to poor factor loadings. The total variance explained by the final two-factor solution with three items removed was 30.8%. Cronbach's α coefficients for both the Positive and Negative Attitude Scales in the final questionnaire were 0.815 and 0.614, respectively. It also showed a good reproducibility with intraclass correlation coefficient (ICC) values of 0.725-0.950 for all the items. This study provided preliminary information about the psychometric properties of the CSAS-Malay. The final 23-item questionnaire had a good construct validity, an acceptable internal consistency, and at least a moderate test-retest reproducibility. It can be used to assess the attitudes of medical students toward learning communication skills. Future research to improve the generalizability of the questionnaire should include medical students from other universities with diverse backgrounds.
  14. Isa RM, Saidi S, Salam A, Nurumal MS, Jamaludin TSS
    Enferm Clin, 2021 04;31 Suppl 2:S321-S325.
    PMID: 33849190 DOI: 10.1016/j.enfcli.2020.12.037
    This study aimed to survey the factors influencing attendance to eye screening among Diabetes mellitus (DM) patients. This cross-sectional survey was carried out among 170 DM patients using self-administered questionnaires. Majority of participants, 45.9% (n=78) highlighted that lack of information regarding diabetes and not understanding the significance of eye screening are the barriers to eye screening. Whereas, 10.6% (n=18) reported lack of access to healthcare facilities, 6.5% (n=11) experienced time limitation and 2.9% (n=5) suffered financial issues. However, more than half of the participants (58.2%) have good knowledge related to diabetic eye complications. There was a significant difference between educational level with patients' attendance in yearly eye screening. Lack of information received by the patients on the importance of eye screening and communication issues seems to be prominent and becomes the reason for patients not attending eye screening.
  15. Nordin N, Hairon SM, Yaacob NM, Hamid AA, Isa SAM, Hassan N
    BMC Public Health, 2021 02 02;21(1):268.
    PMID: 33568119 DOI: 10.1186/s12889-021-10320-y
    BACKGROUND: People with type 2 diabetes mellitus (T2DM) are best managed by a chronic care model that is associated with enhanced quality of care and improved patient outcome. Assessing patients' perceived quality of care is crucial in improving the healthcare delivery system. Hence, this study determined the perceived quality of care among people with T2DM and explored its associations with (i) sociodemographic and clinical characteristics and (ii) types of healthcare clinics to guide future planning.

    METHODS: A cross-sectional study involving 20 primary healthcare clinics in the North East Region of Peninsular Malaysia and people with T2DM as the sampling unit was conducted from February to May 2019. The pro forma checklist, interview-guided Skala Kepuasan Interaksi Perubatan-11, and Patient Assessment of Chronic Illness Care (Malay version; PACIC-M) questionnaire were used for data collection. Univariate analysis and linear regression were used to determine the status of perceived quality of care and the factors associated with the perceived quality of care, respectively.

    RESULTS: Overall, data from 772 participants were analyzed. The majority was from the Malay ethnic group (95.6%) with a mean (standard deviation [SD]) glycated hemoglobin A1c (HbA1c) level of 8.91% (2.30). The median (interquartile range [IQR]) of the number of medical officers available at each clinic was 6 (7), with Family Doctor Concept (FDC) clinics having a higher number of medical officers than non-FDC clinics (p = 0.001). The overall mean (SD) PACIC-M score was 2.65 (0.54) with no significant difference between scores of patients treated in the two clinic types (p = 0.806). Higher perceived quality of care was associated with lower number of medical officers (adjusted regression coefficient [Adj.β], - 0.021; p-value [p], 0.001), and greater doctor-patient interaction in all domains: distress relief (Adj.β, 0.033; p,

  16. Isa ZM, Ibrahim N, Ismail NH, Jaafar MH, Tamil AM, Yusof KH
    J Pak Med Assoc, 2021 Feb;71(Suppl 2)(2):S68-S73.
    PMID: 33785945
    OBJECTIVE: To identify the prevalence of hypertension and its relationship with dietary sodium intake among the Malay population in Selangor, Malaysia.

    Methods: Respondents were recruited from the year 2013 to 2015 from households in Klang Valley (urban area) and several settlements of the Federal Land Development Authority (FELDA) in Selangor (rural area). Data were collected using two questionnaires, a sociodemographic questionnaire and a food frequency questionnaire.

    RESULTS: A total of 3,453 adults participated in this study. The mean age of the respondents was 50.9 (±10.23) years. The prevalence of hypertension was 23.3%. Mean dietary sodium consumption was 3.6 (±6.63) grams/day, 1.6 grams higher than the current WHO recommendation. The prevalence of hypertension was higher among males aged 60 years and older; among rural population with low education level; among housewives and those with high dietary sodium intake. After adjusting for age, gender and marital status in a multiple logistic regression analysis, rural location (OR = 5.81) and high sodium intake (OR = 2.33) have been shown to affect the incidence of hypertension.

    CONCLUSIONS: A substantial proportion of Malay population in Selangor was hypertensive with a higher sodium intake than the WHO recommendation. Hypertension was associated with rural location and high sodium intake. Sustainable and cost-effective population-based health promotion and prevention interventions using a multi-sectoral approach are needed to ensure sufficient community sodium intake.

  17. Isa MH, Ezechi EH, Ahmed Z, Magram SF, Kutty SR
    Water Res, 2014 Mar 15;51:113-23.
    PMID: 24412846 DOI: 10.1016/j.watres.2013.12.024
    This work investigated the removal of boron from wastewater and its recovery by electrocoagulation and hydrothermal mineralization methods respectively. The experimental design was developed using Box-Behnken Model. An initial study was performed based on four preselected variables (pH, current density, concentration and time) using synthetic wastewater. Response surface methodology (RSM) was used to evaluate the effect of process variables and their interaction on boron removal. The optimum conditions were obtained as pH 6.3, current density 17.4 mA/cm(2), and time 89 min. At these applied optimum conditions, 99.7% boron removal from an initial concentration of 10.4 mg/L was achieved. The process was effectively optimized by RSM with a desirability value of 1.0. The results showed that boron removal efficiency enhanced with increase in current density and treatment time. Removal efficiency also increased when pH was increased from 4 to 7 and subsequently decreased at pH 10. Adsorption kinetics study revealed that the reaction followed pseudo second order kinetic model; evidenced by high correlation and goodness of fit. Thermodynamics study showed that mechanism of boron adsorption was chemisorption and the reaction was endothermic in nature. Furthermore, the adsorption process was spontaneous as indicated by negative values of the adsorption free energy. Treatment of real produced water using electrocoagulation resulted in 98% boron removal. The hydrothermal mineralization study showed that borate minerals (Inyoite, Takadaite and Nifontovite) can be recovered as recyclable precipitate from electrocoagulation flocs of produced water.
  18. Isa HM, Kamal AH, Idris MH, Rosli Z, Ismail J
    Trop Life Sci Res, 2017 Jan;28(1):1-21.
    PMID: 28228913 MyJurnal DOI: 10.21315/tlsr2017.28.1.1
    Mangroves support diverse macroalgal assemblages as epibionts on their roots and tree trunks. These algae provide nutrients to the primary consumers in the aquatic food web and have been reported to be substantial contributors to marine ecosystems. The species diversity, biomass, and habitat characteristics of mangrove macroalgae were investigated at three stations in the Sibuti mangrove estuary, Sarawak, Malaysia, from November 2012 to October 2013. Three groups of macroalgae were recorded and were found to be growing on mangrove prop roots, namely Rhodophyta (Caloglossa ogasawaraensis, Caloglossa adhaerens, Caloglossa stipitata, Bostrychia anomala, and Hypnea sp.), Chlorophyta (Chaetomorpha minima and Chaetomorpha sp.), and Phaeophyta (Dictyota sp.). The biomass of macroalgae was not influenced (p>0.05) by the season in this mangrove forest habitat. The macroalgal species Hypnea sp. contributed the highest biomass at both Station 1 (210.56 mg/cm(2)) and Station 2 (141.72 mg/cm(2)), while the highest biomass was contributed by B. anomala (185.89 mg/cm(2)) at Station 3. This study shows that the species distribution and assemblages of mangrove macroalgae were influenced by environmental parameters such as water nutrients, dissolved solids, and salinity in the estuarine mangrove habitats of Sibuti, Sarawak.
  19. Mawardi M, Isa IM, Ulianas A, Sintiara E, Mawardi F, Zalmi Putra R
    Materials (Basel), 2021 Jun 29;14(13).
    PMID: 34209933 DOI: 10.3390/ma14133638
    The objective of this study is to investigate Napa soil's potential as an alternative additive in producing Portland composite cement. The Napa soil of Tanah Datar district, West Sumatra, Indonesia is a natural material which contains SiO2 and Al2O3 as its major components. The parameters used were the fineness of the cement particles, the amount left on a 45 μm sieve, the setting time, normal consistency, loss on ignition, insoluble parts, compressive strength and chemical composition. The composition of Napa soils (% w/w) used as variables include 4, 8, 12 and 16%. Furthermore, 8% pozzolan was used as a control in this research. The results showed that the compressive strength of Napa soil cement which contained 4% Napa soil was much better compared to that of the control on the 7th and 20th day. Furthermore, all the analyzed Napa soil cements met the standard of cement as stipulated in Indonesian National Standard, SNI 7064, 2016.
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