Displaying publications 41 - 60 of 1139 in total

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  1. Yihui Goh, Pooi Wah Lott, Sujaya Singh
    MyJurnal
    A 42-year-old gentleman presented with left eye pain after accidental contact with Euphorbia lactea sap while gar- dening. At presentation, left eye best-corrected visual acuity (BCVA) was 20/30. Ocular examination revealed left eye conjunctiva congestion and cornea abrasion. Eye symptoms and BCVA deteriorated over 12 hours. Cornea showed diffuse stromal oedema with presence of anterior uveitis. A diagnosis of toxic keratouveitis was made. He was treat- ed with intensive topical steroids, cycloplegics, lubricants, prophylactic antibiotics and oral non-steroidal anti-in- flammatory analgesic. Patient achieved complete resolution two weeks later. We aim to raise awareness among the ophthalmologists to detect and manage these injuries.
  2. Yi Ni Koh, Embong Zunaina, Ahmad Tajudin Liza-Sharmini, Che Badariah Abd-Aziz, Che Hussin Che-Maraina, Mei Fong Chong, et al.
    MyJurnal

    Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glu- tathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and gluta- thione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P
  3. Yesi Maifita, Zuriati Zuriati, Rena Oktafiyanti Safnellyza, Urmisha Das, Sandeep Poddar
    MyJurnal
    Introduction: Worldwide fractures among individuals are a major public health problem. As a result, fracture are the most common cause of severe enduring pain and physical disability, and they affect innumerable globally. It has been studied that nutrients that contain high protein helps in the fracture healing process. Eels contains many nutrients, such as phosphate, calcium, protein, collagen and amino acids that can help bone growth. The aim of this study was to examine the effect of eel flour (Monopterus albus) at multilevel dose content to accelerate the healing process of fracture in male Rattus novergicus Wistar Albino rat. Methods: This study design include experimental study with post-test only on controls group. The wok was conducted from May-June 2019 in the Laboratory of Anat- omy of Stikes Piala Sakti Pariaman. The sampling was purposive sampling technique with a sample size of 24 rats. Results: The results of the ANOVA test have proved that administration of eel flour accelerates the healing process of the fracture showing 0.000, followed by Post Hoc LSD to determine the test of significant differences between groups. Conclusion: It was observed that with the increase in the dose of flour given to Wistar Albino rat fracture healing process became faster. From the present study it was evident that consumption of eel flour can accelerate the process of fracture healing. But there is need for further testing on humans as an effort to test the safety of the dose.
  4. Yee Lin Lee, Hasyma Abu Hassan, Intan Hakimah Ismail
    MyJurnal
    Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition which is important for clinicians to recognize as it has a high mortality rate and can result in significant neurological morbidities. It presents as acute encephalopathy with radiological findings of symmetrical brain lesions in bilateral thalami, putamen, brain stem teg- mentum, internal capsule, periventricular white matter and cerebellar medulla. Intravenous methylprednisolone is the mainstay of treatment. Immunoglobulin therapy and therapeutic hypothermia may be used as adjunctive therapy in cases with severe clinical and neuroradiological presentation. We present a case of severe ANEC and discuss the clinical manifestations, neuroimaging and management options.
  5. Yanti Cahyati, Ida Rosdiana, Asita Elengoe, Sandeep Poddar
    MyJurnal
    Introduction: Diabetes characterized by hyperglycemia can cause long term damages and malfunction of different organ and systems, especially the eye, kidney, nerve and cardiovascular systems. The main problem in Diabetes Mellitus patients is a difficulty in regulating blood glucose levels. Various attempts were made to reduce blood sugar levels so that patients can be free from insulin. Exercise and diet are the primary therapies in DM patients, but apart from that, relaxation techniques can help patients reduce stress and anxiety levels, which will ultimately have a good effect on lowering glucose levels in the blood. Benson relaxation techniques modified with aromatherapy are expected to provide a relaxing effect so that this condition can have a better impact on reducing blood glucose. The present study aims to look at the effect of Benson relaxation exercises and aromatherapy on blood glucose levels. Methods: The researchers intervened in two groups of respondents. The intervention group conducted Benson relax- ation exercises and aromatherapy while the control group only conducted Benson relaxation. Results: Differences in the average blood glucose levels before and after exercise in the intervention group and in the control group has been observed. Relaxation conditions will provide a good impact for DM patients because at the time of relaxation stress hormones that trigger an increase in blood glucose levels, will not be released by the body. Conclusion: Present study shows that Benson relaxation exercise and aromatherapy is effective for lowering glucose levels.
  6. Yahaya Mohammed Katagum, Hayati Kadir @ Shahar, Faisal Ibrahim
    MyJurnal
    Poor diagnosis, treatment and prevention practices had characterised Patent Medicine Vendor (PMV) activities in malaria control despite expectations on their contributions to check the menace. Interventions reversing this situation reduces disease burden and legitimise PMV inclusion in basic healthcare delivery. This study seeks to identify and review studies addressing this priority problem. Steps outlined in PRISMA guidelines were adopted to search and conduct reviews via electronic databases. Randomized trials with intervention effects on PMVs were considered and thirteen articles were ultimately reviewed and narratively evaluated. Analysis of search outputs identified intervention types, methods used, sample sizes, intervention periods, knowledge, attitude and practice variables, other outcomes and listing of priority systematic review topics, using pre-determined criteria. All reviewed studies were found to be effective despite adopting different intervention approaches. Furthermore, identifying and prioritizing reviews greatly improves future malaria interventions and results thereof, thereby maximising opportunities to deliver appropriate and evidence-based healthcare.
  7. Xue Meng Lim, Christopher Thiam Seong Lim
    MyJurnal
    Diabetic ketoacidosis (DKA) is a medical emergency which requires prompt management to prevent mortality. Treat- ment is complicated in end stage renal failure (ESRF) patients due to their altered physiology in sugar metabolism and fluid haemodynamics. To date, there are only a few case reports illustrating the presentation and management of DKA in ESRF patients and a definite guideline on treatment of DKA in ESRF is seriously lacking. We report here a case of an ESRF patient on maintenance haemodialysis, who develops DKA due to missed insulin, and outline our successful treatment plan. We hope our reported case report research can further contribute to the knowledge of DKA management in ESRF.
  8. Xin Ying Chong, Syafiiqa Parlan, Tiu Ling Yii, Dayang Nurafiqah Awang Lokman, Clementine Jrillus, Nur Syamira Zainal Abidin, et al.
    MyJurnal
    Introduction: An economical and alternative diabetic wound care product is needed to address the escalating cost of diabetic wound ulcer treatment in Indonesia. Morindac itrifolia or commonly called noni, is a medicinal plant, dietary supplement, and traditional wound care product. This leaves extract contains antioxidant, anti-inflammatory, immune-stimulant, and antimicrobial properties. Trigona honey which is currently used to treat the diabetic wound at Kitamura Wound Specialist Clinic, Pontianak, Indonesia is known for its anti-inflammatory, anti-microbial and anti-proliferative properties. This study aims to compare the effectiveness of Morinda citrifolia leaves extract and Trigona honey in diabetic wound healing. Methods: A quasi-experimental study (a randomized control trial design) was conductedin the clinicon two subjects with diabetic foot ulcers (DFU). Trigona honey and Morinda citrifolia leaves extract packing was done to the ulcer of controlled subject and treatment subject respectively as a primary dressing. DFU assessment was done every 2 days using the MUNGS assessment tool and a wound closure rate for- mula. Wound C&S was analysed using a bacterial count machine. Results: Morinda citrifolia leaves extract was able to promote wound contraction, improved MUNGS score (from 9 to 8), reduced bacteria count significantly (from
    8.51 x 105 to 1.00 x 105), reduced the percentage of slough by 70% and increased granulating tissue by 60% after the first application. Whereas, Trigona honey extract showed no wound contraction but improved MUNGS score (from 11 to 7). However, bacteria count was maintained at the lowest level (1.00 x 105), reduce the percentage of slough by 10%, and only increased granulating tissues by 10% after the first application. Conclusion: Both products were able to promote diabetic wound healing but the Morinda citrifolia leaves extract was found to be more effective, thus concludes the potential use of Morinda citrifolia leaves extract in treating DFU.
  9. Wynn AA, Myint O, Mya NK, Aung TS, Myint T
    MyJurnal
    Abstracts For The 1st International Borneo Healthcare And Public Health Conference And 4th Borneo Tropical Medicine And Infectious Disease Congress. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
    Introduction: Laboratory screening tests are common elements of health care. Comprehensive care of patients is dependent on the results of laboratory investigations. Dissemination of knowledge and improving attitude of com-munity for utilization of laboratory services are utmost important in community health care. This study aimed to assess the knowledge and utilization of the laboratory services among the employees of University Malaysia Sabah, determine their expectations of employees on the medical laboratory services.
    Methods: A total of 200 UMS staff participated. The data were collected using a cross-sectional self-administered questionnaires and descriptive data analysis was done.
    Results: 5% of the participants in this study agreed to have the health check and blood screening tests every year. Less than 10% of respondents agreed to do more frequent blood tests check if they are at high risk such as family history of cancer, hypertension and diabetes 181 out of 200 respondents do not agree that doing laboratory tests can help for early diagnosis of some diseases. The most used laboratory tests were plasma sugar (70.8%), blood grouping (60.4%), urine examination (50%) and serum lipid (46%).
    Conclusion: Based on the results, recommendations were made to improve the knowledge, attitude and utilization of the laboratory services and set up laboratory services easily accessible by the university community. This will lead to positive health benefits in people and improve associated health outcomes.
  10. Woon Fui Chee, Yu Min Si, Chin Yit Siew
    MyJurnal
    Introduction: This cross-sectional study determines factors associated with the rates of gestational weight gain (GWG) among women in the second and third trimester of pregnancy. Methods: A total of 180 pregnant women (29.2 ± 4.3 years old) attending the maternal and child health clinics in Batu Pahat district were enrolled in the present study be- tween January and February, 2015. Information regarding demographic characteristics, obstetrical history, physical activity, and calorie intake was assessed through direct interview. Anthropometric data were collected from medical records. GWG rates were determined based on 2009 IOM recommendations. Results: Of the 180 pregnant women, 37.2% were at their second trimester and 62.8% were at the third trimester of pregnancy. While 53.3% of them had excessive GWG rate, 28.9% have inadequate GWG rate. More than half of the women (56.7%) were normal weight, 21.1% overweight, 14.4% underweight, and 7.8% obese before pregnant. The total mean activity and energy intake of the pregnant women were 195.9±94.2 MET-hour/week and 2365±709 kcal/day, respectively. The multinomial logistic model indicates that women who were overweight or obese at pre-pregnancy were seven times more likely to have excessive GWG rate (OR = 7.44, 95% CI = 2.07-26.66) as compared to women who were pre-pregnancy normal weight. Conclusions: About four in every five of the pregnant women had their GWG rates outside the IOM recommendations. Women who were overweight/obese at pre-pregnancy were at-risk of having excessive GWG rate, which underlines the importance of targeting these women for pre-conception counselling on GWG.
  11. Wong, Y. H., Kasbollah, A., Md. Shah M. N., Abdullah, B. J. J., Yeong, Chai Hong
    MyJurnal
    Introduction: Constipation is affecting a quarter of human population at any one time in all age groups. However, a proper gamma scintigraphic study of whole GI transit is rarely performed in Malaysia due to the lack of suitable radiopharmaceutical. Hence, this study was taken to develop a suitable radiotracer formulation for gamma scintigraphy study of whole gastric-intestinal transit. Methods: The biocompatible polystyrene (PS) incorporated with 152Sm2O3 (5%, w/v) will be used to synthesize the radiotracer. The 152Sm-labelled PS particles was neutron activated to 153Sm in a nuclear reactor for 5 minutes. Characterization of the physicochemical properties, gamma spectrometry and in-vitro radiolabeling studies in simulated gastric fluid (SGF) and simulated intestinal fluid (SIF) were carried out to study the properties and stability of the radiotracer before and after neutron activation. Results: Scanning electron microscope (SEM) and particle size analysis showed that size, shape and surface morphology of the particles remained after neutron activation. The synthesized 153Sm-labelled PS radiotracer (100 mg) particles achieved an activity of 3.7 MBq after 46 hrs. As indicated by the gamma spectrometry result, there is no long half-life radioimpuirties present in the samples. The 153Sm-labelled PS particles achieved radiolabeling efficiency of more than 95% in both SGF and SIF over 72 hrs. Conclusions: A 153Sm-labelled radiotracer particles formulation has been successfully developed from biocompatible PS. The proposed formulation has the advantage of cheaper, easier to be produced and reduced radiation exposure to staff. Further studies are required to validate the in-vivo performance of 153Sm-labelled formulation for assessing GI motility and transit in clinical use.
  12. Wong, W. H., Lim, T. A., Lim, K. Y.
    MyJurnal
    Introduction: Giving two intravenous anaesthetic agents simultaneously generally results in an additive effect. The aim of this study was to investigate the interaction between propofol and thiopental when given to patients who have had sedative premedication. Methods: Fifty patients were admitted into the study. All patients received oral midazolam 3.75 mg and intravenous fentanyl 100 mg before induction of anaesthesia. Twenty patients received an infusion of either propofol or thiopental while 30 patients received an infusion of an admixture of both drugs. Isobolographic analysis was used to determine the interaction between the two drugs. Results: The interaction between propofol and thiopental was
    additive. The average dose at loss of the eyelash reflex for propofol and thiopental was 0.71 mg kg-1 and 1.54 mg kg-1 respectively. Premedication decreased the induction dose by 38.2%. Conclusion: Propofol and thiopental interact in an additive fashion when given at induction of anaesthesia.
  13. Wong, Jyh Eiin, Ahmad Munir Che Muhamed, Poh, Bee Koon
    MyJurnal
    Introduction: Accurate yet inexpensive methods for measuring free-living energy expenditure (EE) are
    much needed. The aim of this study was to determine the feasibility of heart-rate monitoring method
    (HRM) in measuring EE as compared to the established activity diary (AD) method. Methodology:
    Minute-by-minute HRM and an activity diary (AD) were used simultaneously in 34 young adults (18
    females, 16 males; mean age 21.5 ± 1.5 years). Estimates of the EE from HRM were based on individual
    calibration using the Flex-HR procedure while EE from AD were calculated using both individually
    measured and published energy cost of various activities. Total daily energy expenditure (TDEE) and its
    components (EE during sleep, during rest and during physical activity) were compared using Student
    paired-t tests. Results: TDEE from HRM method averaged 8.17 ± 2.00 MJ/day compared to 8.50 ±
    1.28 MJ/day from AD method. Although large intra-individual differences were found (ranging from
    -36.9% to 47.4%), there was no significant difference between the two methods (mean difference -3.6 ± 19.4%). The limits of agreement (mean ± 2SD) were -3.77 and 3.11 MJ/day. There were no significant
    differences for any of the TDEE components between the two methods, except for EE during sleep
    (p
  14. Wong, Daniel Teck Lung, Ruziana Masiran, Wan Salwina Wan Ismail
    MyJurnal
    Childhood- and adolescent-onset schizophrenia are rare. Along with positive, negative, affective and cognitive symptoms, eye-tracking dysfunction characterized by a disturbance in the smooth pursuit system has been the only associated visual impairment found in schizophrenia. This case report highlights a case of a child with persistent hyperplastic primary vitreous who had gradual onset of psychosis over two years duration. A final diagnosis of schizophrenia was considered and she was started on antipsychotics, to which she showed gradual response with mild extrapyramidal side effects.
  15. Wong, A. S-L., Nusaibah Abdul Rahim
    MyJurnal
    Introduction: Polymyxin B (PMB) is one of the remaining antibiotics that is effective against multidrug resistant (MDR) Gram-negative bacteria. However, PMB monotherapy is not able to achieve sustained killing hence, combination with other antibiotics are usually employed. Besides antibiotics, studies are now moving towards non-antibiotic alternatives such as metabolite feeding against MDR pathogens. This study aimed to investigate the susceptibility
    and bacterial killing of PMB in combination with metabolite phenylpyruvate against Klebsiella pneumoniae isolates. Methods: Broth microdilution was used to determine PMB minimum inhibitory concentration (MIC) alone and with phenylpyruvate against two Klebsiella pneumoniae isolates. Time kill studies were performed over 24 h (initial inoculum: ~106 CFU/mL), using PMB 2 mg/L and phenylpyruvate 2 mmol/L, alone and in combination, against the
    PMB-resistant isolate. Microbiological responses were examined using the log-change method. Results: The MIC of PMB was reduced by phenylpyruvate in both isolates. In the time kill studies, during the first hour, PMB monotherapy demonstrated the highest bacterial killing activity even compared to the combination. Phenylpyruvate monotherapy showed negligible activity against K. pneumoniae. A significant reduction in bacterial burden was seen at 1 h following PMB monotherapy and combination therapy but an equally rapid regrowth was seen at 4 h. Notably at 24 h, the regrowth following combination therapy was >1-log10 CFU/mL less than PMB monotherapy. Conclusion: Our results suggest that phenylpyruvate increased PMB susceptibility in K. pneumoniae and may minimise the emergence of resistance to PMB. Future studies investigating phenylpyruvate at higher concentrations against more isolates are
    warranted.
  16. Wong WL, Valliappan VN, Leong MC, Aminudin SNA, Chew SCJ, Cheong AT
    MyJurnal
    Introduction: Delayed diagnosis of type 2 diabetes mellitus (T2D) increases the risk of presenting late with microvas- cular complications due to untreated long-standing hyperglycaemia. This study aimed to determine the prevalence of microvascular complications in newly diagnosed T2D patients in primary healthcare clinics.
    Methods: This was a cross-sectional study carried out in three government primary healthcare clinics in the state of Selangor, Malaysia. Malaysian aged 18 years and above with newly diagnosed T2D (<6 months of diagnosis) were invited to participate in the study. Data collected included the sociodemographic characteristic and the clinical profile (weight, height, waist circumference, blood pressure, lipid, glycaemic, urine albumin, microalbuminuria and renal profile). The assessment of nephropathy, peripheral neuropathy and retinopathy were performed using standard protocol. Multivariate logistic regression analysis was used to identify the significant factors that contribute to the presence of microvascular complications.
    Results: A total of 162 newly diagnosed patients were recruited. The majority was women (64%). The mean age was 51 (SD 11) years. About one-third of the patients (27.7%) had developed at least one microvascular complication. Nephropathy was the commonest microvascular complication (19.2%), followed by peripheral neuropathy (8.6%) and retinopathy (6.5%). Poor glycaemic control was found to be a significant factor contributing to the presence of microvascular complications (OR 5.8, 95%CI:1.466, 23.288).
    Conclusion: There is a high prevalence of microvascular complications among the newly diagnosed T2D. There is a need to develop appropriate strategies to increase the awareness and early detection of T2D.
    Study site: three Klinik Kesihatan, Selangor, Malaysia
  17. Wong K. H.
    MyJurnal
    Introduction: Breast cancer is the commonest cancer in Malaysia, predominantly among women under age of 60 and they often presented late. Borneo is home to multi-racial indigenous with heterogeneous background and breast cancer profile can be absolutely unique. This study aims to examine the demographic characteristics and stage at presentation in Sandakan women with newly diagnosed breast cancer. Methods: This is a cross-sectional, retrospec-tive study involving those women who were newly diagnosed with breast cancer from January 2016 to December 2018 in Duchess of Kent Hospital, Sandakan identified via hospital cancer registry and patient records. Only breast cancer with epithelial origin was included. Age, ethnicity and stages at presentation of breast cancer were analysed. Logistic regression was used to study their relationships. Results: 110 women were newly diagnosed as breast cancer. Mean age was 53.5 (SD 12.7), the youngest at 30 and the eldest at 97. Majority (64.6%) were local indigenous wom-en, constituted by 25.4% Sungai, 14.1% Kadazan-Dusun, 12.7% Bugis and the minorities. Chinese women are the main local non-indigenous (32.7%) followed by 2.7% Malay. 52.1% presented at late stages (stage III/IV). Subgroup analysis of T-staging revealed 41.7% had advanced symptoms (T3/T4). Indigenous group was more likely to present at younger ages (OR 12.0; 95%CI 1.5-93.8) and with advanced symptoms (OR 3.1; 95%CI 1.2-8.0). Conclusion: Awareness on breast cancer remains inadequate particularly among indigenous women. Difficult healthcare accessi-bility and incline towards traditional medicine could attribute to late presentation. Outreach awareness programmes are warranted in addition to mobile screening services.
  18. Wong DTL, Sidi H, Salleh H, Tajjudin I
    MyJurnal
    With the availability of the Internet, pornographic materials are readily accessible. Pornographic materials may have a link to addiction and other deviant sexual behaviour. In this case report, we highlighted a link between voyeuristic disorder and internet sex addiction. Mr. SK is a 22-year-old single gentleman who was referred for psychiatric assessment due to voyeuristic acts. He had been watching pornographic materials since 16 years old and became addicted to it.
  19. Win Win Than, Tin Sabai Aung
    MyJurnal
    Introduction: Cervical cancer remains the second commonest female malignancy worldwide and the seventh among Malaysians. Globally in 2012, an estimated 528 000 women developed cervical cancer and almost 266 000 died from this disease. Of all cervical cancers, 83% occur in the less developed world due to the absence of screening. To promote the community health awareness of cervical cancer which is preventable. Methods: By internet literature searching (Google Scholar) and textbooks. Results: The primary cause of cervical pre-cancer and cancer is persistent infection with one or more of the oncogenic types of HPV, the most common infection acquired during sexual inter-course, usually early in sexual life. Cervical cancer due to HPV can be prevented by HPV vaccination, participation in a screening program, avoidance of smoking, limitation of sex partners and use of a condom. Three HPV vaccines are available worldwide such as bivalent HPV 16/18 vaccine, quadrivalent HPV 16/18/6/11 L1 virus-like particles vaccine and 9-valent HPV 6/11/16/18/31/33/45/52/58 recombinant vaccine. The HPV test can be done on the same sample of cells collected from the Pap test and it can help to know HPV types. Conclusion: Cervical cancer due to HPV can be prevented by vaccination and the pre-cancerous phase of cervical cancer can be screened by the HPV testing with the Pap test. The community health awareness plays a major role in cervical cancer prevention.
  20. Wiki Safarina Narawi, Shaz’ Ain Razak, Nahdiyah Azman
    MyJurnal
    Introduction: Usage of smartphones have increased rapidly because of its importance in our daily life. This led to an increase in incidence of ocular problems among smartphone users. This research was conducted to determine the effect of smartphone usage on accommodation status. Methods: A cross-sectional study was conducted among young adults aged 19 to 30 years old in Management and Science University, Shah Alam. All subjects were asked to use smartphone for 20 minutes. The symptoms and accommodation status were evaluated before and after the smartphone usage. Results: Total subjects showed the mean age of 23.60 ± 2.77 years, 50% (n = 20) were males and 50% (n = 20) were females. The mean smartphone usage per day was 8.60 ± 2.80) hours. After 20 minutes of smartphone usage, subjects complained of tired eyes (92.50%), dry eyes (90.00%), blurred vision (87.50%), and headache (82.50%). Paired t-test showed significant reduction in amplitude of accommodation, monocularly from 9.9 ± 1.9 D to 8.76 ± 2.50 D (p = 0.00), and binocularly from 12.01 ± 1.95 D to 10.96 ± 2.16 D (p = 0.00); monoc- ular accommodative facility from 13.93 ± 3.13 cpm to 11.10 ± 4.32 cpm (p = 0.00) and binocular accommodative facility from 12.70 ± 3.57 cpm to 9.70 ± 4.21 cpm (p = 0.00); positive relative accommodation from -2.72 ± 0.87 D to -2.13 ± 1.28 D (p = 0.00) and increase in lag of accommodation from 0.4 ± 0.26 D to 0.93 ± 0.48 D (p = 0.00). Conclusion: This study shows that there were significance changes on accommodation status after 20 minutes of smartphone usage which can lead to weakness of accommodation.

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