Displaying publications 61 - 80 of 12215 in total

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  1. Kumar S, Wong PS, Hasan SS, Kairuz T
    PLoS One, 2019;14(10):e0224122.
    PMID: 31622445 DOI: 10.1371/journal.pone.0224122
    Poor sleep quality is prevalent among older adults and is compounded by frailty and polypharmacy. This descriptive, cross-sectional study examines the associations between sleep quality, inappropriate medication use and frailty. The study was conducted among 151 residents of 11 aged care homes in three states in Malaysia; convenience sampling was used. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and Groningen Frailty Indicator (GFI) was used to assess frailty. Medication appropriateness was assessed using Drug burden Index (DBI), Potentially Inappropriate Medications (PIMs) and Potentially Inappropriate Prescriptions (PIPs). Most of the subjects (approximately 95%) reported poor sleep quality, as measured by a cut-off of global PSQI score of ≥ 5. With a second cut-off at 10, just over half (56%) reported moderately poor sleep quality followed by 39% who had very poor sleep quality. Most (90%) denied taking medication to improve their sleep during the previous month. There was no statistically significant association between medication inappropriateness (PIMs, PIPs, DBI) and global PSQI score. However, the average number of PIM was associated significantly with sleep efficiency (a measure of the actual 'sleep to total time spent in bed) (p = 0.037). The average number of PIP was associated with subjective sleep quality (p = 0.045) and the use of sleep medications (p = 0.001), and inversely associated with sleep disturbance (0.049). Furthermore, frailty correlated significantly with poor overall sleep quality (p = 0.032). Findings support the need for medication review to identify and reduce PIMs and optimise prescriptions to improve sleep quality and hence, related health outcomes among residents of aged care homes.
    Matched MeSH terms: Aged; Aged, 80 and over; Homes for the Aged; Middle Aged
  2. Koh EJ, Tan KN, Chan ZW, Candice Wong HY, Chin ML, Lee TC
    J Ayub Med Coll Abbottabad, 2023;35(2):334-336.
    PMID: 37422834 DOI: 10.55519/JAMC-02-11470
    Burkholderia pseudomallei affecting the central nervous system has been extensively reported in the literature. However, combined central nervous system and peripheral nervous system involvement in melioidosis has never been reported. We report a 66-year-old man with diabetes mellitus who was diagnosed to have central nervous system melioidosis and developed acute flaccid quadriplegia. Nerve conduction studies and anti-ganglioside antibodies were consistent with Guillain-Barre syndrome. This case report highlights the importance to recognise the possibility of Guillain Barre syndrome complicating central nervous system melioidosis and stresses the urgency of early consideration of this complication, as early immunomodulatory therapy may hasten neurological recovery.
    Matched MeSH terms: Aged
  3. Yu L, Abd Ghani MK, Aghemo A, Barh D, Bassetti M, Catena F, et al.
    Curr Med Chem, 2023;30(39):4390-4408.
    PMID: 36998130 DOI: 10.2174/0929867330666230330092725
    The COVID-19 pandemic, caused by the coronavirus, SARS-CoV-2, has claimed millions of lives worldwide in the past two years. Fatalities among the elderly with underlying cardiovascular disease, lung disease, and diabetes have particularly been high. A bibliometrics analysis on author's keywords was carried out, and searched for possible links between various coronavirus studies over the past 50 years, and integrated them. We found keywords like immune system, immunity, nutrition, malnutrition, micronutrients, exercise, inflammation, and hyperinflammation were highly related to each other. Based on these findings, we hypothesized that the human immune system is a multilevel super complex system, which employs multiple strategies to contain microorganism infections and restore homeostasis. It was also found that the behavior of the immune system is not able to be described by a single immunological theory. However, one main strategy is "self-destroy and rebuild", which consists of a series of inflammatory responses: 1) active self-destruction of damaged/dysfunctional somatic cells; 2) removal of debris and cells; 3) rebuilding tissues. Thus, invading microorganisms' clearance could be only a passive bystander response to this destroy-rebuild process. Microbial infections could be self-limiting and promoted as an indispensable essential nutrition for the vast number of genes existing in the microorganisms. The transient nutrition surge resulting from the degradation of the self-destroyed cell debris coupled with the existing nutrition state in the patient may play an important role in the pathogenesis of COVID-19. Finally, a few possible coping strategies to mitigate COVID-19, including vaccination, are discussed.
    Matched MeSH terms: Aged
  4. Nor Hashimah AMM, Kan SL, Raymond AA
    J R Coll Physicians Edinb, 2022 Jun;52(2):134-137.
    PMID: 36147003 DOI: 10.1177/14782715221104860
    Calcinosis universalis (CU) is characterised by diffuse deposition of insoluble calcium salt in the skin, subcutaneous tissue or organs. Calcium deposits in the breast may be associated with an increased risk for developing breast cancer. We present a case of a 65-year-old woman diagnosed with CU secondary to undifferentiated connective tissue disease. She developed progressive calcification of her skin, which did not improve with oral medications aimed at reducing the calcification. Investigations to look for possible causes of calcification were all unremarkable. During follow-up, calcification was also found in both her breasts. Initial mammography was reported as fibroadenoma. However, 3 years later, she returned with metastatic breast cancer which presented with a massive pleural effusion of the right lung. Calcinosis universalis should now be considered as a risk factor for breast cancer.
    Matched MeSH terms: Aged
  5. Zainol N, Raman P, Devi-S P, Mohd Khalid KH
    Retin Cases Brief Rep, 2023 Jul 01;17(4):362-364.
    PMID: 34381008 DOI: 10.1097/ICB.0000000000001186
    OBJECTIVE: To report a rare case of suprachoroidal hemorrhage during phacoemulsification in a patient with bilateral carotid-cavernous fistula.

    METHOD: Case report.

    RESULT: A 76-year-old woman with underlying hypertension presented left eye poor vision due to an underlying dense cataract. Her initial preoperative assessment was uneventful, and she underwent phacoemulsification. During epinucleus removal, there was sudden, unexpected anterior chamber shallowing, resulting in posterior capsule rupture. While the surgeon extended the wound to facilitate epinucleus removal, there was a further decrease of red reflex, followed by hardening of the globe, indicating a suprachoroidal hemorrhage. The corneal wound was opposed swiftly without an intraocular lens. Further evaluation after that revealed the patient had a chronic headache for several years, and ocular examination showed bilateral esophoria. A computed tomography demonstrated features suggestive of bilateral carotid-cavernous fistula, which was confirmed with computed tomography angiography later.

    CONCLUSION: Patients with carotid-cavernous fistula have elevated episcleral venous pressure and vortex venous pressure. Sudden decompression of the globe in these patients predisposes them to higher suprachoroidal hemorrhage risk, although this condition is generally rare in phacoemulsification.

    Matched MeSH terms: Aged
  6. Ibrahim NA, Wong YY, Lean QY, Ramasamy K, Lim SM, Tan MP, et al.
    Res Social Adm Pharm, 2024 Feb;20(2):172-181.
    PMID: 37980238 DOI: 10.1016/j.sapharm.2023.11.001
    BACKGROUND: Independent and safe medication self-management is essential for successful aging. Nevertheless, how older adults with cognitive frailty (CF) self-manage medications at their own homes remain elusive.

    OBJECTIVE: This study aimed at assessing the medication self-management capability of home-dwelling older adults with CF and exploring the ways, perceived challenges and barriers in medication self-management.

    METHODS: A convergent mixed-method study design was used. The medication management capability of 16 CF individuals aged ≥ 60 years on ≥ 1 long-term prescription drugs were assessed using the Drug Regimen Unassisted Grading Scale (DRUGS). Virtual in-depth interviews were also performed between July-August 2022 using a semi-structured interview guide. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analysed using a thematic analysis approach guided by Bailey and colleagues' model of medication self-management.

    RESULTS: The mean DRUGS summary score was 96.86 [standard deviation (SD) 3.74] with highest performance scores observed in medication access (100 %) and lowest performance score in medication identification (91.46 %). Informants were able to independently take their medications and they tended to organise their medication intakes according to mealtime even though some admitted missing medication doses due to forgetfulness. Informants had difficulties with recalling drug names, with little awareness of self-monitoring their own health conditions and the effects of medications. Misconceptions towards medications, difficulties in accessing medications, reduced mobility and worsening health conditions could potentially deter informants from safe and independent medication self-management. In contrast, trust in doctors and a desire to achieve treatment goal could motivate medication self-management.

    CONCLUSION: The findings revealed knowledge gaps among older adults with CF in identifying their medications and self-monitoring which warrant reinforcement by healthcare professionals to ensure chronic safe medication use. Future studies should evaluate strategies to enhance medication safety in terms of self-monitoring in individuals with CF.

    Matched MeSH terms: Aged
  7. Mohd Mokhtar MA, Pin TM, Zakaria MI, Hairi NN, Kamaruzzaman SB, Vyrn CA, et al.
    Geriatr Gerontol Int, 2015 Aug;15(8):944-50.
    PMID: 25311907 DOI: 10.1111/ggi.12369
    AIM: To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting.
    METHODS: The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week.
    RESULTS: A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged <60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P 
    Matched MeSH terms: Aged*
  8. Abolfathi Momtaz Y, Hamid TA, Ibrahim R
    Psychogeriatrics, 2013 Sep;13(3):182-8.
    PMID: 25913768 DOI: 10.1111/psyg.12009
    Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope.
    Matched MeSH terms: Aged; Aged, 80 and over
  9. Arokiasamy JT
    Med J Malaysia, 2011 Oct;66(4):286-7.
    PMID: 22299543
    Matched MeSH terms: Health Services for the Aged*
  10. Hussain M, Hisham AN
    Asian J Surg, 2008 Apr;31(2):59-62.
    PMID: 18490216 DOI: 10.1016/S1015-9584(08)60059-7
    Over the years, subtotal thyroidectomy has been the mainstay of treatment for toxic goitre; however, total thyroidectomy is increasingly being considered as the procedure of choice. This study aimed to review our experience with total thyroidectomy in toxic goitre and evaluate the outcome of this procedure.
    Matched MeSH terms: Aged; Middle Aged
  11. Siar CH, Ng KH
    Ann Acad Med Singap, 1993 Nov;22(6):856-60.
    PMID: 8129343
    Four hundred and one cases of ameloblastoma of the jaw diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, between 1967 and 1991 have been analysed. There were 214 males and 187 females. Of these, 50.1% were Malays, 34.7% Chinese, 8.2% Indians and 7.0% other races. Seventy-two percent of patients were in the second, third and fourth decades of life (mean age: 30.8 years). Ninety-three percent of tumours occurred in the mandible and 6.5% in the maxilla. There were 337 cases of conventional ameloblastoma, 49 cases of the unicystic variant and four cases of peripheral ameloblastoma. The predominant histologic patterns were plexiform (34.2%), follicular (16.5%) and mixture of both (17.7%). Majority of the cases were conservatively treated by enucleation. Fifty-nine cases presented with recurrences. Present findings were generally compatible with regional serial studies reported from Thailand, Singapore and Japan.
    Matched MeSH terms: Aged; Middle Aged
  12. Ismal NMN
    Malays J Pathol, 1997 Jun;19(1):21-5.
    PMID: 10879238
    Matched MeSH terms: Aged; Middle Aged
  13. Chin K, Singham KT, Masduki A
    Med J Malaysia, 1983 Jun;38(2):108-11.
    PMID: 6621438
    Forty nine patients with sick sinus syndrome seen at the University Hospital, Kuala Lumpur are reviewed. The ages of patients ranged from 17 to 85 years. There were 21 males and 28 females. The diagnostic criteria were sinus bradycardia in 8 patients (Group I), sinus arrest or sinoatrial block in 24 patients. (Group Il), and bradycardia tachycardia syndrome in 17 patiens (Group Ill). The aetiology was unknown in the majority of patients. Ischaemic heart disease was the commonest known aetiological factor. Patients with symptomatic sinus bradycardia and sinus arrest were initially treated with oral isoprenaline, and if this failed, they were paced. Temporary transvenous pacing was necessary in 27 patients and subsequent permanent pacing performed on 23 patients.
    Matched MeSH terms: Aged; Middle Aged
  14. Yeoh NTL, Lim KH
    Med J Malaysia, 1982 Sep;37(3):245-8.
    PMID: 7177006
    Matched MeSH terms: Aged; Middle Aged
  15. Wong KT, Ng SC, Kuperan P, Yap SF, Menaka N, Bosco J
    Med J Malaysia, 1990 Jun;45(2):136-43.
    PMID: 2152018
    A retrospective study of 37 cases of multiple myeloma admitted from 1980 to 1987 to the University Hospital Kuala Lumpur, Malaysia, was carried out to analyse the biodata, clinical presentation, laboratory and radiological profiles. The cases were selected after they had satisfied preset diagnostic criteria. The mean age was 60 years. There was no sex or ethnic preponderance. The most common symptom was bone pain. Pallor was detected in 73% of the patients. Haemoglobin was less than 120 g/L in 95%, and ESR was greater than 100 mm/hr in 70% of cases. Bone marrow and trephine biopsies were diagnostically important. Hypercalcaemia occurred in seven cases out of which three were IgA myelomas. Either serum creatinine or blood urea was raised in nearly 50% of cases. The most common heavy chain paraprotein was IgG while Kappa light chain was the commoner light chain type. 86% of cases had osteolytic lesions. These findings are, in general, similar to those of larger studies on multiple myeloma.

    Study site: University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Aged; Middle Aged
  16. Woi PJ, Kaur S, Waugh SJ, Hairol MI
    F1000Res, 2016;5:1961.
    PMID: 28184281 DOI: 10.12688/f1000research.9410.1
    The human visual system is sensitive in detecting objects that have different luminance level from their background, known as first-order or luminance-modulated (LM) stimuli. We are also able to detect objects that have the same mean luminance as their background, only differing in contrast (or other attributes). Such objects are known as second-order or contrast-modulated (CM), stimuli. CM stimuli are thought to be processed in higher visual areas compared to LM stimuli, and may be more susceptible to ageing. We compared visual acuities (VA) of five healthy older adults (54.0±1.83 years old) and five healthy younger adults (25.4±1.29 years old) with LM and CM letters under monocular and binocular viewing. For monocular viewing, age had no effect on VA [F(1, 8)= 2.50, p> 0.05]. However, there was a significant main effect of age on VA under binocular viewing [F(1, 8)= 5.67, p< 0.05].  Binocular VA with CM letters in younger adults was approximately two lines better than that in older adults. For LM, binocular summation ratios were similar for older (1.16±0.21) and younger (1.15±0.06) adults. For CM, younger adults had higher binocular summation ratio (1.39±0.08) compared to older adults (1.12±0.09). Binocular viewing improved VA with LM letters for both groups similarly. However, in older adults, binocular viewing did not improve VA with CM letters as much as in younger adults. This could reflect a decline of higher visual areas due to ageing process, most likely higher than V1, which may be missed if measured with luminance-based stimuli alone.
    Matched MeSH terms: Aged; Middle Aged
  17. Abdul Sattar Arif Khammas, Hasyma Abu Hassan
    MyJurnal
    The most common cause of the chronic liver disease is non-alcoholic fatty liver disease (NAFLD). This study was designed to compare a mean subcutaneous tissue thickness (SCTT) and hepatic echo-intensity attenuation rate (HEIAR) among NAFLD grades. Sonography was carried out on 628 consecutive subjects. The distance between the skin surface and the liver capsule was measured and was labelled the SCTT. Also, the ultrasound of HEIAR was retrospectively quantified on an image archiving. HEIAR was calculated as the difference between mean intensity of echo for two regions of interest (ROIs) in near- and far-fields divided by the distance between these two ROIs multiply by frequency of the probe. Of the 628, 235 subjects were diagnosed with NAFLD. The age range was 45 – 75 years with mean 54.5 ± 6.7 years. There was a significant difference of mean SCTT among NAFLD grades (p
    Matched MeSH terms: Aged; Middle Aged
  18. Chiu CJ, Yu YC, Du YF, Yang YC, Chen JY, Wong LP, et al.
    JMIR Mhealth Uhealth, 2020 06 02;8(6):e14024.
    PMID: 32484448 DOI: 10.2196/14024
    BACKGROUND: Many technology-assisted innovations have been used to manage disease. However, most of these innovations are not broadly used by older adults due to their cost. Additionally, disease management through technology-assisted innovations has not been compared with other interventions.

    OBJECTIVE: In this study, we tested the employment of a free and widely used social and communication app to help older adults with diabetes manage their distress and glycemic control. We also compared the effectiveness of the app with 2 other methods, namely telephone and conventional health education, and determined which subgroup experiences the most effects within each intervention.

    METHODS: Adults aged ≥50 years with type 2 diabetes were recruited from Southern Taiwan (N=231) and were allocated to different 3-month interventions. Informed consent was obtained at the Ministry of Science and Technology and approved by the National Cheng Kung University Hospital Institutional Review Board (No. A-ER-102-425).

    RESULTS: Participants in the mobile-based group had significant reductions in hemoglobin A1c compared with the telephone-based and usual care groups (mean changes of -0.4%, 0.1%, and 0.03%, respectively; P=.02). Diabetes-specific distress decreased to a greater extent in the mobile-based group compared to the other 2 groups (mean changes of -5.16, -3.49, and -2.44, respectively, P=.02). Subgroup analyses further revealed that the effects on reducing blood glucose levels in the social and communication app groups were especially evident in patients with lower distress scores, and diabetes-related distress was especially evident in participants who were younger than 60 years or had higher educational levels.

    CONCLUSIONS: The findings of this study inform more flexible use of social and communication apps with in-person diabetes education and counselling.

    Matched MeSH terms: Aged; Middle Aged
  19. Chia YC, Kario K, Tomitani N, Park S, Shin J, Turana Y, et al.
    J Clin Hypertens (Greenwich), 2020 03;22(3):407-414.
    PMID: 31891447 DOI: 10.1111/jch.13731
    Blood pressure variability (BPV) has been shown to be independently associated with cardiovascular (CV) mortality and morbidity. Patients with type 2 diabetes mellitus (T2DM) have also been shown to have increased BPV. We aimed to compare BPV in hypertensive patients with diabetes with those without diabetes. A total of 1443 hypertensive patients measured their blood pressure (BP) twice in the morning and twice before bed at home for a week. Demographic data, history of T2DM, and anti-hypertensive use were captured. Clinic BP was measured twice in the clinic. Control of BP was defined as clinic systolic BP (SBP) <140 mm Hg and home SBP 
    Matched MeSH terms: Aged; Middle Aged
  20. Alex D, Khor HM, Chin AV, Hairi NN, Cumming RG, Othman S, et al.
    Front Public Health, 2020;8:506238.
    PMID: 33304870 DOI: 10.3389/fpubh.2020.506238
    Falls are major issues affecting the older population with potentially serious complications, including fractures, head injury, institutionalization, fear of falling and depression. While risk factors for falls have been established across Western Europe and North America, geographical differences in falls risk have not been well researched. We aim to examine the clinical and physical risk factors for falls in a middle-income South East Asian country. Cross-sectional data from the Malaysian Elders Longitudinal Research (MELoR) study involving 1,362 community dwelling individuals aged 55 years and above was utilized. Information on sociodemographic and medical history was obtained by computer-assisted questionnaires completed during home visits and hospital-based detailed health checks. Univariate and multivariate analyses compared non-fallers and fallers in the previous 12 months. Urinary incontinence, hearing impairment, depression, arthritis and cognitive impairment were risk factors for falls in the past 12 months after adjustment for age in our study population. Awareness about the risk factors in a population helps the design of fall prevention strategies that target specific or multiple risk factors.
    Matched MeSH terms: Aged; Middle Aged
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