Displaying publications 81 - 100 of 134 in total

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  1. Rohizat NS, Ripain AHA, Lim CS, Tan CL, Zakaria R
    Sci Rep, 2021 Oct 04;11(1):19688.
    PMID: 34608217 DOI: 10.1038/s41598-021-99189-w
    Hybrids plasmonic nanoparticles (NPs) and unique 2D graphene significantly enhanced the photoresponse of the photodetectors. The metallic NPs that exhibit localized surface plasmon resonance (LSPR) improves strong light absorption, scattering and localized electromagnetic field by the incident photons depending on the optimum condition of NPs. We report high-performance photodetectors based on reduced graphene oxide (rGO) integrated with monometallic of Au and Ag nanoparticles via a familiar fabrication technique using an electron beam evaporation machine. Under 680 nm illumination of light, our rGO photodetector exhibited the highest performance for Au-rGO with the highest responsivity of 67.46 AW-1 and the highest specific detectivity (2.39 × 1013 Jones). Meanwhile, Ag-rGO achieved the highest responsivity of 17.23 AW-1, specific detectivity (7.17 × 1011 Jones) at 785 nm. The response time are 0.146 µs and 0.135 µs for Au-rGO and Ag-rGO respectively for both wavelengths. The proposed photodetector with combining monometallic and graphene provide a new strategy to construct reliable and next-generation optoelectronic devices at VIS-NIR region.
  2. Safdar A, Zakaria R, Aziz CBA, Rashid U, Azman KF
    Biogerontology, 2020 04;21(2):203-216.
    PMID: 31792648 DOI: 10.1007/s10522-019-09854-x
    One of the most significant hallmarks of aging is cognitive decline. D-galactose administration may impair memory and mimic the effects of natural aging. In this study, the efficiency of goat milk to protect against memory decline was tested. Fifty-two male Sprague-Dawley rats were randomly divided into four groups: (i) control group, (ii) goat milk treated group, (iii) D-galactose treated group, and (iv) goat milk plus D-galactose treated group. Subcutaneous injections of D-galactose at 120 mg/kg and oral administrations of goat milk at 1 g/kg were chosen for the study. Goat milk and D-galactose were administered concomitantly for 6 weeks, while the control group received saline. After 6 weeks, novel object recognition and T-maze tests were performed to evaluate memory of rats. Following behavioral tests, the animals were sacrificed, and right brain homogenates were analyzed for levels of lipid peroxidation, antioxidant enzymes and neurotrophic factors. The left brain hemisphere was used for histological study of prefrontal cortex and hippocampus. There was a significant memory impairment, an increase in oxidative stress and neurodegeneration and a reduction in antioxidant enzymes and neurotrophic factors levels in the brain of D-galactose treated rats compared to controls. Goat milk treatment attenuated memory impairment induced by D-galactose via suppressing oxidative stress and neuronal damage and increasing neurotrophic factors levels, thereby suggesting its potential role as a geroprotective food.
  3. Safdar A, Azman KF, Zakaria R, Ab Aziz CB, Rashid U
    J Tradit Complement Med, 2021 Mar;11(2):117-122.
    PMID: 33728271 DOI: 10.1016/j.jtcme.2020.02.005
    Background and aim: Goat milk is a food of high nutritional value and has been proved to possess strong antioxidant and anti-inflammatory properties. However, thus far, little is known of its possible effects on brain especially on memory during aging. The aim of this study was to assess the effect of goat milk supplementation on memory in d-galactose-induced aging rat model.

    Experimental procedure: Fifty-two male Sprague Dawley rats were randomly divided into four groups: 1) control group, 2) goat milk treated group, 3) d-galactose treated group, and 4) goat milk plus d-galactose treated group. Goat milk (1 g/kg orally) and/or d-galactose (120 mg/kg subcutaneously) were administered continuously for six weeks preceded and followed by novel object recognition and T-maze test.

    Results and conclusion: Prior to goat milk and d-galactose administration, there was no significant difference (p > 0.05) in memory between all groups. Goat milk administration alone significantly increased short- and long-term memory (p 

  4. Safdar A, Azman KF, Zakaria R, Ab Aziz CB, Rashid U
    J Tradit Complement Med, 2021 Jul;11(4):381.
    PMID: 34195033 DOI: 10.1016/j.jtcme.2021.06.003
    [This corrects the article DOI: 10.1016/j.jtcme.2020.02.005.].
  5. Sagadevan S, Venilla S, Marlinda AR, Johan MR, Wahab YA, Zakaria R, et al.
    J Nanosci Nanotechnol, 2020 Apr 01;20(4):2488-2494.
    PMID: 31492266 DOI: 10.1166/jnn.2020.17185
    Herein, we report the effect of synthesis temperature on the morphologies, optical and electronic properties of magnesium oxide (MgO) nanostructures. The MgO nanostructures were synthesized at different temperatures, i.e., 100 °C, 300 °C, and 600 °C by simple chemical reaction process and their morphology, particle size, optical, and electrical properties were examined by different techniques such as scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy and UV-Vis. spectroscopy. The morphological investigations revealed that various morphologies of MgO nanostructures, i.e., nanoparticles, nanosheet networks, and nanoneedles were synthesized at 100 °C, 300 °C, and 600 °C. The XRD results confirmed that with increasing the synthesis temperature, the crystallinity of the synthesized nanostructures increases. Further, the dielectric properties and AC conductivity at various frequencies for MgO nanostructures were studied which revealed that the dielectric losses decrease with increase in frequency and temperature. In addition, the observed band gap decreases from 4.89 eV to 4.438 eV (100 °C to 600 °C) representing its increase in the conductivity.
  6. Sainuddin SS, Norhayati MN, Abdul Kadir A, Zakaria R
    Med J Malaysia, 2023 Sep;78(5):675-686.
    PMID: 37775497
    INTRODUCTION: Postpartum depression (PPD) is a mental and emotional condition that can affect women during their first postnatal year and concern globally. This study aimed to determine the overall prevalence and determinants of postpartum depression (PPD) in Association of Southeast Asian Nations (ASEAN) countries.

    MATERIALS AND METHODS: A systematic search of observational studies conducted in ASEAN countries between 1 January 2010 and 31 December 2020 was performed in the Medline, PubMed and Google Scholar databases. The quality of studies was evaluated based on The Joanna Briggs Institute Checklist. The analysis was performed with Review Manager software version 5.4. Metaanalysis of the estimates from primary studies was conducted by adjusting for possible publication bias and heterogeneity.

    RESULTS: Twenty-five studies including 19924 postnatal mothers were included in this review. The pooled prevalence of PPD is 22.32% (95% CI: 18.48, 26.17). Thailand has the highest prevalence of PPD with a pooled prevalence of 74.1% (95% CI: 64.79, 83.41). The prevalence of PPD was highest when the assessment for PPD was conducted up to 6 weeks postpartum with a pooled prevalence of 25.24% (95% CI: 14.08, 36.41). The identified determinants of PPD were unplanned pregnancy, term pregnancy, lack of family support and physical violence. There were limited studies done and high heterogeneity in terms of quality, methodology, culture, screening method and time of PPD measurement.

    CONCLUSIONS: Approximately one in five postpartum women in ASEAN countries had PPD. The risk factor that lowers the risk of PPD is unplanned and term pregnancies, while women with a lack of family support and experienced physical violence increase the risk of PPD. Robust prevalence studies are needed to assess the magnitude of this problem in ASEAN countries.

  7. Sajid MR, Muhammad N, Zakaria R, Bukhari SAC
    J Public Health Res, 2020 Oct 14;9(4):1893.
    PMID: 33244464 DOI: 10.4081/jphr.2020.1893
    Background: Modifiable risk factors are associated with cardiovascular mortality (CVM) which is a leading form of global mortality. However, diverse nature of urbanization and its objective measurement can modify their relationship. This study aims to investigate the moderating role of urbanization in the relationship of combined exposure (CE) of modifiable risk factors and CVM. Design and Methods: This is the first comprehensive study which considers different forms of urbanization to gauge its manifold impact. Therefore, in addition to existing original quantitative form and traditional two categories of urbanization, a new form consisted of four levels of urbanization was duly introduced. This study used data of 129 countries mainly retrieved from a WHO report, Non-Communicable Diseases Country Profile 2014. Factor scores obtained through confirmatory factor analysis were used to compute the CE. Age-income adjusted regression model for CVM was tested as a baseline with three bootstrap regression models developed for the three forms of urbanization. Results: Results revealed that the CE and CVM baseline relationship was significantly moderated through the original quantitative form of urbanization. Contrarily, the two traditional categories of urbanization could not capture the moderating impact. However, the four levels of urbanization were objectively estimated the urbanization impact and subsequently indicated that the CE was more alarming in causing the CVM in levels 2 and 3 urbanized countries, mainly from low-middle-income countries. Conclusion: This study concluded that the urbanization is a strong moderator and it could be gauged effectively through four levels whereas sufficiency of two traditional categories of urbanization is questionable.
  8. Sajid MR, Muhammad N, Zakaria R, Shahbaz A, Bukhari SAC, Kadry S, et al.
    Interdiscip Sci, 2021 Jun;13(2):201-211.
    PMID: 33675528 DOI: 10.1007/s12539-021-00423-w
    BACKGROUND: In the broader healthcare domain, the prediction bears more value than an explanation considering the cost of delays in its services. There are various risk prediction models for cardiovascular diseases (CVDs) in the literature for early risk assessment. However, the substantial increase in CVDs-related mortality is challenging global health systems, especially in developing countries. This situation allows researchers to improve CVDs prediction models using new features and risk computing methods. This study aims to assess nonclinical features that can be easily available in any healthcare systems, in predicting CVDs using advanced and flexible machine learning (ML) algorithms.

    METHODS: A gender-matched case-control study was conducted in the largest public sector cardiac hospital of Pakistan, and the data of 460 subjects were collected. The dataset comprised of eight nonclinical features. Four supervised ML algorithms were used to train and test the models to predict the CVDs status by considering traditional logistic regression (LR) as the baseline model. The models were validated through the train-test split (70:30) and tenfold cross-validation approaches.

    RESULTS: Random forest (RF), a nonlinear ML algorithm, performed better than other ML algorithms and LR. The area under the curve (AUC) of RF was 0.851 and 0.853 in the train-test split and tenfold cross-validation approach, respectively. The nonclinical features yielded an admissible accuracy (minimum 71%) through the LR and ML models, exhibiting its predictive capability in risk estimation.

    CONCLUSION: The satisfactory performance of nonclinical features reveals that these features and flexible computational methodologies can reinforce the existing risk prediction models for better healthcare services.

  9. Salmi AA, Zaki NM, Zakaria R, Nor Aliza AG, Rasool AH
    VASA, 2012 Mar;41(2):96-104.
    PMID: 22403127 DOI: 10.1024/0301-1526/a000171
    This study aims to determine whether gestational diabetes mellitus (GDM) is associated with increased arterial stiffness, inflammatory and pro-atherogenic markers compared to age matched controls.
  10. Samsir S, Zakaria R, Razak SA, Ismail MS, Rahim MZA, Lin CS, et al.
    Malays J Med Sci, 2018 Sep;25(5):68-78.
    PMID: 30914864 MyJurnal DOI: 10.21315/mjms2018.25.5.7
    Background: Neuroimaging is increasingly used to locate the lesion that causes cerebral palsy (CP) and its extent in the brains of CP patients. Conventional structural magnetic resonance imaging (MRI) does not indicate the connectional pattern of white matter; however, with the help of diffusion MRI, fibre tracking of white matter can be done.

    Methods: We used diffusion MRI and probabilistic tractography to identify the putative white matter connectivity in the brains of 10 CP patients. We tracked the corticospinal tract (CST) of the patients' upper and lower limbs and calculated the white matter connectivity, as indexed by streamlines representing the probability of connection of the CST.

    Results: Our results show that diffusion MRI with probabilistic tractography, while having some relation with the clinical diagnosis of CP, reveals a high degree of individual variation in the streamlines representing the CST for upper and lower limbs.

    Conclusion: Diffusion MRI with probabilistic tractography provides the state of connectivity from lesioned areas to other parts of the brain and is potentially beneficial to be used as an adjunct to the clinical management of CP, providing a means to monitor intervention outcomes.

  11. Selamat R, Zain F, Raib J, Zakaria R, Marzuki MS, Ibrahim TF
    J Am Coll Nutr, 2011 Dec;30(6):522-8.
    PMID: 22331687
    OBJECTIVE: To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year.

    MATERIALS AND METHODS: A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software.

    RESULTS: The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference.

    CONCLUSION: The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.

  12. Shafin N, Zakaria R, Hussain NH, Othman Z
    Menopause, 2013 Jun;20(6):661-6.
    PMID: 23715378 DOI: 10.1097/GME.0b013e31827758c6
    The aim of this study was to examine the association between changes in blood oxidative stress level/activity and changes in memory performance among postmenopausal women.
  13. Shafin N, Ismail CAN, Mustafa MZ, Ghani N, Ahmad AH, Othman Z, et al.
    Mult Scler, 2022 Dec;28(14):2160-2170.
    PMID: 35164590 DOI: 10.1177/13524585221075542
    Recent interest in multiple sclerosis research warrants literature analysis to evaluate the current state of the discipline and new research domains. This bibliometric review summarised the research trends and analysed research areas in multiple sclerosis over the last decade. The documents containing the term 'multiple sclerosis' in the article title were retrieved from the Scopus database. We used Harzing's Publish or Perish and VOSviewer for citation analysis and data visualisation, respectively. We found a total of 18,003 articles published in journals in the English language between 2012 and 2021. The emerging keywords identified utilising the enhanced strategic diagram were 'covid-19', 'teriflunomide', 'clinical trial', 'microglia', 'b cells', 'myelin', 'brain', 'white matter', 'functional connectivity', 'pain', 'employment', 'health-related quality of life', 'meta-analysis' and 'comorbidity'. This study demonstrates the tremendous growth of multiple sclerosis literature worldwide, which is expected to grow more than double during the next decade especially in the identified emerging topics.
  14. Siew-Keah L, Sundaram A, Sirajudeen KN, Zakaria R, Singh HJ
    J Physiol Biochem, 2014 Mar;70(1):73-9.
    PMID: 23975651 DOI: 10.1007/s13105-013-0282-3
    Antenatal and postnatal environments are hypothesised to influence the development of hypertension. This study investigates the synergistic effect of cross-fostering and melatonin supplementation on the development of hypertension and renal glutathione system in spontaneously hypertensive rats (SHR). In one experiment, 1-day-old male SHR pups were fostered to either SHR (shr-SHR) or Wistar-Kyoto rats, (shr-WKY). In a concurrent experiment, SHR dams were given melatonin in drinking water (10 mg/kg body weight) from day 1 of pregnancy. Immediately following delivery, 1-day-old male pups were fostered either to SHR (Mel-shr-SHR) or WKY (Mel-shr-WKY) dams receiving melatonin supplementation until weaning on day 21. Upon weaning, melatonin supplementation was continued to these pups until the age of 16 weeks. Systolic blood pressures (SBP) were recorded at the age of 4, 6, 8, 12 and 16 weeks. Renal antioxidant activities were measured. Mean SBP of shr-WKY, Mel-shr-SHR and Mel-shr-WKY was significantly lower than that in shr-SHR until the age of 8 weeks. At 12 and 16 weeks of age, mean SBP of Mel-shr-WKY was lower than those in non-treated shr-SHR and shr-WKY pups but was not significantly different from that in Mel-shr-SHR. Renal glutathione peroxidase (GPx) and glutathione S-transferase (GST) activities were significantly higher in Mel-shr-SHR and Mel-shr-WKY at 16 weeks of age. It appears that combination of cross-fostering and melatonin supplementation exerts no synergistic effect on delaying the rise in blood pressure in SHR. The elevated GPx and GST activities are likely to be due to the effect of melatonin supplementation.
  15. Slik JW, Aiba S, Bastian M, Brearley FQ, Cannon CH, Eichhorn KA, et al.
    Proc Natl Acad Sci U S A, 2011 Jul 26;108(30):12343-7.
    PMID: 21746913 DOI: 10.1073/pnas.1103353108
    The marked biogeographic difference between western (Malay Peninsula and Sumatra) and eastern (Borneo) Sundaland is surprising given the long time that these areas have formed a single landmass. A dispersal barrier in the form of a dry savanna corridor during glacial maxima has been proposed to explain this disparity. However, the short duration of these dry savanna conditions make it an unlikely sole cause for the biogeographic pattern. An additional explanation might be related to the coarse sandy soils of central Sundaland. To test these two nonexclusive hypotheses, we performed a floristic cluster analysis based on 111 tree inventories from Peninsular Malaysia, Sumatra, and Borneo. We then identified the indicator genera for clusters that crossed the central Sundaland biogeographic boundary and those that did not cross and tested whether drought and coarse-soil tolerance of the indicator genera differed between them. We found 11 terminal floristic clusters, 10 occurring in Borneo, 5 in Sumatra, and 3 in Peninsular Malaysia. Indicator taxa of clusters that occurred across Sundaland had significantly higher coarse-soil tolerance than did those from clusters that occurred east or west of central Sundaland. For drought tolerance, no such pattern was detected. These results strongly suggest that exposed sandy sea-bed soils acted as a dispersal barrier in central Sundaland. However, we could not confirm the presence of a savanna corridor. This finding makes it clear that proposed biogeographic explanations for plant and animal distributions within Sundaland, including possible migration routes for early humans, need to be reevaluated.
  16. Slik JW, Arroyo-Rodríguez V, Aiba S, Alvarez-Loayza P, Alves LF, Ashton P, et al.
    Proc Natl Acad Sci U S A, 2015 Jun 16;112(24):7472-7.
    PMID: 26034279 DOI: 10.1073/pnas.1423147112
    The high species richness of tropical forests has long been recognized, yet there remains substantial uncertainty regarding the actual number of tropical tree species. Using a pantropical tree inventory database from closed canopy forests, consisting of 657,630 trees belonging to 11,371 species, we use a fitted value of Fisher's alpha and an approximate pantropical stem total to estimate the minimum number of tropical forest tree species to fall between ∼ 40,000 and ∼ 53,000, i.e., at the high end of previous estimates. Contrary to common assumption, the Indo-Pacific region was found to be as species-rich as the Neotropics, with both regions having a minimum of ∼ 19,000-25,000 tree species. Continental Africa is relatively depauperate with a minimum of ∼ 4,500-6,000 tree species. Very few species are shared among the African, American, and the Indo-Pacific regions. We provide a methodological framework for estimating species richness in trees that may help refine species richness estimates of tree-dependent taxa.
  17. Slik JWF, Franklin J, Arroyo-Rodríguez V, Field R, Aguilar S, Aguirre N, et al.
    Proc Natl Acad Sci U S A, 2018 02 20;115(8):1837-1842.
    PMID: 29432167 DOI: 10.1073/pnas.1714977115
    Knowledge about the biogeographic affinities of the world's tropical forests helps to better understand regional differences in forest structure, diversity, composition, and dynamics. Such understanding will enable anticipation of region-specific responses to global environmental change. Modern phylogenies, in combination with broad coverage of species inventory data, now allow for global biogeographic analyses that take species evolutionary distance into account. Here we present a classification of the world's tropical forests based on their phylogenetic similarity. We identify five principal floristic regions and their floristic relationships: (i) Indo-Pacific, (ii) Subtropical, (iii) African, (iv) American, and (v) Dry forests. Our results do not support the traditional neo- versus paleotropical forest division but instead separate the combined American and African forests from their Indo-Pacific counterparts. We also find indications for the existence of a global dry forest region, with representatives in America, Africa, Madagascar, and India. Additionally, a northern-hemisphere Subtropical forest region was identified with representatives in Asia and America, providing support for a link between Asian and American northern-hemisphere forests.
  18. Srinivasan V, Mohamed M, Zakaria R, Ahmad AH
    Infect Disord Drug Targets, 2012 Oct;12(5):371-9.
    PMID: 23082960
    Malaria, one of the most deadly diseases of our time affects more than 200 million people across the globe and is responsible for about one million deaths annually. Until recently Plasmodium falciparum has been the main cause for malarial infection in human beings but now Plasmodium knowlesi from Malaysia remains as one of the most virulent parasite spreading fast not only in Malaysia but in different parts of the world. Hence there is urgent need for the global fight to control malaria. Global malaria eradication program by use of insecticide spraying has resulted in good response in the past. Treatment of malaria infected patients with anti-malarial drugs has helped to eliminate malarial infections successfully but with increased resistance displayed by malarial parasites to these drugs there is resurgence of malaria caused both by drug resistance as well as by infection caused by new malarial species like Plasmodium knowlesi. With recent advances on molecular studies on malarial parasites it is now clear that the pineal hormone melatonin acts as a cue for growth and development of Plasmodium falciparum. Same may be true for Plasmodium knowlesi also. Hence treatment modalities that can effectively block the action of melatonin on Plasmodium species during night time by way of using either bright light therapy or use of melatonin receptor blocking can be considered as useful approaches for eliminating malarial infection in man.
  19. Srinivasan V, Ahmad AH, Mohamed M, Zakaria R
    PMID: 22537380
    Malaria remains a global health problem affecting more than 515 million people all over the world including Malaysia. It is on the rise, even within unknown regions that previous to this were free of malaria. Although malaria eradication programs carried out by vector control programs are still effective, anti-malarial drugs are also used extensively for curtailing this disease. But resistance to the use of anti-malarial drugs is also increasing on a daily basis. With an increased understanding of mechanisms that cause growth, differentiation and development of malarial parasites in rodents and humans, new avenues of therapeutic approaches for controlling the growth, synchronization and development of malarial parasites are essential. Within this context, the recent discoveries related to IP3 interconnected signalling pathways, the release of Ca2+ from intracellular stores of Plasmodium, ubiquitin protease systems as a signalling pathway, and melatonin influencing the growth and differentiation of malarial parasites by its effects on these signalling pathways have opened new therapeutic avenues for arresting the growth and differentiation of malarial parasites. Indeed, the use of melatonin antagonist, luzindole, has inhibited the melatonin's effect on these signalling pathways and thereby has effectively reduced the growth and differentiation of malarial parasites. As Plasmodium has effective sensors which detect the nocturnal plasma melatonin concentrations, suppression of plasma melatonin levels with the use of bright light during the night or by anti-melatonergic drugs and by using anti-kinase drugs will help in eradicating malaria on a global level. A number of patients have been admitted with regards to the control and management of malarial growth. Patents related to the discovery of serpentine receptors on Plasmodium, essential for modulating intra parasitic melatonin levels, procedures for effective delivery of bright light to suppress plasma melatonin levels and thereby arresting the growth and elimination of malarial parasites from the blood of the host are all cited in the paper. The purpose of the paper is to highlight the importance of melatonin acting as a cue for Plasmodium faciparum growth and to discuss the ways of curbing the effects of melatonin on Plasmodium growth and for arresting its life cycle, as a method of eliminating the parasite from the host.
  20. Tahir NSM, Zakaria R, Draman N
    Korean J Fam Med, 2019 Sep;40(5):348-350.
    PMID: 30477049 DOI: 10.4082/kjfm.18.0001
    Anxiety disorders are the most prevalent psychiatric disorders in the general population. The relationship between dyspepsia and particularly gastroesophageal reflux disease (GERD) and psychiatric comorbidity such as anxiety is poorly defined. However, GERD was noted to be strongly associated and often coincident in onset with generalized anxiety disorder in the community. In this paper, we report the case of an adult man who presented with severe weight loss and underlying GERD, and was later found to have an anxiety disorder as the cause of both.
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