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Benefits of 3D rotational DSA compared with 2D DSA in the evaluation of intracranial aneurysm

Wong SC, Nawawi O, Ramli N, Abd Kadir KA

Acad Radiol, 2012 Jun;19(6):701-7.
PMID: 22578227 DOI: 10.1016/j.acra.2012.02.012

The aim of this study was to compare conventional two-dimensional (2D) digital subtraction angiography (DSA) with three-dimensional (3D) rotational DSA in the investigation of intracranial aneurysm in terms of detection, size measurement, neck diameter, neck delineation, and relationship with surrounding vessels. A further aim was to compare radiation dose, contrast volume, and procedural time between the two protocols.

Matched MeSH terms: Adult; Young Adult
Neurometabolites Alteration in the Acute Phase of Mild Traumatic Brain Injury (mTBI): An In Vivo Proton Magnetic Resonance Spectroscopy (1H-MRS) Study

Veeramuthu V, Seow P, Narayanan V, Wong JHD, Tan LK, Hernowo AT, et al.

Acad Radiol, 2018 09;25(9):1167-1177.
PMID: 29449141 DOI: 10.1016/j.acra.2018.01.005

RATIONALE AND OBJECTIVES: Magnetic resonance spectroscopy is a noninvasive imaging technique that allows for reliable assessment of microscopic changes in brain cytoarchitecture, neuronal injuries, and neurochemical changes resultant from traumatic insults. We aimed to evaluate the acute alteration of neurometabolites in complicated and uncomplicated mild traumatic brain injury (mTBI) patients in comparison to control subjects using proton magnetic resonance spectroscopy (1H magnetic resonance spectroscopy).
MATERIAL AND METHODS: Forty-eight subjects (23 complicated mTBI [cmTBI] patients, 12 uncomplicated mTBI [umTBI] patients, and 13 controls) underwent magnetic resonance imaging scan with additional single voxel spectroscopy sequence. Magnetic resonance imaging scans for patients were done at an average of 10 hours (standard deviation 4.26) post injury. The single voxel spectroscopy adjacent to side of injury and noninjury regions were analysed to obtain absolute concentrations and ratio relative to creatine of the neurometabolites. One-way analysis of variance was performed to compare neurometabolite concentrations of the three groups, and a correlation study was done between the neurometabolite concentration and Glasgow Coma Scale.
RESULTS: Significant difference was found in ratio of N-acetylaspartate to creatine (NAA/Cr + PCr) (χ2(2) = 0.22, P

Matched MeSH terms: Adult; Young Adult
Microsimulation modelling of driver behaviour towards alternative warning devices at railway level crossings

Tey LS, Zhu S, Ferreira L, Wallis G

Accid Anal Prev, 2014 Oct;71:177-82.
PMID: 24929822 DOI: 10.1016/j.aap.2014.05.014

Level crossings are amongst the most complex of road safety issues, due to the addition of rail infrastructure, trains and train operations. The differences in the operational characteristics of different warning devices together with varying crossing, traffic or/and train characteristics, cause different driver behaviour at crossings. This paper compares driver behaviour towards two novel warning devices (rumble strips and in-vehicle audio warning) with two conventional warning devices (flashing light and stop sign) at railway level crossings using microsimulation modelling. Two safety performance indicators directly related to collision risks, violation and time-to-collision, were adopted. Results indicated the active systems were more effective at reducing likely collisions compared to passive devices. With the combined application of driving simulation and traffic microsimulation modelling, traffic safety performance indicators for a level crossing can be estimated. From these, relative safety comparisons for the different traffic devices are derived, or even for absolute safety evaluation with proper calibration from field investigations.

Matched MeSH terms: Adult; Young Adult
Driving anger in Malaysia

Sullman MJ, Stephens AN, Yong M

Accid Anal Prev, 2014 Oct;71:1-9.
PMID: 24863369 DOI: 10.1016/j.aap.2014.04.019

The present study examined the types of situations that cause Malaysian drivers to become angry. The 33-item version of the driver anger scale (Deffenbacher et al., 1994) was used to investigate driver anger amongst a sample of 339 drivers. Confirmatory factor analysis showed that the fit of the original six-factor model (discourtesy, traffic obstructions, hostile gestures, slow driving, illegal driving and police presence), after removing one item and allowing three error pairs to covary, was satisfactory. Female drivers reported more anger, than males, caused by traffic obstruction and hostile gestures. Age was also negatively related to five (discourtesy, traffic obstructions, hostile gestures, slow driving and police presence) of the six factors and also to the total DAS score. Furthermore, although they were not directly related to crash involvement, several of the six forms of driving anger were significantly related to the crash-related conditions of: near misses, loss of concentration, having lost control of a vehicle and being ticketed. Overall the pattern of findings made in the present research were broadly similar to those from Western countries, indicating that the DAS is a valid measure of driving anger even among non-European based cultures.

Matched MeSH terms: Adult; Young Adult
Motorcycle-related spinal injury: crash characteristics

Zulkipli ZH, Abdul Rahmat AM, Mohd Faudzi SA, Paiman NF, Wong SV, Hassan A

Accid Anal Prev, 2012 Nov;49:237-44.
PMID: 23036400 DOI: 10.1016/j.aap.2011.12.011

This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury.

Matched MeSH terms: Adult; Young Adult
Factors related to seatbelt-wearing among rear-seat passengers in Malaysia

Ng CP, Law TH, Wong SV, Kulanthayan S

Accid Anal Prev, 2013 Jan;50:351-60.
PMID: 22633252 DOI: 10.1016/j.aap.2012.05.004

The benefit of wearing a rear seatbelt in reducing the risk of motor vehicle crash-related fatalities and injuries has been well documented in previous studies. Wearing a seatbelt not only reduces the risk of injury to rear-seat passengers, but also reduces the risk of injury to front-seat occupant who could be crushed by unbelted rear-seat passengers in a motor vehicle crash. Despite the benefits of wearing a rear seatbelt, its rate of use in Malaysia is generally low. The objective of this study was to identify factors that are associated with the wearing of a seatbelt among rear-seat passengers in Malaysia. Multinomial logistic regression analysis of the results of a questionnaire survey of 1651 rear-seat passengers revealed that rear-seat passengers who were younger, male, single and less educated and who had a perception of a low level of legislation enforcement, a lower risk-aversion and less driving experience (only for passengers who are also drivers) were less likely to wear a rear seatbelt. There was also a significant positive correlation between driver seatbelt and rear seatbelt-wearing behaviour. This implies that, in regards to seatbelt-wearing behaviour, drivers are more likely to adopt the same seatbelt-wearing behaviour when travelling as rear-seat passengers as they do when driving. These findings are crucial to the development of new interventions to increase the compliance rate of wearing a rear seatbelt.

Matched MeSH terms: Adult
Fatigue-related crashes involving express buses in Malaysia: will the proposed policy of banning the early-hour operation reduce fatigue-related crashes and benefit overall road safety?

Mohamed N, Mohd-Yusoff MF, Othman I, Zulkipli ZH, Osman MR, Voon WS

Accid Anal Prev, 2012 Mar;45 Suppl:45-9.
PMID: 22239931 DOI: 10.1016/j.aap.2011.09.025

Fatigue-related crashes have long been the topic of discussion and study worldwide. The relationship between fatigue-related crashes and time of day is well documented. In Malaysia, the possibility of banning express buses from operating during the early-hours of the morning has emerged as an important consideration for passenger safety. This paper highlights the findings of an impact assessment study. The study was conducted to determine all possible impacts prior to the government making any decision on the proposed banning. This study is an example of a simple and inexpensive approach that may influence future policy-making process. The impact assessment comprised two major steps. The first step involved profiling existing operation scenarios, gathering information on crashes involving public express buses and stakeholders' views. The second step involved a qualitative impact assessment analysis using all information gathered during the profiling stage to describe the possible impacts. Based on the assessment, the move to ban early-hour operations could possibly result in further negative impacts on the overall road safety agenda. These negative impacts may occur if the fundamental issues, such as driving and working hours, and the need for rest and sleep facilities for drivers, are not addressed. In addition, a safer and more accessible public transportation system as an alternative for those who choose to travel at night would be required. The proposed banning of early-hour operations is also not a feasible solution for sustainability of express bus operations in Malaysia, especially for those operating long journeys. The paper concludes by highlighting the need to design a more holistic approach for preventing fatigue-related crashes involving express buses in Malaysia.

Matched MeSH terms: Adult
The direct and indirect effects of corruption on motor vehicle crash deaths

Hua LT, Noland RB, Evans AW

Accid Anal Prev, 2010 Nov;42(6):1934-42.
PMID: 20728645 DOI: 10.1016/j.aap.2010.05.015

Recent empirical research has found that there is an inverted U-shaped or Kuznets relationship between income and motor vehicle crash (MVC) deaths, such that MVC deaths increase as national income increases and decrease after reaching a critical level. Corruption has been identified as one of the underlying factors that could affect this relationship, primarily by undermining institutional development and effective enforcement schemes. The total effect of corruption can be decomposed into two components, a direct and an indirect effect. The direct effect measures the immediate impact of corruption on MVC deaths by undermining effective enforcement and regulations, while the indirect effect captures the impact of corruption on hindering increases in per capita income and the consequent impact of reduced income on MVC deaths. By influencing economic growth, corruption can lead to an increase or decrease in MVC deaths depending on the income level. Using data from 60 countries between 1982 and 2003, these effects are estimated using linear panel and fixed effects negative binomial models. The estimation results suggest that corruption has different direct effects for less developed and highly developed countries. It has a negative (decreasing) effect on MVC deaths for less developed countries and a positive (increasing) effect on MVC deaths for highly developed countries. For highly developed countries, the total effect is positive at lower per capita income levels, but decreases with per capita income and becomes negative at per capita income levels of about US$ 38,248. For less developed countries, the total effect is negative within the sample range and decreases with increased per capita income. In summary, the results of this study suggest that reduction of corruption is likely a necessary condition to effectively tackle road safety problems.

Matched MeSH terms: Adult; Young Adult
Driver characteristics associated with child safety seat usage in Malaysia: a cross-sectional study

Kulanthayan S, Razak A, Schenk E

Accid Anal Prev, 2010 Mar;42(2):509-14.
PMID: 20159074 DOI: 10.1016/j.aap.2009.09.015

The rapidly motorizing environment in Malaysia has made child occupant safety a current public health concern. The usage of child safety seats (CSS) is a widely regarded intervention to enhance child occupant safety, yet no study has been conducted on CSS in Malaysia. This study aims to determine the CSS usage rates in Malaysia and to assess driver characteristics that are associated with CSS usage.

Matched MeSH terms: Adult
Measuring driver responses at railway level crossings

Tey LS, Ferreira L, Wallace A

Accid Anal Prev, 2011 Nov;43(6):2134-2141.
PMID: 21819844 DOI: 10.1016/j.aap.2011.06.003

Railway level crossings are amongst the most complex of road safety control systems, due to the conflicts between road vehicles and rail infrastructure, trains and train operations. Driver behaviour at railway crossings is the major collision factor. The main objective of the present paper was to evaluate the existing conventional warning devices in relation to driver behaviour. The common conventional warning devices in Australia are a stop sign (passive), flashing lights and a half boom-barrier with flashing lights (active). The data were collected using two approaches, namely: field video recordings at selected sites and a driving simulator in a laboratory. This paper describes and compares the driver response results from both the field survey and the driving simulator. The conclusion drawn is that different types of warning systems resulted in varying driver responses at crossings. The results showed that on average driver responses to passive crossings were poor when compared to active ones. The field results were consistent with the simulator results for the existing conventional warning devices and hence they may be used to calibrate the simulator for further evaluation of alternative warning systems.

Matched MeSH terms: Adult; Young Adult
Role of sensory and cognitive conspicuity in the prevention of collisions between motorcycles and trucks at T-intersections

Law TH, Ghanbari M, Hamid H, Abdul-Halin A, Ng CP

Accid Anal Prev, 2016 Nov;96:64-70.
PMID: 27505097 DOI: 10.1016/j.aap.2016.04.013

Motorcyclists are particularly vulnerable to injury in crashes with heavy vehicles due to substantial differences in vehicle mass, the degree of protection and speed. There is a considerable difference in height between motorcycles and trucks; motorcycles are viewed by truck drivers from downward angles, and shorter distances between them mean steeper downward angles. Hence, we anticipated that the effects of motorcycle conspicuity treatments would be different for truck drivers. Therefore, this study aims to evaluate the effects of motorcycle conspicuity treatments on the identification and detection of motorcycles by truck drivers. Two complementary experiments were performed; the first experiment assessed the impact of motorcycle sensory conspicuity on the ability of un-alerted truck drivers to detect motorcycles, and the second experiment assessed the motorcycle cognitive conspicuity to alerted truck drivers. The sensory conspicuity was measured in terms of motorcycle detection rates by un-alerted truck drivers when they were not anticipating a motorcycle within a realistic driving scene, while the cognitive conspicuity was determined by the time taken by alerted truck drivers to actively search for a motorcycle. In the first experiment, the participants were presented with 10 pictures and were instructed to report the kinds of vehicles that were presented in the pictures. Each picture was shown to the participants for 600ms. In the second experiment, the participants were presented with the same set of pictures and were instructed to respond by clicking the right button on a mouse as soon as they detected a motorcycle in the picture. The results indicate that the motorcycle detection rate increases, and the response time to search for a motorcycle decreases, as the distance between the targeted motorcycle and the viewer decreases. This is true regardless of the type of conspicuity treatment used. The use of daytime running headlights (DRH) was found to increase the detection rate and the identification of a motorcycle by a truck driver at a farther distance, but effect deteriorates as the distance decreases. The results show that the detection rate and the identification of a motorcyclist wearing a black helmet with a reflective sticker increases as the distance between the motorcycle and the truck decreases. We also found that a motorcyclist wearing a white helmet and a white outfit is more identifiable and detectable at both shorter and longer distances. In conclusion, although this study provides evidence that the use of appropriate conspicuity treatments enhances motorcycle conspicuity to truck drivers, we suggest that more attention should be paid to the effect of background environment on motorcycle conspicuity.

Matched MeSH terms: Adult
The effect of motion and signalling on drivers' ability to predict intentions of other road users

Lee YM, Sheppard E

Accid Anal Prev, 2016 Oct;95(Pt A):202-8.
PMID: 27450792 DOI: 10.1016/j.aap.2016.07.011

Failure in making the correct judgment about the intention of an approaching vehicle at a junction could lead to a collision. This paper investigated the impact of dynamic information on drivers' judgments about the intentions of approaching cars and motorcycles, and whether a valid or invalid signal was provided was also manipulated. Participants were presented with videoclips of vehicles approaching a junction which terminated immediately before the vehicle made any manoeuvre, or images of the final frame of each video. They were asked to judge whether or not the vehicle would turn. Drivers were better in judging the manoeuvre of approaching vehicles in dynamic than static stimuli, for both vehicle types. Drivers were better in judging the manoeuvre of cars than motorcycles for videos, but not for photographs. Drivers were also better in judging the manoeuvre of approaching vehicles when a valid signal was provided than an invalid signal, demonstrating the importance of providing a valid signal while driving. However, drivers were still somewhat successful in their judgments in most of the conditions with an invalid signal, suggesting that drivers were able to focus on other cues to intention. Finally, given that dynamic stimuli more closely reflect the demands of real-life driving there may be a need for drivers to adopt a more cautious approach while inferring a motorcyclist's intentions.

Matched MeSH terms: Adult; Young Adult
The relationship between the demographic, personal, and social factors of Malaysian motorcyclists and risk taking behavior at signalized intersections

Borhan MN, Ibrahim ANH, Aziz A, Yazid MRM

Accid Anal Prev, 2018 Dec;121:94-100.
PMID: 30237047 DOI: 10.1016/j.aap.2018.09.004

In the context of road safety, risk-taking is undoubtedly one of the main contributory factors in road accidents. The actual forces which influence individuals to take such risks, nevertheless, are still not fully understood. To address this, this study was therefore conducted to investigate the relationship of the demographic, personal, and social factors of motorcyclists, with a specific focus on their risk-taking behavior at signalized intersections in Malaysia. This study adopted the quantitative method using cross-sectional questionnaire surveys and involved 251 respondents. The demographic factors were analyzed using the t-test and an ANOVA Scheffe Post-Hoc test, while the motorcyclists' personal and social characteristics were analyzed with multiple linear regression. The findings indicate that the individuals who were greater risk takers at signalized intersections were teenage motorcyclists (16-25 years old) who had finished their education before taking their high school diploma, and who also received a lower than average monthly income from private sector firms. The actual experience of accidents was also shown to be positively related to this risk-taking behavior. In addition, in term of personal and social factors, results showed that, for these individuals, there was a significant difference between the strength of peer influence and that of parental and spouse guidance. However, there was no significant difference in the risk-taking behavior of Malaysian motorcyclists riding at signalized intersections for the following factors: between genders, in terms of accident involvement, in terms of enforcement of traffic regulations, and prevention steps and confidence level after being involved in an accident.

Matched MeSH terms: Adult; Young Adult
Evaluating the effect of lane width and roadside configurations on speed, lateral position and likelihood of comfortable overtaking in exclusive motorcycle lane

Ibrahim MKA, Hamid H, Law TH, Wong SV

Accid Anal Prev, 2018 Feb;111:63-70.
PMID: 29172046 DOI: 10.1016/j.aap.2017.10.023

Construction of exclusive motorcycle lanes is one of the measures to reduce motorcycle fatalities. Previous studies highlighted the risk of crashes with roadside objects and the tendency of motorcyclists to ride with excessive speed on exclusive motorcycle lanes. However, the risk of same-direction crashes on exclusive motorcycle lanes was not explored in much detail, especially on the impact of lane geometry and roadside configurations. This study used naturalistic riding data to determine the effects of lane width and roadside configurations on overtaking speed, lateral position and likelihood of comfortable overtaking on tangential sections of an exclusive motorcycle lane. Twenty-nine recruited motorcyclists rode the instrumented motorcycles along a 20km stretch of an exclusive motorcycle lane along a major urban road. Results revealed that both the roadside configurations and lane width significantly affect the participants' lateral position, while the roadside configurations only affects the overtaking speed. Participants' overtaking speeds and the front motorcycles' lateral position contribute significantly to the likelihood of comfortable overtaking in exclusive motorcycle lanes. The findings highlight the importance of micro-level behavior indicators in improving the design and overall safety of the exclusive motorcycle facility.

Matched MeSH terms: Adult; Young Adult
Comparing exercise prescription methods in knee osteoarthritis patients in Malaysia

D'Gasper D, Bains BS, Sadeghi H, Kumar P

Acta Medica Bulgarica, 2018;45(1):26-31.
DOI: 10.2478/amb-2018-0005

Aim: This study was a qualitative study that investigated the exercise prescription method in knee osteoarthritis patients in Malaysia. It purposed to find out the most common and effective method used by physiotherapist in prescribing exercises for knee osteoarthritis patients in Malaysia.
Method: This study used a self-administered survey questionnaire. The subjects recruited for this study were diagnosed with knee osteoarthritis, age range of between 50 to 80 years old.The methods of delivery were divided into three categories, which include only verbal instructions, verbal instruction together with demonstration and lastly a combination of all three methods including verbal instruction, demonstration and handouts with diagrams.
Results: The results showed that 52% received their exercise prescription with verbal instruction and together with demonstration, about 43% of them received all three types of methods which included the verbal instruction, demonstration and take home handouts and 5% of them only received verbal instruction. Out of 5% who received verbal instruction alone, only 1% understood the exercises and the remaining 4% did not and 45% out of 52% who received verbal and demonstration method understood the exercises and the remaining 7% did not. 5% who received only verbal instruction did not seem to continue the exercises at home. 52% received verbal instruction together with demonstration, with about 44% of them having continued their exercises but the remaining 8% did not. 43% who received all three methods reported to continue.
Conclusion: The best method of delivering exercises to knee osteoarthritis patients was proven to be the method with a combination of verbal instruction, demonstration together with a take home handout. This method showed very positive outcome and should be implemented and emphasized more in both the government and private sectors of physiotherapy departments.

Matched MeSH terms: Adult
Fulltext Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominis plane block in providing postoperative analgesia after appendectomy

Abdul Jalil RM, Yahya N, Sulaiman O, Wan Mat WR, Teo R, Izaham A, et al.

Acta Anaesthesiol Taiwan, 2014 Jun;52(2):49-53.
PMID: 25016507 DOI: 10.1016/j.aat.2014.05.007

The basis for the transversus abdominis plane (TAP) block involves infiltration of a local anesthetic into the neurofascial plane between the internal oblique and the transversus abdominis muscles, causing a regional block that spreads between the L1 and T10 dermatomes. Thus, the TAP block is said to be suitable for lower abdominal surgery. This study was designed to compare the analgesic efficacy of two different concentrations of ropivacaine for TAP block in patients undergoing appendectomy.

Matched MeSH terms: Adult
Hepatocyte nuclear factor 4 alpha P2 promoter variants associate with insulin resistance

Saif-Ali R, Harun R, Al-Jassabi S, Wan Ngah WZ

Acta Biochim. Pol., 2011;58(2):179-86.
PMID: 21633728

This study aimed to investigate the associations of hepatocyte nuclear factor 4 (HNF4) alpha single nucleotide polymorphisms (SNPs) and haplotype with insulin resistance and metabolic syndrome parameters. Nine SNPs spanning the HNF4 alpha P2 promoter (rs4810424, rs1884613 and rs1884614) and coding region (rs2144908, rs6031551, rs6031552, rs1885088, rs1028583 and rs3818247) were genotyped in 160 subjects without diabetes or metabolic syndrome. The HNF4 alpha P2 promoter SNPs rs4810424, rs1884613 and rs1884614 were associated with insulin resistance (p = 0.017; 0.037; 0.024) and body mass index (BMI) (p = 0.03; 0.035; 0.039). The intron 1D SNP rs2144908 was associated with high-density lipoprotein cholesterol (HDLc) (p = 0.020) and the intron 9 SNP rs3818247 showed association with systolic (p = 0.02) and diastolic (p = 0.034) blood pressure. HNF4 alpha common haplotype CCCGTC associated with higher insulin resistance (p = 0.022), fasting blood glucose (FBG) (p = 0.035) and lower HDLc (p = 0.001). In conclusion, subjects with HNF4 alpha P2 variants and haplotypes have been shown to have a higher insulin resistance and are therefore at a higher risk for developing type 2 diabetes mellitus.

Matched MeSH terms: Adult
Fulltext Metabolomics approach for multibiomarkers determination to investigate dengue virus infection in human patients

Shahfiza N, Osman H, Hock TT, Abdel-Hamid AZ

Acta Biochim. Pol., 2017;64(2):215-219.
PMID: 28350402 DOI: 10.18388/abp.2015_1224

BACKGROUND: Dengue is one of the major public health problems in the world, affecting more than fifty million cases in tropical and subtropical region every year. The metabolome, as pathophysiological end-points, provide significant understanding of the mechanism and progression of dengue pathogenesis via changes in the metabolite profile of infected patients. Recent developments in diagnostic technologies provide metabolomics for the early detection of infectious diseases.
METHODS: The mid-stream urine was collected from 96 patients diagnosed with dengue fever at Penang General Hospital (PGH) and 50 healthy volunteers. Urine samples were analyzed with proton nuclear magnetic resonance (1H NMR) spectroscopy, followed by chemometric multivariate analysis. NMR signals highlighted in the orthogonal partial least square-discriminant analysis (OPLS-DA) S-plots were selected and identified using Human Metabolome Database (HMDB) and Chenomx Profiler. A highly predictive model was constructed from urine profile of dengue infected patients versus healthy individuals with the total R2Y (cum) value 0.935, and the total Q2Y (cum) value 0.832.
RESULTS: Data showed that dengue infection is related to amino acid metabolism, tricarboxylic acid intermediates cycle and β-oxidation of fatty acids. Distinct variations in certain metabolites were recorded in infected patients including amino acids, various organic acids, betaine, valerylglycine, myo-inositol and glycine.
CONCLUSION: Metabolomics approach provides essential insight into host metabolic disturbances following dengue infection.

Matched MeSH terms: Adult
Pulse wave velocity as an index of arterial stiffness: a comparison between newly diagnosed (untreated) hypertensive and normotensive middle-aged Malay men and its relationship with fasting insulin

Ngim CA, Abdul Rahman AR, Ibrahim A

Acta Cardiol, 1999 Oct;54(5):277-82.
PMID: 10596307

BACKGROUND: Arterial stiffness, an aging process which is accelerated by hypertension, is emerging as a useful index of vascular health. There are evidences to suggest that hyperinsulinaemia may be an independent risk factor for coronary artery disease, besides its possible pathogenic role in essential hypertension. The main objectives of this study were to compare arterial stiffness between untreated hypertensives and normotensives and to investigate the relationship between fasting serum insulin and arterial stiffness.
METHODS: A cross-sectional observational study was designed. Forty normotensive (median age 47 +/- 6 yrs.) and twenty untreated hypertensive Malay men (median age 50 +/- 7 yrs.) without clinical evidence of cardiovascular complications were selected. Pulse wave velocity measured using the automated Complior machine was used as an index of arterial stiffness. Other measurements obtained were blood pressure, body mass index, fasting insulin, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glucose and creatinine level.
RESULTS: The blood pressure and pulse wave velocity (PWV) were significantly higher in the hypertensives compared to the normotensives (blood pressure 169/100 mm Hg +/- 14/7 vs. 120/80 mm Hg +/- 10/4, p < 0.001; PWV 11.69 m/s +/- 1.12 vs. 8.83 m/s +/- 1.35, p < 0.001). Other variables such as body mass index, fasting insulin, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and haematocrit were comparable among the two groups. Within each group, there was a significant positive correlation between pulse wave velocity and systolic blood pressure (r = 0.76, p < 0.001 in normotensives; r = 0.73, p < 0.001 in hypertensives) and mean arterial pressure (r = 0.74, p < 0.001 in normotensives; r = 0.73, p < 0.001 in hypertensives). No correlation was noted between pulse wave velocity and diastolic blood pressure, age, body mass index, fasting insulin level, cholesterol, HDL-cholesterol, LDL-cholesterol or triglyceride levels.
CONCLUSION: Arterial stiffness as determined by PWV is increased in newly diagnosed untreated hypertensive subjects even before clinically evident cardiovascular disease. However, arterial stiffness is not correlated with the fasting insulin level in normotensives and newly diagnosed hypertensives.

Matched MeSH terms: Adult
Fulltext A comparison of long-term outcomes between narrow and broad QRS complex patients treated with cardiac resynchronization therapy

Yap LB, Nguyen ST, Qadir F, Ma SK, Muhammad Z, Koh KW, et al.

Acta Cardiol, 2016 Jun;71(3):323-30.
PMID: 27594128 DOI: 10.2143/AC.71.3.3152093
Matched MeSH terms: Adult

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