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Relationship between education and cognitive performance among healthy Malay adults

Amir Hamzah A, Abu Bakar Z, Abdul Sani N, Tan JK, Ahmad Damanhuri M, Makpol S, et al.

Sains Malaysiana, 2016;45:1371-1380.

Higher level of education is associated with better cognitive performance and lower risk of developing dementia. However, the effect of education on cognitive performance varies across different cognitive domains and in different populations. The aim of this study was to determine the relationship between education and performance of different cognitive domains among healthy Malay adults. A total of 53 individuals aged 29 to 77 years participated in a battery of neurophysiological tests consisting of Mini-Mental State Examination, Montreal Cognitive Assessment, digit span, visual reproduction and digit symbol speed test (DSST). Blood test was performed for each participant to obtain their biochemical profile. Educational level was divided into level 1 (PMR), level 2 (SPM), level 3 (STPM), level 4 (Diploma) and level 5 (Degree). Simple linear regression indicated that years of education was positively associated with scores of delayed visual reproduction (b=1.348, p=0.002) and DSST (b=3.257, p=0.012). However, scores of all the tests were not significantly different among different levels of education after controlling for age, gender and blood test profile by ANCOVA. Multiple linear regression analysis showed that MMSE score was associated with red cell distribution width (b=-0.628, p=0.005), age (b=-0.119, p<0.001) and there was interaction between high density lipoprotein (HDL) with age (b=0.047, p<001). MoCA score was associated with age (b=-0.121, p<0.001), gender (male compared to female, b=1.870, p=0.020) and HDL (b=1.681, p=0.047). Age was associated with backward digit span (b=-0098, p<0.001) and immediate visual reproduction (b=-0.348, p<0.001), resp. Delayed visual reproduction was associated with age (b=-0.323, p<0.001) and potassium level (b=-4.471, p=0.016). DSST was associated with age (b=-0.911, p<0.001) and alanine aminotransferase (b=-0.754, p=0.002). The lack of association between educational level and cognitive performance after adjusting for confounders in this study maybe due to multiple factors influencing cognitive performance and further studies with a larger sample size are needed to further identify the factors involved.
Keywords: Cognitive performance; education; healthy Malay adults
ABSTRAK
Tahap pendidikan yang tinggi telah dikaitkan dengan prestasi kognitif yang lebih baik dan risiko perkembangan dementia yang lebih rendah. Namun, kesan pendidikan terhadap prestasi kognitif berbeza antara domain kognitif dan populasi yang berlainan. Kajian ini bertujuan untuk menentukan hubungan antara pendidikan dengan prestasi pada domain kognitif yang berlainan pada individu dewasa Melayu yang sihat. Seramai 53 individu yang berumur antara 29 hingga 77 tahun telah menyertai ujian neuropsikologi yang terdiri daripada Pemeriksaan Keadaan Mental Mini, Penilaian Kognitif Montreal, digit span, penghasilan semula visual dan ujian kelajuan simbol digit (DSST). Tahap pendidikan dibahagikan kepada tahap 1 (PMR), tahap 2 (SPM), tahap 3 (STPM), tahap 4 (Diploma) dan tahap 5 (Ijazah Sarjana Muda). Regresi linear mudah menunjukkan bahawa tahap pendidikan berhubung kait secara positif dengan penghasilan semula visual tertunda (b=1.348, p=0.002) dan DSST (b=3.257, p=0.012). Namun, semua skor ujian menjadi tidak berbeza antara tahap pendidikan yang berbeza selepas mengambil kira kesan konpengasas dengan menggunakan ANCOVA. Regresi linear berganda menunjukkan bahawa skor MMSE berhubung kait dengan lebar taburan sel merah (b=-0.628, p=0.005), umur (b=-0.119, p<0.001) dan interaksi antara lipoprotein ketumpatan tinggi (HDL) dan umur (b=0.047, p<001). MoCA didapati berhubung kait dengan umur (b=-0.121, p<0.001), jantina (lelaki berbanding perempuan, b=1.870, p=0.020) dan HDL (b=1.681, p=0.047). Umur juga berhubung kait dengan digit span ke belakang (b=-0098, P<0.001) dan penghasilan semula visual segera (b=-0.348, p<0.001). Penghasilan semula visual tertunda berhubung kait dengan umur (b=-0.323, p<0.001) dan tahap kalium (b=-4.471, p=0.016). DSST berhubung kait dengan umur (b=-0.911, p<0.001) dan alanin aminotransferase (b=-0.754, p=0.002). Hubungan antara tahap pendidikan dan prestasi kognitif tidak dikesan selepas mengambil kira kesan konpengasas yang mencadangkan bahawa prestasi kognitif mungkin dipengaruhi oleh pelbagai faktor dan kajian lanjut dengan bilangan sampel yang lebih besar diperlukan untuk mengenal pasti faktor ini.

Matched MeSH terms: Sample Size
Which aging group prone to have inadequate nutrient intake?: TUA study

Nik Nur Izzati Nik Mohd Fakhruddin, Suzana Shahar, Nurul Atiqah Abd Aziz, Roslee Rajikan, Hanis Mastura Yahya

Sains Malaysiana, 2016;45:1381-1391.

Older adults quite often had an inadequate diet leading to micronutrient deficiencies and impaired immune response with subsequent development of degenerative diseases. This study aimed to determine the adequacy of energy and nutrient intake and its distribution among three aging groups i.e. successful aging (SA), usual aging (UA) and mild cognitive impairment (MCI). This is a cross-sectional study involving a large sample size (n = 2322) of older adults recruited through multistage random sampling from four states of Malaysia. An interview was conducted to measure dietary intake, neurocognitive status and functional status by using the Diet History Questionnaire (DHQ), Mini-Mental State Examination (MMSE), Rey Auditory Learning Test (RAVLT), Geriatric Depression Scale (GDS), Instrumental Activity of Daily Living (IADL) and Quality of Life Questionnaire. For comparison of dietary intake, a sub-sample of 173 respondents from each aging groups were matched and selected using a comparative cross-sectional approach. Women in SA group had the highest mean intake of vitamin A, calcium (p <0.05), vitamin C, riboflavin and iron (p<0.001). The same aging group also achieved the highest RNI percentage for the same nutrients. More than 80% of respondents for all aging groups did not met the recommended nutrient intake (RNI) for vitamin E, thiamin, niacin, folate, calcium and zinc. In women, MCI respondents were more likely to have an inadequate intake of vitamin A, C, riboflavin and iron followed by UA and SA. Inadequate vitamin E, niacin, folate and calcium were prevalent among all gender and aging groups. There is a need to further distinguish specific dietary patterns associated with these three aging groups to promote optimal nutrient intake for cognitive health.

Matched MeSH terms: Sample Size
Learning styles of Malaysian Generation 'Y' healthcare undergraduates

Nurumal MS, Salahuddin MA, Daud A, Shahadan SZ, Abdul-Mumin K, Shorey S

Enferm Clin, 2019 09;29 Suppl 2:471-475.
PMID: 31350157 DOI: 10.1016/j.enfcli.2019.04.070

OBJECTIVE: The learning styles of millennial students, also known as Generation 'Y', have been examined in the past to match the teaching style of an educator with the aim of improving behaviors, attitudes, and academic achievements. However, focus on Generation 'Y' healthcare undergraduates from a multi-cultural Asian society, is scarce and fragmented. Therefore, this research aims to identify the learning style preferences of Generation 'Y' undergraduates enrolled in varied healthcare programs at a Malaysian University.
METHOD: A quantitative cross-sectional study design was adopted. Honey and Mumford's Learning Style Questionnaire was used to explore the learning styles.
RESULTS: The reflector learning style was most preferred by the Malaysian healthcare undergraduates, and no significant difference was found between the learning styles of the clinical group and the semi-clinical group.
CONCLUSIONS: Educators should engage Malaysian healthcare undergraduates in a non-threatening environment - Association between learning style and sociodemographic warrants further investigation.

Matched MeSH terms: Sample Size
Serum pepsinogen and gastrin-17 as potential biomarkers for pre-malignant lesions in the gastric corpus

Loong TH, Soon NC, Nik Mahmud NRK, Naidu J, Rani RA, Abdul Hamid N, et al.

Biomed Rep, 2017 Nov;7(5):460-468.
PMID: 29181158 DOI: 10.3892/br.2017.985

There is a lack of non-invasive screening modalities to diagnose chronic atrophic gastritis (CAG) and intestinal metaplasia (IM). Thus, the aim of the present study was to determine the sensitivity and specificity of serum pepsinogen I (PGI), PGI:II, the PGI:II ratio and gastrin-17 (G-17) in diagnosing CAG and IM, and the correlations between these serum biomarkers and pre-malignant gastric lesions. A cross-sectional study of 72 patients (82% of the calculated sample size) who underwent oesophageal-gastro-duodenoscopy for dyspepsia was performed in the present study. The mean age of the participants was 56.2±16.2 years. Serum PGI:I, PGI:II, G-17 and Helicobacter pylori antibody levels were measured by enzyme-linked immunosorbent assay. Median levels of PGI:I, PGI:II, the PGI:II ratio and G-17 for were 129.9 µg/l, 10.3 µg/l, 14.7 and 4.4 pmol/l, respectively. Subjects with corpus CAG/IM exhibited a significantly lower PGI:II ratio (7.2) compared with the control group (15.7; P<0.001). Histological CAG and IM correlated well with the serum PGI:II ratio (r=-0.417; P<0.001). The cut-off value of the PGI:II ratio of ≤10.0 demonstrated high sensitivity (83.3%), specificity (77.9%) and area under the receiver operating characteristic curve of 0.902 in detecting the two conditions. However, the sensitivity was particularly low at a ratio of ≤3.0. The serum PGI:II ratio is a sensitive and specific marker to diagnose corpus CAG/IM, but at a high cut-off value. This ratio may potentially be used as an outpatient, non-invasive biomarker for detecting corpus CAG/IM.

Matched MeSH terms: Sample Size
Fulltext Surgical Treatment and Proposed Modified Classification for Harrington Class III Periacetabular Metastases

Wei R, Lim CY, Yang Y, Tang XD, Yan TQ, Yang RL, et al.

Orthop Surg, 2021 Apr;13(2):553-562.
PMID: 33665985 DOI: 10.1111/os.12918

OBJECTIVES: This study aims to: (i) evaluate the outcome of patients with Harrington class III lesions who were treated according to Harrington classification; (ii) propose a modified surgical classification for Harrington class III lesions; and (iii) assess the efficiency of the proposed modified classification.
METHODS: This study composes two phases. During phase 1 (2006 to 2011), the clinical data of 16 patients with Harrington class III lesions who were treated by intralesional excision followed by reconstruction of antegrade/retrograde Steinmann pins/screws with cemented total hip arthroplasty (Harrington/modified Harrington procedure) were retrospectively reviewed and further analyzed synthetically to design a modified surgical classification system. In phase 2 (2013 to 2019), 62 patients with Harrington class III lesions were classified and surgically treated according to our modified classification. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) 93 scoring system. The outcome of local control was described using 2-year recurrence-free survival (RFS). Owing to the limited sample size, we considered P

Matched MeSH terms: Sample Size
Fulltext Association between non-alcoholic fatty liver disease evaluated by transient elastography with extracranial carotid atherosclerosis in a multiethnic Asian community

Tan EC, Tai MS, Chan WK, Mahadeva S

JGH Open, 2019 Apr;3(2):117-125.
PMID: 31061886 DOI: 10.1002/jgh3.12114

Background and Aim: There is not much data on the association between non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis assessed using Fibroscan with carotid intima-media thickness (CIMT) in the general population. The objective of this study was to evaluate the association between NAFLD and advanced fibrosis, as diagnosed by Fibroscan, with an increased CIMT in the Malaysian population.
Methods: A cross-sectional study of government officers and their family members attending a health screening at a public healthcare facility was conducted. All subjects underwent clinical evaluation, biochemical testing, anthropometry, ultrasound carotid Doppler, and Fibroscan examination.
Results: Data for 251 subjects were analyzed (mean age 47.1 ± 12.4 years, 74.1% male). Prevalence of NAFLD and advanced fibrosis were 57.4 and 17.5%, respectively. Independent factors associated with NAFLD were waist circumference (odds ratio [OR] = 1.077, 95% confidence interval [CI] 1.038-1.118, P < 0.001) and serum alanine aminotransferase (ALT) (OR = 1.039, 95% CI 1.005-1.074, P = 0.024). Independent factors associated with advanced fibrosis were male gender (OR = 4.847, 95% CI 1.369-17.155, P = 0.014) and serum aspartate aminotransferase (AST) (OR = 1.057, 95% CI 1.003-1.113, P = 0.036). Prevalence of increased CIMT was 29.0%. Independent factor associated with increased CIMT was older age (OR = 1.146, 95% CI 1.067-1.231, P < 0.001). Of the subjects, 34.5% with NAFLD had increased CIMT compared to 19.1% of the subjects without NAFLD (P = 0.063). Advanced fibrosis was not associated with increased CIMT.
Conclusions: Prevalence of NAFLD, advanced liver fibrosis, and increased CIMT were high. NAFLD and advanced liver fibrosis appeared not to be associated with increased CIMT. However, a larger sample size is needed to demonstrate whether there is any association.

Matched MeSH terms: Sample Size
A Comparative Effectiveness Systematic Review and Meta-Analysis of Drugs for the Prophylaxis of Junctional Ectopic Tachycardia

Mendel B, Christianto, Setiawan M, Prakoso R, Siagian SN

Curr Cardiol Rev, 2021 Jun 03.
PMID: 34082685 DOI: 10.2174/1573403X17666210603113430

BACKGROUND: Junctional ectopic tachycardia (JET) is an arrhythmia originating from the AV junction, which may occur following congenital heart surgery, especially when the intervention is near the atrioventricular junction.
OBJECTIVE: The aim of this systematic review and meta-analysis is to compare the effectiveness of amiodarone, dexmedetomidine and magnesium in preventing JET following congenital heart surgery.
METHODS: This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, where 11 electronic databases were searched from date of inception to August 2020. The incidence of JET was calculated with the relative risk of 95% confidence interval (CI). Quality assessment of the included studies was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
RESULTS: Eleven studies met the predetermined inclusion criteria and were included in this meta-analysis. Amiodarone, dexmedetomidine and magnesium significantly reduced the incidence of postoperative JET [Amiodarone: risk ratio 0.34; I2= 0%; Z=3.66 (P=0.0002); 95% CI 0.19-0.60. Dexmedetomidine: risk ratio 0.34; I2= 0%; Z=4.77 (P<0.00001); 95% CI 0.21-0.52. Magnesium: risk ratio 0.50; I2= 24%; Z=5.08 (P<0.00001); 95% CI 0.39-0.66].
CONCLUSION: All three drugs show promise in reducing the incidence of JET. Our systematic review found that dexmedetomidine is better in reducing the length of ICU stays as well as mortality. In addition, dexmedetomidine also has the least pronounced side effects among the three. However, it should be noted that this conclusion was derived from studies with small sample sizes. Therefore, dexmedetomidine may be considered as the drug of choice for preventing JET.

Matched MeSH terms: Sample Size
Fulltext Comparing the nutritional status of vegetarians and non-vegetarians from a Buddhist Organisation in Kuala Lumpur, Malaysia

Gan, Wan Ying, Boo, Shirley, Seik, Mei Yee, Khoo, Hock Eng

Malays J Nutr, 2018;24(1):89-101.
MyJurnal

Introduction: A vegetarian diet is generally considered as healthy for preventing metabolic-related diseases. There is lack of studies in Malaysia comparing the nutritional status of vegetarians and non-vegetarians. This cross-sectional study aims to compare body weight status, dietary intake and blood pressure level between these two groups. Methods: A total of 131 vegetarians and 135 non-vegetarians were recruited using convenience sampling from a Buddhist organisation in Kuala Lumpur. Body weight, height, waist circumference, percentage of body fat, and blood pressure measurements were taken, while dietary intake was assessed using a 2-day 24-hour dietary recall. Results: More vegetarians were underweight than non-vegetarians (31.3% vs 15.6%), while prevalence of overweight and obesity was higher among the non-vegetarians (23.7% vs 9.9%). A higher proportion of nonvegetarians (34.1%) had an unhealthy range of body fat percentage and significantly higher risk of abdominal obesity (24.4%) than the vegetarians (19.1% body fat; 13.7% abdominal obesity). Mean intakes for protein and fat were significantly lower among the vegetarians, while no significant differences were observed in the mean intake for energy and carbohydrate. Vegetarians had significantly higher intakes of vitamins C, D and E, calcium, potassium and folate, while vitamin B12 intake was significantly higher in the non-vegetarians. More non-vegetarians presented with unhealthy blood pressure status. Conclusion: Vegetarians in this study generally showed healthier dietary intake and lower body fatness than the non-vegetarians. Studies are suggested to be undertaken on a bigger sample size of vegetarians to confirm these findings.

Matched MeSH terms: Sample Size
The prevalence of Helicobacter pylori in patients with oesophageal stenosis

Ylmaz Ö, Temur A, Almal N, Dülger AC, Sasmaz MI

Trop Biomed, 2018 Dec 01;35(4):1148-1153.
PMID: 33601862

Oesophageal strictures often occur following esophagectomy which is performed for cases of oesophageal cancer. These patients require repeated dilation procedures. The aim of this study is to investigate the effects of dietary regimens, which are changed because of stenosis, caused by Helicobacter pylori (H. pylori). In this retrospective study, 28 patients who had operation for oesophageal cancer and underwent dilation due to development of stricture were studied. 30 female and 30 male patients who were admitted to the Gastroenterology Clinic with complaints of dyspepsia and did not receive treatment for the eradication of H. pylori were randomly selected and included in this study as a control group. Patients' histopathological records on the hemogram, biochemistry, and endoscopic biopsy were analysed. There were 26 H. pylori (+) cases (92.8 %) in the stenosis group consisting of 28 patients, and 37 H. pylori (+) cases (61.6%) in the control group consisting of 60 patients. These results were found to be statistically significant (P=0.003). The albumin level in the stenosis group was reported to be statistically low (P=0.002). The incidence of H. pylori was found to be significantly higher in patients with stenosis. We ascribed this outcome due to changes in dietary regimens. Our findings showed that the dietary regimens of all patients who underwent esophagectomy should be regulated during the postoperative period considering H. pylori. The relationship between H. pylori and stenosis was significant, there is a need for further research with a larger sample size to enrich the findings.

Matched MeSH terms: Sample Size
Prevalence and intensity of helminths among inhabitants of the Chi River and Lahanna water reservoir areas of Northeastern Thailand

Rattanapitoon SK, Pechdee P, Boonsuya A, Meererksom T, Wakkhuwatapong P, Leng M, et al.

Trop Biomed, 2020 Sep 01;37(3):730-743.
PMID: 33612786 DOI: 10.47665/tb.37.3.730

Helminth infections (HIs) are an important public health problem in tropical countries, and the associated problems have been neglected in rural areas of Thailand. Therefore, this study reports the prevalence and intensity of HIs among inhabitants of the Khon Sawan district, Chaiyaphum province, and Kaeng Samnam Nang district, Nakhon Ratchasima province, which are located near the Chi River and Lahanna water reservoir, northeastern Thailand. A cross-sectional descriptive study was conducted between July 31, 2018, and June 30, 2019, among rural villagers from 40 rural villages in 4 subdistricts. The participants were selected from the village enrolment list after proportional allocation of the total sample size. Faecal samples from 691 inhabitants were prepared using solvent-free faecal parasite concentrator, and helminths were then detected using a light microscope. Statistical analysis included the Chi-square test with Yates correction, and multivariable logistic regression was performed. A P-value of <0.05 was considered statistically significant. The prevalence of HIs was 2.03%. The most prevalent helminths were Opisthorchis viverrini (1.31%), followed by Strongyloides stercoralis (0.44%), Ascaris lumbricoides (0.29%), hookworm (0.15%), Teania spp. (0.15%) and one minute intestinal fluke (0.15%). Coinfections were identified in 2 cases for S. stercoralis and hookworm and 1 case for O. viverrini and S. stercoralis infection. All infected participants had a light intensity of HI. There was no significant difference between general characteristics for all HIs. The prevalence of HIs was not significantly associated with general characteristics. This study indicates that the infections result mainly from foodborne helminths and skin-penetrating nematodes. Therefore, interventions should concentrate on the personal hygiene of the population and improving sanitation to reduce HIs in this area.

Matched MeSH terms: Sample Size
Fulltext Visual impairment and its associated factors among the adult population of Kuala Pajam village, Branang, Selangor, Malaysia

Rozhan, S.M.R., Halim, I., Shamsul Azhar Sha

Malaysian Journal of Community Health, 2009;15(2):1-8.
MyJurnal

Background : Visual impairment among the rural community has rarely been studied in this country. The purpose of this study is to determine the prevalence of visual impairment and its related factors among the adult population of Kampung Kuala Pajam, Branang.
Methodology : A cross sectional study was carried out in Kampung Kuala Pajam, Mukim Beranang from 25th of December till 30th of December 2007. Universal sampling is adopted and the sample size consists of 321 respondents who is 18 years and above. Trained interviewer has been used to obtain the data through questionnaire and eye examinations using logMAR chart, Red Reflex eye test, Relative Afferent Pupillary Defect (RAPD) test and Pin-Hole test.
Result : A total of 261 respondents who fulfil the criteria were interviewed and had eyes examination during the study period. The prevalence of visual impairment in this population was 9.2% and factors that showed significant association were age (p

Matched MeSH terms: Sample Size
Occurrence and antibiotic resistance of Campylobacter jejuni and Campylobacter coli in retail broiler chicken

Usha, M.R., Fauziah, M., Tunung, R., Chai, L.C., Cheah, Y.K., Farinazleen, M.G., et al.

International Food Research Journal, 2010;17(2):247-255.
MyJurnal

Broiler part samples (80 fresh and 80 chilled) were examined for the prevalence and numbers of C. jejuni and C. coli by employing most-probable-number (MPN) and polymerase chain reaction (PCR) techniques. The prevalence of the bacteria was high where C. jejuni was detected in 92.5% fresh and 53.8% chilled samples while C. coli in 80.0% fresh and 56.3% chilled. The number of these bacteria in the positive fresh and chilled samples was from 3 to more than 2400 MPN/g and from 3 to 290 MPN/g, respectively. Antibiotic resistance test (using Kirby-Bauer disc diffusion method) on 10 C. jejuni and 13 C. coli isolates toward ampicillin, tobramycin, enrofloxacin, ciprofloxacin, tetracycline, cephalothin, gentamicin and norfloxacin revealed high resistance toward all antibiotics (20.0% - 100.0%). All isolates were resistant to at least two antibiotics. This study highlights the potential of multidrug-resistant C. jejuni and C. coli transmission to humans through fresh and chilled broiler parts. Consecutive studies with bigger sample sizes and covering all over Malaysia are warranted in future.

Matched MeSH terms: Sample Size
Fulltext Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study

Rai NP, Kumar P, Mustafa SM, Divakar DD, Kheraif AA, Ramakrishnaiah R, et al.

Adv Clin Exp Med, 2016 Jul-Aug;25(4):763-6.
PMID: 27629852 DOI: 10.17219/acem/59014

BACKGROUND: Oral lichen planus (OLP) is a common chronic mucocutaneous disease mostly seen in middle aged and elderly females. Oral lichen planus can occur in different oral sites such as gingiva, labial, buccal mucosa and on the tongue. And can have an indirect effect on initiating periodontitis.
OBJECTIVES: The purpose of the study was to evaluate the periodontal status of OLP patients and compare it with that of healthy controls. The presence of erosive lesions among gingival tissues makes oral hygiene procedures difficult to perform for obvious reasons. Plaque control and rigorous oral hygiene are primary requisites for the treatment of any oro-mucosal disease.
MATERIAL AND METHODS: Thirty patients with the erosive and reticular form of OLP as a study group and 30 healthy subjects as a control group were selected. The periodontal status of all subjects including gingival index (GI), Russell's periodontal index (PI) and bleeding on probing (BOP) were evaluated in both groups. Finally, the data was analyzed by a paired t-test using SPSS software v. 22.
RESULTS: The mean values of GI, PI and BOP were observed to be higher in the study group compared to the control group, and this was statistically significant (p < 0.05). The results shown are suggestive that periodontal status was poor in the study group as compared to the control group.
CONCLUSIONS: Further studies need to investigate periodontal status in oral lichen planus patients with larger sample size, and careful follow-up of these will assure an increase in the quality of life of these patients. The patient should be informed regarding the risk of periodontal problems in OLP and should be advised to have regular dental checkups to avoid a worsening of the conditio.
KEYWORDS: gingivitis; oral lichen planus; periodontitis; pre-cancerous condition

Matched MeSH terms: Sample Size
Fulltext Non-alcoholic fatty liver disease in metabolic syndrome patients in serdang hospital: quantification by contrast-enhanced computed tomography

Subapriya Suppiah, Lee, Roy-Ming Chow, Nor Sharmin Sazali, Hasyma Abu Hassan

Malaysian Journal of Medicine and Health Sciences, 2016;12(1):9-18.
MyJurnal

Introduction: Non-alcoholic Fatty Liver Disease (NAFLD) is one of the end organ damage detected
in patients having metabolic syndrome X and it can lead to chronic liver failure. Therefore, it is
important to be able to assess the condition in a quantifiable manner to help clinicians recognize
and treat this disease. Objective: We aimed to determine the prevalence of NAFLD in patients with
metabolic syndrome in Serdang Hospital, Malaysia using contrast-enhanced multidetector computed
tomography (CECT) abdominal scan. The study also aimed to calculate the quantification of NAFLD
using liver to spleen density CT Hounsfield Unit ratio, CTL/S or CTL/S measurement using abdominal
CECT scans. Furthermore, we aimed to verify the correlation of dyslipidemia with NAFLD based on
the CTL/S parameter. Materials and Method: We conducted a cross-sectional retrospective study in
Hospital Serdang, Malaysia using data from January 2012 to December 2013. The sample size was 279
patients with metabolic syndrome who had undergone CECT abdominal scan. Patient demographics
were descriptively analysed. Spearman’s correlation test was used to look for association among lipid
profile, blood sugar level and CTL/S ratio. Results: The prevalence of NAFLD in metabolic syndrome
patients in our population was 82.8%. Prevalence of NAFLD was high among the elderly population (≥
57 years old). Additionally, Indian ethnics with metabolic syndrome had the highest risk of developing
NAFLD (90.9%). There was a significant association between elevated LDL levels and CTL/S ratio
(p

Matched MeSH terms: Sample Size
Fulltext Drug Utilization on Neonatal Wards: A Systematic Review of Observational Studies

Rosli R, Dali AF, Abd Aziz N, Abdullah AH, Ming LC, Manan MM

Front Pharmacol, 2017;8:27.
PMID: 28228724 DOI: 10.3389/fphar.2017.00027

Despite limited evidence on safety and efficacy of drug use in neonates, drugs are extensively used in this age group. However, the availability of information on drug consumption in neonates, especially inpatient neonates, is limited. This paper systematically reviews published studies on drug utilization in hospitalized neonates. A systematic literature review was carried out to identify observational studies published from inception of databases used till August 2016. Four search engines, namely Medline, CINAHL, Embase, and PubMed, were used. Publications written in English that described drug utilization in neonatal wards were selected. Assessment of the data was based on the category of the study design, the objective of study and the method used in reporting drug consumption. A total of 20 drug utilization studies were identified, 12 of which focused on all drug classes, while the other eight evaluated antimicrobials. Studies were reported in Europe (n = 7), the United States (n = 6), India (n = 5), Brazil (n = 1), and Iran (n = 1). Substantial variance with regard to study types (study design and methods), data source, and sample size were found among the selected studies. Of the studies included, 45% were cross-sectional or retrospective, 40% were prospective studies, and the remaining 15% were point prevalence surveys. More than 70% of the studies were descriptive studies, describing drug consumption patterns. Fifteen per cent of the descriptive studies evaluated changes in drug utilization patterns in neonates. Volume of units was the most prevalent method used for reporting all drug categories. The ATC/DDD system for reporting drug use was only seen in studies evaluating antimicrobials. The most commonly reported drugs across all studies are anti-infectives for systemic use, followed by drugs for the cardiovascular system, the nervous system and the respiratory system. Ampicillin and gentamicin were the most prescribed antimicrobials in hospitalized neonates. The present review reveals that neonates are exposed to a high number of drugs and various methods are used to report drug consumption in this age group. The best measure of drug consumption to quantify prevalence of drug use in neonates remains to be identified and additional research in this area is warranted.

Matched MeSH terms: Sample Size
High-Throughput RT-qPCR for the Analysis of Circulating MicroRNAs

Tan GW, Tan LP

Methods Mol Biol, 2017;1580:7-19.
PMID: 28439823 DOI: 10.1007/978-1-4939-6866-4_2

Reverse transcription followed by real-time or quantitative polymerase chain reaction (RT-qPCR) is the gold standard for validation of results from transcriptomic profiling studies such as microarray and RNA sequencing. The current need for most studies, especially biomarker studies, is to evaluate the expression levels or fold changes of many transcripts in a large number of samples. With conventional low to medium throughput qPCR platforms, many qPCR plates would have to be run and a significant amount of RNA input per sample will be required to complete the experiments. This is particularly challenging when the size of study material (small biopsy, laser capture microdissected cells, biofluid, etc.), time, and resources are limited. A sensitive and high-throughput qPCR platform is therefore optimal for the evaluation of many transcripts in a large number of samples because the time needed to complete the entire experiment is shortened and the usage of lab consumables as well as RNA input per sample are low. Here, the methods of high-throughput RT-qPCR for the analysis of circulating microRNAs are described. Two distinctive qPCR chemistries (probe-based and intercalating dye-based) can be applied using the methods described here.

Matched MeSH terms: Sample Size
Fulltext Prevalence of obesity and associated factors among secondary school students in Slemani City Kurdistan Region, Iraq

Muhammad Saeed Qadir, Rampal, Lekhraj, Sherina Mohd Sidik, Salmiah Md Said, Zhian Salah Ramzi

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):27-38.
MyJurnal

Obesity is a well-established risk factor for cardiovascular disease. The objective of
the study was to determine the prevalence of obesity and factors associated among secondary school students aged between 13 to 17 years at Slemani City Centre, Iraq. Methodology: A cross sectional study design was used. The calculated sample size was 1656. Probability proportional to size sampling technique was used to select the sample. A validated pretested questionnaire was used to collect the data. Weight and height were also taken. Data were analyzed using SPSS version 21. Chi-square test was used to determine an association between two categorical variables. Independent t-test was used to compare two means. Multiple logistic regression was used to determine the predictors for obesity. Results: The response rate was 92.54% and the overall mean age of the 1588 respondents was 15.42 (95% CI = 15.35, 15.49) years. The prevalence of overweight and obesity was 20.6% and 11.3% respectively. Variables significantly associated with overweight and obesity (age, monthly family income, education level of parents, body part satisfaction and body size perception) were entered into the logistic regression model. Multiple logistic regression analysis showed that the predictors for overweight and obesity were age, monthly family income, body part dissatisfaction and body size perception. Conclusion: The prevalence of overweight and obesity is high (20.6% and 11.3% respectively). The predictors of obesity among secondary school students aged between 13 to 17 years old at Slemani City Centre Kurdistan Region, Iraq were age, family income and body image dissatisfaction.

Matched MeSH terms: Sample Size
Fulltext Prevalence and sources of stress among medical students in Universiti Sains Malaysia and Universiteit Maastricht

Liew, Yen Yee, Muhamad Saiful Bahri Yusoff

Education in Medicine Journal, 2013;5(4):34-41.
MyJurnal

Introduction: Various studies had been done on medical students stress, but there is yet no comparative study done between universities in Asia and Europe. Universiti Sains Malaysia (USM) and Universiteit Maastricht (UM) share a lot in common in terms of medical education as both actively apply PBL-oriented education into their curriculum. It will be interesting to find out the effect of differing culture, one Eastern and another Western, on the prevalence of stress and stressors among medical students of both universities.

Method: A comparative study was conducted on medical students from USM and UM. Psychological distress was measured by the 12 item General Health Questionnaire and stressors were measured by the 40 item Medical Student Stressor Questionnaire. The calculated sample size was 215 per university. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.

Result: Results showed that the overall prevalence of psychological distress among medical students of USM and UM was 25.9% and no significant difference was found between the two universities. Binary logistic regression test showed that medical students in pre-clinical phase were 1.84 times more likely to develop psychological distress than medical students in clinical phases (B = 0.612, odd ratio (CI95%) = 1.84 (1.16, 2.93), p = 0.010). The major stressors were related to academic requirements, UM medical students perceived the stressors as causing less stress than USM medical students (t-stat (df) = 5.33 (380), p-value < 0.001).

Conclusion: Psychological health among medical students in the two universities was comparable. Academic requirements were the most stressful events as perceived by the students, but UM medical students had more positive perception toward the stressors than USM medical students. Pre-clinical students experienced higher psychological pressures than the clinical students. The medical schools should provide more attention to pre-clinical students because they might need psychological support from them.

Matched MeSH terms: Sample Size
Fulltext Psychometric properties of the QOLLTI-F questionnaire to assess quality of life in caregivers of cancer patients

Rafi Mahmoud Alnjadat, Aasim Adnan, Zalina Ismail

Education in Medicine Journal, 2014;6(2):41-47.
MyJurnal

Aim: The objective of the present study was to assess the validity and reliability of Malay version of the QOLLTI-F questionnaire.
Methods: A total of 80 Malay caregivers of cancer patients in an outpatient oncology clinic were enrolled in this study. A translated QOLLTI-F questionnaire of 16 items was used in order to assess their quality of life. Demographic characteristics were recorded. Both face and content validity of the translated version were carried out by professionals and the construct validity of the questionnaire was assessed by exploratory factor analysis.
Results: Exploratory factor analysis led to the extraction of seven factors and this was consistent with the English version. Cronbach Alpha coefficient showed good consistency of the questions within the sub-scales (Cronbach's alpha > 0.7).
Conclusion: This study was confined to a Malay population, and the analyses were potentially limited by a small sample size .Nevertheless, the translated questionnaire demonstrated valid and reliable psychometric properties when administered to Malay caregivers. Future studies are needed to see if this instrument can fit other samples in different settings and populations.
Study site: Oncology clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Sample Size
Fulltext The Prevalenve And Impact Of Oro-Facial Pain Among 12-year-old School Children In An Epidemiological Survey Setting

Jaafar, N, Razak, I.A.

Ann Dent, 2002;9(1):-.
MyJurnal

The objective of the study was to attempt to verify the cause of self-reported oro-facial pain among 12-yearold children, objectively via a clinical examination. This is a descriptive, cross-sectional survey using a combination of self-reported questionnaire, face-to-face interview and clinical oral examination. The children were first asked to answer a self-filled questionnaire about their oro-facial pain experience in the past 4- weeks. In order to verify its cause, a clinical examination and an interview followed. Normative oral health status data was also collected. The sample was 1492 Malay schoolchildren with diverse socioeconomic background from the states of Johore, Kelantan and Sabah. The sample size for each state was calculated to give a sampling error of not more than 5 %. In each state, quota sampling was done to achieve a balanced distribution between gender and location. The data collected were normative status for caries, periodontal disease and traumatized teeth. Orofacial pain experience represented the subjective status for oral well-being. The cause of pain was confirmed through a clinical examination. The normative oral health status data implies a very low untreated disease and good oral health among the schoolchildren. However the subjective health status, as reflected by the prevalence of pain suggested that oro-facial pain and suffering was high (27.3%) with about 49% "of moderate and severe" intensity. The two main causes were caries and mouth ulcers. However in about onequarter of pain cases, diagnosis cannot be confirmed in the field survey setting. More than one-half of those with pain experienced disturbed sleep and study. It was concluded that overall oral health status and well-being can be better described if normative data is complemented with subjective data such as pain prevalence. The study shows that the majority (more than 75 %) of cases of subjective pain can be objectively verified in a field epidemiology survey setting. The reliability of the subjective data can be improved by a clinical examination as compared to unverified self-report. The study also confirms that the major source of oro-facial pain among the 12 year-olds were caries and mouth ulcers.

Matched MeSH terms: Sample Size

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