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  1. Yusof Z, Isa Z
    J Oral Rehabil, 1994 Jan;21(1):77-86.
    PMID: 8133391
    The aims of the study were to determine the periodontal status of the teeth in contact with removable partial dentures (RPDs) and to compare them with other teeth in the opposing arch not related to any prosthesis. The periodontal status was also assessed in relation to the age of the dentures. Four hundred and twenty-seven patients treated with RPDs from 1981 to 1986 were recalled for examination. Prior to prosthetic treatment they were given periodontal treatment and fillings when required. Initially all were given oral hygiene instructions and motivation. They were reviewed regularly only on a short-term basis. Eighteen patients were suitable for the present study comprising of eight males and 10 females whose mean age was 41 years. The RPDs were in use from 1.5 to 8 years (mean 4.6 years). The following parameters were assessed: Plaque index (P1I), Gingival index (GI), loss of attachment (LA) and tooth mobility. The wearing of RPDs resulted in higher P1I, GI and LA compared to the controls and these differences were statistically significant. There was an increased frequency of higher P1I, GI and LA with the increase in denture age. Minor changes in tooth mobility were observed. It was concluded that the wearing of RPDs was detrimental to periodontal health in patients whose oral hygiene was less than adequate.
  2. Isa Z, Yusof Z
    J Oral Rehabil, 1990 Nov;17(6):541-50.
    PMID: 2283549
    The aims of this study were to determine the dental and periodontal status and the associated treatment needs, other than that for prosthetic care, in patients who requested removable partial dentures. Forty-six patients who had never worn removable partial dentures before were examined for plaque index, tooth status, gingival index, loss of periodontal attachment and tooth mobility. Prior to prosthetic treatment, 15% of the teeth needed conservative treatment and 1% needed extractions. From the periodontal point of view, 65% of the teeth needed some form of related therapy, and 2% of the teeth were at risk of extraction due to advanced mobility.
  3. Shahrir, S.N., Abdul Manaf, M.R., Mustapha, F.I., Md. Isa, Z.
    MyJurnal
    SHAKE Technical Package outlines the policies and interventions in reducing population salt intake which includes five overarching elements needed to create a successful salt reduction programme followed by the five elements of the SHAKE Package for salt reduction that consist of (1) surveillance, (2) harness the industry, (3) adopt the standards for labelling and marketing, (4) knowledge, and (5) environment. The aim for the present work was to critically review the documents related to the dietary sodium reduction strategies in Malaysia as compared to the SHAKE Technical Package. This review involves online and physical document searches of documents related to dietary sodium reduction within the Ministry of Health Malaysia. Visits to each related department via a liaison officer were done for clarification about the documents. Data was sorted according to the SHAKE Framework and a SWOT analysis was done. A total of 32 documents related to salt reduction policies and 15 health education materials were identified. Malaysia’s salt reduction policies comply to four out of five overarching elements of a successful salt reduction program with the presence of political commitment, dedicated programme leadership and governance, partnership with other ministries and stakeholders and integration with iodine deficiency elimination programme. For the SHAKE Package, Malaysia’s policies comply with all the five SHAKE Package elements. However, further investigation revealed that the food products involved in the food reformulation programme were limited. The SWOT analysis revealed that Malaysia has developed a specific plan for a national salt reduction strategy by producing its own Salt Reduction Strategy to Prevent and Control Non-Communicable Diseases for Malaysia Guidelines 2015-2020. Currently, there is no comprehensive database on the salt content of processed foods in Malaysia mainly due to the absence of mandatory labelling for sodium content in processed foods, which is a significant threat to the implementation of salt reduction initiative in the country. Pro-active non-governmental organisations (NGOs) and civil society groups advocating salt reduction in the community is needed to place salt high on the political and developmental agenda Salt reduction strategy as a policy in Malaysia includes almost all recommendations in the SHAKE Framework Malaysia. However, it is still in its early stage.
  4. Ali O, Isa ZM
    Asia Pac J Clin Nutr, 1995 Sep;4(3):319-24.
    PMID: 24394359
    This study was conducted to investigate the nutritional status of the rural population in Malaysia, especially women and children. A total of 262 women aged 18 and over and 183 children aged 2-6 years were selected using multistage cluster sampling from four locations in rural areas. It was found that the prevalence of malnutrition among children 2-6 years old ranged between 25.5% in the Malays Felda settlement scheme to 80% in the Orang Asli settlement. Malnutrition was associated with worm infestations, bottle feeding and early weaning. More than 30% of Orang Asli women were malnourished compared to less than 15% of Malay Felda settlement women. On the other hand, Malay women in the land settlement scheme had a higher risk of developing overweight and diabetes. Goitre was found among 11.5% of children; however, no cretinism was found. Breast feeding was still a common practice among rural mothers, but inadequate health education tended to reduce the duration of breast feeding and increased early weaning. Upgrading women's status in the rural areas will ultimately improve the nutritional and health status of the children and community as a whole.
  5. Liang R, Isa ZM
    Sci Rep, 2024 Jan 04;14(1):537.
    PMID: 38177226 DOI: 10.1038/s41598-023-50754-5
    Heavy metal pollutant is a serious problem in environmental pollution, and it is very difficult to eradicate once it enters the soil. As heavy metal adsorption has been proven to occur, the heavy metal's behaviour can be modeled as a transport equation with adsorption. Previous adsorption term mostly due to the concentration alone, while in here, the desorption effect given by the rate of change of the concentration is also included. Also, the heavy metals are frequently considered to enter the soil after being dumped into the soil for a certain period of time. But, quick dumping onto the soil can introduce heavy metal instantaneously. Heavy metals entering the soil through leaching or when their concentration in the soil is influenced by chemical reactions, can all lead to the exponential decay of heavy metals entering the soil. Based on two-dimensional advection diffusion equation (ADE) with the new adsorption term, analytical solutions are obtained for the cases of instantaneous and exponential attenuation of heavy metals emission to soil by the method of Laplace transform. The results highlight the significant influence of emission type on the peak concentrations. If heavy metals are instantaneously enter the soil, the peak occurs in the range of 1-3 m radius from the point of emission on the first day, while for exponential attenuation the peak occurs close to the point of emission. Furthermore, there exists a correlation between retardation factors and heavy metal concentrations, where a decrease in retardation factors leads to an increase in heavy metal concentration. It is essential to investigate both types of heavy metals emission to provide valuable information for proper pollution management, effective environmental regulations and enforcement.
  6. Ghazali M, Md Isa Z
    Asia Pac J Clin Nutr, 2023 Dec;32(4):408-416.
    PMID: 38135476 DOI: 10.6133/apjcn.202312_32(4).0005
    BACKGROUND AND OBJECTIVES: Epidemiological studies often use the food frequency questionnaire (FFQ) to predict the food consumption habits of a target group and subsequently promote healthy eating in the group. In the present study, a version of the FFQ for Malaysian young adults aged 18-24 years was designed and validated.

    METHODS AND STUDY DESIGN: This study comprised development and validation phases. In the development phase, 129 young adults from a public university in Klang Valley completed a 3-day food record (3DFR), and the data were used to create a food list for the FFQ. Two weeks later, in the validation phase, another 100 participants recruited from the same university completed the 3DFR and a newly developed FFQ for assessing consumption of 38 food items. Finally, the data obtained from the FFQ and 3DFR were used to analyze the nutrient intake of each participant, and the developed FFQ was validated using Spearman correla-tion coefficients (r) and Bland-Altman methods.

    RESULTS: For the development phase, 38 food items were determined to contribute to 90% of the participants' total energy and macronutrient intake, and these items were included on the FFQ. For the validation phase, the average Spearman correlation coefficient for energy and all nutrients was 0.43, which indicated good agreement between the 3DFR and FFQ. Cross-classification analysis of the 3DFR and FFQ results revealed that 79% of the young adults were classified into similar or neighboring quartiles when each set of results was used. The Bland-Altman plots revealed that the results obtained using the two methods were parallel.

    CONCLUSIONS: The FFQ is a simple and validated tool that can be self-administered to young adults to assess their energy and nutrient consumption.

  7. Sakthiswary R, Wong M, Isa ZM, Nor Azmi K
    Clin Ter, 2012;163(3):195-8.
    PMID: 22964690
    Treatment with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) may suppress aldosterone production only in the initial phase of treatment and subsequently lead to a rising level of aldosterone to baseline or higher. This phenomenon is described as aldosterone breakthrough. Apart from serial plasma aldosterone levels, there are no other test to identify this condition. The purpose of this study was to evaluate the role of spot urine potassium as a potential screening test for aldosterone breakthrough.
  8. Saedi AM, Majid AA, Isa Z
    Int J Occup Saf Ergon, 2021 Sep;27(3):714-727.
    PMID: 31131712 DOI: 10.1080/10803548.2019.1623454
    Introduction. Demographic information is one of the key parameters that organizations utilize to modify their practices in order to respond to the existing risk within work environments. The present article aims to assess the level of safety climate factors as well as to evaluate the influence of personal factors on safety climate in two different-sized industries. Methods. A total of 216 employees in two large and three small and medium-sized chemical manufacturing industries responded to a questionnaire. Descriptive statistics were used to measure the safety climate level; a two-independent-sample Mann-Whitney U test and a Kruskal-Wallis test were run to compare the difference in safety climate scores among different demographic variables. Results. The lower level of safety climate in small and medium-sized industries revealed lower understanding and performance of management and non-management with regard to safety climate compared to the large industries. Additionally, significant mean differences on some safety climate factors among demographic variables were detected in both sizes of industries, emphasizing the important role of the employees' demographic variables on the plants' safety climate. Conclusion. Improving organization-level and group-level safety climates is recommended to improve employees' level of safety climate and control their personal factors.
  9. Mahmud MH, Baharudin UM, Md Isa Z
    BMC Public Health, 2022 Nov 16;22(1):2090.
    PMID: 36384509 DOI: 10.1186/s12889-022-14449-2
    Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.
  10. Pasi H, Md Isa Z, Azhar Shah S
    Asian Pac J Cancer Prev, 2018 Feb 26;19(2):395-400.
    PMID: 29479988
    Objective: To determine the perceived risk of developing cancer in a suburban community in Malaysia. Methods:
    A cross sectional study using a simple random sampling was conducted among residents aged 18 years old and above
    (n=520) who had never been diagnosed with cancer, in selected households in a suburban area of Pahang state in
    Malaysia. The study instruments were a validated questionnaire on risk perception, an automatic blood pressure monitor,
    a weighing scale and a measuring tape. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 and
    the p value was taken at p <0.05 as significant. Result: This study revealed that only 5.0 percent individuals perceived
    they were at risk cancer, whilst the perceived severity was 41.3 percent. Multivariable analysis showed a significant
    association only for a family history of cancer (adjusted OR of 4.80; 95% CI = 1.45-15.82) (p=0.010) among this
    population. Conclusion: The perceived risk of developing cancer in the selected suburban community of Pahang state in
    Malaysia is low as compared to that for other non-communicable diseases in this country, whilst the perceived severity
    was higher than for other diseases. Thus, considering the importance of correct perceptions for behavioral changes,
    more health education and promotion is needed to make the community better aware of the actual threat of cancer.
  11. Md Isa Z, Amsah N, Ahmad N
    Nutrients, 2023 May 15;15(10).
    PMID: 37242192 DOI: 10.3390/nu15102310
    Vitamin D deficiency and insufficiency are public health concerns that have contributed to multiple negative health outcomes. Recent studies have revealed that vitamin D deficiency and insufficiency influence glycaemic control and the development of diabetes complications. The goal of this systematic review is to summarise the latest evidence on the impact of vitamin D deficiency and insufficiency on the outcome of Type 2 Diabetes Mellitus (T2DM) patients. In this PRISMA-guided systematic review, articles were sourced from three databases, namely, PubMed, Scopus, and Web of Science. The review only included literature published from 2012 until 2022, and 33 eligible studies met the inclusion criteria for this review. The included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT). According to our findings, vitamin D deficiency or insufficiency is associated with mental health status, macrovascular and microvascular complications of T2DM, metabolic syndrome, increased risk of obesity, increased blood pressure, dyslipidaemia, glycaemic control, nerve-related disease, musculoskeletal-related complications, and reduced quality of life. Due to the diverse implications of vitamin D deficiency and insufficiency, screening for vitamin D levels in T2DM patients may be beneficial.
  12. Isa ZM, Alias IZ, Kadir KA, Ali O
    Asia Pac J Clin Nutr, 2000 Dec;9(4):274-81.
    PMID: 24394503
    Although endemic goitre is no longer a major public health problem in Malaysia, iodine deficiency still remains a significant problem in a few remote settlements. The aim of this study was to determine the effectiveness of iodized oil intervention in the prevention of endemic goitre among the indigenous people in Malaysia. A pretest and post-test controlled trial was conducted among primary schoolchildren and pregnant mothers in Lasah, Sungai Siput and Perak. Legap Post and Yum Post were selected as the intervention areas, while Perwor Post and Poi Post were taken as controls. The variables studied included thyroid hormone concentrations, thyroid volume, urinary iodine excretions and mental performance. A baseline and two follow-up visits were conducted in both intervention and control areas. Intervention subjects were given iodized oil in the form of capsules which were taken orally (Laboratoire Guerbet, Paris, France). There was a significant increase in serum thyroxine hormone (T4) concentrations (p<0.0001) and a significant decrease in thyroid stimulating hormone (TSH) concentrations (p<0.05) in the schoolchildren following the intervention, however, pregnant mothers did not show any significant changes in T4 and TSH concentrations. Thyroid size was significantly reduced in both groups (p<0.05). Urinary iodine excretions showed a significant increase in both groups following the intervention (p<0.01). However, mental performance in schoolchildren was not affected. In conclusion, iodized oil (oral) is effective in reducing thyroid size, as well as improving the supply of iodine among schoolchildren and pregnant mothers in endemic goitre areas; however, its long-term effects need to be monitored closely. This method can be considered as an alternative while awaiting national coverage for the salt iodization program.
  13. Mat Sutris J, Md Isa Z, Sumeri SA, Ghazi HF
    Ann Glob Health, 2017 3 12;82(5):770-778.
    PMID: 28283128 DOI: 10.1016/j.aogh.2016.10.008
    BACKGROUND: Increasing use of pesticides in agriculture to control pest may result in permanent damage to the environment and consequently cause harmful health problems especially among infant and children. Due to pesticide's natural toxicity and its widespread use, it causes a serious threat to public health especially to this vulnerable group.

    OBJECTIVE: The purpose of this study was to determine the organophosphorus pesticide urinary metabolite levels and its predictors among Orang Asli children of the Mah Meri tribe living in an agricultural island in Kuala Langat, Selangor.

    METHODS: Data collection was carried out at an island in Kuala Langat, Selangor, where a total of 180 Orang Asli children of the Mah Meri tribe voluntarily participated in the study. Data were collected via a validated, modified questionnaire. Urinary organophosphate metabolites, namely dimethylphosphate, diethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylthiophosphate, and diethyldithiophosphate were measured to assess organophosphate pesticide exposure in children.

    FINDINGS: Eighty-four (46.7%) of the respondents were positive for urine dialkyl phosphate metabolites. In multivariable analysis, children who frequently consumed apples had 4 times higher risk of pesticide detection than those who consumed apple less frequently. In addition, those who frequently ate cucumbers had 4 times higher risk for pesticide detection than those who ate cucumbers less frequently. Children with a father whose occupation involved high exposure to pesticides (agriculture) had 3 times higher risk of pesticide detection than those with a father in a low-risk occupation (nonagriculture).

    CONCLUSIONS: Almost half of the children (46.7%) in the study area tested positive for urinary dialkyl phosphate metabolite levels. Most of the metabolite levels were equal to or higher than that reported in other previous studies. Major factors associated with pesticide detection in children in this study were frequent intake of apple and cucumber and fathers who are working in an agricultural area.

  14. Maimaiti N, Ahmed Z, Md Isa Z, Ghazi HF, Aljunid S
    Value Health Reg Issues, 2013 09 13;2(2):259-263.
    PMID: 29702874 DOI: 10.1016/j.vhri.2013.07.003
    OBJECTIVE: To measure the clinical burden of invasive pneumococcal disease (IPD) in selected developing countries.

    METHODS: This is an extensive literature review of published articles on IPD in selected developing countries from East Asia, South Asia, Middle East, sub-Saharan Africa, and Latin America. We reviewed all the articles retrieved from the knowledge bases that were published between the years 2000 and 2010.

    RESULTS: After applying the inclusion, exclusion, and quality criteria, the comprehensive review of the literature yielded 10 articles with data for pneumococcal meningitis, septicemia/bacteremia, and pneumonia. These selected articles were from 10 developing countries from five different regions. Out of the 10 selected articles, 8 have a detailed discussion on IPD, one of them has s detailed discussion on bacteremia and meningitis, and another one has discussed pneumococcal bacteremia. Out of these 10 articles, only 5 articles discussed the case-fatality ratio (CFR). In our article review, the incidence of IPD ranged from less than 5/100,000 to 416/100,000 population and the CFR ranged from 12.2% to 80% in the developing countries.

    CONCLUSIONS: The review demonstrated that the clinical burden of IPD was high in the developing countries. The incidence of IPD and CFR varies from region to region and from country to country. The IPD burden was highest in sub-Saharan African countries followed by South Asian countries. The CFR was low in high-income countries than in low-income countries.

  15. Abdul Samad NI, Md Isa Z, Hod R
    Children (Basel), 2017 Dec 14;4(12).
    PMID: 29240681 DOI: 10.3390/children4120109
    The main concern regarding mercury exposure is the adverse health effect on the developing nervous system. The objective of this cross-sectional study was to determine hair mercury levels and their association with socio-demographic characteristics, complaints about mercury poisoning symptoms and the fish consumption pattern among children in Malaysia. A cross-sectional study was conducted among 215 school children aged 11 years old. Hair was collected from the children and the total mercury was analyzed using oxygen combustion-gold amalgamation atomic absorption spectrophotometry. Anthropometric data, a fish consumption questionnaire and mercury poisoning symptoms were collected during a personal interview. The mean hair mercury level among primary school children was 0.63 ± 0.59 µg/g with the geometric mean of 0.47 µg/g. A total of 14% of respondents had hair mercury levels above 1 µg/g. A multiple binary logistic regression analysis outlined that fish consumption of at least one meal per week increased the likelihood of having a high mercury level (odds ratio (OR) 3.7, 95% confidence interval (CI) 1.3-10.4). This study confirms the existence of a mercury burden among Malaysian children and the level is high compared to other regional studies. This study provides important baseline data regarding the mercury level among children in Malaysia.
  16. Abd Rahman R, Idris IB, Md Isa Z, Abd Rahman R
    PLoS One, 2022;17(12):e0278192.
    PMID: 36473006 DOI: 10.1371/journal.pone.0278192
    Anemia in pregnancy is a public health concern. It has been diagnosed in 27% of pregnant women in Malaysia and up to 40% of pregnant women globally. This study aimed to develop and evaluate the effectiveness of an intervention initiative based on the health belief model. The MyPinkMom program was disseminated through a mobile messaging application to pregnant women to educate them on the prevention of anemia in pregnancy. We conducted a two-arm cluster-assignment, single-blinded, randomized control trial at two government antenatal clinics in Selangor. One clinic was randomly chosen as the intervention group, and the other was chosen as the control group. Sixty pregnant women with anemia from the intervention group received the MyPinkMom intervention program in the form of six infographic video clips, and 60 pregnant women with anemia from the control group received routine counseling on anemia in pregnancy. Pregnant women who had anemia secondary to hemoglobinopathy or other chronic diseases were excluded from this study. MANOVA showed significant increases in hemoglobin, knowledge, attitude, subjective norms, and perceived behavioral control scores for adherence to iron supplements, dietary iron, and dietary vitamin C intake (p < 0.001) in the intervention group at week 6. A significant reduction also occurred in dietary tannin intake (p < 0.001) in the intervention group at week 6. The intervention group at week 6 showed a large effect on hemoglobin level increments (partial eta squared, Ƞp2 0.268), dietary iron intake (Ƞp2 0.213), knowledge of anemia in pregnancy (Ƞp2 0.622), subjective norm scores for adherence to iron supplements (Ƞp2 0.167), and reduction in dietary tannin intake (Ƞp2 0.353). Similarly, repeated measures ANOVA showed that changes in hemoglobin levels were significantly different over time (i.e., at baseline, week 6, and week 12) between the intervention and control groups (p < 0.001). Hemoglobin increased rapidly over time among participants in the intervention group but gradually in the control group. To conclude, the newly developed MyPinkMom program that was delivered through a messaging application showed effectiveness in preventing anemia during pregnancy.
  17. Amsah N, Md Isa Z, Ahmad N, Abdul Manaf MR
    PMID: 36901588 DOI: 10.3390/ijerph20054577
    As the COVID-19 pandemic continues, healthcare services have been grossly overwhelmed by the pandemic. Due to this circumstance, routine care for individuals with type 2 diabetes mellitus (T2DM) has been temporarily disrupted. The purpose of this systematic review was to summarize the evidence regarding the impact of the COVID-19 pandemic on healthcare utilization among patients with T2DM. A systematic search was conducted in the Web of Science, Scopus, and PubMed databases. The process of identifying the final articles followed the PRISMA guidelines. The inclusion criteria were articles published between 2020 and 2022, written in English, and studies focusing on the research question. Any proceedings and books were excluded. A total of fourteen articles relevant to the research question were extracted. Following that, the included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT) and the Joanna Briggs Institute Critical Appraisal Tool to assess the quality of the studies. The findings were further classified into three themes: reduced healthcare utilization among T2DM patients in routine healthcare services, a surge of telemedicine usage, and delay in the delivery of healthcare services. The key messages include demands for monitoring the long-term effects of the missed care and that better preparedness is crucial for any pandemic in the future. A tight diagnostic workup at the community level and regular follow-ups are crucial in managing the impact of the pandemic among T2DM patients. Telemedicine should be on the agenda of the health system to maintain and complement healthcare services. Future research is warranted to determine effective strategies to deal with the impact of the pandemic on healthcare utilization and delivery among T2DM patients. A clear policy is essential and should be established.
  18. Abd Wahil MS, Ja'afar MH, Md Isa Z
    PeerJ, 2023;11:e15132.
    PMID: 37197586 DOI: 10.7717/peerj.15132
    BACKGROUND: The presence of aluminium (Al) in the human body may impact brain neurodevelopment and function, and it is thought to contribute to autism spectrum disease (ASD). The main objective of this study was to assess the association between urinary Al and the development of ASD among Malaysian preschool children in the urban city of Kuala Lumpur.

    METHOD: This was an unmatched case-control study in which children with ASD were recruited from an autism early intervention center and typically developed (TD) children were recruited from government-run nurseries and preschools. Urine samples were collected at home, assembled temporarily at study locations, and transported to the laboratory within 24 h. The Al concentration in the children's urine samples was determined using inductively coupled plasma mass spectrometry (ICP-MS).

    RESULT: A total of 155 preschool children; 81 ASD children and 74 TD children, aged 3 to 6 years, were enlisted in the study. This study demonstrated that ASD children had significantly higher urinary Al levels than TD children (median (interquartile range (IQR): 2.89 (6.77) µg/dL versus 0.96 (2.95) µg/dL) (p 1, p 

  19. Mezbah U, Omar R, Md Isa Z, Knight VF
    PMID: 37641697 DOI: 10.51329/mehdiophthal1439
    BACKGROUND: Clear vision is crucial for effective learning among preschool children. Hence, early detection of vision impairment and prompt treatment are required to improve prognosis. Currently, limited information is available, and no program exists to screen for vision impairment among preschoolers in Bangladesh. This study aimed to validate the KieVision™ Preschool Vision Screening Kit, translated into the Bengali language, to improve vision impairment detection among preschool children.

    METHODS: In this prospective case-control study, 60 preschool teachers from Chittagong were randomly selected. The study group was trained to conduct vision screening among preschool children using the translated kit, whereas the control group was trained using the Chittagong Eye Infirmary and Training Complex (CEITC) School Teachers' Training Module. Fifteen preschool children aged 4-6 years were screened by each preschool teacher and again by the optometrist.

    RESULTS: Sixty preschool teachers screened 900 children. The results showed a higher validity of vision screening findings by the preschool teachers in the study group (sensitivity, 68.00%; specificity, 92.75%) than in the control group (sensitivity 47.37%, specificity 70.39%). The level of agreement between the preschool teachers and optometrists was high for all tests (first-order agreement coefficient [AC1] ≥ 0.80 in the study group). The sensitivity and specificity of the visual acuity test for the study group were 59.65% and 94.15%, respectively, while in the control group it was 13.33% and 62.54%, respectively. A similar trend was noted in the general observation component and Hirschberg's test.

    CONCLUSIONS: The Bengali Language KieVision™ Preschool Vision Screening Kit can be used effectively by preschool teachers in vision screening programs to improve the identification of vision impairment among preschool children in Bangladesh.

  20. Ghazi HF, Mustafa J, Aljunid S, Isa Z, Abdalqader MA
    J Health Popul Nutr, 2013 Sep;31(3):350-5.
    PMID: 24288949
    The unstable geopolitical situation in Iraq since 2003 still affects the health of people, especially children. Several factors may indirectly affect a child's nutritional status. The main aim of this study was to identify factors contributing to malnutrition among 3 to 5 years old children in Baghdad city, Iraq. Two hundred twenty children aged 3 to 5 years were chosen randomly from four kindergartens in Baghdad city according to the cross-sectional design. The nutritional status of the children was assessed using a weight-for-age z-score based on the World Health Organization 2007 cutoff points, in which any child with a z-score of
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