Displaying publications 1 - 20 of 48 in total

  1. Hashim H, Abdul Kadir K
    Biomed Imaging Interv J, 2011 Oct;7(4):e26.
    PMID: 22279503 MyJurnal DOI: 10.2349/biij.7.4.e26
    Pre-operative embolisation of vertebral metastases has been known to effectively devascularise hypervascular vertebral tumours and to reduce intra-operative bleeding. However, the complications that occur during the procedure are rarely reported. This case study attempts to highlight one rare complication, which is epidural tumoural haemorrhage intra-procedure. It may occur due to the fragility of the tumour and presence of neovascularisation. A small arterial dissection may also have occurred due to a slightly higher pressure exerted during injection of embolising agent. Haemostasis was secured via injection of Histoacryl into the area of haemorrhage. The patient was able to undergo the decompression surgery and suffered no direct complication from the haemorrhage.
  2. Talib R, Ali O, Arshad F, Kadir KA
    Asia Pac J Clin Nutr, 1997 Jun;6(2):84-7.
    PMID: 24394705
    A study was undertaken in FELDA (Federal Land Development Authority) resettlement scheme areas in Pahang, Malaysia, to determine the effectiveness of group dietary counselling in motivating diabetic patients to achieve good dietary habits, and weight and diabetes control. Sixty-one non-insulin dependent diabetes mellitus (NIDDM) patients were randomly assigned to either the experimental or control group. The experimental group received six sessions of group dietary counselling over 5 months and the control group received mass media diabetes-educational program during the same period. The one hour group dietary counselling sessions discussed general knowledge of diabetes, food groups for meal planning, the importance of dietary fibre-rich foods, types of fat in food, exercise and weight control. The experimental group met monthly with a dietitian as a counsellor. Effectiveness was assessed by improvement in food choice, and decline in percentage glycated haemoglobin (total HbA1) or body mass index (BMI). Measurements were made at a baseline visit, every two months during the six month program, and six months afterwards. Patients in the experimental group improved their food choices, resulting in a healthier diet high in unrefined carbohydrates and dietary fibre rich foods, and low in fat. There were significant reductions of their percentage total HbA1 levels and BMI following the counselling sessions, which decreased further six months after the program compared with patients in the control group. Thus group dietary counselling is effective in motivating NIDDM patients to achieve better food choice, and related weight and glycaemic control in a Malaysian setting.
  3. 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.
  4. 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.
  5. Shamaan NA, Kadir KA, Rahmat A, Ngah WZ
    Nutrition, 1998 12 3;14(11-12):846-52.
    PMID: 9834927
    The effects of vitamin C and aloe vera gel extract supplementation on induced hepatocarcinogenesis in male Sprague-Dawley rats (120-150 g) by diethylnitrosamine (DEN) and 2-acetylaminofluorene (AAF) was investigated. The severity of the carcinogenesis process was determined by measuring gamma-glutamyl transpeptidase (GGT) and the placental form of glutathione S-transferase (GSTP) histochemically in situ and in plasma and liver fractions. In addition, plasma alkaline phosphatase (ALP) and liver microsomal uridine diphosphate glucuronyl transferase (UDPGT) activity were also determined. Administration of DEN/AAF caused an increase in the surface area and number of enzyme-positive foci (both GGT and GSTP) compared with control. Supplementation of vitamin C or aloe vera gel extract to the cancer-induced rats suppressed this increase significantly (P < 0.05; P < 0.001). Increases in liver UDPGT, GGT, and GSTP activities were also observed with cancer induction that were again suppressed with either vitamin C or aloe vera gel supplementation. Plasma GGT in the DEN/AAF rats were determined monthly for the duration of the experiment and found to be reduced as early as 1 mo with aloe vera gel supplementation and 2 mo with vitamin C supplementation. In conclusion, vitamin C and aloe vera gel extract supplementation were found to be able to reduce the severity of chemical hepatocarcinogenesis.
  6. Tan SMQ, Chiew Y, Ahmad B, Kadir KA
    Nutrients, 2018 Sep 17;10(9).
    PMID: 30227659 DOI: 10.3390/nu10091315
    Tocotrienol-rich vitamin E from palm oil (Tocovid) has been shown to ameliorate diabetes through its superior antioxidant, antihyperglycemic, and anti-inflammatory properties in diabetic rats. This study aimed to investigate the effects of Tocovid on diabetic nephropathy in patients with type 2 diabetes. Baseline parameters of potential subjects such as HbA1c, blood pressure, Advanced Glycation Endproduct (AGE), soluble receptor for AGE (sRAGE), Nε-Carboxymethyllysine (Nε-CML), and Cystatin C were assessed for possible correlation with diabetic nephropathy. Only subjects with diabetic nephropathy or urine microalbuminuria-positive defined as Urine Albumin to Creatinine Ratio (UACR) >10 mg/mmol were recruited into a prospective, randomized, double-blinded, placebo-controlled trial. The intervention group (n = 22) received Tocovid 200 mg twice a day while the control group (n = 23) received placebo twice a day for 8 weeks. Changes in Hemoglobin A1c (HbA1c), blood pressure, serum biomarkers and renal parameters such as UACR, serum creatinine, and estimated Glomerular Filtration Rate (eGFR) were compared between the two groups. It was found that serum Nε-CML significantly correlated to the severity of microalbuminuria. For every 1 ng/mL increase in serum Nε-CML, the odds of diabetic nephropathy increased by 1.476 times. Tocovid, compared to placebo, significantly reduced serum creatinine but not eGFR, UACR, HbA1c, blood pressure, and serum biomarkers. In conclusion, serum Nε-CML is a potential biomarker for diabetic nephropathy. Treatment with Tocovid significantly reduced serum creatinine; therefore Tocovid may be a useful addition to the current treatment for diabetic nephropathy.
  7. Chang CY, Pui WC, Kadir KA, Singh B
    Malar J, 2018 Dec 04;17(1):448.
    PMID: 30509259 DOI: 10.1186/s12936-018-2600-2
    BACKGROUND: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria.

    CASE PRESENTATION: A 46-year-old man presented with fever and acute surgical abdomen with concomitant P. knowlesi malaria infection at Kapit Hospital. He was in compensated shock upon arrival to the hospital. He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fluid in the abdomen. He underwent emergency exploratory laparotomy in view of haemodynamic instability and worsening peritonism. Intraoperatively, haemoperitoneum and bleeding from the spleen was noted. Splenectomy was performed. Histopathological examination findings were suggestive of splenic rupture and presence of malarial pigment. Analysis of his blood sample by nested PCR assays confirmed P. knowlesi infection. The patient completed a course of anti-malarial treatment and recovered well post-operation.

    CONCLUSIONS: Spontaneous splenic rupture is a rare complication of malaria. This is the first reported case of splenic rupture in P. knowlesi malaria infection. Detection of such a complication requires high index of clinical suspicion and is extremely challenging in hospitals with limited resources.

  8. Phang SCW, Palanisamy UD, Kadir KA
    J Integr Med, 2019 Mar;17(2):100-106.
    PMID: 30738774 DOI: 10.1016/j.joim.2019.01.008
    OBJECTIVE: A preliminary study showed that geraniin extracted from Nephelium lappaceum L. at 50 mg/kg caused reduction in blood glucose and insulin resistance. The present study serves to further investigate the effects of geraniin at increasing doses between 3.125 and 100 mg/kg in high-fat diet-treated rats.

    METHODS: Geraniin (95% purity) was extracted and purified from rambutan rind. Two groups of male Sprague-Dawley rats were fed with 60% high-fat diet and standard rat chow, respectively, for 12 weeks. High-fat diet-treated rats were then administered geraniin at different doses. Body weight, blood pressure and blood glucose readings were measured. At the end of treatment, blood was collected for analysis of glycated haemoglobin A1c (HbA1c), insulin, advanced glycation end-product (AGE) levels, renin, aldosterone and electrolytes.

    RESULTS: Within the first week of treatment, even the lowest dose of geraniin caused a significant reduction in blood pressure, which was comparable to control diet-treated rats. There were no changes in serum electrolytes, renin or aldosterone. Similarly, there was a significant reduction in serum insulin, insulin resistance and AGE levels at the lowest dose. However, there was no significant decrease in fasting blood glucose or HbA1c. The effects of decreasing insulin, insulin resistance and AGEs were observed only at the lower doses, unlike the results observed for blood pressure reduction.

    CONCLUSION: Geraniin at lower doses improved blood pressure and other metabolic parameters. Secondary metabolites of geraniin, associated with antihypertensive activity, are relatively different to those involved in inhibiting AGE formation and increasing insulin sensitivity. The secondary metabolites of geraniin may be individually responsible for the bioactivities demonstrated.

  9. Hambali Z, Ngah WZ, Wahid SA, Kadir KA
    Pathology, 1995 Jan;27(1):30-5.
    PMID: 7603748
    The effects of ovariectomy and hormone replacement in control and carcinogen treated female rats were investigated by measuring whole blood and liver glutathione (WGSH, HGSH), glutathione S-transferase (GST), glutathione peroxidase (GPx), and glutathione reductase (GRx) and histological evaluation. Hepatocarcinogenesis was induced by diethylnitrosamine and 2-acetylaminofluorene. In control rats not receiving carcinogen, ovariectomy significantly increased the GST and GRx activities. Replacement with either estrogen or progesterone reduced the GST activities to below intact female values whereas replacement of both hormones together brought the GST activities to that of intact females. GRx activities were brought to intact female values by replacement with estrogen or progesterone, either singly or in combination. Neither ovariectomy nor sex hormone/s replacement influenced the levels of WGSH, HGSH and GPx activities. Carcinogen administration to intact rats increased all the parameters measured. Ovariectomized rats treated with carcinogen showed lower GPx and GRx activities at 2 mths. However, replacement with either progesterone or combined estrogen and progesterone increased GPx and GRx activities to original values. On the other hand GST and GPx activities in ovariectomized rats which had carcinogen treatment were lower than intact rats after 5 mths. Replacement with hormones either singly or both brought GST and GPx activities up to intact rat levels receiving carcinogen. The levels of WGSH, HGSH and GRx activities (5 mths) in carcinogen treated rats were not influenced by ovariectomy and/or hormone/s replacement. The results from this study suggested that ovariectomy reduced the severity of hepatocarcinogenesis which was restored by sex hormone/s replacement.
  10. Fungfuang W, Udom C, Tongthainan D, Kadir KA, Singh B
    Malar J, 2020 Oct 01;19(1):350.
    PMID: 33004070 DOI: 10.1186/s12936-020-03424-0
    BACKGROUND: Certain species of macaques are natural hosts of Plasmodium knowlesi and Plasmodium cynomolgi, which can both cause malaria in humans, and Plasmodium inui, which can be experimentally transmitted to humans. A significant number of zoonotic malaria cases have been reported in humans throughout Southeast Asia, including Thailand. There have been only two studies undertaken in Thailand to identify malaria parasites in non-human primates in 6 provinces. The objective of this study was to determine the prevalence of P. knowlesi, P. cynomolgi, P. inui, Plasmodium coatneyi and Plasmodium fieldi in non-human primates from 4 new locations in Thailand.

    METHODS: A total of 93 blood samples from Macaca fascicularis, Macaca leonina and Macaca arctoides were collected from four locations in Thailand: 32 were captive M. fascicularis from Chachoengsao Province (CHA), 4 were wild M. fascicularis from Ranong Province (RAN), 32 were wild M. arctoides from Prachuap Kiri Khan Province (PRA), and 25 were wild M. leonina from Nakornratchasima Province (NAK). DNA was extracted from these samples and analysed by nested PCR assays to detect Plasmodium, and subsequently to detect P. knowlesi, P. coatneyi, P. cynomolgi, P. inui and P. fieldi.

    RESULTS: Twenty-seven of the 93 (29%) samples were Plasmodium-positive by nested PCR assays. Among wild macaques, all 4 M. fascicularis at RAN were infected with malaria parasites followed by 50% of 32 M. arctoides at PRA and 20% of 25 M. leonina at NAK. Only 2 (6.3%) of the 32 captive M. fascicularis at CHA were malaria-positive. All 5 species of Plasmodium were detected and 16 (59.3%) of the 27 macaques had single infections, 9 had double and 2 had triple infections. The composition of Plasmodium species in macaques at each sampling site was different. Macaca arctoides from PRA were infected with P. knowlesi, P. coatneyi, P. cynomolgi, P. inui and P. fieldi.

    CONCLUSIONS: The prevalence and species of Plasmodium varied among the wild and captive macaques, and between macaques at 4 sampling sites in Thailand. Macaca arctoides is a new natural host for P. knowlesi, P. inui, P. coatneyi and P. fieldi.

  11. Waran V, Tang IP, Karuppiah R, Abd Kadir KA, Chandran H, Muthusamy KA, et al.
    Br J Neurosurg, 2013 Dec;27(6):742-6.
    PMID: 23647078 DOI: 10.3109/02688697.2013.791667
    Abstract The endoscopic transnasal, transsphenoidal surgical technique for pituitary tumour excision has generally been regarded as a less invasive technique, ranging from single nostril to dual nostril techniques. We propose a single nostril technique using a modified nasal speculum as a preferred technique. We initially reviewed 25 patients who underwent pituitary tumour excision, via endoscopic transnasal transsphenoidal surgery, using this new modified speculum-guided single nostril technique. The results show shorter operation time with reduced intra- and post-operative nasal soft tissue injuries and complications.
  12. Waran V, Bahuri NF, Narayanan V, Ganesan D, Kadir KA
    Br J Neurosurg, 2012 Apr;26(2):199-201.
    PMID: 21970777 DOI: 10.3109/02688697.2011.605482
    The purpose of this study was to validate and assess the accuracy and usefulness of sending short video clips in 3gp file format of an entire scan series of patients, using mobile telephones running on 3G-MMS technology, to enable consultation between junior doctors in a neurosurgical unit and the consultants on-call after office hours.
  13. Lim WY, Chia YY, Liong SY, Ton SH, Kadir KA, Husain SN
    Lipids Health Dis, 2009;8:31.
    PMID: 19638239 DOI: 10.1186/1476-511X-8-31
    The metabolic syndrome (MetS) is a cluster of metabolic abnormalities comprising visceral obesity, dyslipidaemia and insulin resistance (IR). With the onset of IR, the expression of lipoprotein lipase (LPL), a key regulator of lipoprotein metabolism, is reduced. Increased activation of glucocorticoid receptors results in MetS symptoms and is thus speculated to have a role in the pathophysiology of the MetS. Glycyrrhizic acid (GA), the bioactive constituent of licorice roots (Glycyrrhiza glabra) inhibits 11beta-hydroxysteroid dehydrogenase type 1 that catalyzes the activation of glucocorticoids. Thus, oral administration of GA is postulated to ameliorate the MetS.
  14. Bebakar WM, Chow CC, Kadir KA, Suwanwalaikorn S, Vaz JA, Bech OM, et al.
    Diabetes Obes Metab, 2007 Sep;9(5):724-32.
    PMID: 17593237 DOI: 10.1111/j.1463-1326.2007.00743.x
    Aim: To evaluate the efficacy and safety of adding biphasic insulin aspart 30 (BIAsp30; NovoMix 30) to existing oral antidiabetic agents (OADs) vs. optimizing OADs in a subgroup of Western Pacific patients with type 2 diabetes inadequately controlled on oral monotherapy or oral combination therapy.

    Methods: This 26-week, multi-centre, open-labelled, randomized, two-arm parallel trial consisted of a 2-week screening period, followed by 24 weeks of treatment. Subjects randomized to BIAsp30 treatment (n = 129) received BIAsp30 once daily (o.d.) at dinnertime between Week 2 and Week 14, and those not reaching treatment targets were switched to twice daily (b.i.d.) BIAsp30 at Week 14 (n = 50). Subjects randomized to the OAD-only arm (n = 63) continued with their previous OAD treatment and, in an attempt to reach treatment goals, the dose was optimized (but OAD unchanged) in accordance to local treatment practice and labelling.

    Results: Significantly greater reductions in HbA(1c) over Weeks 0-13 with BIAsp30 (o.d.) vs. OAD-only treatment (1.16 vs. 0.58%; p < 0.001), and over Weeks 0-26, with BIAsp30 (o.d.) and BIAsp30 (b.i.d.) treatments vs. OAD-only treatment (1.24 vs. 1.34 vs. 0.67%; p < 0.01). Hypoglycaemic episodes were reported in 54% of the patients in BIAsp30 (o.d. and b.i.d. pooled) and 30% of the patients in OAD-only group. All episodes were minor or symptomatic, except for one in each treatment group, which was major.

    Conclusions: Initiating BIAsp30 treatment is a safe and more effective way to improve glycaemic control in Western Pacific patients with type 2 diabetes inadequately controlled with oral monotherapy or oral combination therapy compared with optimizing oral combination therapy alone. In patients not reaching treatment target on BIAsp30 (o.d.), treatment with BIAsp30 (b.i.d.) should be considered.
  15. Fong CY, Hlaing CS, Tay CG, Abdul Kadir KA, Goh KJ, Ong LC
    Eur. J. Paediatr. Neurol., 2016 May;20(3):449-53.
    PMID: 26900103 DOI: 10.1016/j.ejpn.2016.01.012
    Longitudinal extensive transverse myelitis associated with dengue infection is rare with no reported paediatric cases.
  16. Yaw HP, Ton SH, Chin HF, Karim MK, Fernando HA, Kadir KA
    PMID: 26069530
    Stress and high-calorie diets increase the risk of developing metabolic syndrome. Glycyrrhizic acid (GA) has been shown to improve dyslipidaemia in rats fed on a high-calorie diet. This study aimed to examine the effects of GA on lipid metabolism in rats exposed to short- or long-term stress and on a high-calorie diet. The parameters examined included serum lipid profiles, serum free fatty acids and fatty acid profiles in tissues, and expression of peroxisome proliferator-activated receptors (PPAR), lipoprotein lipase (LPL), elongases and desaturases. Within the 14- or 28-day exposure groups, neither stress nor GA affected the lipid profile and serum free fatty acids. Stress did not affect PPAR-α expression in both the 14- and 28-day exposure groups. However, GA-treated rats from the former group had increased PPAR-α expression only in the kidney while all other tissues from the latter group were unaffected. Stress increased PPAR-γ expression in the heart of the 28-day exposure group but its expression was unaffected in all tissues of the 14-day exposure group. GA elevated PPAR-γ expression in the kidney and the skeletal muscles. Neither stress nor GA affected LPL expressions in all tissues from the 14-day exposure group but its expressions were elevated in the QF of the stressed rats and heart of the GA-treated rats of the 28-day exposure group. As for the elongases and desaturases in the liver, stress down-regulated ELOVL5 in the long-term exposure group while up-regulated ELOVL6 in the short-term exposure group while hepatic desaturases were unaffected by stress. Neither elongase nor desaturase expressions in the liver were affected by GA. This research is the first report of GA on lipid metabolism under stress and high-calorie diet conditions and the results gives evidence for the role of GA in ameliorating MetS via site-specific regulation of lipid metabolism gene expressions and modification of fatty acids.
  17. Gendeh BS, Murad S, Razi AM, Abdullah N, Mohamed AS, Kadir KA
    Otolaryngol Head Neck Surg, 2000 May;122(5):758-62.
    PMID: 10793361
    The aim of the study was to determine the incidence of food and house dust mite (HDM) allergy in patients with nasal congestion and rhinorrhea attending the Otorhinolaryngology Clinic, National University of Malaysia, Kuala Lumpur. This was a prospective matched, controlled study of patients skin prick tested with commercial food and common aeroallergens. The participants were 148 Malaysian adults with symptoms of nasal congestion and rhinorrhea and 113 adult Malaysian control subjects without rhinitis symptoms. The skin prick test (SPT) was used to evaluate 11 foods common to the Malaysian diet and 3 HDM inhalants. Forty-eight percent of the patients with rhinitis had positive SPT results to foods, compared with 4.4% of control subjects (P < 0.05). The most commonly implicated foods were shrimp (48%) and rice (30%), which are common in the Malaysian diet. Seventy-two percent of rhinitis patients had positive SPT results to HDM, compared with 22.2% of control subjects (P < 0.05). Patients with rhinitis also had significantly more gastrointestinal problems than control subjects (P < 0.05). The incidences of HDM and food allergy are significantly greater in Malaysian adults with rhinitis symptoms than in control subjects without rhinitis. The effect of avoidance or immunotherapy awaits further study.
    Study site: Otorhinolaryngology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  18. Ngah WZ, Jarien Z, San MM, Marzuki A, Top GM, Shamaan NA, et al.
    Am J Clin Nutr, 1991 04;53(4 Suppl):1076S-1081S.
    PMID: 1672785 DOI: 10.1093/ajcn/53.4.1076S
    The effects of tocotrienols on hepatocarcinogenesis in rats fed with 2-acetylaminofluorene (AAF) were followed morphologically and histologically for a period of 20 wk. No differences between treated and control rats in the morphology and histology of their livers was observed. Cell damage was extensive in the livers of AAF-treated rats but less extensive in the AAF-tocotrienols-treated rats when compared with normal and tocotrienols-treated rats. 2-Acetylaminofluorene significantly increases the activities of both plasma and liver microsomal gamma-glutamyltranspeptidase (GGT) and liver microsomal UDP-glucuronyltransferase (UDP-GT). Tocotrienols administered together with AAF significantly decrease the activities of plasma GGT after 12 and 20 wk (P less than 0.01, P less than 0.002, respectively) and liver microsomal UDP-GT after 20 wk (P less than 0.02) when compared with the controls and with rats treated only with tocotrienols. Liver microsomal GGT also showed a similar pattern to liver microsomal UDP-GT but the decrease was not significant. These results suggest that tocotrienols administered to AAF-treated rats reduce the severity of hepatocarcinogenesis.
  19. Wong YQ, Tan LK, Seow P, Tan MP, Abd Kadir KA, Vijayananthan A, et al.
    PLoS One, 2017;12(6):e0179895.
    PMID: 28658309 DOI: 10.1371/journal.pone.0179895
    OBJECTIVES: This study assesses the whole brain microstructural integrity of white matter tracts (WMT) among older individuals with a history of falls compared to non-fallers.

    METHODS: 85 participants (43 fallers, 42 non-fallers) were evaluated with conventional MRI and diffusion tensor imaging (DTI) sequences of the brain. DTI metrics were obtained from selected WMT using tract-based spatial statistics (TBSS) method. This was followed by binary logistic regression to investigate the clinical variables that could act as confounding elements on the outcomes. The TBSS analysis was then repeated, but this time including all significant predictor variables from the regression analysis as TBSS covariates.

    RESULTS: The mean diffusivity (MD) and axial diffusivity (AD) and to a lesser extent radial diffusivity (RD) values of the projection fibers and commissural bundles were significantly different in fallers (p < 0.05) compared to non-fallers. However, the final logistic regression model obtained showed that only functional reach, white matter lesion volume, hypertension and orthostatic hypotension demonstrated statistical significant differences between fallers and non-fallers. No significant differences were found in the DTI metrics when taking into account age and the four variables as covariates in the repeated analysis.

    CONCLUSION: This DTI study of 85 subjects, do not support DTI metrics as a singular factor that contributes independently to the fall outcomes. Other clinical and imaging factors have to be taken into account.

  20. Ng YM, Lim SK, Kang PS, Kadir KA, Tai MS
    BMC Nephrol, 2016 10 18;17(1):151.
    PMID: 27756244
    BACKGROUND: Epidemiological studies have shown an inverse relationship between vitamin D levels and cardiovascular diseases. However, this does not infer a causal relationship between the two. Chronic kidney disease (CKD) patients have a high prevalence of vitamin D deficiency and carotid atherosclerosis. Therefore, in this study we have aimed to determine the association between serum 25-hydroxyvitamin D levels and carotid atherosclerosis in the CKD population.

    METHODS: 100 CKD stage 3-4 patients were included in the study. Direct chemiluminesent immunoassay was used to determine the level of serum 25-hydroxyvitamin D. All subjects underwent a carotid ultrasound to measure common carotid artery intima-media thickness (CCA-IMT) and to assess the presence of carotid plaques or significant stenosis (≥50 %). Vitamin D deficiency was defined as serum 25-hydroxyvitamin D 

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