Displaying publications 1 - 20 of 53 in total

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  1. Lim MY, Chen HC, Omar MA
    J Vet Med Educ, 2014;41(2):197-203.
    PMID: 24589865 DOI: 10.3138/jvme.0713-099R1
    The ability to assess and control pain is listed as one of the desired Day One competencies among veterinary graduates. As such, a study was conducted to examine the current status and effectiveness of a video-based training module on the attitude toward and knowledge of pain assessment in cats among fourth- and final-year veterinary students of Universiti Putra Malaysia (UPM) in January of 2013. A total of 92 students participated in this study, resulting in a response rate of 60.1%. Upon completion of a pre-training survey, the respondents undertook an interactive video-based presentation, followed by a post-training survey. The majority of the students (96.7%) agreed on the importance of pain management. Before the training, many (76.1%) disagreed that they had received adequate training, while 53.3% were not confident in their pain-recognition skills. After training, their knowledge and confidence in pain assessment increased. Responses to the survey were not associated with differences in gender, level of study, or field of interest. Students were found to have mistaken some physiologic parameters as good pain indicators after ovariohysterectomy. Their assessment of three standardized video cases revealed that they could recognize prominent signs of pain but failed to identify changes in behavior that were more subtle. Refinement to the training module is required to address the above deficiencies.
  2. Omar MA, Mohd Haspani MS
    Malays J Med Sci, 2010 Jul;17(3):48-54.
    PMID: 22135549 MyJurnal
    External ventricular drainage (EVD) has been widely used for the purpose of cerebrospinal fluid (CSF) diversion at Hospital Kuala Lumpur (HKL).
  3. Bin Samsuddin MF, Bin Omar MA
    Asian J Neurosurg, 2019 4 3;14(1):283-285.
    PMID: 30937055 DOI: 10.4103/ajns.AJNS_332_17
    Malignant peripheral nerve sheath tumors (MPNSTs) are uncommon, biologically aggressive soft tissue sarcomas of neural origin that poses tremendous challenges to effective therapy. MPNSTs are among the most challenging mesenchymal malignancies to treat with poor prognosis. They usually affect young and middle-aged adults, tend toward early metastasis, and often demonstrate resistance to chemotherapy. We present a case of a 23-year-old female who initially presented with the right temporal swelling for 1 month associated with constitutional symptom which progressively worsening. The right craniotomy and excision biopsy were done with histopathological examination results suggestive of MPNST. Thorax-abdominal-pelvic computed tomography and magnetic resonance imaging further revealed multiple metastatic lesions involving spine, retroperitoneal, pelvic, chest wall, and lungs. This case illustrates the typical presentation of MPNST with its known poorly outcome.
  4. Goh PP, Omar MA, Yusoff AF
    Singapore Med J, 2010 Aug;51(8):631-4.
    PMID: 20848059
    INTRODUCTION: Diabetic retinopathy (DR) is the commonest complication of diabetes mellitus (DM), and is the leading cause of blindness among working adults. Modification of the associated risk factors as well as early detection and treatment of sight-threatening DR can prevent blindness. Clinical practice guidelines recommend annual eye screening for patients with DM. The proportion of patients in Malaysia who adhere to this recommendation was initially unknown.
    METHODS: The Malaysian National Health and Morbidity Survey is a population-based survey conducted once every decade on the various aspects of health, behaviour and diseases. The DM questionnaire on eye screening was administered as face-to-face interviews with 2,373 patients with known DM who were aged 18 years and older.
    RESULTS: In all, 55 percent of patients with known DM had never undergone an eye examination. Among patients who had undergone eye examinations, 32.8 percent had the last examination within the last one year, 49.8 percent within the last one to two years, and 17.4 percent more than two years ago. A significantly lower proportion of younger patients and patients who received treatment for DM from non-government facilities had previously undergone eye examinations.
    CONCLUSION: The prevalence of DM observed among Malaysians aged 30 and above is 14.9 percent; thus, there is a significant number of people with potential blinding DR. Adherence to eye screening guidelines and the prompt referral of sight-threatening DR are essential in order to reduce the incidence of blindness among patients with DM.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  5. Viswanathan S, Schee JP, Omar MA, Hiew FL
    Ther Apher Dial, 2021 Aug;25(4):513-532.
    PMID: 33029928 DOI: 10.1111/1744-9987.13595
    Evidence on the benefits of intermittent therapeutic plasma exchange (TPE) as maintenance therapy in neuromyelitis optica spectrum disorder (NMOSD) is limited. This study explores the possible effectiveness of sequential intermittent therapeutic plasma exchange (SITPE), a novel TPE protocol in the management of adult NMOSD patients. Through retrospective review of medical records in Kuala Lumpur Hospital, Malaysia, NMOSD patients who underwent SITPE, namely, an induction phase of monthly cycle of TPE (1 cycle = five exchange sessions) for three cycles with or without a subsequent maintenance phase of three-monthly cycle of TPE for three cycles, were included in this controlled historical cohort study. We explored their serial improvements in Expanded Disability Status Scale (EDSS), limb power, visual acuity, and annualized relapse rate following SITPE initiation. Statistical significance was set at P 
  6. Cheah YK, Kee CC, Lim KH, Omar MA
    Pediatr Neonatol, 2021 11;62(6):628-637.
    PMID: 34353744 DOI: 10.1016/j.pedneo.2021.05.025
    BACKGROUND: Mental health disorders are highly correlated with risk behaviors. The objective of the present study is to examine the relationship between risk behaviors and mental health among school-going students with a focus on ethnic minorities.

    METHODS: The National Health and Morbidity Survey (NHMS) 2017 (n = 8230) was used for analyses. It was a nationwide survey conducted in Malaysia. The dependent variables were measured by three risk behaviors (cigarette smoking, alcohol drinking and use of illicit drugs). Probit regressions were utilized to examine the effect of mental health on the probability of smoking, drinking and using illicit drugs. Demographic and lifestyle factors were used as the control variables. Truancy was identified as a mediating variable.

    RESULTS: Anxiety, depression and suicidal ideation affected cigarette smoking, alcohol drinking and use of illicit drugs through mediation of truancy. After controlling for demographic and lifestyle factors, students with anxiety, depression and suicidal ideation were more likely to smoke, drink and use illicit drugs compared with their peers without any mental health disorders. Furthermore, the likelihood of consuming cigarettes, alcohol and illicit drugs was found to be higher among students who played truant than those who did not.

    CONCLUSION: Mental health plays an important role in determining participation in risk behaviors among ethnic minority students in Malaysia. Public health administrators and schools have to be aware that students who suffer from mental health disorders are likely to indulge in risk behaviors.

  7. Zaaba ZF, Lim Xin Yi C, Amran A, Omar MA
    Sensors (Basel), 2021 Nov 03;21(21).
    PMID: 34770621 DOI: 10.3390/s21217313
    The security warning is a representation of communication that is used to warn and to inform a person whether security menaces have been discovered in order to prevent any consequences of damage from taking place. The purpose of a security warning is to provide a legitimate alert (to notify and to warn) to the users so that a secure manner of action is safely conducted. It is worth noting that the majority of computer users prefer to dismiss security warnings due to lack of attention, the use of technical words, and the deficiency of information provided. This paper determines to achieve two outcomes: firstly, a thorough review of problems, challenges, and approaches to improving security warnings. Our work complements the previous classifications in the identification of problems and challenges in security warnings by value-adding a new classification, namely immersion in the primary task. Then, we add other related works within the known classifications accordingly. In addition, our work also presents the classifications of approaches to improving security warnings. Secondly, we propose two timelines by addressing the problems, challenges, and approaches to improving security warnings. It is expected that the outcomes of this research will be useful to researchers within the niche area for analysing trends and providing the groundwork in security warning studies, respectively.
  8. Ibrahim A, Singh DKA, Shahar S, Omar MA
    J Multidiscip Healthc, 2017;10:409-416.
    PMID: 29138571 DOI: 10.2147/JMDH.S142520
    Background: Early detection of falls risk among older adults using simple tools may assist in fall prevention strategies. The aim of this study was to identify the best parameters associated with previous falls, either the timed up and go (TUG) test combined with sociodemographic factors and a self-rated multifactorial questionnaire (SRMQ) on falls risk or the TUG on its own. Falls risk was determined based on parameters associated with previous falls.

    Design: This was a retrospective cohort study.

    Setting: The study was conducted in a community setting.

    Participants: The participants were 1,086 community-dwelling older adults, with mean age of 69.6±5.6 years. Participants were categorized into fallers and nonfallers based on their history of falls in the past 12 months.

    Method: Participants' sociodemographic data was taken, and SRMQ consisting of five falls-related questions was administered. Participants performed the TUG test twice, and the mean was taken as the result.

    Results: A total of 161 participants were categorized as fallers (14.8%). Multivariate logistic regression analysis showed that the model (χ(2)(6)=61.0, p<0.001, Nagelkerke R(2)=0.10) consisting of the TUG test, sociodemographic factors (gender, cataract/glaucoma and joint pain), as well as the SRMQ items "previous falls history" (Q1) and "worried of falls" (Q5), was more robust in terms of falls risk association compared to that with TUG on its own (χ(2)(1)=10.3, p<0.001, Nagelkerke R(2)=0.02).

    Conclusion: Combination of sociodemographic factors and SRMQ with TUG is more favorable as an initial falls risk screening tool among community-dwelling older adults. Subsequently, further comprehensive falls risk assessment may be performed in clinical settings to identify the specific impairments for effective management.

  9. Ho BK, Kaur J, Nainu BM, Omar MA, Saleh M, Yau WK, et al.
    Med J Malaysia, 2013 Aug;68(4):332-7.
    PMID: 24145262 MyJurnal
    INTRODUCTION: The objective of this study was to determine the prevalence and factors associated with the awareness, treatment and control of hypertension among the elderly population in Malaysia.
    METHODS: Analysis of secondary data from a cross-sectional national population based survey using stratified multistage sampling conducted from April to August 2006 throughout Malaysia National Health and Morbidity Survey III (NHMS III). Adults aged 60 and older who had participated in the survey were included in the study.
    RESULTS: A total of 4954 respondents (14.3%) were elderly from the 34,539 respondents aged 18 years and above for hypertension module in NHMS III. A total of 4933 elderly had their blood pressure examined (giving a response rate of 99.6%). The overall prevalence of hypertension among elderly was 74.0%, more in elderly female (77.4%) than men (70.1%). Only 49.3% of them were aware of their hypertensive status, 42.4% were currently treated and 22.6% of those being treated were under control. The results of multiple logistic regression showed factors associated with higher awareness and treatment rates were similar i.e. females, young-old age group (age 60-74), urban residents, Chinese ethnic group and higher education. For those elderly who were on treatment, determinants associated with controlled hypertension were Chinese and Indians ethnic groups and higher educational level.
    CONCLUSIONS: There was a high prevalence of hypertension among the elderly in Malaysia but with poor awareness, treatment and control rate. Reliable information on these aspects is important for the development of patient education programs, health policies to improve disease management and overall health care resource allocation especially among the elderly in Malaysia.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  10. Bukar MM, Yusoff R, Haron AW, Dhaliwal GK, Khan MA, Omar MA
    Trop Anim Health Prod, 2012 Oct;44(7):1505-11.
    PMID: 22461200 DOI: 10.1007/s11250-012-0095-3
    The effects of different estrus synchronization techniques on follicular development and estrus response were studied in 81 nulliparous Boer does. The does were divided into nine groups. Eight of the nine groups were synchronized with prostaglandin F2-alpha (PGF(2α)) or flugestone acetate (FGA) or their combinations, and the ninth group was a control group. In addition to the above combinations, four of the eight synchronized groups were given 5 mg follicle-stimulating hormone (FSH) and the remaining four groups were administered 300 IU equine chorionic gonadotrophin (eCG). Posttreatment follicular development was monitored until ovulation occurred using a real-time B-mode ultrasound scanner (Aloka, 500 SSD, Japan), with a 7.5-MHz transrectal linear probe. All the does from the synchronized groups that were given eCG exhibited oestrus while only 88.9% of the does synchronized with FSH showed estrus. The estrus response was observed to be the least among the does synchronized with PGF(2α) + FSH (33.3%) combination followed closely by the FGA + FSH (42.9%) combinations. It was observed that the combinations of FGA + PGF(2α) + FSH resulted in increased percentage of estrus response, duration of estrus, and ovulation. The number of follicles was higher (P < 0.05) in FSH-synchronized groups than the eCG-synchronized groups. It was concluded that the best estrus synchronization protocol in goats is the FGA + eCG with or without PGF(2α). However, the PGF(2α) + FGA + FSH method of estrus synchronization is the most promising combination for further development as a better alternative to estrus synchronization with eCG in does.
  11. Khoo TB, Kassim AB, Omar MA, Hasnan N, Amin RM, Omar Z, et al.
    Disabil Rehabil, 2009;31(21):1753-61.
    PMID: 19479558 DOI: 10.1080/09638280902751964
    To determine the magnitude and impact of physical disability on Malaysian school-aged children between 7 and less than 18 years old.
  12. Kaka U, Rahman NA, Abubakar AA, Goh YM, Fakurazi S, Omar MA, et al.
    J Pain Res, 2018;11:743-752.
    PMID: 29695926 DOI: 10.2147/JPR.S152475
    Objectives: The effects of pre-emptive infusion of ketamine-lidocaine with tramadol on the suppression of central sensitization were investigated in a dog ovariohysterectomy model.

    Patients and methods: Twelve dogs were randomly assigned to two groups: ketamine-lidocaine-tramadol (KLT) and tramadol (T) groups. Both groups received intravenous tramadol 4 mg/kg body weight as premedication. Immediately after induction, the KLT group received ketamine and lidocaine at 0.5 and 2 mg/kg loading dose, followed by continuous rate infusion of 50 and 100 µg/kg/min, respectively, for 2 hours. Dogs in T group received saline bolus and continuous rate infusion at equi-volume. Intraoperatively, hemodynamic responses to surgical stimulation were recorded, whereas postoperative pain was evaluated using an algometer and short form of the Glasgow composite measure pain scale.

    Results: Intraoperatively, hemodynamic responses to surgical stimulation were obtunded to a greater degree in KLT compared to T group. Postoperatively, the pain scores increased only for the first hour in KLT group, compared to 12 hours in T group. Mechanical thresholds at the abdomen decreased postoperatively between 12 and 60 hours in KLT group versus the entire 72 hours in T group. Thresholds at tibia and radius in both groups increased in the immediate 1 hour postoperatively, but decreased thereafter. Significant decrement of thresholds from baseline were detected in the tibia at 24, 42, and 60 hours in KLT group compared to 24-72 hours in T group, and in the radius between 36 and 48 hours in T group, but none in KLT group.

    Conclusion: Addition of pre-emptive ketamine-lidocaine infusion to single intravenous dose of tramadol enhanced attenuation of central sensitization and improved intra- and postoperative analgesia.

  13. Hussin NM, Shahar S, Yahya HM, Din NC, Singh DKA, Omar MA
    BMC Public Health, 2019 Aug 22;19(1):1159.
    PMID: 31438929 DOI: 10.1186/s12889-019-7508-4
    BACKGROUND: Limited information is available from longitudinal studies regarding the predictors and incidence of MCI in older Asian adults. Thus, a community-based longitudinal study was conducted to determine the incidence of MCI among multi-ethnic older adults in Malaysia. The role of health and lifestyle as predictors of MCI was also examined.

    METHODS: Analysis of data obtained from the Towards Useful Aging (TUA) study (2014-2016), wave 1 (baseline) and wave 2 (1½ years of follow-up) was conducted. For the baseline, comprehensive, interview-based questionnaires were administered to 1227 subjects who were 60 years old and above. MCI is a unique transitional state between normal ageing and dementia. MCI characteristics include a decline and disturbance of cognition, minimal impairment of complex activities, ability to perform regular daily functions, and absence of dementia. The incidence of MCI was assessed using comprehensive neuropsychological batteries. The study then performed a logistic regression analysis to examine the effect of each possible predictor of MCI. This analysis began with univariate analyses and a separate review of the effect of every variable. Binary logistic analyses followed hereafter.

    RESULTS: During the follow-up after 1½ years, 179 (14.6%) of the participants who did not exhibit MCI at baseline were observed to have developed MCI. Among the participants who did not exhibit MCI at baseline, the incidence rate was 10.5 per 100 person-years. Male sex and lack of engagement in mental activities were predictors of MCI among participants without MCI at baseline.

    CONCLUSION: After the 1½-year follow-up, the incidence rate for MCI was considerably high among the respondents. Being male and being less engaged in mental activities were predictors of the occurrence of MCI. Mental activities need to be promoted for the prevention of MCI incidence among older adults.

  14. Handool KO, Ibrahim SM, Kaka U, Omar MA, Abu J, Yusoff MSM, et al.
    J Exp Orthop, 2018 May 02;5(1):13.
    PMID: 29721763 DOI: 10.1186/s40634-018-0128-6
    BACKGROUND: The use of a closed fracture model has become the preferred model to study the fracture healing process, given that the periosteum and the soft tissue surrounding the fracture site play an important role in the fracture healing process. Some techniques like osteotomy, drilling the long bones and the use of the guillotine-like apparatus to induce fracture are characterized by some undesirable effects and complications. The aim of this study is to optimize and evaluate an in vivo fracture model using three-point bending pliers that can be used to study secondary bone fracture healing in rats.

    METHODS: Modified three-point bending pliers were used as a device to create the closed rat tibial bone fracture that was prefixed with an intramedullary pin (23 G × 11/2″) in rats. The exact location of the induced closed fracture was along the long bone. The presence of bone comminution, and the fracture bone alignment were immediately examined after the induction of the fracture until the 6th week.

    RESULTS: All fractures induced were transverse, located in the middle to proximal one third of the tibia, and they all healed without complications. Bone union as shown radiographically occurred within 2-3 weeks postoperative. The average angle of the fracture line with the axis of the tibia was 89.41 ± 2.11°. The lateral and anterio-posterior pin angulation views were 167.33 ± 3.67° and 161.60 ± 4.87° respectively. The average length of proximal end of the fractured bone in comparison with the whole length of intact bone was 41.02 ± 3.27%. There was a significant difference in percentage of the gross callus area and gross callus index, while there was no significant difference in X-ray callus index. There was no significant difference of the gross callus area between slight comminution (n = 4) and non comminution (n = 21).

    CONCLUSION: The optimized rat tibial fracture model resulted in mainly transverse tibial mid-shaft fractures with minimal bone comminution and absence of surrounding soft tissue damage. The size area of consequent soft callus formation and the extent to which the closed fracture model was reproducible are very good outcomes making it feasible for in vivo laboratory research use.

  15. Hussin NM, Shahar S, Din NC, Singh DKA, Chin AV, Razali R, et al.
    Aging Clin Exp Res, 2019 Feb;31(2):215-224.
    PMID: 30062670 DOI: 10.1007/s40520-018-1007-9
    BACKGROUND: Multimorbidity in older adults needs to be assessed as it is a risk factor for disability, cognitive decline, and mortality.

    AIMS: A community-based longitudinal study was performed to determine the incidence and to identify possible predictors of multimorbidity among multiethnic older adults population in Malaysia.

    METHODS: Comprehensive interview-based questionnaires were administered among 729 participants aged 60 years and above. Data were analyzed from the baseline data of older adults participating in the Towards Useful Aging (TUA) study (2014-2016) who were not affected by multimorbidity (349 without any chronic diseases and 380 with one disease). Multimorbidity was considered present in an individual reporting two or more chronic diseases.

    RESULTS: After 1½ years of follow-up, 18.8% of participants who were initially free of any diseases and 40.9% of those with one disease at baseline, developed multimorbidity. The incidence rates were 13.7 per 100 person-years and 34.2 per 100 person-years, respectively. Female gender, smoking, and irregular preparing of food (lifestyle) were predictors for incidence of multimorbidity, especially in those without any disease, while Body Mass Index (BMI) 22-27 kg/m2 and inadequate daily intake of iron were identified as predictors of multimorbidity among participants who already have one disease.

    CONCLUSIONS: The incidence rates of multimorbidity among Malaysian older adults were between the ranges of 14-34 per 100 person-years at a 1½-year follow-up. Gender, smoking, BMI 22-27 kg/m2, inadequate daily intake of iron and lack of engagement in leisure or lifestyle physical activities were possible predictors in the development of multimorbidity. There is a need to formulate effective preventive management strategies to decelerate multimorbidity among older adults.

  16. Cheah YK, Syed Anera SN, Kee CC, Lim KH, Omar MA
    Hypertens Res, 2022 Feb 16.
    PMID: 35173284 DOI: 10.1038/s41440-022-00858-8
    The prevalence of high sodium-related diseases is increasing across the globe. Knowledge plays an important role in disease prevention. The objective of the present study was to examine sociodemographic factors associated with knowledge of high sodium-related diseases. The Malaysian Community Salt Survey (MyCoSS) was used in the present study for secondary analyses. It is a nationwide cross-sectional survey that was conducted in Malaysia. A non-parametric test to evaluate trends and a negative binomial regression were utilised to assess knowledge of high sodium-related diseases. Income, educational level, gender, ethnicity, house locality and hypertension were found to be significantly associated with knowledge of high sodium-related diseases. In particular, higher income earners, well-educated people, women, Malays, urban dwellers and hypertensive adults were more likely to have acquired a lot of knowledge of high sodium-related diseases compared to that acquired by lower income earners, less-educated people, men, individuals of other ethnic groups, rural dwellers and nonhypertensive adults. In conclusion, sociodemographic factors and hypertension play an important role in knowledge acquired about high sodium-related diseases. The findings of the present study could inform a future policy directed towards increasing knowledge about high sodium-related diseases among the population in Malaysia.
  17. Ganapathy SS, Yi Yi K, Omar MA, Anuar MFM, Jeevananthan C, Rao C
    BMC Public Health, 2017 08 11;17(1):653.
    PMID: 28800758 DOI: 10.1186/s12889-017-4668-y
    BACKGROUND: Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study.

    METHODS: A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths.

    RESULTS: Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good.

    CONCLUSION: We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.

  18. Won H, Abdul MZ, Mat Ludin AF, Omar MA, Razali R, Shahar S
    Clin Interv Aging, 2017;12:275-282.
    PMID: 28223785 DOI: 10.2147/CIA.S118942
    PURPOSE: Older adults are at risk of mild cognitive impairment (MCI), and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI) and waist circumference (WC) for predicting the risk of MCI in older Malaysian adults.

    METHODS: A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC) curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis.

    RESULTS: A BMI cut-off value of 26 kg/m(2) (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8%) was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8%) for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7%) for women. The optimum calf circumference (CC) cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity 61.1%) for men and 26 cm (AUC 0.598; sensitivity 79.1%; specificity 45.3%) for women.

    CONCLUSION: The cut-off values could be advocated and used as part of the screening of MCI among older Malaysian adults. There is a need to further determine the predictive values of these cut-off points on outcomes through longitudinal study design.

  19. Mazeli MI, Pahrol MA, Abdul Shakor AS, Kanniah KD, Omar MA
    Sci Total Environ, 2023 May 20;874:162130.
    PMID: 36804978 DOI: 10.1016/j.scitotenv.2023.162130
    In 2016, the World Health Organization (WHO) estimated that approximately 4.2 million premature deaths worldwide were attributable to exposure to particulate matter 2.5 μm (PM2.5). This study assessed the environmental burden of disease attributable to PM2.5 at the national level in Malaysia. We estimated the population-weighted exposure level (PWEL) of PM10 concentrations in Malaysia for 2000, 2008, and 2013 using aerosol optical density (AOD) data from publicly available remote sensing satellite data (MODIS Terra). The PWEL was then converted to PM2.5 using Malaysia's WHO ambient air conversion factor. We used AirQ+ 2.0 software to calculate all-cause (natural), ischemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD), lung cancer (LC), and acute lower respiratory infection (ALRI) excess deaths from the National Burden of Disease data for 2000, 2008 and 2013. The average PWELs for annual PM2.5 for 2000, 2008, and 2013 were 22 μg m-3, 18 μg m-3 and 24 μg m-3, respectively. Using the WHO 2005 Air Quality Guideline cut-off point of PM2.5 of 10 μg m-3, the estimated excess deaths for 2000, 2008, and 2013 from all-cause (natural) mortality were between 5893 and 9781 (95 % CI: 3347-12,791), COPD was between 164 and 957 (95 % CI: 95-1411), lung cancer was between 109 and 307 (95 % CI: 63-437), IHD was between 3 and 163 deaths, according to age groups (95 % CI: 2-394) and stroke was between 6 and 155 deaths, according to age groups (95 % CI: 3-261). An increase in estimated health endpoints was associated with increased estimated PWEL PM2.5 for 2013 compared to 2000 and 2008. Adhering the ambient PM2.5 level to the Malaysian Air Quality Standard IT-2 would reduce the national health endpoints mortality.
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