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  1. Sanggar A, Razak AA, Phoa PKA
    Psychogeriatrics, 2025 Jan;25(1):e13218.
    PMID: 39557512 DOI: 10.1111/psyg.13218
    BACKGROUND: Stressful life events greatly increase the risk of depression, which affects about 22% of older persons in northeast Malaysia. But how emotional distress manifests itself in reaction to these stressful events differs from person to person. Therefore, this study aims to delve into the nuances of emotional expression among older adults with depression symptoms in northeast Malaysia, alongside their help-seeking behaviours and utilisation of professional support.

    METHODS: Using a qualitative interpretative phenomenological approach, we conducted in-depth face-to-face interviews with participants, guided by Kleinman's explanatory model of illness. Nineteen older adults who screened positive for depression were included in the research.

    RESULTS: None of the participants explicitly acknowledged experiencing depression. However, they articulated their distress through three primary themes: 'Life is miserable,' 'Depression is a sign of weakness,' and 'Belief in pre-determination.' Remarkably, despite screening positive for depression, participants demonstrated a lack of awareness regarding available professional mental health services. Moreover, they expressed a reluctance to seek such services, citing reasons related to stigma and misconceptions. The predominant themes that emerged concerning help-seeking behaviours were 'Self-efficacy,' 'Social support,' and 'Formal assistance from non-mental healthcare professionals.'

    CONCLUSION: The expression of emotion among older adults is restricted by socio-cultural influences. Thus, there is a need to improve mental health literacy among older adults in Malaysia, and their preferred source of support such as religious leaders and non-mental healthcare physicians.

  2. Ismail A, Ab Razak A, Sayuti KA, Phoa PKA
    Cureus, 2023 Oct;15(10):e46670.
    PMID: 37942372 DOI: 10.7759/cureus.46670
    This article discusses the case of an adult woman with comorbid major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Due to her poor response to initial treatment regimens, a brain computed tomography (CT) was performed, revealing mega cisterna magna (MCM). Subsequently, she responded well to the addition of lorazepam, a benzodiazepine, along with fluvoxamine and quetiapine XR. The clinical significance of MCM and MDD-OCD remains partially understood. Thus, this case report aims to contribute to the literature and review the treatment of benzodiazepines in relation to MCM, MDD, and OCD comorbidities.
  3. Phoa PKA, Wee LH, Wong YH, Siau CS, Chan CMH, Dain C, et al.
    Tob Control, 2025 Jan 08.
    PMID: 39779329 DOI: 10.1136/tc-2024-058874
    In Malaysia, tobacco smoking continues to be one of the leading public health concerns; hence, the tobacco control community aims to see a generation free of tobacco use by 2040. Drafted and presented to the parliament, the Malaysian Control of Smoking Products for Public Health Bill 2022 highlighted the Generational Endgame (GEG) policy, which forbids the use and sale of tobacco products and smoking substances to individuals born on or after 1 January 2007. Stakeholders, including government and non-governmental organisations, policymakers, healthcare professionals, tobacco industry representatives and retailers, have expressed differing opinions indicating non-support of the policy. The Attorney General Chamber deemed the policy as 'unconstitutional' for discriminating against those within the implementation age range, which prompted its omission from the revised Control of Smoking Products for Public Health 2023 Bill. This paper discusses the obstacles and possible implications of the GEG policy implementation in Malaysia and details its implementation in other countries. This paper also proposes several recommendations for future directions in tackling the obstacles mentioned more effectively.
  4. Tagiling N, Ibrahim IL, Lee YY, Udin MY, Mohamad Kamarulzaman MD, Phoa PKA, et al.
    J Gastroenterol Hepatol, 2024 Aug;39(8):1517-1527.
    PMID: 38705971 DOI: 10.1111/jgh.16585
    BACKGROUND AND AIM: Measurements of gastric emptying and accommodation for alternative test-meal protocol during gastric emptying scintigraphy (GES), such as high-calorie nutrient drinks, are not fully established. We aimed to compare the effects of standardized egg-white meal (EWM) versus high-calorie nutrient drink (Vital®; Abbott Laboratories) on global GES parameters and intragastric meal distribution at immediate scan (IMD0h).

    METHODS: Of 84 screened participants, 60 asymptomatic healthy Asian population (38 females; 24.0 ± 1.5 years; 23.8 ± 2.6 kg/m2) were recruited in this 2 × 2 (AB/BA) crossover trial. Participants were randomized to a 4-h GES with 99mTc-radiolabeled EWM (~255.8 kcal), followed by a 200 mL Vital® (300 kcal), or vice versa, separated by a 2-week washout period. Global meal retention (GMR), power-exponential model emptying parameters (half-emptying [T1/2], lag phases [Tlag2%, Tlag5%, Tlag10%]), and IMD0h were determined and compared.

    RESULTS: GMRs for both test meals were within the international standard references for solid GES. Compared to EWM, Vital® exhibited significantly lower GMRs (faster emptying) from 0.5 to 3 h (all P 

  5. Ab Razak A, Rahman NA, Zulkifly MFM, Sapiai NA, Phoa PKA, Mohamed Mustafar MF, et al.
    Malays J Med Sci, 2023 Oct;30(5):1-6.
    PMID: 37928788 DOI: 10.21315/mjms2023.30.5.1
    Improving healthcare and living conditions has led to an increase in life expectancies and challenges of population aging in Malaysia. The Advanced Memory and Cognitive Service builds on integrated healthcare among multidisciplinary specialists to provide holistic and patient-centred healthcare. The service treats older adults experiencing neurocognitive impairment as well as young individuals with complex neurocognitive disorders and thoroughly screens asymptomatic individuals at high risk of developing neurocognitive disorders. This early intervention strategy is a preventive effort in the hope of reducing disease burden and improving quality of life to prepare Malaysia for the forthcoming population aging.
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