Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.

Genetic diversity of the S-type small subunit ribosomal RNA gene of Plasmodium knowlesi isolates from Sabah,Malaysian Borneo and Peninsular Malaysia

Objective:To determine the genetic diversity of Plasmodium(P.)knowlesi isolates from Sabah,Malaysian Borneo and Peninsular Malaysia,targeting the S-type SSU rRNA gene and including aspects of natural selection and haplotype.Methods:Thirty-nine blood samples infected with P.knowlesi were collected in Sabah,Malaysian Borneo and Peninsular Malaysia.The S-type SSU rRNA gene was amplified using polymerase chain reaction,cloned into a vector,and sequenced.The natural selection and haplotype of the S-type SSU rRNA gene sequences were determined using DnaSP v6 and illustrated using NETWORK v10.This study's 39 S-type SSU rRNA sequences and eight sequences from the Genbank database were subjected to phylogenetic analysis using MEGA 11.Results:Overall,the phylogenetic analysis showed no evidence of a geographical cluster of P.knowlesi isolates from different areas in Malaysia based on the S-type SSU rRNA gene sequences.The S-type SSU rRNA gene sequences were relatively conserved and with a purifying effect.Haplotype sharing of the S-type SSU rRNA gene was observed between the P.knowlesi isolates in Sabah,Malaysian Borneo,but not between Sabah,Malaysian Borneo and Peninsular Malaysia.Conclusions:This study suggests that the S-type SSU rRNA gene of P.knowlesi isolates in Sabah,Malaysian Borneo,and Peninsular Malaysia has fewer polymorphic sites,representing the conservation of the gene.These features make the S-type SSU rRNA gene suitable for comparative studies,such as determining the evolutionary relationships and common ancestry among P.knowlesi species.

Treatment of uveitis and scleritis patients in Malaysia

●AIM:To determine the common causes and visual outcome after treatment among uveitis and scleritis patients.●METHODS:This is a retrospective cohort observational study.All consecutive clinical records of patients with newly diagnosed uveitis and scleritis over a 4-year period,from Jan.1,2017 to Dec.31,2020,were analysed.Data was collected at the presentation and included a follow-up period of one year.●RESULTS:A total of 288 patients were recruited during the study period.Anterior uveitis was the most common anatomical diagnosis(50.0%)followed by panuveitis(25.0%),scleritis(13.5%),posterior uveitis(6.9%),and intermediate uveitis(4.5%).Viral Herpes was the most common cause of infectious cases,while Vogt-Koyanagi-Harada(VKH)disease and human leucocyte antigen(HLA)B27 spondyloarthropathy were the leading causes of identifiable non-infectious cases.Majority of patients presented with unilateral,non-granulomatous uveitis with an absence of hypopyon.Anatomical locations like posterior uveitis and panuveitis,and visual acuity worse than 3/60 at presentation were the factors associated with poor visual outcomes(P<0.05).About 60%of patients had an identifiable cause for the uveitis and scleritis,with nearly equal distribution of infectious(n=85,29.5%)and noninfectious causes(n=84,29.2%).About 14.5%of patients were clinically blind at 1y of follow-up.The most common complication in our uveitis patients was glaucoma(47.5%),followed by cystoid macula oedema(18.9%)and cataract(13.9%).●CONCLUSION:Uveitis and scleritis are important causes of ocular morbidity.They are potentially blinding diseases which can have a good outcome if diagnosed and treated early.

Development and validation of a novel questionnaire regarding vision screening among preschool teachers in Malaysia

AIM:To develop and evaluate the validity and reliability of a knowledge,attitude,and practice questionnaire related to vision screening(KAP-VST)among preschool teachers in Malaysia.METHODS:The questionnaire was developed through a literature review and discussions with experts.Content and face validation were conducted by a panel of experts(n=10)and preschool teachers(n=10),respectively.A pilot study was conducted for construct validation(n=161)and test-retest reliability(n=60)of the newly developed questionnaire.RESULTS:Based on the content and face validation,71 items were generated,and 68 items were selected after exploratory factor analysis.The content validity index for items(I-CVI)score ranged from 0.8-1.0,and the content validity index for scale(S-CVI)/Ave was 0.99.Internal consistency was KR^(2)0=0.93 for knowledge,Cronbach’s alpha=0.758 for attitude,and Cronbach’s alpha=0.856 for practice.CONCLUSION:The KAP-VST is a valid and reliable instrument for assessing knowledge,attitude,and practice in relation to vision screening among preschool teachers in Malaysia.

Occurrence of K1 and K2 serotypes and genotypic characteristics of extended spectrumβ-lactamases-producing Klebsiella pneumoniae isolated from selected hospitals in Malaysia

Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.Methods:A total of 192 K.pneumoniae isolates were collected and subjected to antibiotic susceptibility,hypermucoviscosity test and multiplex PCR to detect the presence of K1-and K2-serotype associated genes.Multilocus sequence typing(MLST)was performed on ESBL-producing K.pneumoniae isolates presented with K1 and K2 serotypes,followed by phylogenetic analysis.Results:A total of 87 out of 192(45.3%)of the K.pneumoniae isolates collected were ESBL producers.However,only 8.3%(16/192)and 10.9%(21/192)of the total isolates were detected to carry K1-and K2-serotype associated genes,respectively.Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype(P=0.196).However,they were significantly associated with hypervirulent,as demonstrated by the positive string test(P<0.001).MLST analysis revealed that ST23 as the predominant sequence type(ST)in the K1 serotype,while the ST in the K2 serotype is more diverse.Conclusions:Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low,their coexistence warrants the need for continuous surveillance.MLST showed that these isolates were genetically heterogeneous.

Bilateral adrenal histoplasmosis in a Malaysian tertiary hospital:Report of four cases

Rationale:Adrenal histoplasmosis can present as bilateral adrenal enlargement with constitutional symptoms and/or adrenal insufficiency.Often these patients are initially investigated as secondary adrenal metastases before eventually their diagnosis established by histopathological examination of the adrenal tissues.Patients concerns:We report 4 cases of patients aged 55-78 who presented with hypocortisolism and bilateral adrenal masses.Diagnoses:Bilateral adrenal histoplasmosis.Interventions:Three patients received antifungal treatment for at least one year while 1 patient passed away before the initiation of antifungal treatment.Outcomes:Two patients’adrenal function recovered not requiring any steroid replacement,while 1 patient still requires long-term steroid replacement.Lessons:Adrenal histoplasmosis should be excluded in patients from endemic areas presenting with bilateral adrenal masses and adrenal insufficiency.Usually patients have an exposure to bird droppings,bat guano or soil contaminated with histoplasmosis fungi.Histopathological examination of biopsied adrenal tissues is still the gold standard investigation as serology and molecular diagnostic methods are still not widely available in most centers in Malaysia.

Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

AIM:To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis,treatment,and best practices of diabetic macular edema(DME).The experts'panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula.The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load.METHODS:On two different occasions,a panel of 14 retinal specialists from Malaysia,together with an external expert,responded to a questionnaire on management of DME.A consensus was sought by voting after compiling,analyzing and discussion on first-phase replies on the round table discussion.A recommendation was deemed to have attained consensus when 12 out of the 14 panellists(85%)agreed with it.RESULTS:The terms target response,adequate response,nonresponse,and inadequate response were developed when the DME patients'treatment responses were first characterized.The panelists reached agreement on a number of DME treatment-related issues,including the need to classify patients prior to treatment,firstline treatment options,the right time to switch between treatment modalities,and side effects associated with steroids.From this agreement,recommendations were derived and a treatment algorithm was created.CONCLUSION:A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.

Selected fermented indigenous vegetables and fruits from Malaysia as potential sources of natural probiotics for improving gut health

In the Peninsular Malaysia and Northern Borneo island of Malaysia, various rich indigenous leafy vegetables and fruits grow and contribute to the nutritional and dietary values of the population. They have high water contents, thus, naturally vulnerable to rapid food spoilage. Food preservation and processing play a vital role in the inhibition of food pathogens in fruits and vegetables that are prevalent in Malaysia. Lactic acid fermentation is generally a local-based bioprocess, among the oldest form and well-known for food-processing techniques among indigenous people there. The long shelf life of fermented vegetables and fruits improves their nutritional values and antioxidant potentials. Fermented leaves and vegetables can be utilized as a potential source of probiotics as they are host for several lactic acid bacteria such as Lactobacillus confusus, Weissella paramesenteroides, Enterococcus faecalis, Lactobacillus plantarum, Lactobacillus buchneri, Lactobacillus paracasei, Lactobacillus pentosus, Pediococcus acidilactici, Pediococcus pentosaceus and Leuconostoc mesenteroides. These strains may be more viable in metabolic systems whereby they can contribute to a substantial increase in essential biologically active element than industrial starter cultures. This review is aimed to address some essential fermented fruits and vegetables in Malaysia and their remarkable reputations as a potential sources of natural probiotics.

Postvaccination breakthrough SARS-CoV-2 infections among adults in Malaysia and attitudes towards future vaccination

Objective:To determine the frequency and severity of the breakthrough infections and the associated factors in Malaysia.Methods:This cross-sectional study was conducted among the adult general population in Malaysia who completed at least one dose of vaccination.The validated online questionnaires were used for data collection between December 2022 to February 2023.The participants were recruited by a convenient sampling method.The data were analysed by descriptive statistics,and logistic regression by using SPSS(Version 27).Qualitative data from open-ended questions were analysed as thematic analysis by using RQDA software.Results:A total of 524 participants'data were analyzed and 77.5%of them completed three doses of COVID-19 vaccination.Breakthrough infections after vaccination were reported in 57.3%of the participants.Age group of 18 and 30 years(aOR 2.32,95%CI 1.01-5.32)and other ethnicities(aOR 2.00,95%CI 1.02-3.93)significantly associated with the occurrence of breakthrough infections.A total of 35.5%of the participants were not willing to take another booster dose in the future because of their attitudes towards fear of long-term side effects,lack of trust to the vaccine,less susceptibility to severe infection,belief in natural immunity,and myths.Conclusions:Future public health policies and interventions should be focused on disseminating the information about safety of booster doses of vaccine,management and re-assurance of side effects,and targeted vaccination to the working(younger age group)and ethnic minorities.

Insecticide resistance status of Aedes aegypti and Aedes albopictus in Malaysia(2010 to 2022):A review

This review aimed to determine the prevalence of the insecticide resistance status of the field-collected Aedes(Ae.)aegypti and Ae.albopictus in Malaysia from 2010 to 2022 towards carbamates,organochlorines,organophosphates and pyrethroids.Biological and environmental controls were summarized with an emphasis on the mosquito vector control strategies in Malaysia.The information in this review was extracted from several databases such as PubMed(MEDLINE),Science Direct and Scopus by using keywords including“insecticide resistance”,“carbamate resistance”,“organochlorine resistance”,“organophosphate resistance”,“pyrethroid resistance”,“Aedes”and“Malaysia”,between January 2022 and December 2022.Distribution of resistant Ae.aegypti and Ae.albopictus in Malaysia was mapped using QGIS software.Insecticide resistance in both Ae.aegypti and Ae.albopictus is widespread in Malaysia,although the rates vary by states.The most notable was the steep increase in permethrin resistance of Ae.aegypti in Selangor,Malaysia,over the past decade.Ae.albopictus also displayed moderate resistance to permethrin,though not as widespread as Ae.aegypti in Selangor,but showed sign of resistance in Sarawak,East Malaysia.Resistance towards four main classes of insecticides have been widely documented in Malaysia.The extensive resistance towards permethrin in Malaysia which is one of the current insecticides used in Malaysia suggested that policies supporting the widespread use of permethrin fogging needs further evaluation.

Prevalence and Factors Associated with Smartphone Addiction among Adolescents–A Nationwide Study in Malaysia

Smartphone ownership among adolescents is getting common in this decade especially in Malaysia;Adolescent are strongly devoted to their smartphone and this may lead to smartphone addiction.Studies have reported that smartphone addiction has become an emerging social and health problem especially among the youth in many countries however there is lack of study among adolescents in Malaysia.This study aimed to examine the prevalence and factors associated with smartphone addiction among adolescents in Malaysia.This was a cross-sectional study involving adolescents from 15 primary care clinics throughout the country.Respondents were assessed on their smartphone activities using the Malaysian short version of the Smartphone addiction scale(SAS-M-SV).Multiple logistic regression was used to determine the predictors of smartphone addiction among adolescents.The study was conducted among 921 adolescents with 49.6%male(n=457).The mean age of adolescents was 16.4±2.4 years.The ethnicity distribution were 74.6%Malay,7.3%Chinese,4.7%Indian and 13.4%other ethnicities.The prevalence of smartphone addiction was 37.1%(342/921);37.4%in male and 36.9%in female.Based on multiple logistic regression analysis,longer duration of smartphone use per week was associated with higher odds of smartphone addiction among adolescent(odd ratio=1.005%,95%confidence interval=1.000–1.009,p-value=0.039).Smartphone addiction is present in nearly four in ten adolescents in Malaysia.Adolescents who spend longer duration in smartphone usage per week were associated with higher odds of having smartphone addiction.Parents should be more alert and vigilant about this finding.Hence,parents should limit their children from spending too much of time with smartphone in order to prevent their children from getting smartphone addiction.

Hybridized Intelligent Neural Network Optimization Model for Forecasting Prices of Rubber in Malaysia

Rubber producers,consumers,traders,and those who are involved in the rubber industry face major risks of rubber price fluctuations.As a result,decision-makers are required to make an accurate estimation of the price of rubber.This paper aims to propose hybrid intelligent models,which can be utilized to forecast the price of rubber in Malaysia by employing monthly Malaysia’s rubber pricing data,spanning from January 2016 to March 2021.The projected hybrid model consists of different algorithms with the symbolic Radial Basis Functions Neural Network k-Satisfiability Logic Mining(RBFNN-kSAT).These algorithms,including Grey Wolf Optimization Algorithm,Artificial Bee Colony Algorithm,and Particle Swarm Optimization Algorithm were utilized in the forecasting data analysis.Several factors,which affect the monthly price of rubber,such as rubber production,total exports of rubber,total imports of rubber,stocks of rubber,currency exchange rate,and crude oil prices were also considered in the analysis.To evaluate the results of the introduced model,a comparison has been conducted for each model to identify the most optimum model for forecasting the price of rubber.The findings showed that GWO with RBFNN-kSAT represents the most accurate and efficient model compared with ABC with RBFNNkSAT and PSO with RBFNN-kSAT in forecasting the price of rubber.The GWO with RBFNN-kSAT obtained the greatest average accuracy(92%),with a better correlation coefficient R=0.983871 than ABC with RBFNN-kSAT and PSO with RBFNN-kSAT.Furthermore,the empirical results of this study provided several directions for policymakers to make the right decision in terms of devising proper measures in the industry to address frequent price changes so that the Malaysian rubber industry maintains dominance in the international markets.

Molecular epidemiology of piliated pneumococcal isolates at a major tertiary hospital in the Klang Valley,Malaysia

Objective:To characterise a collection of pili-carrying and none pili-carrying pneumococcal isolates of clinical origin for serotypes,antibiotic resistance and genotype.Methods:In total,42 clinical isolates were collected between October 2017 and December 2019.Those isolates were analysed for antimicrobial susceptibility,serotype distribution,detection of pneumococcal virulence and pilus genes.Multilocus sequence typing was performed only for piliated isolates,followed by phylogenetic analysis.Results:The common isolation sites among the pneumococcal isolates were tracheal aspirate(28.6%),blood(26.2%),and sputum(23.8%).Fifty percent isolates were resistant to erythromycin,tetracycline(50.0%)and trimethoprim-sulfamethoxazole(43.0%).The most frequent were serotypes 19F(28.6%),6A/B(23.8%)and 19A(14.3%).Piliated isolates were detected in a small proportion(33.3%);64.3%were multidrug-resistant.ST320 was the prevalent sequence type among the piliated isolates and genetically related to the Pneumococcal Molecular Epidemiology Network clones Taiwan19F-14(CC271).In the phylogenetic analysis,some piliated isolates showed a close association having similar ST320,carrying serotype 19A and both pilus genes indicating their clonal spread.Conclusions:Pneumococcal lineages of piliated isolates have been globally disseminated and pili could have played a role in the spread of antibiotic resistant clones.

Heavy metal pollution assessment in marine sediments in the Northwest coast of Sabah,Malaysia

Heavy metal contents along the Northwest coast of Sabah were determined to interpret the pollution level in the marine sediment. The metal abundance is regulated by the physico-chemical properties such as the average sediment pH(7.82, 9.00 and 8.99), organic matter(0.62%, 1.60%, and 2.27%), moisture content(25.00%, 29.70%, and 15.00%) and sandy texture in Kota Belud, Kudat and Mantanani Island,respectively. The major elements show Ca>Fe>Mg>Al>Mn for all study sites, while the heavy metals show Ni>Cr>Zn>Cu>Co>Pb, Cr>Ni>Zn>Cu>Pb>Co and Zn>Pb>Cr>Ni, for Kota Belud, Kudat and Mantanani Island, respectively. The pollution degree of heavy metals was evaluated by using the Sediment Quality Assessment(SQA). The SQA parameters indicated none to moderate pollution in Kota Belud that shows Class 0, Class 1 and Class 2 pollution. The parameters also indicated none to low pollution in Kudat and Mantanani Island that show only Class 0 pollution. The enrichment factor(EF) suggested minor to moderately severe metal enrichment by anthropogenic sources in Kota Belud, whereas only minor enrichment in Kudat and Mantanani Island. The modified pollution degree(MCD<1.5) and pollution load index(0 PLI<1) indicating only low pollution level in the marine sediments for all study sites. The objectives of this study are:(1) to determine the physico-chemical parameters of sediments,(2) interpret the heavy metal contents and(3) evaluate the sediment quality.

Disease burden,antimicrobial resistance and molecular characterization of invasive group B Streptococcus among non-pregnant adults in Malaysia:A protocol study

and pili genes are also investigated.Methods:This multicentre,prospective,observational study is conducted in seven major tertiary hospitals in Malaysia among non-pregnant adults.Simultaneously,a retrospective study is conducted in the selected hospitals with similar approaches.GBS isolates are subjected to phenotyping,serotyping by multiplex PCR,antimicrobial susceptibility testing and PCR-detection of GBS virulence and pilus genes.Seven housekeeping genes are amplified and sequenced for multi-locus sequence typing.Discussion:Findings from the study may contribute to the management of clinical practice to diagnose and prevent GBS related diseases in a timely manner.Prudent use of antibiotics is encouraged by monitoring antimicrobial resistance.

Pest and disease incidence of coniferous species in Taman Saujana Hijau,Putrajaya urban park,Malaysia

Taman Saujana Hijau(TSH),Putrajaya is a 41-ha urban park planted with various coniferous species from around the world.Insect pests and disease incidences of this park are unknown and there is a need for an evaluation of the health status of this urban park.This study assessed the level of pest and disease incidents of coniferous species in 12 plots of 7 species(Araucaria bidwilii,Araucaria haterophylla,Araucaria cunninghamii,Pinus caribaea,Pinus merkusii,Podocarpus polystachyus,and Podocarpus costalis).Termites,canker disease,and foliar disease are three major problems.The highest pest and disease incidence(PnDI)was foliar disease with a 0.49 coefficient correlation between the total number of trees and the PnDI,followed by canker disease with 0.40,and termites with 0.36.Of the seven conifers,A.haterophylla was the most infected followed by A.bidwilii and A.cunninghamii.It was concluded that the incidence of pests and diseases in TSH was moderate.To our knowledge,this may be the first baseline inventory of pests and diseases of coniferous species in Malaysia.

Antibiotic resistance and molecular typing of clinical Staphylococcus aureus isolates from Malaysian military hospital

Objective:To determine the antibiotic resistance profile(ARP)of Staphylococcus(S.)aureus isolates and molecular typing of the methicillin-resistant S.aureus(MRSA)isolates from Tuanku Mizan Armed Forces Hospital(TMAFH),Kuala Lumpur.Methods:The ARP and presence of the pvl gene were determined for 209 S.aureus isolates from clinical specimens.Of these,123 were methicillin-susceptible S.aureus(MSSA)isolates and 86 were MRSA isolates.All MRSA isolates were characterized using SCCmec typing and spa typing.Descriptive analysis was performed to compare the demographic data with the phenotypic and genotypic variables of the S.aureus isolates.Results:No vancomycin-intermediate and-resistant S.aureus(VISA and VRSA,respectively)were detected among the study isolates.The MSSA isolates showed low resistance rates to all tested antibiotics,were commonly invasive(28/42,66.7%),and mostly harboured pvl(35/42,83.3%).Meanwhile,MRSA isolates showed high resistance to penicillin(86/86,100%),ampicillin(86/86,100%),sulbactam/ampicillin(86/86,100%),cefuroxime(81/86,94.19%),cefoperazone(76/86,88.37%),azithromycin(56/86,65.12%),and erythromycin(54/86,62.79%).The majority of MRSA isolates were of SCCmec type IVh(65/86,75.58%),spa type t032(55/85,63.95%),and grouped into spaCC-t022(66/85,77.65%).The t032 type was found to be associated with resistance traits to azithromycin and erythromycin(P<0.05).We also found several spa types that are typically associated with hospital-,community-,and livestock-associated MRSA co-existing in our MRSA population.Conclusions:This study reflected the consistent absence of VISA and VRSA and corroborated the clonal shifting of MRSA isolates in the Malaysian MRSA isolates.

Association between vision and cognitive function among community-dwelling older adults in Selangor,Malaysia

AIM:To determine the association between distance and near visual acuity(VA)and cognitive function among older adults in Selangor,Malaysia.METHODS:A total of 230 older adults(age≥60y)participated in this study.Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart,respectively.Global cognitive function was assessed using the Mini-Mental State Examination(M-MSE)and the Malay language version of the Montreal Cognitive Assessment(M-MoCA).Digit Symbol(DS)subtest was used to measure information processing.RESULTS:No significant association was observed between vision and M-MSE and M-MoCA scores.However,poor distance and near VA were found to be significantly associated with low DS scores[distance VA:β=-0.01,R2=0.1,P=0.02;odds ratio(OR)=2.84,95%confidence interval(CI),1.10-7.33,P=0.03;near VA:β=-0.05,R2=0.08,P=0.00;OR=3.32,95%CI,1.28-8.59,P=0.01].CONCLUSION:Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.

Elemental Assessments in Paddy Soil for Geographical Traceability of Rice from Peninsular Malaysia

This investigation aimed to establish the geographical traceability of Malaysian rice by assessing the elemental composition in paddy soil.Multi-element determination in combination with a chemometric approach was applied to evaluate the elemental concentrations of paddy soil from granaries cultivated with the same rice variety and to assess the relationship between elements in the soil and rice(SAR) system.A total of 29 elements(aluminum,arsenic,barium,bromine,calcium,chlorine,cobalt,chromium,cesium,europium,iron,gallium,hafnium,potassium,lanthanum,lutetium,magnesium,manganese,sodium,rubidium,antimony,scandium,samarium,thorium,titanium,uranium,vanadium,ytterbium and zinc) were successfully determined in paddy soil from Kedah,Selangor and Langkawi by neutron activation analysis.A significant difference(P < 0.05) between 18 elements in the soil samples was obtained.The chemometric approaches of principal component and linear discriminant analyses demonstrated clear discrimination and highly corrected classification(100%) of the soil samples.A high classification(98.1%) was also achieved by assessing 10 elements(aluminum,arsenic,bromine,chlorine,potassium,magnesium,manganese,sodium,rubidium and zinc),which similarly applied to rice geographical origin determination.Similar elements in SAR were also observed for differences in the pattern of correlation and bioaccumulation factor between the granaries.Furthermore,the generalized Procrustes analysis showed a 98% consensus between SAR and clear differences between the studied regions.The canonical correlation analysis demonstrated a significant correlation between the chemical profile of SAR(r~2 = 0.88,P < 0.001).Therefore,the current work model provides a reliable assessment to establish rice provenance.