Introduction: Consumers are advised to read the nutrition labeling when purchasing packaged food. To what extent consumers read nutrition labeling and understand what they read is not well established among Malaysian older persons. Methods: Data from the National Health and Morbidity Survey III (NHMS III) undertaken in 2006 was analysed to determine the use and understanding of nutrition labeling and its associated factors among free living elderly men and women aged >60 years. Descriptive analysis and binary Logistic Regression were used to analyse the data. Results: A total of 4,898 respondents provided self-reported information on their use and understanding of nutrition labeling when they bought or received food. Use of nutrition labeling was higher among elderly men [61.9% (95% CI: 59.6-64.1)] than for women [36.6% (95% CI: 34.5-38.8)]. Nutrition labeling use was significantly associated with age, formal education, higher household income levels and marital status among both elderly men and women. Understanding of nutrition labeling among elderly men and women was 91.8% (95% CI: 90.1-93.2) and 89.7% (95% CI: 87.4- 91.7) respectively and was significantly associated with formal education for both elderly men and women. Conclusion: Overall, the reading of nutrition labeling among Malaysian elderly is moderate. Elderly men and women with formal education were more likely to understand nutrition labeling. The importance of reading nutrition labels should be inculcated in consumers including older persons so that they choose foods that are nutritious and safe.

Adult ; Diabetes Mellitus ; etiology ; Fractures, Spontaneous ; etiology ; Humans ; Hypogonadism ; etiology ; Hypoparathyroidism ; etiology ; Hypothyroidism ; etiology ; Iron Overload ; etiology ; Male ; Osteoporosis ; etiology ; Osteoporotic Fractures ; etiology ; Recurrence ; Transfusion Reaction ; beta-Thalassemia ; therapy

Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients’ illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system.
Gatekeeping ; Primary Health Care

Diabetes mellitus is an important cardiovascular risk factor. The objective of this study was to provide population-based estimates on the prevalence, awareness, treatment and control rate of diabetes among the older persons in Malaysia. Analysis of secondary data from a cross-sectional national population-based survey was done, which was conducted in 2011 throughout Malaysia. A total of 2764 respondents (15.5%) were older persons. The overall prevalence of diabetes among older persons was 34.4% in which 65.2% were aware of their diabetes status. Out of those who were aware, 87.5% had been treated. Only 21.8% of those treated had their diabetes controlled. The results of multiple logistic regression showed that the factors associated with higher awareness rates were women, Indians and higher income groups; factors associated with higher treatment rates were urban residents and those who were married and widow/widower/ divorcee. There was a high overall prevalence, awareness and treatment rate of diabetes among older persons in Malaysia but with suboptimal control rate.
Diabetes Mellitus ; Aged ; prevention & control ; Therapeutics

BACKGROUND AND OBJECTIVES: The myogenic response was originally described as a contraction of a blood vessel that occurred following an increase in intravascular distending pressure. Conversely, a reduction in intravascular pressure produces myogenic vascular relaxation. Recent attention has focused on the potential role of this myogenic mechanism in the control of tone in the resistance vasculature, and in particular on how this mechanism may contribute to the increased vascular resistance seen in hypertension. Therefore, in the present study, we investigated the role of myogenic tone in the generation and/or maintenance of hypertension. MATERICAL AND METHODS: Myogenic tone was developed by stretching of the basilar arteries of WKY (istar Kyoto rat) and SHR (spontaneously hypertensive rats). Contractile responses, PKC (protein kinase C) immunoblots and translocation of PKC and RhoA were measured. In the presence of extracellular Ca2+ the stretching of the resting vessel evoked a myogenic contraction in the basilar arteries of SHR and WKY. Myogenic tone was significantly greater in SHR than in WKY. However, in the absence of extracellular Ca2+, stretching evoked a myogenic contraction in SHR, but not in WKY. The stretch-induced myogenic tone was inhibited by nifedipine. The effect of nifedipine was similar in both SHR and WKY rats. H-7, calphostin C and Y-27632, also inhibited stretch-induced myogenic tone in both SHR and WKY. The inhibitory effects of these drugs were greater in SHR than in WKY. Immunoblotting showed rho A and PKC alpha were translocated from the cytosol to the cell membrane with stretching in both SHR and WKY. PKC beta, however, was translocated to the cell membrane with stretching in SHR, but not in WKY. CONCLUSION: These results suggest that stretch-induced myogenic tone is significantly greater in SHR than in WKY. Furthermore, the increase in amount and/or activity of PKC beta and ROK (rhoA-associated kinase) may be a key mechanism accounting for the enhanced myogenic tone in SHR.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine ; Basilar Artery ; Blood Vessels ; Cell Membrane ; Cytosol ; Hypertension ; Immunoblotting ; Nifedipine ; Phosphotransferases ; Protein Kinase C* ; Protein Kinases* ; Rats, Inbred SHR* ; Rats, Inbred WKY ; Relaxation ; rhoA GTP-Binding Protein ; Vascular Resistance

PURPOSE: Different techniques for cystocele repair including the conventional anterior colporrhaphy and mesh technique are known. Our goal was to evaluate the anatomical success and safety of our method of transvaginal anterior vaginal wall repair by the purse-string technique reinforced with three simple additional sutures in the repair of cystocele over a 4-year follow-up period. METHODS: This was a retrospective review of 69 consecutive patients (grades 2 to 4) who underwent the above operations between 2001 and 2011, including their success rates as assessed by use of the Baden-Walker halfway classification system. RESULTS: Of the patients, 62 patients (98%) were completely cured of cystocele and 1 patient showed grade 2 cystocele recurrence that required no further treatment. Two patients with grade 4 cystocele were completely cured. There was no vaginal erosion related to the cystocele repair. CONCLUSIONS: Transvaginal anterior colporrhaphy by a purse-string technique reinforced with simple additive sutures appears to be a simple, safe, and easily performed approach in cystocele repair. There is no need for other material for reinforcement, even in high-grade cystocele, which is an advantage of our technique.
Cystocele ; Follow-Up Studies ; Humans ; Imidazoles ; Nitro Compounds ; Prolapse ; Recurrence ; Reinforcement (Psychology) ; Retrospective Studies ; Sutures ; Urinary Bladder Diseases ; Vagina

Although extracellular Ca2+ entry through the voltage-dependent Ca2+ channels plays an important role in the spontaneous phasic contractions of the pregnant rat myometrium, the role of the T-type Ca2+ channels has yet to be fully identified. The aim of this study was to investigate the role of the T-type Ca2+ channel in the spontaneous phasic contractions of the rat myometrium. Spontaneous phasic contractions and [Ca2+]i were measured simultaneously in the longitudinal strips of female Sprague-Dawley rats late in their pregnancy (on day 18~20 of gestation: term=22 days). The expression of T-type Ca2+ channel mRNAs or protein levels was measured. Cumulative addition of low concentrations (<1 micrometer) of nifedipine, a L-type Ca2+ channel blocker, produced a decrease in the amplitude of the spontaneous Ca2+ transients and contractions with no significant change in frequency. The mRNAs and proteins encoding two subunits (alpha1G, alpha1H) of the T-type Ca2+ channels were expressed in longitudinal muscle layer of rat myometrium. Cumulative addition of mibefradil, NNC 55-0396 or nickel induced a concentration-dependent inhibition of the amplitude and frequency of the spontaneous Ca2+ transients and contractions. Mibefradil, NNC 55-0396 or nickel also attenuated the slope of rising phase of spontaneous Ca2+ transients consistent with the reduction of the frequency. It is concluded that T-type Ca2+ channels are expressed in the pregnant rat myometrium and may play a key role for the regulation of the frequency of spontaneous phasic contractions.
Animals ; Benzimidazoles ; Calcium Channels ; Contracts ; Cyclopropanes ; Female ; Humans ; Mibefradil ; Mice ; Muscle, Smooth ; Muscles ; Myometrium ; Naphthalenes ; Nickel ; Nifedipine ; Pregnancy ; Proteins ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger

This study was conducted to define the molecular mechanism of fasting-induced down-regulation of neuronal nitric oxide synthase (nNOS) expression in the hypothalamic paraventricular nucleus (PVN). Rats were adrenalectomized (ADX), and then either underwent food deprivation or received varying doses of dexamethasone for 48 h. The brain tissues were processed for NADPH-diaphorase (NADPH-d) staining, a histochemical marker of nNOS enzyme activity. Both the ADX and the sham operated rats showed a significant weight loss after 48 h of food deprivation. Food deprivation decreased the number of NADPH-d containing cells in the PVN of sham rats, however, not in the ADX rats. Dexamethasone dose- dependently decreased NADPH-d cells in the PVN of ADX rats. The effect of ADX or dexamethasone was limited to the parvocellular subdivision of PVN. These results suggest that the adrenal glucocorticoids may down-regulate nNOS expression in the PVN during food deprivation.
*Adrenalectomy ; Animals ; Biological Markers ; Dexamethasone/blood/pharmacology ; Down-Regulation/physiology ; Fasting/*physiology ; Food Deprivation/physiology ; Glucocorticoids/blood/pharmacology ; Male ; NADPH Dehydrogenase/*metabolism ; Nitric-Oxide Synthase/*metabolism ; Paraventricular Hypothalamic Nucleus/*enzymology ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't

OBJECTIVES: Orphan nuclear receptor small heterodimer partner (SHP) is involved in osteoblastic differentiation. This study was undertaken to demonstrate a role of SHP in in vivo bone development using microcomputed tomographic (microCT) analysis of SHP knockout (KO) mice. MATERIAL & METHODS: Tibia bones were harvested from 1-, 4-, 8- and 20-week-old wild type (WT) and SHP KO mice. The microarchitecture of tibial bone was analyzed using a microCT (Skyscan 1172; Skyscan, Kontich, Belgium). Samples were scanned at a resolution of 17 microm (isotropic). The X-ray was operated with 50 kV, 200 microA of energy, 1.2 sec of exposure time, and a 0.5 mm thick aluminum filter. Projections were acquired over an angular range of 180degrees. For quantification of the bone mineral density (BMD), the microCT was calibrated using 2 standard phantoms with densities of 0.25 and 0.75 g/cm3. The image slices were reconstructed and analyzed using CT analyzer software (CTan, Skyscan). RESULTS: The CT values of tibial trabecular bone were significantly decreased in SHP KO compared to WT at 20-week-old mice determined by microCT; (bone volume / tissue volume [BV/TV, 40%], BMD [80%], and trabecular number [Tb.N, 50%]). However, the CT values were not significantly different between WT and SHP KO in cortical bone. Furthermore, the qualitative indices of trabecular bone such as the structure model index (SMI) and the polar moment inertia (PMI) did not differ between WT and SHP KO mice. CONCLUSION: These microCT results supports that SHP may act as a positive regulator of trabecular bone formation.
Aluminum ; Animals ; Bone Density ; Bone Development ; Child ; Child, Orphaned ; Humans ; Mice ; Mice, Knockout ; Osteoblasts ; Osteogenesis ; Tibia ; X-Ray Microtomography