The term metabolic syndrome (MetS) describes a clustering of risk factors for cardiovascular disease and type 2 diabetes mellitus which include high blood pressure, low fasting high-density lipoprotein cholesterol (HDL-c), high fasting triglyceride (TG), high fasting blood glucose (BG), and abdominal obesity. The aim of this cross sectional study was to determine the dietary patterns (DPs) associated with MetS among 451 older adults in Malaysia. Food intake was determined using validated Diet History. DP was identified based on 40 food groups by using principal component analysis (PCA), and the factors were rotated by varimax rotation. Fasting venous blood samples were taken to determine HDL-c, TaG and BG level. Blood pressure and anthropometric measurements were also performed. Three major dietary patterns have been identified; 1) bread, spreads and oats, 2) Malaysia traditional pancakes and 3) vegetables and healthy cooked dishes. Three models were built to compare the potential confounder such as age, education years, marital status, calorie intakes, ciggarate smoking and body mass indeks (BMI). Only vegetables and healthy cooked dishes DP was associated with MetS. This DP reflects high consumption of various types of vegetables, noodle in soup, healthy cooked fish or seafood and low consumption of all type of high calorie rice, noodles and fried desserts. For all models, subject in the highest tertile of vegetables and healthy cooked dishes DP had a lower odd ratio (OR) for MetS as compared to lowest tertile. As more potential confounders added in new models, the significant values are increased. After adjustment of body mass index, the association for vegetables and healthy cooked dishes DP was attenuated (OR: 0.67, CI: 0.39-1.16, p: 0.156). In conclusion, high consumption of vegetable and healthy cooked dishes may lower the occurance of MetS among Malaysian elderly.

Introduction: The accuracy of image interpretations of CT and MRI studies is absolutely dependent on the quality of the images produced. Motion artifacts which result from the patients' movement during image acquisitions may lead to misinterpretation, wrong diagnosis or inconclusive examinations. In pediatric age groups, most of CT and MRI examinations require sedation or general anesthesia to achieve the degree of cooperation or immobilisation to complete the procedures successfully. Methods: The patients were randomly chosen among children, from newborn to 12 years of age who underwent sedation and general anesthesia for CT scan and and MRI in the University of Malaya Medical Centre between September 2001 and August 2003. The quality of MRI and CT images were evaluated by radiologists using a three-point scale: 1-no motion artifact; 2-minor motion artifacts and 3-major motion artifacts. Results: Among sedated children, 75.5% and 41% had good CT and MRI images respectively. In general, the anesthesia group, 100% had good CT images and 85.7% had good MRI images. Children who received sedation (33.5%) had severe motion artifacts whereas none of the anesthetised children had severe motion artifacts. Conclusion: General anesthesia is much better for good quality images in both MRI and CT examinations; however it is associated with a higher cost and longer hospital stay. Combination of oral chloral hydrate and intravenous midazolam was found to be the most effective sedative agent in terms of CT/MRI image quality.

Poor appetite and inadequate food intake together with depression are associated with malnutrition, that will increase risk of morbidity and mortality among elderly people. Identifying factors associated with these conditions are essential for formulation of preventive strategies. Therefore, a study was conducted to identify factors associated with poor appetite and depression among institutionalised Chinese elderly people in Butterworth, Penang. A total of 100 Chinese elderly (49 men and 51 women) aged 60 years and above, (mean age ± SD of 74.7 ± 9.2 years), with no known terminal and mental illnesses from two nursing homes participated in this study. Subjects were interviewed to gather information on appetite using Council of Nutrition Appetite Questionnaire (CNAQ), depression using Geriatric Depression Scale (GDS) and also socio demographic and health status. Food intake was assessed using a combination of one-day food weighing and 24 hour diet recall. Body weight and height were measured. Results showed that the mean energy and nutrients intake did not achieve the Recommended Nutrient Intake of Malaysia (RNI), with the exception for vitamin C. Only 4% of the subjects were underweight and obese, 65% normal and 31% overweight. A total of 70% and 73% of subjects had poor appetite and depression, respectively. Subjects who had depression (adjusted OR = 2.78, 95% CI = 0.95-8.03), energy intake below RNI (adjusted OR = 2.34, 95% CI = 0.68-6.95) and difficulty to fall asleep at night (insomnia) (adjusted OR = 2.22, 95% CI = 0.72-6.82) were more likely to have poor appetite. Subjects who had poor appetite (adjusted OR = 3.36, 95% CI = 1.19-9.47) and insomnia (adjusted OR = 2.58, 95% CI = 0.83-7.98) were more likely to have depression. In conclusion, although the majority of subjects had normal body weight but the nutrient intake was inadequate. Poor appetite and depression were prevalent and interrelated and also strongly associated with insomnia.

This cross sectional study was conducted to determine the validity of three screening tools, Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Risk Screening Tool for Community (MRST-C) and Malnutrition Risk Screening Tool for Hospital (MRST-H) among elderly people at health clinics. The screening tools were validated against anthropometric and functional assessments. The anthropometric assessments that were carried out included body weight, height, arm span, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A set of questionnaire on manual dexterity, muscular strength, instrumental activities daily living (IADL) and cognitive status was used to assess functional abilities. A total of 156 subjects were recruited from rural (38 subjects) and urban (118 subjects) health clinics at Sabak Bernam and Cheras respectively. Subjects’ age ranged from 60 to 83 years old, with 44.2% were men and 55.8% women. The prevalence of muscle wasting among the subjects assessed from MUAC and CC were both 7.0%. MNA-SF had the highest correlation with BMI (r = 0.497, p<0.001), followed by MUAC (r = 0.398, p<0.001), CC (r = 0.473, p<0.001), cognitive assessment (r = 0.229, p<0.001) and handgrip strength (r = 0.209, p<0.001). Whilst MRST-C had the highest correlation with IADL score (r = -0.320, p<0.001) and MRST-H had the highest correlation with the lock and key test (r = -0.325, p<0.01). Sensitivity was the highest for MNA-SF (93.2%), followed by MRST-H (52.5%) and MRST-C (25.8%). Specificity was the highest for MRST-H (97.3%), followed by MRST-C (90.8%) and MNA-SF (79.4%). Positive predictive value (PPV) for MRST-H, MNA-SF and MRST-C was 55.5%, 18.2% and 14.1%, respectively. In conclusion, among the screening tools being validated, MNA-SF is considered the most appropriate tool to be used in health clinics for identification of elderly individuals who are at high risk of malnutrition.
Lower case are ; lower case pea ; SF Brand of Topical Fluoride ; Carbon ion ; upper case aitch

Honey is a natural substance produced by honeybees, Apis mellifera, from the nectar of blossomed flowers or exudates of trees and plants producing nectar honeys or honeydews, respectively. It is a supersaturated solution of sugars, enriched with proteins, minerals, vitamins, organic acids and polyphenols. Honey possesses numerous nutritional, healing and prophylactic properties attributed by the rich components found in honey. Some of the health beneficial properties include wound healing, antimicrobial, antioxidant and anti-inflammatory potential. This review relates the nutritional composition, antioxidant and therapeutical effects of honey with emphasis on Malaysian honeys.

The management of Enterocutaneous fistula (ECF) is challenging. It remains associated with morbidity and mortality, despite advancements in medical and surgical therapies. Early nutritional support using parenteral, enteral or fystuloclysis routs is essential to reverse catabolism and replace nutrients, fluid and electrolyte losses. This study aims to review the current literature on the management of ECF. Fistulae classifications have an impact on the calories and protein requirements. Early nutritional support with parenteral, enteral nutrition or fistuloclysis played a significant role in the management outcome. Published literature on the nutritional management of ECF is mostly retrospective and lacks experimental design. Prospective studies do not investigate nutritional assessment or management experimentally. Individualising the nutritional management protocol was recommended due to the absence of management guidelines for ECF patients.

Objective: Dental attendance among pregnant women has been low although they frequently experience oral health problems. Nurses who provide antenatal health care are well positioned to advise and refer their pregnant patients to dentists. this study aimed to assess the practices of medical nurses regarding advice for dental visits and referral of their pregnant patients to dentists. Methods: A total of 202 medical nurses who provide antenatal health care at Ministry of Health facilities in the district of Kota bharu, Kelantan, Malaysia were included in this cross-sectional study. A structured self-administered questionnaire was used to obtain information on variables of interest. Results: Most nurses frequently advised (90.6%) and referred (91.1%) their pregnant patients to dentists, although some (9.4%) advised their patients to defer dental visits until after parturition. Multivariable analysis indicated that individuals who worked as nurses for 10 years or fewer and had their own dental visits within the past year were more likely to advise their patients to see dentists with adjusted OR of 3.98 (95% cI=1.37-11.54) and 2.58 (95% cI=0.99-6.70) respectively. Nurses who visited dentists within the past year were also more likely to make dental referrals (OR=3.46, 95% cI=1.32-9.10). conclusions: Most nurses routinely advise and refer their pregnant patients for dental visits. the time since a nurse’s last personal dental visit was associated with their advice and referral of patients to dentists, and duration employment as a nurse was associated with advising patients for dental visits.

Background: This study assessed the knowledge and attitudes of medical nurses regarding oral health and oral health care of pregnant women. Methods: This cross sectional study of 133 nurses in the district of Tumpat, Kelantan (Malaysia) used self-administered questionnaires. Results: Most nurses knew that dental plaque is associated with periodontal disease (97.7%). However, most nurses erroneously believed that tooth decay (86.5%) and excessive sugar consumption (87.2%) led to periodontal disease. About half of the nurses knew about the relationship between periodontal disease of pregnant women and low birth weight (43.6%) and preterm birth (48.9%). Many nurses had the misconception that the developing foetus draws calcium from the mothers’ teeth (78.2%). Most nurses had good attitudes toward improving their oral health knowledge (97.0%) and agreed they should help to deliver oral health education to pregnant women (94.0%). Age, length of service as a nurse, and length of service in antenatal care had no effect on the scores for the nurses’ knowledge and attitude regarding oral health and oral health care of pregnant women. Conclusion: Medical nurses had limited knowledge about oral health of pregnant women and had some misunderstandings about oral health, although they had good attitudes. Age, length of service as a nurse, and length service in antenatal care had no effect on the knowledge and attitude scores of the nurses.
Oral Health, Pregnant Women

Introduction: This two-phase longitudinal study sought to determine the association between isoflavones intake on cognitive function and comorbidities among older adults from the state of Johor, Malaysia. Methods: Phase I involved baseline data collection to examine the association between isoflavones intake and cognitive function among 400 respondents aged 60-years and above, recruited through multistage random sampling. Phase 2 determined the association between isoflavones intake at the baseline and comorbidities at an 18-month follow-up. The baseline data collected included information on socio-demographics, health status, andunpometric measurements, and dietary intake using a dietary history questionnaire (DHQ). Each participant's cognitive function was evaluated using a mini mental state examination (MMSE), digit span, digit symbol, and geriatric depression scale (GDS). Results: The daily intake of total isoflavones, daidzein, and genistein were 19.1±19.7,11.7±12.3 and 7.6+8.1 mg/day, respectively. There was no significant association between isoflavones intake, and specific cognitive function including global, memory, executive functions, and depression. However, there was a significant association (p<0.05) between isoflavones intake r=0.131 (95% CI: 0.064-0.199), daidzein intake r0.132 (95% CI: 0.064-0.199), and genistein intake ra0.129 (95% CI: 0.062-0.197) with memory (digit span) after adjustment for age, gender, educational level, and body mass index (11M1). No association was found between isoflavones intake and comorbidities (p> 0.05). Conclusion: This study found an association between isoflavones intake and memory function, but not with global cognitive, executive functions, depression, and comorbidities. There is a need to promote adequate isoflavones intake in view of its association with memory function.

Introduction: This two-phase longitudinal study sought to determine the association between isoflavones intake on cognitive function and comorbidities among older adults from the state of Johor, Malaysia. Methods: Phase I involved baseline data collection to examine the association between isoflavones intake and cognitive function among 400 respondents aged 60-years and above, recruited through multistage random sampling. Phase 2 determined the association between isoflavones intake at the baseline and comorbidities at an 18-month follow-up. The baseline data collected included information on socio-demographics, health status, andunpometric measurements, and dietary intake using a dietary history questionnaire (DHQ). Each participant's cognitive function was evaluated using a mini mental state examination (MMSE), digit span, digit symbol, and geriatric depression scale (GDS). Results: The daily intake of total isoflavones, daidzein, and genistein were 19.1±19.7,11.7±12.3 and 7.6+8.1 mg/day, respectively. There was no significant association between isoflavones intake, and specific cognitive function including global, memory, executive functions, and depression. However, there was a significant association (p<0.05) between isoflavones intake r=0.131 (95% CI: 0.064-0.199), daidzein intake r0.132 (95% CI: 0.064-0.199), and genistein intake ra0.129 (95% CI: 0.062-0.197) with memory (digit span) after adjustment for age, gender, educational level, and body mass index (11M1). No association was found between isoflavones intake and comorbidities (p> 0.05). Conclusion: This study found an association between isoflavones intake and memory function, but not with global cognitive, executive functions, depression, and comorbidities. There is a need to promote adequate isoflavones intake in view of its association with memory function.