This study aimed to identify the prevalence of energy misreporting amongst a sample of Malay children aged 9-11 years (n = 14) using a range of commonly used cut points. Participants were interviewed using repeated 24 h dietary recalls over three occasions. The Goldberg equations (1991 and 2000), Torun cut points and the Black and Cole method were applied to the data. Up to 11 of 14 children were classified as misreporters, with more under-reporters (between seven and eight children) than over-reporters (four or less children). There were significant differences in the proportion of children classified as energy misreporters when applying basal metabolic rate calculated using FAO/UNU/WHO (1985) and Malaysian-specific equations (p < 0.05). The results show that energy misreporting is common amongst Malay children, varying according to cut point chosen. Objective evaluation of total energy expenditure would help identify which cut point is appropriate for use in Malay paediatric populations.
Proximal peripheral nerve conduction studies can provide useful information to the clinician. The difficulty of measuring the length of the proximal nerve as well as a frequent inability to stimulate at 2 points along the nerve adds a challenge to the use of electrodiagnosis for this purpose. The purpose of this article is to present normal values for the suprascapular, axillary, and musculocutaneous nerves using surface electrodes while accounting for side-to-side variability.
This study aimed to determine the relationship between blood lead (BPb) concentrations and cognitive and physical development in school children. A total of 169 urban children and 100 industrial children of Malay ethnicity, in the age range of 6(1/2) to 8(1/2) years, were selected. BPb was determined using GF atomic absorption spectrophotometer. The mean cognitive score (102.55) of the children from the industrial area was significantly higher than that of the urban children (95.09; P < .001). However, no significant differences were found in the BPb levels between the 2 groups (industrial, 3.75 microg/dL; urban, 3.56 microg/dL). There was significant inverse correlation between BPb and cognitive scores for all children (P < .05). The cognitive scores for all children were influenced by BPb after adjustments (P < .05). The urban children had significantly better Weight for Height and Left Arm Circumference values than those from industrial area. There was no significant correlation between BPb and the anthropometric measurements. In conclusion, low BPb influenced the cognitive development, whereas physical development was not affected.
Chronic obstructive pulmonary disease (COPD) is a systemic disease that leads to weight loss and muscle dysfunction resulting in an increase in mortality. This study aimed to determine the prevalence rate of malnutrition and nutritional status and also factors associated with nutritional status. A total of 149 subjects were involved in the cross-sectional study. The study was conducted at two medical centers in Kuala Lumpur, Malaysia. The results of the study showed that malnutrition was more prevalent (52.4%) in the subjects with severe stages of COPD as compared to mild and moderate COPD stages (26.2%) (P < 0.05). Fat-free mass depletion as assessed using fat-free mass index (FFMI) affected 41.9% of the subjects. Plasma vitamin A, peak expiratory flow (PEF), and handgrip were the predictors for body mass index (BMI) (R(2) = 0.190, P < 0.001). Plasma vitamin A and force expiratory volume in one second (FEV(1)) were the predictors of FFMI (R(2) = 0.082, P = 0.007). BMI was the predictor of respiratory factors, that is, FEV(1)% predicted (R(2) = 0.052, P = 0.011). It can be concluded that there is a need to identify malnourished COPD patients for an appropriate nutrition intervention.
Study site: outpatient clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Institute of Respiratory Medicine
Our objective was to establish thyroid volume by sonography in Brazilian schoolchildren and to correlate thyroid volume with anthropometric characteristics.
Spirometry was performed on 1,999 subjects (1,385 males and 614 females) ranging in age from 13 to 69 years and comprising of all the main races in Malaysia. They were divided into 6 age groups. Mean forced vital capacity (FVC) in the males and females was 3.49 +/- 0.02 L and 2.51 +/- 0.02 L respectively. Both FVC and FEV1 correlated negatively with age. Regression analysis on data between the ages of 20 to 69 years revealed an age-related decline in FVC of about 30 ml per year of life in the males and 22 ml per year in the females. Multiple stepwise regression of the data for the prediction of an individual's FVC above the age of 20 years gave an equation for the males: FVC = 0.0407 (height)-0.0296 (age)-2.343 L and for the females: FVC = 0.031 (height)-0.022 (age)-1.64 L. Predicted FVC values derived from equations based on other populations were considerably higher than the observed mean in this study, re-emphasizing the need to be cautious when applying formulae derived from one population to another. Grossly erroneous conclusions may be reached unless predicted equations for lung-function tests for a given population group are derived from studies based upon the same population group.
We conducted a study to measure the peak expiratory flow rate (PEFR), forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in a group of normal Malay primary school children aged 7 to 12 years. PEFR was measured in 920 children (482 boys and 438 girls) while FVC and FEV1 were measured in 292 of them (168 boys and 124 girls). In agreement with previous studies, we found that PEFR was correlated with age and height of the subjects but FVC and FEV1 were correlated with height only. Prediction equations for all 3 lung function indices for Malay boys and girls were formulated. In comparison with the lung function values from Western and Chinese subjects, the lung function values in our subjects are lower.
A study was undertaken to produce reference values of lung function in Chinese children and a means of calculating adjusted standard deviation scores of lung function for Malay and Indian ethnic groups.
Circulating zinc concentrations were measured in 73 healthy adult males and females 19-52 years of age who were volunteers for eight different metabolic studies at the University of California, Berkeley. The interindividual variation in the eight studies varied from 5 to 20%; the global coefficient of variation for all studies was 12 +/- 7% (mean +/- SD). The analysis of a reference plasma sample on six different days showed a mean coefficient of variation of 3.8%. Thus, only a small portion of the intraindividual variation is due to day-to-day analytical differences. There was no relationship between circulating zinc concentrations and age, height, or body mass index. Nor were there any significant differences due to gender. Information regarding dietary zinc and protein intakes was available from three-day weighed food intake records from 44 of the subjects. Plasma zinc concentrations were unrelated to the intake of either zinc or protein in those subjects. The results of this study show that the impact of age, gender, body size and dietary zinc or protein on circulating zinc concentrations are too small to be detected in the presence of the analytical and endogenous factors that influence plasma/serum zinc concentrations. Also, within a population of healthy adults, circulating zinc concentrations may vary by as much as 15%.
Selected students were subjected to a general health appraisal including vision and hearing tests by teachers, nurses and finally a medical officer. The findings of all three examiners were then compared taking the results of the medical officer as the indicator of accuracy. The findings of the survey indicated that the problems of school children were similar to those reported by other workers and by MCH Division of the Ministry of Health namely dental caries, head lice, malnutrition, skin infections and visual disability. Other problems like skeletal deformity and abnormalities of heart, lung, speech and behaviour were extremely uncommon and formed only 1.5% of the total. Teachers and nurses performed extremely well in relation to the doctor with 93% and 95.8% concurrence respectively in detecting these abnormalities. Teachers were also requested to give a feedback on their view of and role in the SHS as well as problems faced in following the school health card. The majority perceived the SHS as a joint effort between the Ministry of Health and Education and agreed that they had a role to play in the SHS. Many teachers also indicated a willingness to carry out the various tasks in the SHS. The main problem in filling the school health card seemed to be in getting relevant details from parents though over 50% of teachers complained that there were too many details to fill. The role of teachers in the SHS is discussed in the light of the findings of the study and recommendations are made.
Over the past hundred years in industrialised countries and recently in some developing countries, children have been getting larger and growing to maturity more rapidly. This paper compares the growth of Malaysian children with similar socioeconomic backgrounds but born about twelve years apart. Data were obtained from records of 227 children born between 1968 and 1973 and 238 children born between 1980 and 1985. The children were followed-up regularly at the University Hospital Child Health Clinic in Kuala Lumpur for a variable period from birth to five years of age. Measurements for their weight, length and head circumference were taken at each visit. There is a directional indication that boys and girls of the 1980-1985 cohort are taller, heavier and have bigger head circumferences from birth to five years of age and the difference widens as the child grows older. This study clearly shows that a positive secular trend has taken place in the last decade, reflecting an improvement of living conditions with time. The factors involved in the positive secular trend are manifold and the most important is probably nutrition.
Prediction equations for peak expiratory flow rate (PEFR) of Malay, Chinese and Indian children were obtained by analysing 1020 PEFR recordings of children free of respiratory symptoms and illnesses. Boys had significantly higher PEFR than girls. For both sexes the highest levels of PEFR were observed in Malays and the lowest in Indians. The differences between Malay and Chinese boys were not statistically significant but the levels of PEFR for Malay and Chinese boys were significantly higher than those for Indian boys. In girls the differences among the ethnic groups were not statistically significant. Although ethnic differences were observed in boys these differences might not be clinically important. A common prediction equation for each sex should be both practical and accurate. When compared with predicted levels for white American and Australian children the predicted levels of PEFR of Malaysian children were found to be lower; these differences could be clinically important and the use of standards for Western children when assessing Malaysian children might not be appropriate.
Most in vivo body composition methods rely on assumptions that may vary among different population groups as well as within the same population group. The assumptions are based on in vitro body composition (carcass) analyses. The majority of body composition studies were performed on Caucasians and much of the information on validity methods and assumptions were available only for this ethnic group. It is assumed that these assumptions are also valid for other ethnic groups. However, if apparent differences across ethnic groups in body composition 'constants' and body composition 'rules' are not taken into account, biased information on body composition will be the result. This in turn may lead to misclassification of obesity or underweight at an individual as well as a population level. There is a need for more cross-ethnic population studies on body composition. Those studies should be carried out carefully, with adequate methodology and standardization for the obtained information to be valuable.
Introduction: Metabolic syndrome (MetS) is a condition that includes the presence of a cluster of risk factors specific for cardiovascular disease (CVD). The criteria used to aid the diagnosis of MetS includes abdominal obesity, elevated triglycerides, low high density lipoprotein (HDL) cholesterol, hypertension or use of antihypertensive medication, elevated fasting blood glucose and other risk factors. Objective: This study aimed to determine the prevalence of metabolic syndrome (MetS) among postmenopausal women and its associated factors in a tertiary center in Malaysia Methods: This is a cross-sectional study done among 411 postmenopausal women attending Gynaecology clinic and Family Medicine clinic in a tertiary center in Malaysia. Socio demographic data, reproductive profile, menopausal profile and medical history were obtained. Then waist circumference (WC), weight, height and blood pressure (BP) were also recorded. A fasting blood sample was obtained for serum glucose and lipid profile determinations. Metabolic syndrome was defined according to the criteria of International Diabetes Federation. Results: The mean age of participants was 57.2 + 6.9 years. The prevalence of metabolic syndrome was 36.7%. The risk of MetS increased with the presence of obstetrics history of hypertension (HPT) (odds ratio (OR) 2.64, 95% (CI) 1.25-5.62), previous usage of contraception (odds ratio (OR) 1.56, 95% (CI) 1.02-2.42), family history of HPT (odds ratio (OR) 1.71, 95% (CI) 1.13-2.59) and obesity (odds ratio (OR) 2.59, 95% (CI) 1.08-6.23). Conclusion: There was a high prevalence of the metabolic syndrome in postmenopausal women seeking gynaecologic and primary health care in the tertiary center Malaysia. The associated factors of MetS include previous obstetrics history of HPT, family history of HPT and obesity.
CONTEXT: Selecting an appropriate size double-lumen tube (DLT) for one-lung ventilation has always been a challenge as most choose it based on experience or using the existing guidelines based on gender and height.
AIMS: The aim of this study was to determine if the appropriate choice of this tube could be based on the patients' height, weight, tracheal diameter (TD), or the left main stem bronchus diameter (LMBD) and also to determine the relationship between height and depth of insertion among Asians.
SUBJECTS AND METHODS: This was a retrospective review of 179 patients who were intubated with a left-sided DLT and also had a posterior-anterior view of a digital chest radiograph for tracheal and left main bronchus diameter measurements. Additional data collected included patients' demographics and DLT size used.
RESULTS: There were 123 (68.7%) males and 56 (31.3%) females with an overall mean age of 33.3 ± 16.3 years. Majority of the males (48.8%) used a size 39 Fr while females (46.4%) used a 35 Fr. There were weak correlations between DLT size with height (male: R2 = 0.222; female: R2 = 0.193), DLT size with weight (male: R2 = 0.109; female: R2 = 0.211), DLT size with TD (male: R2 = 0.027); female: R2 = 0.016), and DLT size with LMBD (male: R2 = 0.222; female: R2 = 0.193). There was a good correlation between depth of DLT inserted with patient's height for both genders.
CONCLUSION: The appropriate size of the left-sided DLT could not be predicted based on patients' height, weight, tracheal or left main bronchus diameter alone in Asians; however, the depth of insertion of the tube was dependent on the height in both genders.
BACKGROUND AND OBJECTIVE: There is increased use of the 2-min walk test (2MWT) to assess functional exercise capacity. However, the distance achieved during this test may be difficult to interpret in the absence of reference values from a local population. Regression equations to estimate the 2-min walk distance (2MWD) only exist for American and Brazilian populations. The objective of this study was to develop regression equations to estimate the 2MWD in Malaysian adults who were free from major health problems.
METHODS: Eighty-seven adults (43 males; mean ± SD age: 57.1 ± 9.6 years) performed two 2MWT using a standardized protocol. Heart rate (HR) was recorded every 30 s during the test. Stepwise multiple regression analysis was performed using age, gender, height, weight and change in HR (ΔHR) as independent variables, and better of the two 2MWD as the dependent variable. A second regression equation, without ΔHR, was planned if ΔHR was retained as one of the predictors of the 2MWD in the first equation.
RESULTS: The better of the two 2MWD was 200 ± 34 m. Males walked 33 ± 6 m further than females (P < 0.001). The two regression equations were 196 - 1.1 × age, years + 1.0 × ΔHR, bpm + 31.2 × gender (R2 = 0.73) and 279 - 1.7 × age, years + 35.9 × gender (R2 = 0.47) with females = 0 and males = 1.
CONCLUSION: The equations derived in this study may facilitate the interpretation of the 2MWD in clinical populations in Malaysia, as well as in countries with similar cultural backgrounds to Malaysia.
Study site: volunteers from four villages in the Batu sub-district, Gombak, Malaysia