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  1. Ho LH, Abdul Aziz NA, Azahari B
    Food Chem, 2013 Aug 15;139(1-4):532-9.
    PMID: 23561142 DOI: 10.1016/j.foodchem.2013.01.039
    The physico-chemical and sensorial properties of the control (BCtr), commercial wheat flour (CWF) bread substituted with 10% BPF (banana pseudo-stem flour) (B10BPF) and B10BPF with added 0.8% w/w (flour weight basis) xanthan gum (XG) or sodium carboxymethylcellulose (CMC) (B10BPFXG and B10BPFCMC, respectively) were examined. The proximate analyses revealed that the composite bread had significantly higher moisture, ash, crude fibre, soluble, insoluble and total dietary fibre contents but lower protein, fat and carbohydrate contents than the BCtr. Bread incorporated with BPF resulted in a lower volume, darker crumb and lighter crust colour than the BCtr. The addition of CMC improved the bread volume. All breads containing BPF had greater total phenolics, and antioxidant properties than the control bread. Sensory evaluation indicated that the B10BPFCMC bread had the highest acceptability.
  2. Abdul Aziz NA, Wong LM, Bhat R, Cheng LH
    J Sci Food Agric, 2012 Feb;92(3):557-63.
    PMID: 25363645 DOI: 10.1002/jsfa.4606
    Mango is a highly perishable seasonal fruit and large quantities are wasted during the peak season as a result of poor postharvest handling procedures. Processing surplus mango fruits into flour to be used as a functional ingredient appears to be a good preservation method to ensure its extended consumption.
  3. Abdul Aziz NA, Baharudin NS, Alias NA
    Malays J Med Sci, 2023 Jun;30(3):176-183.
    PMID: 37425381 DOI: 10.21315/mjms2023.30.3.16
    INTRODUCTION: A high level of perceived social support can lessen stress. However, the lack of knowledge on stress and perceived social support among students during the coronavirus disease (COVID-19) pandemic was explored. Thus, this study aimed to investigate the relationship between stress and perceived social support among undergraduate Health Sciences students.

    METHODS: A convenience sampling method was used in a cross-sectional study of 290 undergraduate Health Sciences students in public universities. The Perceived Stress Scale (PSS-10) was used to measure the perception of stress, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support from three sources, including family, friends and significant others.

    RESULTS: A statistically significant correlation was found between the stress level and the total score of the MSPSS (r = -0.432), perceived social support from family (r = -0.429), significant others (r = -0.328), and friends (r = -0.219, P < 0.001). Over three-quarters (73.4%) of the students have a moderate stress level (mean = 21.17, SD = 5.75). The highest social support perceived was from a family (mean = 5.21, SD = 1.48).

    CONCLUSION: The study suggested that social support from family is the strongest for students to go through the stress of tough times. It also highlighted the need for attention to stress management among undergraduate students for healthy well-being. Future studies that involve other academic fields of study and qualitative research would give useful information on perceived social support among students.

  4. Makhtar ST, Tan SW, Nasruddin NA, Abdul Aziz NA, Omar AR, Mustaffa-Kamal F
    BMC Vet Res, 2021 Mar 23;17(1):128.
    PMID: 33757494 DOI: 10.1186/s12917-021-02837-6
    BACKGROUND: Morbilliviruses are categorized under the family of Paramyxoviridae and have been associated with severe diseases, such as Peste des petits ruminants, canine distemper and measles with evidence of high morbidity and/or could cause major economic loss in production of livestock animals, such as goats and sheep. Feline morbillivirus (FeMV) is one of the members of Morbilliviruses that has been speculated to cause chronic kidney disease in cats even though a definite relationship is still unclear. To date, FeMV has been detected in several continents, such as Asia (Japan, China, Thailand, Malaysia), Europe (Italy, German, Turkey), Africa (South Africa), and South and North America (Brazil, Unites States). This study aims to develop a TaqMan real-time RT-PCR (qRT-PCR) assay targeting the N gene of FeMV in clinical samples to detect early phase of FeMV infection.

    RESULTS: A specific assay was developed, since no amplification was observed in viral strains from the same family of Paramyxoviridae, such as canine distemper virus (CDV), Newcastle disease virus (NDV), and measles virus (MeV), and other feline viruses, such as feline coronavirus (FCoV) and feline leukemia virus (FeLV). The lower detection limit of the assay was 1.74 × 104 copies/μL with Cq value of 34.32 ± 0.5 based on the cRNA copy number. The coefficient of variations (CV) values calculated for both intra- and inter-assay were low, ranging from 0.34-0.53% and 1.38-2.03%, respectively. In addition, the clinical sample evaluation using this assay showed a higher detection rate, with 25 (35.2%) clinical samples being FeMV-positive compared to 11 (15.5%) using conventional RT-PCR, proving a more sensitive assay compared to the conventional RT-PCR.

    CONCLUSIONS: The TaqMan-based real-time RT-PCR assay targeting the N gene described in this study is more sensitive, specific, rapid, and reproducible compared to the conventional RT-PCR assay targeting the N gene, which could be used to detect early infection in cats.

  5. Sipin Q, Mustaffa Kamal F, Watanabe M, Megat Abdul Rani PA, Low VL, Abdul Aziz NA
    PMID: 33120297 DOI: 10.1016/j.cimid.2020.101563
    Ticks are important vectors in transmitting various pathogens and they could jeopardize the health and welfare of humans and animals worldwide. The present study aimed to investigate the presence of important tick-borne haemopathogens (TBH) in dogs and ticks via polymerase chain reaction (PCR) assays. A total of 220 blood samples and 140 ticks were collected from 10 animal shelters in Peninsular Malaysia. Of 220 blood samples, 77 (35 %) were positive to TBH, of which 20 % were E. canis, 12 % were A. platys, 7 % were B. gibsoni and 7 % were B. vogeli. All ticks were identified as Rhipicephalus sanguineus with five samples (3.57 %) positive with TBH. Co-infections of TBH (0.45-9.55 %) in dogs were also observed in this study.
  6. Edgar S, Ellis M, Abdul-Aziz NA, Goh KJ, Shahrizaila N, Kennerson ML, et al.
    Neurobiol Aging, 2021 12;108:200-206.
    PMID: 34404558 DOI: 10.1016/j.neurobiolaging.2021.07.008
    Recent studies have identified SOD1, FUS, TARDBP and C9orf72 as major ALS-related genes in both European and Asian populations. However, significant differences exist in the mutation frequencies of these genes between various ancestral backgrounds. This study aims to identify the frequency of mutations in the common causative ALS genes in a multi-ethnic Malaysian cohort. We screened 101 Malaysian ALS patients including 3 familial and 98 sporadic cases for mutations in the coding regions of SOD1, FUS, and TARDBP by Sanger sequencing. The C9orf72 hexanucleotide repeat expansion was screened using the repeat-primed polymerase chain reaction assay. Mutations were found in 5.9% (6 of 101) of patients including 3.0% (3 of 101) of patients with the previously reported SOD1 missense mutations (p.V48A and p.N87S) and 3.0% (3 of 101) of patients with the C9orf72 repeat expansion. No mutations were found in the FUS and TARDBP genes. This study is the first to report the mutation frequency in an ethnically diverse Malaysian ALS population and warrants further investigation to reveal novel genes and disease pathways.
  7. Toh TH, Abdul-Aziz NA, Yahya MA, Goh KJ, Loh EC, Capelle DP, et al.
    Clin Neurophysiol, 2021 10;132(10):2722-2728.
    PMID: 34312065 DOI: 10.1016/j.clinph.2021.05.034
    OBJECTIVE: We aimed to develop a model to predict amyotrophic lateral sclerosis (ALS) disease progression based on clinical and neuromuscular ultrasound (NMUS) parameters.

    METHODS: ALS patients were prospectively recruited. Muscle fasciculation (≥2 over 30-seconds, examined in biceps brachii-brachialis (BB), brachioradialis, tibialis anterior and vastus medialis) and nerve cross-sectional area (CSA) (median, ulnar, tibial, fibular nerve) were evaluated through NMUS. Ultrasound parameters were correlated with clinical data, including revised ALS Functional Rating Scale (ALSFRS-R) progression at one year. A predictive model was constructed to differentiate fast progressors (ALSFRS-R decline ≥ 1/month) from non-fast progressors.

    RESULTS: 40 ALS patients were recruited. Three parameters emerged as strong predictors of fast progressors: (i) ALSFRS-R slope at time of NMUS (p = 0.041), (ii) BB fasciculation count (p = 0.027) and (iii) proximal to distal median nerve CSA ratio 

  8. Wan Abdul Azim WA, Kassim NK, Taib H, Abdullah NH, Che Abdul Aziz NA, Ibrahim HA
    Cureus, 2024 Jul;16(7):e65166.
    PMID: 39176315 DOI: 10.7759/cureus.65166
    Introduction Chronic kidney disease (CKD) is known to cause an increase in fibroblast growth factor 23 (FGF23). Periodontitis, a condition recognized as a risk factor for CKD, is also potentially associated with the increment of FGF23. This study aims to compare FGF23 levels in CKD patients with and without periodontitis and non-CKD patients with and without periodontitis. Correlation with serum phosphate, calcium, and intact parathyroid hormone (iPTH) was assessed. Additionally, associations between FGF23, calcium, phosphate, iPTH, creatinine, urea, plaque score, and bleeding score with periodontitis in CKD patients were determined. Method A total of 124 participants were categorized into four groups: CKD patients with periodontitis (n=31), CKD patients without periodontitis (n=32), periodontitis patients without CKD (n=32), and healthy population (n=29). The selected CKD patients include those from stages 3 and 4 (predialysis) patients. Serum levels of FGF23, calcium, phosphate, iPTH, creatinine, and urea were analyzed. Oral examinations were conducted to determine the presence and absence of periodontitis and assess plaque and bleeding scores. Result A significantly higher level of FGF23 was found in CKD compared to non-CKD groups; however, no difference was observed with the presence of periodontitis in both CKD and non-CKD. There was no significant correlation found between FGF23 and serum calcium, phosphate, or iPTH concerning periodontal status. Apart from the bleeding score, there was no association between FGF23, calcium, phosphate, iPTH, creatinine, urea, and plaque score with the presence of periodontitis in CKD patients. Conclusion The presence of periodontitis was not associated with higher FGF23 levels in CKD patients. Changes in FGF23, calcium, phosphate, iPTH, creatinine, urea, and plaque score could not be attributed to the presence of periodontitis in CKD patients.
  9. Abdul Aziz NA, Toh TH, Loh EC, Capelle DP, Goh KJ, Abdul Latif L, et al.
    PMID: 33726578 DOI: 10.1080/21678421.2021.1893336
    Objective: To compare two ALS staging systems, King's clinical staging and Milano-Torino (MiToS) functional staging, using prospective data from a multi-ethnic cohort of ALS patients. Methods: The stages of disease were determined prospectively based on existing definitions. The two systems were compared for timing of stages using box plots, correspondence using chi-square tests and association using Spearman's rank correlation. Results: The distribution of stages differed between the two systems. The proportions of disease stages of the King's staging system were more evenly distributed whereas in MiToS, there was greater weight seen at the later stages of disease. At the early stages, patients moved consecutively in the MiToS staging system but not in the King's staging system where patients tended to skip stages to reach later stages. Both systems had good correlation (Spearman's rho = 0.869) and the King's stage 4 most frequently corresponded to MiToS stage 2. Conclusion: We found the King's staging was helpful in determining the stages of disease burden, whereas both were helpful in determining the time to functional dependence with MiToS further refining the levels of dependence.
  10. Chang CT, Shunmugam P, Abdul Aziz NA, Abdul Razak NS, Johari N, Mohamad N, et al.
    J Paediatr Child Health, 2020 Mar;56(3):426-431.
    PMID: 31654469 DOI: 10.1111/jpc.14646
    AIM: Bed sharing is defined as a newborn sleeping in the same bed with an adult. Bed sharing may put the newborn at risk of suffocation due to accidental smothering.

    METHODS: This was a quasi-experimental study conducted in a tertiary referral hospital. Healthy post-delivery Malaysian mothers were randomly selected and enrolled into the control or the intervention group. On the day of discharge, mothers in the intervention group were interviewed face-to-face in the post-natal ward on their plans for sleeping arrangement with their newborn. After the interview, mothers were advised not to bed share with their newborn and were given an educational leaflet on safe sleeping practices. One week after discharge, mothers in both groups were interviewed over the telephone regarding their actual sleeping arrangements with their newborn using the same questionnaire. Logistic regression was performed to determine factors associated with reduced bed sharing.

    RESULTS: A total of 94 mothers and 95 mothers were recruited to the control and intervention group, respectively. The baseline bed-sharing prevalence was similar between groups: 60.6% in the control group and 61.1% in the interventional group. The proportion of mothers who bed shared with their newborn reduced from 61.1 to 37.9% after the intervention (P 

  11. Edgar S, Abdul-Aziz NA, Loh EC, Capelle D, Goh KJ, Latif LA, et al.
    Neurodegener Dis Manag, 2021 08;11(4):307-314.
    PMID: 34284643 DOI: 10.2217/nmt-2021-0004
    Aim: To investigate the patients' perception of their disease, its management and the impact of the COVID-19 pandemic on persons living with amyotrophic lateral sclerosis (ALS) in Malaysia. Patients & methods: An online survey comprising 42 questions was conducted on ALS patients during the peak of the COVID-19 pandemic. Results: Responses were received from 37/60 (62%) participants with ALS directly or through their caregivers. During the COVID-19 pandemic, two-thirds of patients were negatively impacted by the sudden disruption to their hospital appointments, rehabilitation sessions and reduced social interactions. Conclusion: This study provided insight into patients' perception of their care and management of ALS in Malaysia which will facilitate in implementing changes that can improve care to persons living with this devastating illness.
  12. Abdul Aziz NA, Mokhtar NM, Harun R, Mollah MM, Mohamed Rose I, Sagap I, et al.
    BMC Med Genomics, 2016;9(1):58.
    PMID: 27609023 DOI: 10.1186/s12920-016-0218-1
    Histopathological assessment has a low potential to predict clinical outcome in patients with the same stage of colorectal cancer. More specific and sensitive biomarkers to determine patients' survival are needed. We aimed to determine gene expression signatures as reliable prognostic marker that could predict survival of colorectal cancer patients with Dukes' B and C.
  13. Abdul Aziz NA, Toh TH, Goh KJ, Loh EC, Capelle DP, Abdul Latif L, et al.
    PMID: 33084408 DOI: 10.1080/21678421.2020.1832121
    OBJECTIVE: Studies from multiethnic populations are rarely reported but do indicate differences in phenotypic presentation and survival in amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the natural history of a cohort of ALS patients from a multiethnic population. Methods: Data from ALS patients presenting to our multidisciplinary ALS clinic were prospectively collected from January 2015 to June 2020 as part of an ongoing hospital-based patient registry. Kaplan-Meier and Cox regression model were performed to identify potential prognostic factors. Results: A total of 144 ALS patients were recruited. We estimated the crude ALS incidence as 0.53 per 100,000 for 2019 but rises to 2 per 100,000 in patients aged 60-74 years. The majority of patients were of Chinese ethnicity (59.7%), followed by Malay (24.3%), Indian (11.1%), and others (4.9%). Malaysian Indians had a significantly steeper ALSFRS-R slope at diagnosis (p = 0.040). We found a worse prognosis in patients with bulbar-onset (HR = 1.915, p = 0.019), older age (HR = 1.052, p = 0.000), and who were fast-progressors (HR = 1.274, p = 0.000). In contrast, a higher body mass index (HR = 0.921, p = 0.007) and a longer time to diagnosis (HR = 0.967, p = 0.006), noninvasive ventilation (HR = 0.820, p = 0.000) and percutaneous endoscopic gastrostomy insertion (HR = 0.823, p = 0.000) were associated with better survival. On multivariate analysis, diagnostic delay and slow disease progression were associated with better survival. Conclusions: In our cohort, diagnostic delay and a slow disease progression were significantly associated with better survival in ALS. We also found ethnic variation with Chinese preponderance and more rapid disease progression in patients of Indian descent.
  14. Selamat R, Raib J, Abdul Aziz NA, Zulkafly N, Ismail AN, W Mohamad WNA, et al.
    Ecol Food Nutr, 2019 11 22;59(3):263-278.
    PMID: 31755310 DOI: 10.1080/03670244.2019.1694922
    This study aimed to determine dietary practices and meal patterns among Malaysian overweight and obese school children at baseline. This study was part of a school-based obesity intervention study, My Body is Fit and Fabulous at School (MyBFF@school). It involved 1045 primary and 1041 secondary overweight and obese school children from a randomly selected 23 out of 1196 primary and 15 out of 416 secondary government schools in central Peninsular Malaysia. The results showed a significantly higher of adequate intake (4-8 servings/day) of cereals and grains among primary (54.7%) than secondary school children (48.2%). About 28.2% of primary and 32.6% of secondary school children had consumed adequate fruit (2 servings/day), while a very low percentage of both primary (5.0%) and secondary (3.6%) school children consumed adequate vegetables (3 servings/day). As for the meal patterns, school children in both primary and secondary were not taking breakfast regularly (mean±SD for primary: 3.16 ± 2.61 days/week vs secondary: 2.97 ± 2.52 days/week). There was also a significantly higher mean frequency of primary school children brought plain water to school than the secondary school children. In conclusion, urgent actions to address improper dietary practices and meal patterns of overweight and obese school children in Malaysia are warranted.
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