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Fulltext Nutrient intake among elderly in southern Peninsular Malaysia

Suriah AR, Zainorni M, Shafawi S, Mimie Suraya S, Zarina N, Wan Zainuddin W, et al.

Malays J Nutr, 1996 Mar;2(1):11-9.
PMID: 22692097 MyJurnal

Studies were conducted in selected areas in three states namely Johor (n=117, male=55, female=62), Negeri Sembilan (n=130, male=52, female=78) and Malacca (n=97, male=33, female=64) involving free living elderly (age range from 60 to 93 years old). Respondents were divided into three age cohort groups that is 60 to 69 years, 70 to 79 years and above 80 years old. Assessment of macro and micronutrients were obtained from 24-hour diet recall for three consecutive days. Household measurements were used to estimate the amount of food consumed. Mean energy intake for both sexes were lower than the Malaysian RDA. Mean energy intake were also found to decline with age increment. The percentage of carbohydrate from total calories is higher compared to fat and protein. No respondents were found to consume less than 1/3 RDA for protein. Although no significant difference in nutrient intake was noted among age cohort groups, there was a decline in the intake of protein, fat and carbohydrate. Significantly (p <0.05) lower carbohydrate intake was noted in cohort group above 80 years. As for vitamins and minerals consumption, more than 50% of the elderly population studied consumed less than 2/3 RDA for vitamin A, thiamine, riboflavin, niacin and calcium. Very low intake of nutrient may lead to many health problems. Overall mean energy intake indicate the respondents consume less than the Malaysian RDA for all three age cohort groups. Total mean energy intake were also found to decline with age increment for both sexes. Due to the low energy intake, higher percentage of elderly were found consuming less than 2/3 RDA for thiamine (65%), riboflavin (63%) and niacin (90%). Other nutrients which were also being consumed less than 2/3 RDA by the respondents are vitamin A (67%) and calcium (65%). The intake of calcium which was found to be extremely low (ranged from 277 to 303 mg) could lead to problems like osteoporosis.
Fulltext Antropometric measurements of elderly

Suriah AR, Zalifah M, Zainorni M, Shafawi S, Minie Suraya S, Zarina N, et al.

Malays J Nutr, 1998 Dec;4(1):55-63.
PMID: 22692341

Body composition was assessed in a group of 344 free-living elderly between 60 and 89 years by means of anthropometry. The height, weight and body mass indexes of the elderly were reduced with advancing age in both the males and females. Skinfold thickness measurements also declined with age. Overall, the female elderly had a greater tricep skinfold thickness but smaller mid-arm circumferences, mid-arm muscle circumference and mid-arm muscle area compared to the male.
Outpatient versus inpatient intravaginal misoprostol for the treatment of first trimester incomplete miscarriage: a randomised controlled trial

Ng BK, Annamalai R, Lim PS, Aqmar Suraya S, Nur Azurah AG, Muhammad Abdul Jamil MY

Arch Gynecol Obstet, 2015 Jan;291(1):105-13.
PMID: 25078052 DOI: 10.1007/s00404-014-3388-0

BACKGROUND: Study objective To assess the efficacy of outpatient misoprostol administration versus inpatient misoprostol administration for the treatment of first trimester incomplete miscarriage.
MATERIALS AND METHODS: A prospective randomised controlled trial was conducted at a tertiary hospital from May 2012 to April 2013. A total of 154 patients with first trimester incomplete miscarriage were randomised to receive misoprostol either as outpatient or inpatient. Intra-vaginal misoprostol 800 mcg was administered eight hourly to a maximum of three doses. Complete evacuation is achieved when the cervical os was closed on vaginal examination or ultrasound showed no more retained products of conception evidenced by endometrial thickness of less than 15 mm. Treatment failure was defined as failure in achieving complete evacuation on day seven hence surgical evacuation is offered.
RESULTS: Outpatient administration of misoprostol was as effective as inpatient treatment with success rate of 89.2 and 85.7 % (p = 0.520). The side effects were not significantly different between the two groups. Side effects that occurred were minor and only required symptomatic treatment. Duration of bleeding was 6.0 days in both groups (p = 0.317). Mean reduction in haemoglobin was lesser in the outpatient group (0.4 g/dl) as compared to in the inpatient group (0.6 g/dl) which was statistically significant (p = 0.048).
CONCLUSION: Medical evacuation using intra-vaginal misoprostol 800 mcg eight hourly for a maximum of three doses in an outpatient setting is as effective as in inpatient setting with tolerable side effects.

Study site: tertiary hospital
Pregnancy outcomes with a primary complaint of perception of reduced fetal movements

Nor Azlin MI, Maisarah AS, Rahana AR, Shafiee MN, Aqmar Suraya S, Abdul Karim AK, et al.

J Obstet Gynaecol, 2015 Jan;35(1):13-5.
PMID: 24987985 DOI: 10.3109/01443615.2014.930108

Reduced fetal movement is a worrisome common complaint, not only for mothers but also for the attending medical personnel. The aim of this study was to analyse the pregnancy outcomes of women who presented primarily with reduced fetal movements (RFM). A retrospective study was performed based on patients' perception alone. Obstetric, past medical history, current presentation and outcomes of pregnancy were analysed. A total of 230 case notes were reviewed, with the majority being primigravidae. Less than half (48.7%) of the women had spontaneous labour, 45.7% had induction and 5.6% had elective caesarean section. There were no maternal complications in 97.4% (n = 224) of them. About 0.9% (n = 2) and 1.7% (n = 4) had primary postpartum haemorrhage and extended perineal tear, respectively. Although there was no major neonatal mortality and morbidity, until a randomised trial with a significant sample is conducted in the management of RFM, careful selections for elective delivery or conservative management would prevent untoward complications.
Self-reported prevalence and severity of opioid and kratom (Mitragyna speciosa korth.) side effects

Saref A, Suraya S, Singh D, Grundmann O, Narayanan S, Swogger MT, et al.

J Ethnopharmacol, 2019 Jun 28;238:111876.
PMID: 31014959 DOI: 10.1016/j.jep.2019.111876

ETHNOPHARMACOLOGICAL RELEVANCE: Mitragyna speciosa (Korth.) is a traditional medicinal plant widely used in Southeast Asia for its opioid-like effects. Although kratom produces analgesia through binding of mitragynine and other alkaloids at the mu-opioid receptor (MOR), the association of long-term kratom use with adverse opioid-like effects remains unknown.
AIM OF THE STUDY: To determine the self-reported prevalence and severity of opioid-related adverse effects after kratom initiation in a cohort of illicit opioid users.
MATERIALS AND METHODS: A total of 163 illicit opioid users with current kratom use history were recruited through convenience sampling from the northern states of Peninsular Malaysia. Face-to-face interviews were conducted using a semi-structured questionnaire.
RESULTS: Respondents were all males, majority Malays (94%, n = 154/163), with a mean age of 37.10 years (SD = 10.9). Most were single (65%, n = 106/163), had 11 years of education (52%, n = 85/163) and employed (88%, n = 144/163). Half reported using kratom for over >6 years (50%, n = 81/163), and 41% consumed >3 glasses of kratom daily (n = 67/163). Results from Chi-square analysis showed kratom initiation was associated with decreased prevalence of respiratory depression, constipation, physical pain, insomnia, depression, loss of appetite, craving, decreased sexual performance, weight loss and fatigue.
CONCLUSIONS: Our findings indicate that kratom initiation (approximately 214.29 mg of mitragynine) was associated with significant decreases in the prevalence and severity of opioid adverse effects.
Self-Report Data on Regular Consumption of Illicit Drugs and HIV Risk Behaviors after Kratom (Mitragyna Speciosa korth.) Initiation among Illicit Drug Users in Malaysia

Saref A, Suraya S, Singh D, Grundmann O, Narayanan S, Swogger MT, et al.

J Psychoactive Drugs, 2019 11 04;52(2):138-144.
PMID: 31682782 DOI: 10.1080/02791072.2019.1686553

This study sought to determine the relationship between kratom (Mitragyna speciosa) initiation and regular consumption of illicit drugs and HIV risk behaviors in a cohort of illicit drug users in Malaysia. 260 illicit drug users with current kratom use were recruited through convenience sampling for this cross-sectional study. All were male, with the majority being Malays (95%, n = 246/260). Results suggest that kratom initiation was associated with significant decrease in the regular use of heroin (odds ratio (OR) = 0.50, 95% confidence interval (CI): 0.40- 0.72; p = .0001), methamphetamine (OR = 0.23, CI: 0.16- 0.35; p < .0001), and amphetamine (OR = 0.17, CI: 0.09- 0.34; p < .0001). Kratom initiation was also associated with reduction in regular HIV risk behaviors such as having sex with sex workers (OR = 0.20, CI: 0.12-0.32; p < .0001), using drugs before sexual intercourse (OR = 0.20, CI: 0.13- 0.31; p < .0001), injecting behaviors (OR = 0.10, CI: 0.04- 0.25; p < .0001), sharing of injection equipment (OR = 0.13, CI: 0.04- 0.43; p < .0001), and injecting with other injection drug users (IDUs) (OR = 0.07, CI: 0.02- 0.24; p < .0001).
Public Perceptions toward Kratom (Mitragyna Speciosa) Use in Malaysia

Singh D, Narayanan S, Suraya S, Saref A, Grundmann O, Prozialeck WC, et al.

J Psychoactive Drugs, 2020 03 10;52(3):282-288.
PMID: 32153252 DOI: 10.1080/02791072.2020.1738603

Kratom (Mitragyna speciosa), an indigenous medicinal plant of Southeast Asia, is believed to be harmful. We compared the perceptions toward kratom use among kratom users and non-users in Malaysia. 356 respondents (137 kratom users and 219 non-users) were recruited for this cross-sectional study. The majority of respondents were male (60%, n = 212/356), Malays (88%), and 51% were ≥37 years old. Non-users showed higher unadjusted odds of reporting a perception that kratom use can cause addiction (OR = 6.72, CI: 3.91-11.54, p