Cardiovascular risk factors of Alzheimer's disease and other neurocognitive disorders in Malaysia.

INTRODUCTION: Risk factors for cardiovascular disease (CVD) have been increasingly implicated in the development of dementia but little is known about the effects in a Malaysian population. We aimed to determine the interaction between sociodemographic and CVD risk factors among the dementia and mild cognitive impairment (MCI) patients in Malaysia. MATERIALS AND METHODS: A cross-sectional study was conducted in the memory clinic at Hospital Kuala Lumpur (HKL). Medical records data from 2014 to 2019 were extracted. Mini Mental State Examination (MMSE) test was used to assess the neurocognitive function of patients. RESULTS: A total of 298 patients (30 MCI, and 268 dementia) were evaluated, with dementia patients consisting of 78 Alzheimer's disease (AD), 93 Vascular dementia (VaD), 94 Mixed dementia, 2 early-onset Alzheimer's disease (EOAD) and 1 Logopenic Progressive Aphasia type of AD (LPA). MCI and dementia were significantly associated with a history of CVD, particularly stroke (p=0.023). CONCLUSION: Given that stroke significantly predicted the risk of developing vascular dementia among the patients in a central Malaysian population, lifestyle modifications are recommended to alleviate these risk factors of CVD.

Managing adolescent pregnancy: The unique roles and challenges of private general practitioners in Malaysia.

INTRODUCTION: Managing adolescent pregnancy in the primary care setting is complex, as it requires doctors to navigate through a combination of medical, social, financial and legal needs. Objective: This study explores the perspectives of private general practitioners on their roles and challenges in managing adolescent pregnancy in Malaysia. METHODS: Nineteen private general practitioners in Selangor and Kuala Lumpur participated in in-depth interviews in 2015. A topic guide was used for interview navigation. Participants were asked to discuss their experiences and approaches in managing pregnant adolescents. We used purposive sampling to recruit consenting private general practitioners who had experience in managing adolescent pregnancy. The verbatim transcripts of the audio-recorded interviews were analyzed using thematic analysis. Data reached saturation at the nineteenth in-depth interview. Results: Two themes emerged. Under the theme 'inadvertent advocator,' participants described their tasks with regards to building trust, calming angry parents and delivering comprehensive counseling and care related to the sexual and reproductive health of adolescents, including requests for abortions. Theme two, 'challenges of private general practitioners,' refers mainly to personal and religious conflicts arising from a request for an abortion and deficiencies in support and multidisciplinary integration within their practice settings. CONCLUSION: General practitioners practicing in the private sector identify themselves as active players in supporting pregnant adolescents but face many challenges arising from the personal, religious, professional and community levels. Addressing these challenges is important for optimal care delivery to pregnant adolescents in this community.

Quaternary ultraviolet AlInGaN MQW laser diode performance using quaternary AlInGaN electron blocking layer.

The effect of polarization-matched Al(0.25)In(0.08)Ga(0.67)N electron-blocking layer (EBL) on the optical performance of ultraviolet Al(0.08)In(0.08)Ga(0.84)N/Al(0.1)In(0.01)Ga(0.84)N multi-quantum well (MQW) laser diodes (LDs) was investigated. The polarization-matched Al(0.25)In(0.08)Ga(0.67)N electron blocking layer (EBL) was employed in an attempt to reduce the polarization effect inside the active region of the diodes. The device performance which is affected by piezoelectric was studied via drift-diffusion model for carrier transport, optical gain and losses using the simulation program of Integrated System Engineering Technical Computer Aided design (ISE TCAD). The optical performance of the LD using quaternary Al(0.25)In(0.08)Ga(0.67)N EBL was compared with the LD using ternary Al(0.3)Ga(0.7)N EBL where both materials have the same energy band gap of Eg = 3.53 eV. The self-consistent ISE-TCAD simulation program results showed that the polarization-matched quaternary Al(0.25)In(0.08)Ga(0.67)N EBL is beneficial as it confines the electrons inside the quantum well region better than ternary Al(0.3)Ga(0.7)N EBL. The results indicated that the use of Al(0.25)In(0.08)Ga(0.67)N EBL has lower threshold current and higher optical intensity than those for Al(0.3)Ga(0.7)N EBL. The effect of Al(0.25)In(0.08)Ga(0.67)N EBL thickness on the performance of LDs has also been studied. Results at room temperature indicated that lower threshold current, high slope efficiency, high output power, and high differential quantum efficiency DQE occurred when the thickness of Al(0.25)In(0.08)Ga(0.67)N EBL was 0.25 µm.

Surface phonon polariton characteristics of In(0.04)Al(0.06)Ga(0.90)N/AlN/Al(2)O(3) heterostructure.

Surface phonon polariton (SPP) characteristics of In(0.04)Al(0.06)Ga(0.90)N/AlN/Al(2)O(3) heterostructure are investigated by means of p-polarized infrared (IR) attenuated total reflection spectroscopy. Two absorption dips corresponding to In(0.04)Al(0.06)Ga(0.90)N SPP modes are observed. In addition, two prominent dips and one relatively weak and broad dip corresponding to the Al(2)O(3) SPP mode, In(0.04)Al(0.06)Ga(0.90)N/Al(2)O(3) interface mode, and Al(2)O(3) bulk polariton mode, respectively, are clearly seen. No surface mode feature originating from the AlN layer is observed because it is too thin. Overall, the observations are in good agreement with the theoretical predictions.

The epidemiology of hepatitis B virus among family members in the Middle East.

In 1985, the authors studied the epidemiology of hepatitis B virus (HBV) in a healthy Middle Eastern population. Residents of three remote villages and urban areas of Jordan were assessed for seroprevalence of hepatitis B surface antigen (HBsAg) and HBV infection. Infection was defined as the presence of antibody to hepatitis B core antigen (total) and/or antibody to hepatitis B surface antigen, with or without HBsAg. The overall HBsAg prevalence was 9.9% and was not age-related, although significant differences were noted between the villages (range, 5.7%-12.8%). The prevalence of HBV infection was 36% and increased with age. In addition, there were differences between the villages in patterns of age-specific infection. A newly constructed socioeconomic index showed greater HBsAg prevalence in lower (14.4%) than in upper (2.4%) socioeconomic groups. A history of contact with a jaundiced person and socioeconomic status were independent risk factors for HBsAg-positive status, while contact with a jaundiced person, rural background, and age were independently related to HBV infection. There was evidence of familial clustering of HBV in two of the villages, with HBV carriers and infected children particularly aggregating around HBsAg-positive siblings. There was also a trend toward an association of HBsAg-positive children with HbsAg-positive mothers. HBV carrier prevalence correlated with family size, and HBV infection in the household increased proportionately with the number of carriers in the family. Hepatitis B e antigen was detected most frequently in children and antibody to hepatitis B e antigen in adults. Postnatal early childhood transmission through contact among children of poorer and larger families probably accounts for the high endemicity of HBV in this region.

Meningitis and septicaemia due to a multiply resistant strain of Haemophilus influenzae type b.

A case of meningitis and septicaemia caused by a multiply resistant strain of Haemophilus influenzae in a Saudi infant aged 7 months is reported. Haemophilus influenzae, resistant to ampicillin and chloramphenicol, was isolated from the cerebrospinal fluid, the blood and throat. The minimum inhibitory concentrations (MIC) for ampicillin and chloramphenicol were 64 mg/l and 16 mg/l respectively. After failure of initial therapy with high doses of ampicillin and chloramphenicol, the child made a full and uneventful recovery when treated with cefotaxime. The implications of isolating such a strain on the policy for treating meningitis in our situation are discussed.