Associations of eating behaviours, fast food purchasing and availability with BMI-for-age z-score among adolescents in Labuan, Malaysia

@#Introduction: A cross-sectional study was conducted to determine the associations of socio-demographic factors, eating behaviours, fast food purchasing by parents for family meals, and availability of neighbourhood fast-food outlets with BMI-for-age z-score (BAZ) among adolescents. Methods: Through multi-stage stratified cluster sampling method, a total of 420 adolescents from five selected public secondary schools participated in the current study. Data on socio-demographic factors, eating behaviours, and parent’s purchases of fast food were obtained through selfadministered questionnaires. The availability of fast-food outlets was assessed using Geographic Information System (GIS). Body weight and height of the adolescents were measured. Results: The prevalence of overweight, obesity, thinness and severe thinness among adolescents in the present study were 17.6%, 15.5%, 3.1% and 0.7%, respectively. The current findings showed that a higher monthly household income (rs =0.12, p=0.02) and less purchases of fast food by parents for family meals (rs =-0.11, p=0.03) were significantly associated with higher BAZ of the adolescents. However, there were no significant associations between eating outside of home, eating at fast-food restaurants, buying delivery fast food, and availability of neighbourhood fast-food outlets with BAZ. Multiple linear regression showed that less purchases of fast food by parents for family meals significantly contributed towards higher BAZ (β=−0.25, p=0.02). Conclusion: A higher household income and less fast food purchasing by parents were associated with higher BAZ. Fast food purchasing of adolescents were not associated with BAZ. Therefore, an appropriate obesity intervention programme should focus on adolescents and their parents from middle- and high-income households in Labuan.

Orbital apex cyst: a rare cause of compressive optic neuropathy post-functional endoscopic sinus surgery.

There are various causes that can lead to compressive optic neuropathy. We present here orbital apex cyst as an unusual cause of compressive optic neuropathy in a 49-year-old male. He presented with 2 weeks painless loss of vision in the left eye with left-sided headache. He had had left functional endoscopic sinus surgery for left nasal polyps 4 years earlier. Magnetic resonance imaging of brain and orbit revealed a left discrete orbital nodule, possibly orbital cyst or mucocele, which was compressing on the left optic nerve. Left eye vision improved markedly from hand movement to 6/36 pinhole 6/18 after initiation of intravenous dexamethasone. A subsequent endoscopic endonasal left optic nerve decompression found the orbital nodule lesion to be an orbital cyst. Marsupialization was performed instead of excision, as the cyst ruptured intraoperatively. Postoperative vision improved to 6/7.5 with normal optic nerve function postoperatively. Possible cause of orbital apex cyst is discussed.

Prevalence and Factors Associated With Second Eye Cataract Surgery and the Trend in the Time Interval Between the Two Eye Surgeries Based on the Malaysian National Eye Database.

PURPOSE: To study the prevalence of second eye cataract surgery (SECS), trend in time interval between subsequent surgeries over the years, and factors associated with SECS utilization among patients who underwent cataract surgeries in the Ministry of Health (MOH), Malaysia. DESIGN: Secondary cross-sectional analysis of the Malaysian National Eye Database (NED) data. METHODS: The Malaysian Cataract Surgery Registry collected data on patients who had cataract surgery from 2002-2004 and 2007-2012. Data collected included demography, operative events, time interval between 2 surgeries, and postoperative visual outcomes. Descriptive analysis was performed. RESULTS: Total surgeries increased from 11,954 in 2002 to 30,265 in 2012 with a proportionate increase in SECS (30.7% in 2002 to 34.3% in 2012). Poor vision (<6/12) was reduced from 81.1% to 14.2% after surgery. With improved data capturing, missing data reduced from 29.22% to 1.05%. The time interval between surgeries was 10.58 months in 2002 and 14.49 months in 2012. Malays (40.2%) and those aged 61-70 years (38.1%) had the highest number of SECS. Those aged 40-50 years (10.96 months) and with poorer vision (9.97 months) had the shortest time interval between the 2 surgeries. The commonest surgical method was phacoemulsification (72.3%). Negeri Sembilan State had the highest SECS rate (35.91%) and Melaka had the shortest interval between surgeries (10.15 months). CONCLUSIONS: Despite an increase in the number of SECS, the time interval is still long. Poor presenting second eye vision and disparity among different states warrants the health authority's attention and intervention.

Manipulating magnetic 3D spheroids in hanging drops for applications in tissue engineering and drug screening.

Magnetic spheroid manipulation can be carried out in hanging drops to generate distinctly structured heterotypic microtissues through sequential addition of cells or spheroid to homotypic spheroids. These spheroids can also be incorporated in a droplet-based assay to screen for therapeutic efficacy in prolonged studies. This simple and versatile technique can offer potential benefits in tissue engineering and drug screening applications.

Partial spontaneous cross union post-division of hughes flap.

We report three cases of partial spontaneous canthal cross union, a rare complication in cases where Hughes flaps are used to reconstruct lower eyelid defects that also involve the canthi. All cases of spontaneous cross union were identified within 2 months of uneventful division of Hughes' flap. Two cases were successfully divided with good aesthetic results although one patient was not keen on surgery, as it was aesthetically acceptable to him. The postulated mechanism was either the proximity of the divided nonepithelial margins or the failure to trim the residual upper eyelid tarsoconjunctival remnant. We recommended adequate trimming of the residual upper eyelid tarsoconjunctival remnant and an early postoperative review to prevent adhesions from developing.

Nonarteritic anterior ischaemic optic neuropathy.

PURPOSE OF REVIEW: There have been many reports in recent literature concerning the use of scanning laser polarimetry, Heidelberg retinal tomography and optical coherence topography in assessing the optic nerve and peripapillary nerve fibre layer. It is important to assess the validity of new equipment and see whether this has improved our understanding of the disease. There are also reports about possible association of nonarteritic anterior ischaemic optic neuropathy with cataract surgery and phosphodiesterase type-5 inhibitors. This review attempts to look at some of the techniques used and possible associations with nonarteritic anterior ischaemic optic neuropathy. RECENT FINDINGS: Scanning laser polarimetry, Heidelberg retinal tomography and optical coherence tomography have been helpful in quantifying optic nerve and peripapillary retinal nerve fibre layer defects, with different efficacy and limitations. Although these confirm the damage to retinal nerve fibre layer beyond what is detected by standard visual field examination, the effect of cataract surgery and phosphodiesterase type-5 inhibitors remains to be further studied on a larger scale. The few experimental treatments for nonarteritic anterior ischaemic optic neuropathy also need further confirmatory studies. SUMMARY: More studies are required to evaluate the benefits of new imaging methods. The availability of a primate model may provide clues to assessing experimental treatments for nonarteritic anterior ischaemic optic neuropathy.

Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments after phacoemulsification.

PURPOSE: To review the clinical features and outcomes of pars plana vitrectomy (PPV) in patients with retained lens fragments after phacoemulsification and compare the results with those in previous studies. SETTING: Department of Ophthalmology, Queen's Medical Centre, Nottingham, United Kingdom. METHODS: This retrospective chart review comprised 82 consecutive eyes of 82 patients who had vitrectomy for retained lens material after phacoemulsification between January 2000 and June 2006. Data on demographics, preexisting eye conditions, cataract surgery details, findings at presentation, interval between phacoemulsification and vitrectomy, details of vitrectomy, details of follow-up visits, and postoperative complications were collected. RESULTS: The incidence of raised intraocular pressure (IOP) was 46.3%. Anterior vitrectomy was associated with a lower incidence of increased IOP (P = .006). There was no association between late vitrectomy and a worse visual outcome. There was a much lower rate of complications than in other studies; the incidence of retinal detachment and of cystoid macular edema was 4.9%, and there were no cases of endophthalmitis. CONCLUSION: The incidence of raised IOP in patients who had anterior vitrectomy at the time of cataract surgery was low. The visual outcomes were good, and the incidence of complications was low irrespective of the timing of the PPV.

Oxidative DNA damage estimated by plasma 8-hydroxydeoxyguanosine (8-OHdG): influence of 4, 4'-methylenebis (2-chloroaniline) exposure and smoking.

Oxidative DNA damage may play an important role in the human carcinogenic process. Recently, we reported a case of bladder cancer among 4, 4'-methylenebis (2-chloroaniline) (MBOCA)-exposed workers. By measuring the plasma level of 8-hydroxydeoxyguanosine (8-OHdG), we investigated the association between oxidative DNA damage and MBOCA exposure. In addition, we examined the effects of different confounders on the plasma level of 8-OHdG. We undertook a cross-sectional survey at four MBOCA-producing factories in Taiwan (158 subjects). Plasma 8-OHdG levels and urinary MBOCA concentrations were measured by liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS). Personal characteristics were collected by questionnaire. The workers were classified according to their job titles as exposed (n=57) or unexposed (n=101) groups as well as classified according to urinary MBOCA levels as high urinary MBOCA (>20 microg/g creatinine) (n=45) or low urinary MBOCA (n=108) groups. Neither the MBOCA-exposed workers nor the high urinary MBOCA workers had a significant increase in the mean plasma 8-OHdG level, even after adjustment for potential confounders. Age and gender were significantly positively correlated with plasma 8-OHdG levels. Smokers among high urinary MBOCA workers also had significantly higher 8-OHdG levels than non-smokers among high urinary MBOCA workers. Our study provides evidence that smoking rather than MBOCA exposure induces elevation of plasma 8-OHdG levels among workers exposed to MBOCA, indicating that oxidative DNA damage does not play an important role in the carcinogenic processes of MBOCA.

Spontaneous dislocation of posterior polar cataract.

We report an unusual case of unilateral spontaneous lens dislocation in a 52-year-old woman with a posterior polar cataract. We postulate that the increasing lens size secondary to nuclear sclerosis may have exerted pressure on a thinned posterior capsule, causing the capsule to rupture spontaneously. The unusual weak posterior capsule in posterior polar cataract is a well-recognized risk factor in phacoemulsification surgery. We believe this is the first report case of spontaneous lens dislocation secondary to posterior capsule rupture in posterior polar cataract.

Lens dislocation following trauma sustained 40 years ago during cataract surgery pre-assessment.

BACKGROUND: To report a case of spontaneous lens dislocation following pupillary dilatation during preoperative assessment for cataract surgery. METHODS: Our patient had been punched on the left side of the face 40 years ago but throughout this period the patient's vision had remained normal and ophthalmic evaluation by opticians had also been normal on multiple visits. He was referred to our clinic for cataract assessment. Detailed ophthalmic evaluation, including pupillary dilatation with fundus evaluation,had revealed no evidence of anterior or posterior segment trauma. RESULTS: He presented 1 week later with lens dislocation. The dislocated lens was successfully removed. CONCLUSION: We recommend that caution be exercised (even in the presence of normal ophthalmic evaluation) when dilating patients with an apparently trivial/or old history of trauma to the face.

Epstein-Barr Virus DNA quantification: an adjunctive diagnostic marker for AIDS-associated lymphoma.

We report an HIV-positive patient who developed a unilateral retinitis and subsequent intracranial lesions. The finding of Epstein Barr virus (EBV) DNA at a > 1-log greater concentration in the vitreous compared to blood raised the possibility of a primary CNS non-Hodgkin's lymphoma, which was subsequently confirmed on brain biopsy. EBV DNA quantification acted as a diagnostic marker that led to a change in the management of our patient.

Lateral tarsal strip and quickert sutures for lower eyelid entropion.

PURPOSE: To evaluate the long-term outcome of involutional entropion repair by means of a combined procedure of lateral tarsal strip and Quickert everting sutures. METHODS: Noncomparative interventional case series of patients who underwent a combined procedure of lateral tarsal strip and Quickert sutures for treatment of involutional entropion between September 1999 and September 2002. Of 75 patients who underwent surgery, 36 were followed for at least 2 years. At the 2-year clinical examination, patient comfort, complications, recurrence rates, overcorrection, and cosmetic appearance were assessed. RESULTS: The average age of the 36 patients was 76.67 years. There were 5 bilateral cases, for a total of 41 eyelids. Nine eyelids underwent the procedure to correct recurrent entropion. The recurrence rate was 0% at 1 month after surgery, 2 of 41(4.9%) at 6 months, and 5 of 41 (12.2%) at 2 years. The recurrence rate after a primary procedure was 3 of 32 (9.4%), and, after a failed previous procedure, 2 of 9 (22.2%). There were no cases of secondary ectropion, and all patients were happy with their cosmetic appearance. CONCLUSIONS: A combined lateral tarsal strip and Quickert sutures procedure is effective, simple, and addresses all of the factors that contribute to involutional entropion formation, with a good long-term success rate and cosmetic outcome.

Retinopathy of prematurity: an optimum screening strategy.

OBJECTIVE: We sought to find out whether birth weight of less than 1251 g or gestational age less than 30 weeks could provide a safe and efficient screening criteria of detecting treatable retinopathy of prematurity (ROP). METHODS: Infants either with a birth weight less than 1500 g or gestational age less than 32 weeks were screened for ROP during an 8-year period. RESULTS: In our study, the incidence of ROP was 36 of 187 (19.3%) infants. Although there was a slight increase in the number of infants screened over the years, the incidence of ROP of any stage remained stable. The maximum stage of ROP reached was stage 1 in 10 of 187 (5.3%), stage 2 in 8 of 187 (4.3%), and stage 3 in 18 of 187 (9.6%) infants. Among those with stage 3 disease, threshold ROP was present in 16 of 18 (88.9%). All infants with threshold ROP had a BW less than 1100 g and gestational age less than or equal to 28 weeks. Significantly fewer babies (105/187, or 56%) would have been examined had inclusion criteria of a birth weight of less than 1251 g and gestational age less than 30 weeks been applied. In addition, 31% (134/437) of screening examinations could have been avoided. CONCLUSIONS: Our study suggests that a birth weight of less than 1251 g and gestational age less than 30 weeks can be safely and efficiently used to screen infants without missing a diagnosis of sight-threatening ROP in our catchment population.