Ageing is associated with increased oxidative stress accompanied by cognitive decline. The aim of this study was to evaluate oxidative stress biomarkers and their possible relationship with cognitive performances during ageing among the Malay population. Approximately 160 healthy Malay adults aged between 28 and 79 years were recruited around Selangor and Klang Valley. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA), forward digit span (FDS), backward digit span (BDS), digit symbol, Rey Auditory Verbal Learning Test immediate recalled [RAVLT(I)] and delayed recalled [RAVLT(D)], and visual reproduction immediate recalled (VR-I) and delayed recalled (VR-II). DNA damage, plasma protein carbonyl and malondialdehyde (MDA) levels were also determined. Cognitive function test showed significant lower scores of MoCA, BDS, RAVLT(I), RAVLT(D), digit symbol, VR-I, and VR-II in the older age group (60 years old) compared with the 30-, 40-, and 50-year-old group. The extent of DNA damage was sequential with age: 60 > 50 > 40 > 30, whereas protein carbonyl was higher in 40-, 50-, and 60-year-old groups compared with the youngest group (30 years old). However, the MDA level was observed unchanged in all age groups. Approximately 21.88% of the participants had cognitive impairment. Multiple logistic regression analysis revealed that DNA damage and protein carbonyl levels are predictors for cognitive impairment in healthy Malays. In conclusion, cognitive decline occurred in healthy adult Malay population at an early age of 30 years old with corresponding higher DNA damage and protein oxidation.

Purpose: To investigate the incidence, characteristics and risk factors of adverse drug reactions (ADRs) in hospitalized children in a Malaysian hospital. Methods: Patients admitted to the Paediatric Department of Hospital Ampang in Kuala Lumpur, Malaysia were monitored for occurrence of ADRs by spontaneous reporting or daily review of their case notes. Characteristics of ADRs were categorised and ADRs were analysed for causality, severity and preventability. Multivariate analyses were performed to determine associations between certain selected risk factors and ADR occurrence. Results: In 423 paediatric patients admitted in Hospital Ampang (436 admissions), the ADR incidence rate was 80 % (95 % CI, 5 - 11 %). The most commonly involved medications were systemic antibacterial drugs (77.4 %). About 61.3 % of the ADRs were of probable causality and 12.9 % were definitely preventable No severe ADRs were detected, with 41.9 % being moderate and 58.1 % being mild, based on a severity scale Younger children (OR = 3.387, 95 % CI, 1.377, 8.334) and the number of systemic antibacterial drugs given (OR = 1.469, 95 % CI 1.201, 1.798) were potential risk factors associated with ADRs. Conclusion: ADRs occur at a significant rate in the Malaysian children admitted to the hospital studied. Further studies are needed to provide drug safety data for the paediatric population in Malaysia.

Background: Adverse drug reactions (ADRs) cause significant morbidity and mortality. Improved assessment of ADRs to identify the causal relationship, the severity, and the preventability will aid ADRs prevention or reduce patient burden. Objective: The aim of this study was to develop mobile apps in assisting clinical decision in ADR assessments of causality, severity, and preventability using validated tools. The usability of the apps was assessed. Methods: We designed mobile apps using validated assessment tools for ADRs. They are the Liverpool ADRs Causality Assessment Tool, Hartwig's Severity Assessment Scale, and the Modified Schumock and Thronton Preventability Scale. The apps were named Adverse Drug ReactionCausality, Adverse Drug ReactionSeverity, and Adverse Drug RxnPreventability. A survey was conducted using the System Usability Scale (SUS) to assess the usability of the developed apps among health care professionals. Results: These apps are available for download through Google Play Store for free since January 2015. From the survey, the mean SUS score was 70.9 based on 26 responses from the pediatric ward of Hospital Ampang, Malaysia. Conclusions: The developed apps received an overall acceptable usability among health care professionals. The usage of these apps will improve detection, assessment, and avoidance of future ADRs. They will also contribute to future research on ADRs, thus increasing drug safety.

Higher level of education is associated with better cognitive performance and lower risk of developing dementia. However, the effect of education on cognitive performance varies across different cognitive domains and in different populations. The aim of this study was to determine the relationship between education and performance of different cognitive domains among healthy Malay adults. A total of 53 individuals aged 29 to 77 years participated in a battery of neurophysiological tests consisting of Mini-Mental State Examination, Montreal Cognitive Assessment, digit span, visual reproduction and digit symbol speed test (DSST). Blood test was performed for each participant to obtain their biochemical profile. Educational level was divided into level 1 (PMR), level 2 (SPM), level 3 (STPM), level 4 (Diploma) and level 5 (Degree). Simple linear regression indicated that years of education was positively associated with scores of delayed visual reproduction (b=1.348, p=0.002) and DSST (b=3.257, p=0.012). However, scores of all the tests were not significantly different among different levels of education after controlling for age, gender and blood test profile by ANCOVA. Multiple linear regression analysis showed that MMSE score was associated with red cell distribution width (b=-0.628, p=0.005), age (b=-0.119, p<0.001) and there was interaction between high density lipoprotein (HDL) with age (b=0.047, p<001). MoCA score was associated with age (b=-0.121, p<0.001), gender (male compared to female, b=1.870, p=0.020) and HDL (b=1.681, p=0.047). Age was associated with backward digit span (b=-0098, p<0.001) and immediate visual reproduction (b=-0.348, p<0.001), resp. Delayed visual reproduction was associated with age (b=0.323, p<0.001) and potassium level (b=-4.471, p=0.016). DSST was associated with age (b=-0.911, p<0.001) and alanine aminotransferase (b=-0.754, p=0.002). The lack of association between educational level and cognitive performance after adjusting for confounders in this study maybe due to multiple factors influencing cognitive performance and further studies with a larger sample size are needed to further identify the factors involved.