The Malaysian HEalth and WellBeing AssessmenT (MyHEBAT) Study Protocol: An Initiation of a National Registry for Extended Cardiovascular Risk Evaluation in the Community.

Cardiovascular disease (CVD) has been a burden to many developing countries for decades, including Malaysia. Although various steps have been taken to prevent and manage CVD, it remains the leading cause of morbidity and mortality. The rising prevalence of CVD risk factors such as hypertension, hypercholesterolaemia, diabetes, overweight and obesity is the main driving force behind the CVD epidemic. Therefore, a nationwide health study coined as the Malaysian Health and Wellbeing Assessment (MyHEBAT) was designed. It aimed to investigate the prevalence of CVD and the associated risk factors in the community across Malaysia. The MyHEBAT study recruited participants (18-75 years old) through community health screening programmes from 11 states in Malaysia. The MyHEBAT study was further divided into two sub-studies, namely, the Cardiovascular Risk Epidemiological Study (MyHEBAT-CRES) and the MyHEBAT Familial Hypercholesterolaemia Study (MyHEBAT-FH). These studies assessed the prevalence of CVD risk factors and the prevalence of FH in the community, respectively. The data garnered from the MyHEBAT study will provide information for healthcare providers to devise better prevention and clinical practice guidelines for managing CVD in Malaysia.

A magnetic resonance imaging study on the articulatory and acoustic speech parameters of Malay vowels.

The phonetic properties of six Malay vowels are investigated using magnetic resonance imaging (MRI) to visualize the vocal tract in order to obtain dynamic articulatory parameters during speech production. To resolve image blurring due to the tongue movement during the scanning process, a method based on active contour extraction is used to track tongue contours. The proposed method efficiently tracks tongue contours despite the partial blurring of MRI images. Consequently, the articulatory parameters that are effectively measured as tongue movement is observed, and the specific shape of the tongue and its position for all six uttered Malay vowels are determined.Speech rehabilitation procedure demands some kind of visual perceivable prototype of speech articulation. To investigate the validity of the measured articulatory parameters based on acoustic theory of speech production, an acoustic analysis based on the uttered vowels by subjects has been performed. As the acoustic speech and articulatory parameters of uttered speech were examined, a correlation between formant frequencies and articulatory parameters was observed. The experiments reported a positive correlation between the constriction location of the tongue body and the first formant frequency, as well as a negative correlation between the constriction location of the tongue tip and the second formant frequency. The results demonstrate that the proposed method is an effective tool for the dynamic study of speech production.

Bilateral asymmetrical mucoceles of the paranasal sinuses with unilateral orbital complications.

We report the rare occurrence of bilateral asymmetrical mucoceles of the paranasal sinuses that resulted in a unilateral orbital complication. The patient was a 47-year-old woman who presented with complaints of diplopia, blurred vision, and protrusion of her right eye that had progressed over a period of several months following an upper respiratory tract infection. Computed tomography detected the presence of two large, asymmetrical mucoceles. The lesion on the right involved the frontal and ethmoid sinuses, and the one on the left involved the ethmoid sinus. The mucoceles were locally expansile and had eroded the surrounding bony structures on the right. The expansile nature of the right-sided mass had displaced the right orbit, which was the cause of the vision deterioration. Transnasal endoscopic surgery was performed to excise and marsupialize the mucoceles. This modality was preferred over conventional open surgery because it affords good visualization, it is safe, and it is a less morbid procedure. The patient's recovery was uneventful, and she was discharged home on the third postoperative day. On continuing follow-up, her vision had improved, her intraocular pressure had returned to normal, and her orbits were in their normal position. Based on our literature search, no case of bilateral frontal and ethmoid sinus mucoceles has been previously reported.

Otological disorders in Down's Syndrome.

OBJECTIVE: To assess if children with Down's Syndrome have a higher prevalence of otological abnormality compared to their normal counterparts in Malaysia. METHODOLOGY: Thirty children with Down's Syndrome and normal children underwent otoscopic ear examination and Impedance test in the ENT outpatients clinic in University Hospital, Kuala Lumpur, Malaysia. RESULTS: The study showed that children with Down's Syndrome had higher otological disorders. Forty four percent had impacted wax compared to 14.4% in normal children. Twenty one percent of ears in the study group had retracted drums compared to 6.6% of control. Fifteen percent of ears in the study group had middle ear effusion compared to 3.4% in controls, 55% had a type B tympanogram compared to 8.3% in controls and 73.4% had auditory canal stenosis compared to 14.4% in controls. CONCLUSION: Children with Down's Syndrome, thus have a higher incidence of otological disorders.

Long-term survival of nasopharyngeal carcinoma patients treated with adjuvant chemotherapy subsequent to conventional radical radiotherapy.

PURPOSE: To assess the long-term survival of patients with nasopharyngeal carcinoma (NPC) who were treated with conventional radical radiotherapy (RT) followed by adjuvant chemotherapy. METHODS AND MATERIALS: Ninety-one newly diagnosed patients with Stage III and IV (American Joint Committee on Cancer, 1988) NPC, seen at the University of Malaya Medical Center, Kuala Lumpur, Malaysia between January 1992 and May 1997, were treated with RT followed by adjuvant chemotherapy. The tumor dose was 70 Gy delivered in 35 fractions, 5 fractions weekly. Three cycles of chemotherapy, each consisting of 5-fluorouracil, 1 g/m(2)/d on Days 1-4 and cisplatin 100 mg/m(2) on Day 1, were administered 3 weeks after RT completion. Thirty-six patients had Stage II, 10 had Stage III, and 45 had Stage IV disease (AJCC 1997 staging system). RESULTS: After a median follow-up of 61 months, the 5-year overall survival rate for all 91 patients was 80.1%, the disease-free survival rate was 76%, and the locoregional control rate was 85%. The 3-year overall survival rate for Stage II was 94.3%; it was 80% for Stage III and 79.8% for Stage IV (p = 0.0108). The 3-year DFS rate for Stage II was 90%; it was 80% for Stage II and 65% for Stage IV. The rate of distant failure for Stage IV was 8.9%. CONCLUSION: Radical RT followed by adjuvant chemotherapy was effective in our patients with locoregionally advanced NPC. The long-term results appear encouraging, even for patients with Stage IV disease. This single institution experience deserves further investigation in prospective trials.