Mohd Jamil Yaacob

APOE genotype and neuropsychological outcome in mild-to-moderate traumatic brain injury: a pilot study.

Primary objective: The influence of apolipoprotein (APOE) on neuropsychological outcome was investigated in 19 patients (25.79 ± 7.22 years) with mild-to-moderate traumatic brain injury and 14 matched healthy control subjects (27.43 ± 6.65 years). Research design: Within- and between-group comparisons were employed. Methods and procedure: APOE genotype was determined using the Polymerase Chain Reaction–Restriction Fragment Length Polymorphism method. Verbal learning and memory, speed of processing and executive function were assessed at 6 weeks and 6 months post-injury. A three-way [Group*Type*Time] ANOVA with repeated measures on the third factor was employed to determine the differences between groups and APOE genotype. Main outcomes and results: No Group*APOE Genotype*Time interaction was found for all neuropsychological measures, Auditory Verbal Learning Test (p = 0.484, η2 = 0.017), Trail Making Test-B (p = 0.454, η2 = 0.019), Controlled Oral Word Association (p = 0.107, η2 = 0.087) and Wisconsin Card Sorting Test-64 (p = 0.291, η2 = 0.038). The results of this pilot study support earlier findings that showed no relationship between APOE ε4 and poor recovery in the same population. Conclusion: The preliminary findings suggest no clear APOE genotype influence on neuropsychological outcome in mild and moderate TBI patients. Large-scale studies with longer follow-up duration are warranted.

Psychometric properties of the Medical Student Well-Being Index among medical students in a Malaysian medical school

This study evaluated the convergent, discriminant, construct, concurrent and discriminative validity of the Medical Student Wellbeing Index (MSWBI) as well as to evaluate its internal consistency and optimal cut-off total scores to detect at least moderate levels of general psychological distress, stress, anxiety and depression symptoms. A cross sectional study was done on 171 medical students. The MSWBI and DASS-21 were administered and returned immediately upon completion. Confirmatory factor analysis, reliability analysis, ROC analysis and Pearson correlation test were applied to assess psychometric properties of the MSWBI. A total of 168 (98.2%) medical students responded. The goodness of fit indices showed the MSWBI had a good construct (χ(2)=6.14, p=0.803, RMSEA<0.001, RMR=0.004, GFI=0.99, AGFI=0.97, CFI=1.00, IFI=1.02, TLI=1.04). The Cronbachs alpha value was 0.69 indicating an acceptable level of internal consistency. Pearson correlation coefficients and ROC analysis suggested each MSWBIs item showed adequate convergent and discriminant validity. Its optimal cut-off scores to detect at least moderate levels of general psychological distress, stress, anxiety, and depression were 1.5, 2.5, 1.5 and 2.5 respectively with sensitivity and specificity ranged from 62 to 80% and the areas under ROC curve ranged from 0.71 to 0.83. This study showed that the MSWBI had good level of psychometric properties. The MSWBI score more than 2 can be considered as having significant psychological distress. The MSWBI is a valid and reliable screening instrument to assess psychological distress of medical students.

Impaired working memory in children with attention deficit hyperactivity disorder and their siblings

Introduction: Impairment of working memory in children with attention deficit hyperactivity disorder (ADHD) has been well described. If similar impairment in working memory can be demonstrated among their siblings, this could suggest impaired working memory is a genetic component of ADHD.

Perinatal, maternal and antenatal associated factors for autism: A case control study

Autism disorders are a group of neurodevelopmental disorders which characterized into three main domains which are social interaction impairment, communication delay and repetitive or stereotypic behavior. Many studies had suggested that the risk factors for autism derive from three big factors namely environmental factors, genetic predisposition and vaccine induced. The aim of this study was to investigate the perinatal, maternal and antenatal associated factors on autistic disorder children at Hospital Pulau Pinang and Hospital Bukit Mertajam, Pulau Pinang. A case control study involving 312 cases and control was conducted using data retrieved from hospital records at Pulau Pinang hospital and Bukit Mertajam hospital from 2001 to 2008. The departments involved were Psychiatric, Obstetrics and Gynecology and Record and Management Department. All cases which met the inclusion and exclusion criteria were included in the study. Univariable and multivariable logistic regression were used to explore the perinatal, maternal and antenatal associated factors associated with autistic disorder children. There were seven associated factors contributed most to autistic disorder determination. The factors were maternal age [Adjusted Odds Ratio (OR): 1.41; 95% Confidence Interval (CI): (1.27, 1.57)], maternal smoking reported at first antenatal visit [Adjusted OR: 13.61; 95% CI: (1.87, 99.35)], birth asphyxia [Adjusted OR: 0.35; 95% CI: (0.11, 1.08)], psychiatric history [Adjusted OR: 54.94; 95% CI: (12.07, 250.04)], multiple gestation [Adjusted OR: 4.81; 95% CI: (1.86, 12.45)], parity for more than 4 [Adjusted OR: 0.11; 95% CI: (0.03, 0.47)], parity between 0 and 1 [Adjusted OR: 0.19; 95% CI: (0.07,0.55)], Chinese race compared to the Malay race [Adjusted OR: 10.11; 95% CI: (3.61, 28.30)] and Indian race compared to the Malay race [Adjusted OR: 5.14; 95% CI: (1.38, 19.16)]. The results suggested that autistic disorders were associated with perinatal, maternal and antenatal factors such as delivery, pregnancy and maternal characteristics.