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Lim KB, Lim SY, Hor JW, Krishnan H, Mortadza F, Lim JL, Chinna K, Saedon NI, Tan AH. Orthostatic hypotension in Parkinson's disease: Sit-to-stand vs. supine-to-stand protocol and clinical correlates. Parkinsonism Relat Disord 2024; 123:106980. [PMID: 38657381 DOI: 10.1016/j.parkreldis.2024.106980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/14/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Screening for orthostatic hypotension (OH) is integral in Parkinson's disease (PD) management, yet evidence-based guidelines on best practice methods for diagnosing OH in PD are lacking. METHODS We investigated the frequency and correlates of OH, symptomatic OH, and neurogenic OH, in a large consecutively recruited PD cohort (n = 318), and compared the diagnostic performance of the sit-to-stand vs. the supine-to-stand blood pressure (BP) test. We evaluated the utility of continuous BP monitoring and tilt table testing in patients with postural symptoms or falls who were undetected to have OH with clinic-based BP measurements. Disease severity, fluid intake, orthostatic and overactive bladder symptoms, falls, comorbidities and medication history were evaluated. RESULTS Patients' mean age was 66.1 ± 9.5years, with mean disease duration 7.8 ± 5.5years. OH frequency was 35.8 % based on the supine-to-stand test. OH in PD was significantly associated with older age, lower body mass index, longer disease duration, worse motor, cognitive and overactive bladder symptoms and functional disabilities, falls, and lower fluid intake. A similar profile was seen with asymptomatic OH. Three quarters of OH were neurogenic, with the majority also having supine hypertension. The sit-to-stand test had a sensitivity of only 0.39. One quarter of patients were additionally diagnosed with OH during continuous BP monitoring. CONCLUSIONS The sit-to-stand test substantially underdiagnoses OH in PD, with the important practice implication that supine-to-stand measurements may be preferred. Screening for OH is warranted even in asymptomatic patients. Adequate fluid intake, treatment of urinary dysfunction and falls prevention are important strategies in managing PD patients with OH.
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Affiliation(s)
- Kai Bin Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jia Wei Hor
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Heamah Krishnan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Firdaus Mortadza
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jia Lun Lim
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Cheras, Kuala Lumpur, Malaysia
| | - Nor Izzati Saedon
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Zhao Y, Sazlina SG, Rokhani FZ, Chinna K, Su J, Chew BH. The expectations and acceptability of a smart nursing home model among Chinese older adults: a mixed methods study. BMC Nurs 2024; 23:40. [PMID: 38218894 PMCID: PMC10788001 DOI: 10.1186/s12912-023-01676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Smart nursing homes (SNHs) integrate advanced technologies, including IoT, digital health, big data, AI, and cloud computing to optimise remote clinical services, monitor abnormal events, enhance decision-making, and support daily activities for older residents, ensuring overall well-being in a safe and cost-effective environment. This study developed and validated a 24-item Expectation and Acceptability of Smart Nursing Homes Questionnaire (EASNH-Q), and examined the levels of expectations and acceptability of SNHs and associated factors among older adults in China. METHODS This was an exploratory sequential mixed methods study, where the qualitative case study was conducted in Hainan and Dalian, while the survey was conducted in Xi'an, Nanjing, Shenyang, and Xiamen. The validation of EASNH-Q also included exploratory and confirmatory factor analyses. Multinomial logistic regression analysis was used to estimate the determinants of expectations and acceptability of SNHs. RESULTS The newly developed EASNH-Q uses a Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree), and underwent validation and refinement from 49 items to the final 24 items. The content validity indices for relevance, comprehensibility, and comprehensiveness were all above 0.95. The expectations and acceptability of SNHs exhibited a strong correlation (r = 0.85, p < 0.01), and good test-retest reliability for expectation (0.90) and acceptability (0.81). The highest tertile of expectations (X2=28.89, p < 0.001) and acceptability (X2=25.64, p < 0.001) towards SNHs were significantly associated with the willingness to relocate to such facilities. Older adults with self-efficacy in applying smart technologies (OR: 28.0) and those expressing a willingness to move to a nursing home (OR: 3.0) were more likely to have the highest tertile of expectations compared to those in the lowest tertile. Similarly, older adults with self-efficacy in applying smart technologies were more likely to be in the highest tertile of acceptability of SNHs (OR: 13.8). CONCLUSIONS EASNH-Q demonstrated commendable validity, reliability, and stability. The majority of Chinese older adults have high expectations for and accept SNHs. Self-efficacy in applying smart technologies and willingness to relocate to a nursing home associated with high expectations and acceptability of SNHs.
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Affiliation(s)
- Yuanyuan Zhao
- The School of Smart Health and Wellness (Health Medical College), Zhejiang Dongfang Polytechnic, Wenzhou, Zhejiang Province, China
| | - Shariff-Ghazali Sazlina
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing TM ), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Fakhrul Zaman Rokhani
- Faculty of Engineering, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing TM ), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kulala Lumpur, Selangor, Malaysia
| | - Jing Su
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan Province, China
| | - Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
- Clinical Research Unit, Hospital Sultan Abdul Aziz Shah (HSAAS Teaching Hospital), Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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Krishnasamy K, Zakaria MI, Tan MP, Chinna K, Narayanan V, Hasnan N. Effects of COVID-19 on Patient Safety Culture among Staff at a Teaching Hospital in Malaysia. Disaster Med Public Health Prep 2023; 17:e494. [PMID: 37746761 DOI: 10.1017/dmp.2023.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Affiliation(s)
| | - Mohd Idzwan Zakaria
- Academic Unit Trauma and Emergency, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Centre for Innovations in Medicine Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Selangor, Malaysia
| | - Vairavan Narayanan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Nazirah Hasnan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Wong CK, Ng KS, Choo SQR, Lee CJ, Teo YP, Liew SM, Chinna K, Khoo EM, Ng WL, Tok PSK, Kee YS, Chiang DM. Factors associated with all-cause mortality in tuberculosis patients in a Malaysian tertiary hospital. J Infect Dev Ctries 2023; 17:1138-1145. [PMID: 37699097 DOI: 10.3855/jidc.16967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/06/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION The all-cause mortality for tuberculosis is 1 in every 10 patients in Malaysia. The currently available national surveillance database does not record patients' variables such as socio-economic factors, existing co-morbidities, and risk behavior for investigation. An electronic medical record system can capture this missing information and use it to determine all-cause mortality factors more accurately. Our study aims to determine the factors associated with all-cause mortality in a cohort of tuberculosis patients in a Malaysian tertiary hospital which is equipped with an electronic medical record system. METHODOLOGY Records of patients diagnosed with tuberculosis from 1st January 2018 to 30th September 2019 were retrieved. Sociodemographic and clinical data were extracted. Treatment outcomes and all-cause mortality were recorded at 1 year after diagnosis. Univariate, multivariate, and stepwise regression were used to determine the factors associated with all-cause mortality. RESULTS Four-hundred and seventy-one patients were reviewed. The mean age was 46.6 ± 19.7 years. The all-cause mortality rate at one year of diagnosis was 15.3%. Factors identified were age [aOR 1.026 (95% CI: 1.004-1.049)], chronic kidney disease [aOR 3.269 (1.508-7.088)], HIV positive status [aOR 4.743 (1.505-14.953)], active cancer [aOR 5.758 (1.605-20.652)], liver disease [aOR 6.220 (1.028-37.621)], and moderate to advanced chest X-ray findings [aOR 3.851 (1.033-14.354)]. CONCLUSIONS On average, one in seven patients diagnosed with TB died within a year in a Malaysian tertiary hospital. Identification of this vulnerable group using the associated factors found in this study may help to reduce the risk of mortality through early intervention strategies.
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Affiliation(s)
- Chee Kuan Wong
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kee Seong Ng
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sarah Qian Rou Choo
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Choon Jiat Lee
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yik Pheng Teo
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wei Leik Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peter Seah Keng Tok
- Department of Social and Preventive Medicine, Centre for Epidemiology and Evidence-Based Practice, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yan Shen Kee
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - De Min Chiang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Andoy-Galvan JA, Sriram S, Kiat TJ, Xin LZ, Shin WJ, Chinna K. Obesogenic Environment in the medical field: First year findings from a five-year cohort study. F1000Res 2023; 12:550. [PMID: 37868299 PMCID: PMC10589624 DOI: 10.12688/f1000research.125203.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 10/24/2023] Open
Abstract
Background: Doctors with a normal BMI and healthy living habits have shown to be more confident and effective in providing realistic guidance and obesity management to their patients. This study investigated obesogenic tendencies of medical students as they progress in their medical studies. Methods: A cohort of forty-nine medical students enrolled in a five-year cohort study and was followed up after one year. At the initiation of the cohort, socio-demography and information on anthropometry, accommodation, eating behavior, stress and sleeping habits of the students had been recorded. Follow-up data was collected using a standardized self-administered questionnaire. Results: Thirty-seven percent of the students in the cohort are either obese or overweight in the one-year period.. A year of follow-up suggests that there is an increase in BMI among the male students (P=0.008) and the changes are associated with changes in accommodation (P=0.016), stress levels (P=0.021), and sleeping habits (P=0.011). Conclusion: Medical education system should seriously consider evaluating this aspect in the curriculum development to help our future medical practitioners practice a healthy lifestyle and be the initiator of change in the worsening prevalence of obesity worldwide.
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Affiliation(s)
- Jo Ann Andoy-Galvan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, 47500, Malaysia
| | - Shyamkumar Sriram
- School of Health Sciences and Professions, Department of Social and Public Health, Ohio University, Athens, OH, 45701, USA
| | - Tey Jin Kiat
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, 47500, Malaysia
| | - Lim Zig Xin
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, 47500, Malaysia
| | - Wong Jun Shin
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, 47500, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Cheras, Kuala Lumpur, 56100, Malaysia
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Hussein N, Liew SM, Hanafi NS, Lee PY, Cheong AT, Ghazali SS, Chinna K, Pang YK, Kassim A, Parker RA, Schwarze J, Sheikh A, Pinnock H, Khoo EM. Asthma control and care among six public health clinic attenders in Malaysia: A cross-sectional study. Health Sci Rep 2023; 6:e1021. [PMID: 37152232 PMCID: PMC10154831 DOI: 10.1002/hsr2.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 05/09/2023] Open
Abstract
Background and Aims Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5-17 years old) with asthma attending six public health clinics in Klang District, Malaysia. Methods We conducted a cross-sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis. Results A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5-17 years old. Only 34.1% of adults had well-controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well-controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13-2.01); cold food (OR 1.54; 95% CI 1.15-2.07), extreme emotion (OR 1.90; 95% CI 1.26-2.89); air-conditioning (OR 1.63; 95% CI 1.20-2.22); and physical activity (OR 2.85; 95% CI 2.13-3.82). In children, hot weather (OR 3.14; 95% CI 1.22-8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13-5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education. Conclusion Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes.
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Affiliation(s)
- Norita Hussein
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health SciencesUniversiti Putra MalaysiaSeri KembanganMalaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health SciencesUniversiti Putra MalaysiaSeri KembanganMalaysia
| | - Karuthan Chinna
- Faculty of Business and ManagementUCSI UniversityKuala LumpurMalaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Asiah Kassim
- Kuala Lumpur Women and Children Hospital, Ministry of HealthKuala LumpurMalaysia
| | - Richard A. Parker
- Edinburgh Clinical Trials Unit, Usher InstituteThe University of EdinburghEdinburghUK
| | - Jürgen Schwarze
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteThe University of EdinburghEdinburghUK
- Child Life and Health, Centre for Inflammation ResearchThe University of EdinburghEdinburghUK
| | - Aziz Sheikh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteThe University of EdinburghEdinburghUK
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher InstituteThe University of EdinburghEdinburghUK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
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Kaur H, Chinna K, Sivanesom R. Sleep disturbances and their association with behaviour in children with autism spectrum disorder: A cross-sectional study. Singapore Med J 2023:374228. [PMID: 37077060 DOI: 10.4103/singaporemedj.smj-2021-425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Introduction In this study, we aimed to determine the prevalence of sleep disturbances among children aged 2-5 years with autism spectrum disorder (ASD) and their association with behaviour in these children. Method A cross-sectional study was conducted at Hospital Tunku Azizah, Kuala Lumpur, Malaysia, from June 2020 to December 2020. Children between 2 and 5 years old, diagnosed with ASD based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, were recruited. Two parent-reported questionnaires, the Children's Sleep Habits Questionnaire (CSHQ) and the Child Behaviour Checklist (CBCL/1.5-5), were used to assess sleep and behaviour, respectively. Children were classified as good sleepers (CSHQ score <41) and poor sleepers (CSHQ score ≥41). Poor sleepers were further categorised into those with mild or moderate to severe sleep problems (based on the 75th percentile CSHQ score). The CBCL/1.5-5 raw scores were converted to standardise T-scores, yielding scores of three summary scales (internalising, externalising and total problems). Results A total of 134 children participated in this study. Their mean age was 42.23 ± 9.95 months, and 81.3% were males. Mean CSHQ score was 49.77 ± 6.90, and 93.3% were poor sleepers. Internalising, externalising and total problems scores were significantly higher in poor sleepers (62, 59 and 62, respectively) compared to good sleepers (56, 47 and 51, respectively). Children with moderate to severe sleep problems had clinical scores of internalising (median 65) and externalising (median 65) problems, as compared to mild sleep problems (median internalising score 61, median externalising score 57). Conclusion Sleep disturbances are prevalent among children with ASD. Poor sleep quality is associated with more behavioural problems.
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Affiliation(s)
- Harminder Kaur
- Paediatric Department, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Ranjini Sivanesom
- Paediatric Department, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Kasim AS, Golbabapour S, Zaini AA, Peng EK, Jalaludin MY, Nathan AM, Chinna K, Thavagnanam S. Pulmonary dysfunction in overweight and obese children with obstructive sleep apnoea. Endocrinol Diabetes Metab 2023; 6:e417. [PMID: 37021461 PMCID: PMC10164429 DOI: 10.1002/edm2.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 04/07/2023] Open
Abstract
INTRODUCTION Overweight and obese children are at risk of obstructive sleep apnoea (OSA) and abnormal pulmonary function (PF). AIM Investigate the relationship between body mass index (BMI), OSA on PF in children. MATERIALS & METHOD Seventy-four children were recruited. Mixed obstructive apnoea-hypopnea index (MOAHI), BMI, oxygen saturation (SpO2 ), forced expiratory volume one second (FEV1 ), forced vital capacity (FVC) and fractionated exhaled nitric oxide (FeNO) were measured. RESULTS Twenty-four and thirty children had mild OSA and moderate-to-severe OSA respectively. BMI correlated negatively with SpO2 nadir (r = -.363, p = .001). FVC, FEV1 and nadir SpO2 values decreased with OSA severity (p < .001). The odds of a child with OSA having an abnormal spirometry was 3.16 (95% CI: 1.08, 9.22). There was significant association between FeNO and AHI (r = .497, <.001). DISCUSSION Overweight and obese children with OSA have significant abnormalities in pulmonary function independent of BMI. OSA severity and elevated FeNO also correlated with diminishing lung function.
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Affiliation(s)
- Aina Salwa Kasim
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahram Golbabapour
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK
| | - Azriyanti Anuar Zaini
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Paediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Eg Kah Peng
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Paediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Paediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Anna Marie Nathan
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Paediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Surendran Thavagnanam
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Paediatric and Child Health Research Group, University of Malaya, Kuala Lumpur, Malaysia
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Shunnmugam B, Islam T, Sinnadurai S, Seng Hui C, Mee Hong S, Chinna K, Aishah Mohd Taib N. Reliability and Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia. Asia Pac J Public Health 2023; 35:129-135. [PMID: 37171249 DOI: 10.1177/10105395231163345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study aims to translate the BREAST-Q into Malay and validate it in breast cancer patients undergoing surgery. The English BREAST-Q was translated to Malay using the back-translation method. A total of 144 newly diagnosed breast cancer patients were sampled conveniently between December 2015 and November 2016. Test-retest was done after two to three weeks. Data were analyzed using SPSS and AMOS software. Content experts agreed the items in the Malay BREAST-Q were measuring the constructs appropriately. Internal consistencies were good for all items in each subscale (Cronbach's alpha = 0.83-0.95). The highest inter-item correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation values ranged from 0.47 to 0.72. The test-retest analysis showed good reproducibility (intraclass correlation coefficient = 0.71-0.98). In exploratory factor analysis, the Kaiser-Meyer-Olkin values were excellent in all four subscales (0.76, 0.92, 0.91, and 0.86). For all subscales, the number of factors extracted cumulatively explained more than 50% of the variance. The Malay BREAST-Q demonstrated good reliability, face validity, content validity, and construct validity.
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Affiliation(s)
- Bairave Shunnmugam
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tania Islam
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siamala Sinnadurai
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chua Seng Hui
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - See Mee Hong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- University Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Arasu K, Chang CY, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM, Chee WSS. Effect of soluble corn fibre and calcium supplementation on bone mineral content and bone mineral density in preadolescent Malaysian children-a double-blind randomised controlled trial (PREBONE-Kids Study). Osteoporos Int 2023; 34:783-792. [PMID: 36808216 DOI: 10.1007/s00198-023-06702-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
UNLABELLED Soluble corn fibre (SCF) with calcium did not improve bone indices after 1 year in preadolescent children. INTRODUCTION SCF has been reported to improve calcium absorption. We investigated the long-term effect of SCF and calcium on bone indices of healthy preadolescent children aged 9-11 years old. METHODS In a double-blind, randomised, parallel arm study, 243 participants were randomised into four groups: placebo, 12-g SCF, 600-mg calcium lactate gluconate (Ca) and 12-g SCF + 600-mg calcium lactate gluconate (SCF + Ca). Total body bone mineral content (TBBMC) and total body bone mineral density (TBBMD) were measured using dual-energy X-ray absorptiometry at baseline, 6 and 12 months. RESULTS At 6 months, SCF + Ca had a significant increase in TBBMC from baseline (27.14 ± 6.10 g, p = 0.001). At 12 months, there was a significant increase in TBBMC from baseline in the SCF + Ca (40.28 ± 9.03 g, p = 0.001) and SCF groups (27.34 ± 7.93 g, p = 0.037). At 6 months, the change in TBBMD in the SCF + Ca (0.019 ± 0.003 g/cm2) and Ca (0.014 ± 0.003 g/cm2) groups was significantly different (p < 0.05) from SCF (0.004 ± 0.002 g/cm2) and placebo (0.002 ± 0.003 g/cm2). However, the changes in TBBMD and TBBMC were not significantly different among groups at 12 months. CONCLUSION SCF did not increase TBBMC and TBBMD in Malaysian children after 1 year although calcium supplementation increased TBBMD at 6 months. Further work is needed to fully understand the mechanism and health benefits of prebiotics in this study population. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/ct2/show/NCT03864172.
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Affiliation(s)
- Kanimolli Arasu
- Division of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Chung Yuan Chang
- Division of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Soon Yee Wong
- Division of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Shu Hwa Ong
- Institute of Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
| | - Wai Yew Yang
- Division of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Megan Hueh Zan Chong
- Division of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Seremban, Malaysia
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Seremban, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
| | | | - Winnie Siew Swee Chee
- Division of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia.
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Eturajulu RC, Tan MP, Zakaria MI, Chinna K, Ng KH. Development of the modified safety attitude questionnaire for the medical imaging department. Singapore Med J 2023; 0:369060. [PMID: 36751846 DOI: 10.4103/singaporemedj.smj-2021-254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments. Methods Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups. Results A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups. Conclusion The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
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Affiliation(s)
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohd Idzwan Zakaria
- Academic Unit, Trauma and Emergency, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
| | - Kwan Hoong Ng
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur; Faculty of Medicine and Health Sciences, UCSI University, Negeri Sembilan, Malaysia
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Abjani F, Madhavan P, Chong PP, Chinna K, Rhodes CA, Lim YAL. Urbanisation and its Associated Factors Affecting Human Gut Microbiota: Where are we Heading to? Ann Hum Biol 2023; 50:137-147. [PMID: 36650931 DOI: 10.1080/03014460.2023.2170464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
ContextThe continuous rise in urbanisation and its associated factors have been reflected in the structure of the human gut ecosystem.ObjectiveThe main focus of the review is to discuss and summarise the major risk factors associated with urbanisation that affects human gut microbiota thus affecting human health.MethodsMultiple medical literature databases, namely PubMed, Google, Google Scholar, and Web of Science were used to find relevant materials for urbanization and its major factors affecting human gut microbiota/microbiome. Both layman and Medical Subject Headings (MeSH) terms were used in the search. Due to the scarcity of the data, no limitation was set on the publication date. Relevant material in the English language which includes case reports, chapters of books, journal articles, online news reports and medical records was included in this review.ResultsBased on the data discussed in the review, it is quite clear that urbanisation and its associated factors have long-standing effects on the human gut microbiota that result in alterations of gut microbial diversity and composition. This is a matter of serious concern as chronic inflammatory diseases are on the rise in urbanised societies.ConclusionA better understanding of the factors associated with urbanisation will help us to identify and implement new biological and social approaches to prevent and treat diseases and improve health globally by deepening our understanding of these relationships and increasing studies across urbanisation gradients.HIGHLIGHTSHuman gut microbiota has been linked to almost every important function, including metabolism, intestinal homeostasis, immune system, biosynthesis of vitamins, brain processes, and its behaviour.However, dysbiosis i.e., alteration in the composition and diversity of gut microbiota is associated with the pathogenesis of many chronic conditions.In the 21st century, urbanisation represents a major demographic shift in developed and developing countries.During this period of urbanisation, humans have been exposed to many environmental exposures, all of which have led to the dysbiosis of human gut microbiota.The main focus of the review is to discuss and summarize the major risk factors associated with urbanisation and how it affects the diversity and composition of gut microbiota which ultimately affects human health.
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Affiliation(s)
- Farhat Abjani
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Jalan Taylors, 47500 Subang Jaya, Selangor, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University 56100 Cheras, Kuala Lumpur, Malaysia
| | - Charles Anthony Rhodes
- Department of Parasitology, University Malaya Medical Centre, 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
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Kong YC, Danaee M, Kaur R, Thiagarajan M, Zaharah H, Sener M, Rajah HDA, Taib NA, Chinna K, Yip CH, Bhoo-Pathy N. Development and Validation of a Dual-Language (English and Malay) Needs Assessment Tool for Breast Cancer (NeAT-BC). Diagnostics (Basel) 2023; 13:diagnostics13020241. [PMID: 36673050 PMCID: PMC9858119 DOI: 10.3390/diagnostics13020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/16/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Background: Needs assessment tools may be used to guide the optimisation of cancer survivorship services. We sought to develop and validate a dual-language needs assessment tool for women with breast cancer. Methods: The study comprised two phases; (I) co-design, and (II) psychometric testing. In Phase I, items were generated based on focus group discussions with patients and a literature review. These items were then translated into the Malay language. Content and face validation were undertaken with an expert panel. In phase II, 315 Malaysian women living with breast cancer were recruited. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to determine construct validity and reliability. Criterion validity was assessed using the EORTC QLQ-C30 questionnaire. Results: We co-designed and validated a 48-item dual-language needs assessment tool for breast cancer (NeAT-BC). Five underlying constructs were revealed in the EFA: (1) emotional support, (2) social and intimate relationships, (3) hospital appointments, (4) personal care and health, and (5) information and services. The NeAT-BC demonstrated good reliability across all constructs (Cronbach’s alpha: 0.90 to 0.96). CFA also demonstrated acceptable convergent and divergent validity, composite reliability ≥ 0.87, and Heterotrait−Monotrait index < 0.85 for all constructs. Criterion validity was established given the significant negative correlation between overall needs and quality of life (r = −0.14; p = 0.02). The NeAT-BC took approximately 25 min to be completed and could be interviewer-administered or self-administered. Conclusion: The utilization of the NeAT-BC is expected to guide establishment of evidence-based cancer survivorship services in Malaysia, with wider potentials for adoption in other multi-ethnic and/or low-and-middle income settings.
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Affiliation(s)
- Yek-Ching Kong
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Ranjit Kaur
- Breast Cancer Welfare Association Malaysia, Petaling Jaya 46200, Malaysia
| | | | - Hafizah Zaharah
- Department of Radiotherapy and Oncology, National Cancer Institute, Putrajaya 62250, Malaysia
| | - Mustafa Sener
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Erasmus University Medical Centre, 3015 GD Rotterdam, The Netherlands
| | - Harenthri Devy Alagir Rajah
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur 56100, Malaysia
| | - Cheng-Har Yip
- Subang Jaya Medical Centre, Subang Jaya 47500, Malaysia
| | - Nirmala Bhoo-Pathy
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: or ; Tel.: +6-03-7967-7526
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Tai YT, Lim QH, Ratnasingam J, Paramasivam SS, Tan PC, Omar SZ, Chinna K, Lim LL, Vethakkan SR. ODP413 Impact of Gestational Weight Gain according to 2009 IOM Recommendations on Neonatal Anthropometrics in Asians: A Pilot Study from Malaysia. J Endocr Soc 2022. [PMCID: PMC9625168 DOI: 10.1210/jendso/bvac150.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction Gestational Weight Gain (GWG) modulates pregnancy outcomes and long-term offspring metabolic health [1,2]. Thus far, the widely used 2009 Institute of Medicine (IOM) recommendations on GWG have largely been evaluated in Caucasian populations and some monoethnic East Asian cohorts. We designed this study to determine if IOM GWG thresholds are applicable in a multi-ethnic Asian cohort of Malaysian mothers. Methods In this prospective observational study, 875 mothers were recruited from a Malaysian tertiary urban center during screening for gestational diabetes. Amongst data collected were Total GWG (maternal weight at delivery – self-reported pre-gravid weight) and neonatal anthropometrics. BMI was stratified by Caucasian (overweight ≥25kg/m 2, obese ≥30 kg/m 2) and Asian (overweight ≥23kg/m 2, obese ≥27.5kg/m 2) thresholds, and patients categorized by 2009 IOM GWG recommendations. Results This study included 67% Malay, 23% Chinese and 10% Indian mothers. There was a high prevalence of overweight/obesity regardless of cut-offs used (Asian 56.9% vs Caucasian 44%). When Asian BMI cut-offs were used, excessive GWG prevalence increased (34.1% → 40.6%) whilst inadequate GWG declined (30% → 24.9%). Prevalence of LGA, macrosomia, Birth Weight(BW)/Neonatal Fat Mass(NFM)/Sum of Skinfold Thickness(SSFT) >90th centile was highest (p<0. 05) in those with excess GWG whether stratified by Caucasian or Asian BMI cut-offs. Upon multivariate analysis adjusting for age, parity, race, GDM, Ln HOMA2%S and baby gender, excessive GWG (by Asian BMI categories) was associated only with increased risk of SSFT >90th centile (aOR 5.7, 95% CI 2.33–14. 03). Excessive GWG (by Caucasian BMI categories) was associated with increased risk of macrosomia (aOR 8.65, 95% CI 1. 07–70. 01), NFM >90th centile (aOR 2.14, 95% CI 1. 02–4.45) and SSFT >90th centile (aOR 3.88, 95% CI 1.77–8.51). SGA status was associated with insufficient GWG by both Caucasian (aOR 4.26, 95% CI 2.46–7.38) and Asian BMI cut-offs (aOR 3.55, 95% CI 2. 07–6.10). Conclusion The 2009 IOM recommendations, using either Caucasian or regional Asian BMI thresholds, are applicable in our multi-ethnic Asian cohort in terms of predicting increased neonatal adiposity and SGA status. References: 1. Rasmussen K, Yaktine AL, eds; Institute of Medicine; National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press; National Academy of Sciences; 2009.2. He Y, Tam CH, et al. Optimal gestational weight gain for Chinese women - analysis from a longitudinal cohort with childhood follow-up. Lancet Reg Health West Pac. 2021 Jul 6;13: 100190. Presentation: No date and time listed
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Eturajulu RC, Ng KH, Tan MP, Zakaria MI, Chinna K, Ponnampalavanar S, Vijayananthan A, Yaakup NA, Chung E. Quality Improvement Report: Safety Program for Prevention of Central Line-associated Bloodstream Infections. Radiographics 2022; 42:E216-E223. [PMID: 36269668 DOI: 10.1148/rg.220035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The increasing usage of peripherally inserted central catheters (PICCs) in medical imaging departments has led to a corresponding increase in cases of central line-associated bloodstream infection (CLABSI). However, this condition is preventable with proper monitoring and use of aseptic techniques. A Comprehensive Unit-based Safety Program (CUSP) is a quality improvement (QI) measure implemented by health care institutions to reduce the incidence of CLABSI. However, effective strategies have yet to be established. The authors describe a QI project that evaluated the implementation of CUSP at a teaching hospital to reduce PICC-associated bloodstream infection (BSI). The framework consists of a five-step process: understand and train staff on the science of safety, assemble a team, engage senior executives, identify defects through sensemaking, and implement teamwork and communication strategies in a series of related and sequential steps that use QI tools. Targets were identified for improvement from existing processes, and the workflow was reengineered. Nine months after the start of the CUSP intervention, PICC-associated BSI incidence in the hospital had been reduced from 3.4 to 2.7 per 1000 central lines days after intervention. The incidence of BSI was also reduced correspondingly from 8.8% to 5.9%. The QI processes in this study may be adopted by other hospitals, as they involve minimal cost with significant impact on patient safety and well-being. The QI sequential steps described capture the implementation processes that can be modified for use in other department settings where patient safety could be compromised. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Ravi Chanthriga Eturajulu
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Kwan Hoong Ng
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Maw Pin Tan
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Mohd Idzwan Zakaria
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Karuthan Chinna
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Sasheela Ponnampalavanar
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Anushya Vijayananthan
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Nur Adura Yaakup
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
| | - Eric Chung
- From the Department of Biomedical Imaging, University of Malaya Medical Centre, Kuala Lumpur, Malaysia (R.C.E.); Department of Biomedical Imaging (K.H.N., A.V., N.A.Y., E.C.), Department of Medicine (M.P.T., S.P.), and Academic Unit Trauma and Emergency (M.I.Z.), Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (K.H.N.); and Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia (K.C.)
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Singh BKS, Khor BH, Sahathevan S, Gafor AHA, Fiaccadori E, Chinna K, Ng SH, Karupaiah T. Barriers and Facilitators to Intradialytic Parenteral Nutrition Implementation Targeting Protein Energy Wasting in Malaysian Hemodialysis Patients. Healthcare (Basel) 2022; 10:healthcare10102090. [PMID: 36292538 PMCID: PMC9602673 DOI: 10.3390/healthcare10102090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 11/22/2022] Open
Abstract
The capacity to deliver intradialytic parenteral nutrition (IDPN) for patients on hemodialysis (HD) diagnosed with protein energy wasting (PEW) in low resource settings is unknown. This study aimed to examine the extent of IDPN practice in HD units in Malaysia, and its implementation to treat PEW. We surveyed pharmacists (n = 56), who are central to parenteral nutrition delivery in Malaysia including IDPN. Seventeen healthcare stakeholders engaging with the Promoting Action on Research Implementation in Health Services (PARIHS) framework used the Likert scale to rate survey outcomes on IDPN implementation to treat PEW, according to the Evidence, Context, and Facilitation elements. IDPN for HD patients was available in 28 of 56 hospitals providing parenteral nutrition services, with only 13 hospitals (23.2%) providing IDPN to outpatients. Outpatient treatment was concentrated to urban locations (12/13) and significantly associated (p < 0.001) with resident nephrologists. The Evidence domain was rated poorly (2.18 ± 0.15) pertaining to IDPN indication when the oral spontaneous intake was ≤20 kcal/kg/day. The Context domain indicated good adherence to international best practice relating to IDPN administration (4.59 ± 0.15) and infusion time (4.59 ± 0.12). Poor adherence was observed in the Facilitation domain on ’Access to pharmacist and dietitian at HD units’ (2.65 ± 0.21) and ’Access to continuous medical education on managing PEW patients on HD’ (2.53 ± 0.15). The IDPN outpatient service was concentrated to urban hospitals with greater manpower resources. The PARIHS evaluation on IDPN implementation to treat PEW revealed facilitators in good practice adherence for prescribing and administration of IDPN but highlighted major barriers relating to IDPN indication and nutrient calculation.
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Affiliation(s)
- Birinder Kaur Sadu Singh
- Department of Pharmacy, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Sharmela Sahathevan
- Division of Nutrition and Dietetics, Faculty of Health Sciences, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Enrico Fiaccadori
- Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, 43121 Parma, Italy
| | - Karuthan Chinna
- Faculty of Business and Management, USCI University, Kuala Lumpur 56000, Malaysia
| | - See-Hoe Ng
- School of BioSciences, Faculty of Health and Medical Sciences, Taylor’s University Lakeside, Selangor 47500, Malaysia
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health and Medical Sciences, Taylor’s University Lakeside, Selangor 47500, Malaysia
- Correspondence:
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Sazlina SG, Lee PY, Cheong AT, Hussein N, Pinnock H, Salim H, Liew SM, Hanafi NS, Abu Bakar AI, Ng CW, Ramli R, Mohd Ahad A, Ho BK, Mohamed Isa S, Parker RA, Stoddart A, Pang YK, Chinna K, Sheikh A, Khoo EM. Feasibility of supported self-management with a pictorial action plan to improve asthma control. NPJ Prim Care Respir Med 2022; 32:34. [PMID: 36127355 PMCID: PMC9486786 DOI: 10.1038/s41533-022-00294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/16/2022] [Indexed: 11/09/2022] Open
Abstract
Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre-post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months follow-up. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. The proportion of at least one acute exacerbation (3 months: % difference -19.7; 95% CI -34.7 to -3.1; 6 months: % difference -20.3; 95% CI -5.8 to -3.2), one or more emergency visit (1 month: % difference -28.6; 95% CI -41.2 to -15.5; 3 months: % difference -18.0; 95% CI -32.2 to -3.0; 6 months: % difference -20.3; 95% CI -34.9 to -4.6), and one or more asthma admission (1 month: % difference -14.3; 95% CI -25.2 to -5.3; 6 months: % difference -11.9; 95% CI -23.2 to -1.8) improved over time. Estimated savings for the 59 patients at 6-months follow-up and for each patient over the 6 months were RM 15,866.22 (USD3755.36) and RM268.92 (USD63.65), respectively. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary-care patients.Trial registration number: ISRCTN87128530; prospectively registered: September 5, 2019, http://www.isrctn.com/ISRCTN87128530 .
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Affiliation(s)
- Shariff Ghazali Sazlina
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. .,Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Malaysia.
| | - Ping Yein Lee
- UMeHealth Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Hani Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Chiu-Wan Ng
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rizawati Ramli
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azainorsuzila Mohd Ahad
- Klinik Kesihatan Lukut, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | - Salbiah Mohamed Isa
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | - Richard A Parker
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Andrew Stoddart
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Yong Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kuala Lumpur, Malaysia
| | - Aziz Sheikh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Sualeheen A, Khor BH, Balasubramaniam GV, Sahathevan S, Chinna K, Mat Daud ZA, Khosla P, Abdul Gafor AH, Karupaiah T. Benchmarking Diet Quality to Assess Nutritional Risk in Hemodialysis Patients: Applying Adequacy and Moderation Metrics of the Hemodialysis-Healthy Eating Index. J Ren Nutr 2022; 32:726-738. [PMID: 35182714 DOI: 10.1053/j.jrn.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/01/2022] [Accepted: 02/06/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study modified Healthy Eating Index (HEI) based on hemodialysis (HD) specific guidelines and investigated associations between the diet quality (DQ) and nutritional risk in HD patients. METHODS The HD-HEI tool adapted the XXX Dietary Guidelines 2010 framework according to HD-specific nutrition guidelines. This HD-HEI was applied to 3-day dietary records of 382 HD patients. Relationships between HD-HEI scores and nutritional parameters were tested by partial correlations. Binary logistic regression models adjusted with confounders were used to determine adjusted odds ratio (adjOR) with 95% confidence interval (CI) for nutritional risk based on HD-HEI scores categorization. RESULTS The total HD-HEI score (51.3 ± 10.2) for this study population was affected by ethnicity (Ptrend<0.001) and sex (P=0.003). No patient achieved "good" DQ (score: 81-100), while DQ of 54.5% patients were classified as "needs improvement" (score: 51-80) and remaining as "poor" (score: 0-51). Total HD-HEI scores were positively associated with dietary energy intake (DEI) and dietary protein intakes (DPI), dry weight and handgrip strength, but inversely associated with Dietary Monotony Index (DMI) (all P<0.05). Individually, scores for refined grain, total protein, and animal protein were positively associated with DEI (all P< 0.05), whilst total, animal, fish and vegetable proteins indicated positive associations with DPI (all P< 0.05). Moderating metrics for convenience meals, saturated fats, sodium, and fluid negatively correlated towards DEI with similar trends for DPI excepting convenience meals and fluids. "Poor" DQ was associated with DMI ≥ 29.2 (adjOR: 18.83, 95% CI: 9.36-37.86, P<0.001), Malnutrition Inflammation Score (MIS) ≥ 5 (adjOR: 1.78, 95% CI: 1.01-3.15, P=0.045), and Protein Energy Wasting (PEW) (adjOR: 1.96, 95% CI: 1.14-3.34, P=0.031), but became nullified with covariate adjustments. "Poor" DQ was also associated with low lean tissue mass (< 32.6 kg) in men (adjOR: 2.38, 95% CI: 1.01-5.58, P=0.046) but not women. CONCLUSIONS "Poor" DQ was associated with poor nutritional status in XXX HD patients, who should be targeted for nutritional counselling.
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Affiliation(s)
- Ayesha Sualeheen
- Dietetics Program, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, University Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | | | - Sharmela Sahathevan
- Dietetics Program, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor 47500, Malaysia
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia
| | - Pramod Khosla
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USA
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, 56000, Kuala Lumpur, Malaysia
| | - Tilakavati Karupaiah
- School of Biosciences, Faculty of Health & Medical Science, Taylor's University Lakeside Campus, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia.
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Abdullah A, Liew SM, Salim H, Ng CJ, Chinna K. Correction: Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review. PLoS One 2022; 17:e0261430. [PMID: 34982790 PMCID: PMC8726497 DOI: 10.1371/journal.pone.0261430] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sahathevan S, Karupaiah T, Khor BH, Sadu Singh BK, Mat Daud ZA, Fiaccadori E, Sabatino A, Chinna K, Abdul Gafor AH, Bavanandan S, Visvanathan R, Yahya R, Wahab Z, Goh BL, Morad Z, Bee BC, Wong HS. Muscle Status Response to Oral Nutritional Supplementation in Hemodialysis Patients With Protein Energy Wasting: A Multi-Center Randomized, Open Label-Controlled Trial. Front Nutr 2022; 8:743324. [PMID: 34977109 PMCID: PMC8717812 DOI: 10.3389/fnut.2021.743324] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Muscle wasting, observed in patients with end-stage kidney disease and protein energy wasting (PEW), is associated with increased mortality for those on hemodialysis (HD). Oral nutritional supplementation (ONS) and nutrition counseling (NC) are treatment options for PEW but research targeting muscle status, as an outcome metric, is limited. Aim: We compared the effects of combined treatment (ONS + NC) vs. NC alone on muscle status and nutritional parameters in HD patients with PEW. Methods: This multi-center randomized, open label-controlled trial, registered under ClinicalTrials.gov (Identifier no. NCT04789031), recruited 56 HD patients identified with PEW using the International Society of Renal Nutrition and Metabolism criteria. Patients were randomly allocated to intervention (ONS + NC, n = 29) and control (NC, n = 27) groups. The ONS + NC received commercial renal-specific ONS providing 475 kcal and 21.7 g of protein daily for 6 months. Both groups also received standard NC during the study period. Differences in quadriceps muscle status assessed using ultrasound (US) imaging, arm muscle area and circumference, bio-impedance spectroscopy (BIS), and handgrip strength (HGS) methods were analyzed using the generalized linear model for repeated measures. Results: Muscle indices as per US metrics indicated significance (p < 0.001) for group × time interaction only in the ONS + NC group, with increases by 8.3 and 7.7% for quadriceps muscle thickness and 4.5% for cross-sectional area (all p < 0.05). This effect was not observed for arm muscle area and circumference, BIS metrics and HGS in both the groups. ONS + NC compared to NC demonstrated increased dry weight (p = 0.039), mid-thigh girth (p = 0.004), serum prealbumin (p = 0.005), normalized protein catabolic rate (p = 0.025), and dietary intakes (p < 0.001), along with lower malnutrition–inflammation score (MIS) (p = 0.041). At the end of the study, lesser patients in the ONS + NC group were diagnosed with PEW (24.1%, p = 0.008) as they had achieved dietary adequacy with ONS provision. Conclusion: Combination of ONS with NC was effective in treating PEW and contributed to a gain in the muscle status as assessed by the US, suggesting that the treatment for PEW requires nutritional optimization via ONS.
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Affiliation(s)
- Sharmela Sahathevan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Perak, Malaysia
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside, Selangor, Malaysia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Birinder Kaur Sadu Singh
- Department of Pharmacy, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Enrico Fiaccadori
- Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Alice Sabatino
- Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Lakeside, Selangor, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sunita Bavanandan
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | - Rosnawati Yahya
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Zaimi Wahab
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Bak-Leong Goh
- Department of Nephrology, Serdang Hospital, Selangor, Malaysia
| | - Zaki Morad
- National Kidney Foundation, Selangor, Malaysia
| | - Boon Cheak Bee
- Department of Nephrology, Selayang Hospital, Selangor, Malaysia
| | - Hin Seng Wong
- Department of Nephrology, Selayang Hospital, Selangor, Malaysia
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Patil S, Hasamnis A, Chinna K, Wei Wei N, Rae Min B. Perceived impact of the prolonged COVID-19 pandemic on Malaysian medical students: A descriptive, cross-sectional study. Med J DY Patil Vidyapeeth 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_180_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Khor B, Sahathevan S, Ali MSM, Sualeheen A, Chinna K, Gafor AHA, Daud ZAM, Khosla P, Karupaiah T. Associations of dietary fatty acid intakes with inflammation, nutritional status, and all-cause mortality in maintenance hemodialysis patients. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thavagnanam S, H'ng SY, Nathan AM, Eg KP, Chinna K, Hajar Bte Turbirin S, Anne de Bruyne J. WRISTOX 2 is a reliable tool to diagnose obstructive sleep apnoea syndrome. Int J Pediatr Otorhinolaryngol 2021; 151:110930. [PMID: 34571207 DOI: 10.1016/j.ijporl.2021.110930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/10/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Overnight pulse oximetry is an alternative to polysomnography (PSG) in diagnosing obstructive sleep apnoea syndrome, but its sensitivity is reported to be low. AIMS To determine the (a) diagnostic accuracy, interobserver reliability and reliable oxygen desaturation index of 4% (ODI4) score at diagnosing obstructive sleep apnoea syndrome in children and (b) correlation between the apnoea hypopnoea index (AHI) with ODI4 and oxygen nadir between both PSG and oximetry. METHODS This cross-sectional study included children aged 1-18 years old, undergoing a fully attended overnight PSG for suspected obstructive sleep apnoea syndrome. The Nonin 3150 WristOx2 ™ [Fig. 2] was worn simultaneously during the PSG. Poor oximetry recordings were excluded. Pulse oximetry was scored using the McGill Oximetry Score (MOS) whereby a score of 2-4 was positive for OSAS. Specificity, sensitivity, positive predictive values (PPV), negative predictive values (NPV) and interobserver reliability of the WristOx2 were calculated. RESULTS One hundred and sixty-two children with a mean (SD) age of 9.3 (±3.5) years (range 2 years 6 months old - 17 years old) were included after excluding 18 children (poor oximetry data [n = 16] and incomplete PSG [n = 2]). Interobserver agreement of the WristOx2 was 0.8763 (95% CI:0.80, 0.95). WristOx2 had a sensitivity 50%, specificity 96.7%, PPV 96% and NPV 53% at diagnosing OSAS. ODI4 ≥ 2 events/hour in oximetry had a sensitivity of 97.6% and negative predictive value of 85.7% at diagnosing OSA. CONCLUSION Overnight pulse oximetry with the Nonin 3150 WristOx2 ™ is an accurate and reliable tool in diagnosing significant OSAS in children.
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Affiliation(s)
- Surendran Thavagnanam
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia; Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia; Department of Paediatrics, Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1BB, United Kingdom
| | - Shih Ying H'ng
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Anna Marie Nathan
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia; Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia
| | - Kah Peng Eg
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia; Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Medicine and Department of Social and Preventive, Medicine, University Malaya, 50603, Kuala Lumpur, Malaysia; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Malaysia
| | | | - Jessie Anne de Bruyne
- Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia; Faculty of Medicine and Department of Social and Preventive, Medicine, University Malaya, 50603, Kuala Lumpur, Malaysia
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Cheong AT, Lee PY, Shariff-Ghazali S, Salim H, Hussein N, Ramli R, Pinnock H, Liew SM, Hanafi NS, Abu Bakar AI, Mohd Ahad A, Pang YK, Chinna K, Khoo EM. Implementing asthma management guidelines in public primary care clinics in Malaysia. NPJ Prim Care Respir Med 2021; 31:47. [PMID: 34845205 PMCID: PMC8630037 DOI: 10.1038/s41533-021-00257-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
Implementing asthma guideline recommendations is challenging in low- and middle-income countries. We aimed to explore healthcare provider (HCP) perspectives on the provision of recommended care. Twenty-six HCPs from six public primary care clinics in a semi-urban district of Malaysia were purposively sampled based on roles and experience. Focus group discussions were guided by a semi-structured interview guide and analysed thematically. HCPs had access to guidelines and training but highlighted multiple infrastructure-related challenges to implementing recommended care. Diagnosis and review of asthma control were hampered by limited access to spirometry and limited asthma control test (ACT) use, respectively. Treatment decisions were limited by poor availability of inhaled combination therapy (ICS/LABA) and free spacer devices. Imposed Ministry of Health programmes involving other non-communicable diseases were prioritised over asthma. Ministerial policies need practical resources and organisational support if quality improvement programmes are to facilitate better management of asthma in public primary care clinics.
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Affiliation(s)
- Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sazlina Shariff-Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing™, Universiti Putra Malaysia, Serdang, Malaysia
| | - Hani Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rizawati Ramli
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Azainorsuzila Mohd Ahad
- Klinik Kesihatan Lukut, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Agarwal D, Hanafi NS, Khoo EM, Parker RA, Ghorpade D, Salvi S, Abu Bakar AI, Chinna K, Das D, Habib M, Hussein N, Isaac R, Islam MS, Khan MS, Liew SM, Pang YK, Paul B, Saha SK, Wong LP, Yusuf OM, Yusuf SO, Juvekar S, Pinnock H. Predictors for detecting chronic respiratory diseases in community surveys: A pilot cross-sectional survey in four South and South East Asian low- and middle-income countries. J Glob Health 2021; 11:04065. [PMID: 34737865 PMCID: PMC8561335 DOI: 10.7189/jogh.11.04065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Our previous scoping review revealed limitations and inconsistencies in population surveys of chronic respiratory disease. Informed by this review, we piloted a cross-sectional survey of adults in four South/South-East Asian low-and middle-income countries (LMICs) to assess survey feasibility and identify variables that predicted asthma or chronic obstructive pulmonary disease (COPD). Methods We administered relevant translations of the BOLD-1 questionnaire with additional questions from ECRHS-II, performed spirometry and arranged specialist clinical review for a sub-group to confirm the diagnosis. Using random sampling, we piloted a community-based survey at five sites in four LMICs and noted any practical barriers to conducting the survey. Three clinicians independently used information from questionnaires, spirometry and specialist reviews, and reached consensus on a clinical diagnosis. We used lasso regression to identify variables that predicted the clinical diagnoses and attempted to develop an algorithm for detecting asthma and COPD. Results Of 508 participants, 55.9% reported one or more chronic respiratory symptoms. The prevalence of asthma was 16.3%; COPD 4.5%; and ‘other chronic respiratory disease’ 3.0%. Based on consensus categorisation (n = 483 complete records), “Wheezing in last 12 months” and “Waking up with a feeling of tightness” were the strongest predictors for asthma. For COPD, age and spirometry results were the strongest predictors. Practical challenges included logistics (participant recruitment; researcher safety); misinterpretation of questions due to local dialects; and assuring quality spirometry in the field. Conclusion Detecting asthma in population surveys relies on symptoms and history. In contrast, spirometry and age were the best predictors of COPD. Logistical, language and spirometry-related challenges need to be addressed.
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Affiliation(s)
- Dhiraj Agarwal
- Vadu Rural Health Program, KEM Hospital Research Centre (KEMHRC), Pune, India
| | | | - Ee Ming Khoo
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Richard A Parker
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Deesha Ghorpade
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Sundeep Salvi
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | | | - Karuthan Chinna
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Deepa Das
- Christian Medical College (CMC), Vellore, India
| | - Monsur Habib
- Bangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh
| | - Norita Hussein
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Rita Isaac
- Christian Medical College (CMC), Vellore, India
| | | | | | - Su May Liew
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Yong Kek Pang
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | | | - Samir K Saha
- Child Health Research Foundation (CHRF), Dhaka, Bangladesh
| | - Li Ping Wong
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Osman M Yusuf
- The Allergy & Asthma Institute (AAI), Islamabad, Pakistan
| | | | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre (KEMHRC), Pune, India
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
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Lugova H, Andoy-Galvan JA, Patil SS, Wong YH, Baloch GM, Suleiman A, Nordin R, Chinna K. Prevalence and Associated Factors of the Severity of Depression, Anxiety and Stress Among Low-Income Community-Dwelling Adults in Kuala Lumpur, Malaysia. Community Ment Health J 2021; 57:1489-1498. [PMID: 33417170 DOI: 10.1007/s10597-020-00765-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 12/23/2020] [Indexed: 11/28/2022]
Abstract
Growing prevalence of mental illnesses and the role they play in the global disease burden is an emerging public health issue. The prevalence of depression and anxiety is on the rise in Malaysia. Low-income urban communities are among the key affected populations with regards to mental health problems. This cross-sectional study was aimed to determine the prevalence and severity of depression, anxiety and stress, and their associated factors among adults in the low-income community of Kuala Lumpur, Malaysia. A total of 248 participants aged 18-60 years old were recruited. Data were collected via face-to-face interviews using the Depression, Anxiety and Stress Scale-21 Items (DASS-21). Chi-squared test was used to examine the association between the variables. Multiple ordinal regression model was introduced to identify the predictors of depression, anxiety and stress. The proportions of participants with depression, anxiety and stress were 24.2% (95% CI: 19.6-30.4), 36.3% (95% CI: 29.9-43.0), and 20.6% (95% CI: 15.4-26.5), respectively. There was a statistically significant association of ethnicity (p = 0.002) and age (p = 0.014) with the severity of depression, ethnicity (p = 0.001) and age (p = 0.024) with the severity of anxiety, and ethnicity (p < 0.001) and marital status (p = 0.006) with the severity of stress. In a multivariable analysis, only non-Malay ethnicity was an independent predictor of the severity of depression [OR = 2.43, 95% CI (1.25, 4.72), p = 0.009], anxiety [OR = 2.55, 95% CI (1.41, 4.62), p = 0.002] and stress [OR = 4.28, 95% CI (2.06, 8.89), p = <0.001]. Mental health interventions should target low-income communities to address social inequalities of mental health within economically disadvantaged populations.
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Affiliation(s)
- Halyna Lugova
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000, Kuala Lumpur, Malaysia.
| | - Jo Ann Andoy-Galvan
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Sapna S Patil
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Yin How Wong
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Gul M Baloch
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Adlina Suleiman
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000, Kuala Lumpur, Malaysia
| | - Rusli Nordin
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Karuthan Chinna
- School of Medicine, Taylor's University Malaysia, No. 1 Jalan Taylor's, 47500, Subang Jaya, Selangor Darul Ehsan, Malaysia
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Chee KH, Tan KL, Luqman I, Saiful SS, Chew YY, Chinna K, Tan ATB. Prevalence and Predictors of Left Ventricular Diastolic Dysfunction in Malaysian Patients With Type 2 Diabetes Mellitus Without Prior Known Cardiovascular Disease. Front Cardiovasc Med 2021; 8:676862. [PMID: 34646868 PMCID: PMC8502921 DOI: 10.3389/fcvm.2021.676862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Existing data showed that left ventricular diastolic dysfunction is common in individuals with type 2 diabetes mellitus (T2DM). However, most of the studies included diabetic patients who have prior cardiovascular disease, which might be the compounding factor for ventricular dysfunction. This study aimed to determine the prevalence and predictors of left ventricular diastolic dysfunction in an Asian population with T2DM without prior cardiovascular disease using the latest recommended echocardiographic assessment for left ventricular diastolic dysfunction. Design and Participants: This is a cross-sectional study in which eligible patients with T2DM without history of coronary artery disease, heart failure, or valvular heart disease were recruited. Demographic data, diabetic control, comorbidities, microvascular/macrovascular complications, and medications prescribed were recorded. Venous blood was sent to test for B-type natriuretic peptide, and transthoracic echocardiography was performed to assess left ventricular dysfunction. Setting: This study was performed in a tertiary healthcare center located in Kuala Lumpur, Malaysia. Results: Of the 301 patients, 83.1% have had T2DM for >10 years, with 45.8% being poorly controlled. Comorbidities include hypertension (77.1%), hyperlipidemia (91.0%), and pre-obesity/obesity (72.9%). Majority had absence of microvascular (albuminuria, retinopathy, and neuropathy) and macrovascular (peripheral vascular disease and stroke) complications. None had raised B-type natriuretic peptide levels, and 93.7% had no symptoms of heart failure. On echocardiographic assessment, 70.1% had left ventricular diastolic dysfunction, and 90.5% had Grade 1/mild severity. Age, ethnicity, insulin therapy, presence of hypertension, and hyperlipidemia were significantly associated with left ventricular diastolic dysfunction. Older T2DM patients of Chinese ethnicity and on insulin are about two times more likely to develop left ventricular diastolic dysfunction. Conclusion: There was a high prevalence of asymptomatic left ventricular diastolic dysfunction among patients with T2DM without prior known cardiovascular disease. Older age, insulin therapy, and Chinese ethnicity were risk factors for left ventricular diastolic dysfunction in T2DM.
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Affiliation(s)
- Kok Han Chee
- Medical Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Kok Leng Tan
- Regenerative Medicine Cluster, Institut Perubatan dan Pergigian Termaju, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Ibrahim Luqman
- Medical Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | - Yee Yean Chew
- Medical Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Medical Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia
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Affiliation(s)
- Wan Ling Lee
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
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Thangiah N, Su TT, Chinna K, Jalaludin MY, Mohamed MNA, Majid HA. Longitudinal assessment between lifestyle-related risk factors and a composite cardiovascular disease (CVD) risk index among adolescents in Malaysia. Sci Rep 2021; 11:19135. [PMID: 34580328 PMCID: PMC8476536 DOI: 10.1038/s41598-021-98127-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/03/2021] [Indexed: 11/09/2022] Open
Abstract
The study aims to create a composite risk index of CVD among adolescents and examine the influence of demographic, socioeconomic and lifestyle-related risk factors on the composite risk index of biological CVD risk factors among adolescents in Malaysia. A Malaysian adolescent cohort of 1320 adolescents were assessed at 13, 15 and 17 years. Seven biological CVD risk factors with moderate correlation were identified, standardized and averaged to form a composite CVD risk index. Generalised estimating equation using longitudinal linear regression was used to examine the effects of changes in adolescent lifestyle-related risk factors on the composite CVD risk index over time. From the ages 13 to 17 years, physical fitness (β = − 0.001, 90% CI = − 0.003, 0.00002) and BMI (β = 0.051, 95% CI = 0.042, 0.060) were significant predictors of attaining high scores of CVD risk. Female (β = 0.118, 95% CI = 0.040, 0.197), Chinese (β = 0.122, 95% CI = 0.006, 0.239), Indians (β = − 0.114, 95% CI = − 0.216, − 0.012) and adolescents from rural schools (β = 0.066, 95% CI = − 0.005, 0.136) were also found to be considerably significant. A more robust and gender-specific intervention programme focusing on healthy lifestyle (including achieving ideal BMI and improving physical fitness) need to be implemented among school-going adolescents.
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Affiliation(s)
- Nithiah Thangiah
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Global Public Health Jeffery Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | | | | | - Hazreen Abdul Majid
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. .,Department of Nutrition, Faculty of Public Health, Universitas of Airlangga, Surabaya, Indonesia.
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Agarwal D, Hanafi NS, Khoo EM, Parker R, Ghorpade D, Salvi S, Yusuf OM, Khan MS, Yusuf SO, Das D, Paul B, Isaac R, Islam MS, Saha S, Liew SM, Hussein N, Bakar AIA, Pang YK, Chinna K, Wong LP, Juvekar S, Pinnock H. Predictors for detecting chronic respiratory diseases in population surveys: a pilot study for RESPIRE 4CCORD study. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa1733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hanafi NS, Agarwal D, Chippagiri S, Brakema E, Pinnock H, Khoo EM, Sheikh A, Liew SM, Ng CW, Isaac R, Chinna K, Wong LP, Hussein N, Abu Bakar AI, Pang YK, Juvekar S. Chronic obstructive pulmonary disease (COPD) prevalence surveys in low- and middle-income countries (LMICs): A systematic scoping review of methodologies. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa3516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Chang CY, Arasu K, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM, Chee WSS. Factors associated with bone health status of Malaysian pre-adolescent children in the PREBONE-Kids Study. BMC Pediatr 2021; 21:382. [PMID: 34479539 PMCID: PMC8414720 DOI: 10.1186/s12887-021-02842-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent (N = 243) Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ physical activity questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results The mean calcium intake was 349 ± 180 mg/day and mean serum 25(OH)D level was 43.9 ± 14.5 nmol/L. In boys, lean mass (LM) was a significant predictor of LSBMC (β = 0.539, p < 0.001), LSBMD (β = 0.607, p < 0.001), TBBMC (β = 0.675, p < 0.001) and TBBMD (β = 0.481, p < 0.01). Height was a significant predictor of LSBMC (β = 0.346, p < 0.001) and TBBMC (β = 0.282, p < 0.001) while fat mass (FM) (β = 0.261, p = 0.034) and physical activity measured as MET scores (β = 0.163, p = 0.026) were significant predictors of TBBMD in boys. Among girls, LM was also a significant predictor of LSBMC (β = 0.620, p < 0.001), LSBMD (β = 0.700, p < 0.001), TBBMC (β = 0.542, p < 0.001) and TBBMD (β = 0.747, p < 0.001). Calcium intake was a significant predictor of LSBMC (β = 0.102, p = 0.034), TBBMC (β = 0.122, p < 0.001) and TBBMD (β = 0.196, p = 0.002) in girls. Conclusions LM was the major determinant of BMC and BMD among pre-adolescent Malaysian children alongside other modifiable lifestyle factors such as physical activity and calcium intake.
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Affiliation(s)
- Chung Yuan Chang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Kanimolli Arasu
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Soon Yee Wong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Shu Hwa Ong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Wai Yew Yang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Megan Hueh Zan Chong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Negeri Sembilan, 70300, Seremban, Malaysia
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Negeri Sembilan, 70300, Seremban, Malaysia
| | - Karuthan Chinna
- Faculty of Health & Medical Sciences, School of Medicine, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
| | | | - Winnie Siew Swee Chee
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Shunnmugam B, Ng CJ, Aishah Mohd Taib N, Chinna K. Validation of the Malay, English, and Chinese Translations of the 9-Item Shared Decision Making Questionnaire (SDM-Q-9) in Breast Cancer Patients Making Treatment Decisions. Asia Pac J Public Health 2021; 33:914-922. [PMID: 34467767 DOI: 10.1177/10105395211036625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to test the psychometric properties of the Malay, English, and Chinese 9-Item Shared Decision Making Questionnaire (SDM-Q-9) in breast cancer patients making treatment decisions. The original German SDM-Q-9 was translated to Malay using the back-translation method. A total of 222 newly diagnosed breast cancer patients making treatment decisions were sampled conveniently from three breast clinics between August 2015 and February 2016. A total of 66 patients answered the SDM-Q-9 in Malay, 87 in English, and 69 in Chinese. Data were analyzed using SPSS and AMOS software. SDM-Q-9 demonstrated good reliability in the three translations. All the items correlated well except for Item 1 in English. The factor loadings were within acceptable range except for Item 1 in Malay, Items 1 and 2 in English, and Items 7 and 9 in Chinese SDM-Q-9. However, no items were deleted in accordance with experts' opinions and the previous SDM-Q-9 validation studies. The Malay, English, and Chinese SDM-Q-9 demonstrated good reliability and validity.
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Affiliation(s)
- Bairave Shunnmugam
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Chinna K, Sundarasen S, Khoshaim HB, Kamaludin K, Nurunnabi M, Baloch GM, Hossain SFA, Sukayt A, Dalina N, Rajagopalan U, Kumar R, Memon Z. Psychological impact of COVID-19 and lock down measures: An online cross-sectional multicounty study on Asian university students. PLoS One 2021; 16:e0253059. [PMID: 34343187 PMCID: PMC8330936 DOI: 10.1371/journal.pone.0253059] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/27/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic and the lockdown measures have taken a toll on every level of the society, worldwide. This study examines their psychological impact on university students in Asia. A cross-sectional online survey was conducted between April and May 2020 in Malaysia, Saudi Arabia, Pakistan, Bangladesh, China, India and Indonesia. The Zung's self-rating anxiety scale (SAS) and questions on adaptive and maladaptive coping strategies were used in this study. A total of 3,679 students from the seven countries participated in this study. Overall, 21.9% and 13.7% of the students in this study experienced mild to moderate and severe to extreme levels of anxiety. More than 20% of the students from China and Bangladesh reported severe to extreme level of anxiety compared to below 10% of the students from Indonesia, Malaysia and India. Among the female students, 15.9% experienced severe to extreme level of anxiety compared to 10.6% among the males. Females from Bangladesh, China, Malaysia, Pakistan and Saudi Arabia experienced significantly higher levels of anxiety compared to their male counterparts. Acceptance was the most used and Seeking Social Support was the least used coping strategies among the students. There were significant differences in the usage of the four strategies by countries. Stressors are predominantly financial constraints, remote online learning, and uncertainty related to their academic performance, and future career prospects.
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Affiliation(s)
- Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
- * E-mail:
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Gul Mohammad Baloch
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Syed Far Abid Hossain
- College of Business Administration, International University of Business Agriculture and Technology (IUBAT), Dhaka, Bangladesh
| | - Areej Sukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Nevi Dalina
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Usha Rajagopalan
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Ramesh Kumar
- Health Services Academy, Chak Shahzad, Islamabad, Pakistan
| | - Zahid Memon
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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Sahathevan S, Khor BH, Yeong CH, Tan TH, Meera Mohaideen AK, Ng HM, Ong GR, Sankara Narayanan S, Abdul Gafor AH, Goh BL, Bee BC, Mat Daud ZA, Chinna K, Karupaiah T. Response to "Intraclass Correlation Coefficient and Reliability of Muscle Mass Measurements". JPEN J Parenter Enteral Nutr 2021; 45:872-873. [PMID: 34165200 DOI: 10.1002/jpen.2206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Sharmela Sahathevan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar Campus, Perak, Malaysia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
| | - Teik Hin Tan
- Nuclear Medicine Centre, Sunway Medical Centre, Selangor, Malaysia
| | - Abdul Kareem Meera Mohaideen
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
| | - Hi Ming Ng
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
| | - Gild Rick Ong
- School of BioSciences, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
| | - Sreelakshmi Sankara Narayanan
- School of BioSciences, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
| | | | - Bak Leong Goh
- Department of Nephrology, Serdang Hospital, Selangor, Malaysia
| | - Boon Cheak Bee
- Department of Nephrology, Selayang Hospital, Selangor, Malaysia
| | | | - Karuthan Chinna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health & Medical Sciences, Taylor's University Lakeside Campus, Selangor, Malaysia
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Lee PY, Cheong AT, Ghazali SS, Salim H, Wong J, Hussein N, Ramli R, Pinnock H, Liew SM, Hanafi NS, Bakar AIA, Ahad AM, Pang YK, Chinna K, Khoo EM. Barriers to implementing asthma self-management in Malaysian primary care: qualitative study exploring the perspectives of healthcare professionals. NPJ Prim Care Respir Med 2021; 31:38. [PMID: 34234145 PMCID: PMC8263608 DOI: 10.1038/s41533-021-00250-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022] Open
Abstract
Asthma self-management is a crucial component of asthma management. We sought to explore healthcare professionals' (HCPs') perceptions on barriers to asthma self-management implementation in primary care. We recruited 26 HCPs from six public primary care clinics in a semi-urban district of Malaysia in 2019. The analysis was done inductively. HCPs described barriers that resonated with the "COM-B" behaviour change framework. Capability-related issues stemmed from a need for specific self-management skills training. Opportunity-related barriers included the need to balance competing tasks and limited, poorly tailored resources. Motivation-related barriers included lack of awareness about self-management benefits, which was not prioritised in consultations with perceived lack of receptiveness from patients. These were compounded by contextual barriers of the healthcare organisation and multilingual society. The approach to implementation of asthma self-management needs to be comprehensive, addressing systemic, professional, and patient barriers and tailored to the local language, health literacy, and societal context.
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Affiliation(s)
- Ping Yein Lee
- UM eHealth Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hani Salim
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Jasmine Wong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rizawati Ramli
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Ihsan Abu Bakar
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azainorsuzila Mohd Ahad
- Klinik Kesihatan Lukut, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Chee WSS, Chang CY, Arasu K, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM. Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia. Nutrients 2021; 13:2175. [PMID: 34202743 PMCID: PMC8308301 DOI: 10.3390/nu13072175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/19/2022] Open
Abstract
Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC-MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.
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Affiliation(s)
- Winnie Siew Swee Chee
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Chung Yuan Chang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Kanimolli Arasu
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Soon Yee Wong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Shu Hwa Ong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Wai Yew Yang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Megan Hueh Zan Chong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Seremban 70300, Malaysia; (M.M.); (E.J.K.)
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Seremban 70300, Malaysia; (M.M.); (E.J.K.)
| | - Karuthan Chinna
- Faculty of Health & Medical Sciences, School of Medicine, Taylor’s University, No. 1, Jalan Taylor’s, Subang Jaya 47500, Malaysia;
| | - Connie M. Weaver
- Distinguished Professor Emerita, Purdue University, West Lafayette, IN 47907, USA;
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Hanafi NS, Agarwal D, Chippagiri S, Brakema EA, Pinnock H, Sheikh A, Liew SM, Ng CW, Isaac R, Chinna K, Wong LP, Hussein N, Abu Bakar AI, Pang YK, Juvekar S, Khoo EM. Chronic respiratory disease surveys in adults in low- and middle-income countries: A systematic scoping review of methodological approaches and outcomes. J Glob Health 2021; 11:04026. [PMID: 34221357 PMCID: PMC8248510 DOI: 10.7189/jogh.11.04026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Chronic respiratory diseases (CRDs) contribute significantly towards the global burden of disease, but the true prevalence and burden of these conditions in adults is unknown in the majority of low- and middle-income countries (LMICs). We aimed to identify strategies - in particular the definitions, study designs, sampling frames, instruments, and outcomes - used to conduct prevalence surveys for CRDs in LMICs. The findings will inform a future RESPIRE Four Country ChrOnic Respiratory Disease (4CCORD) study, which will estimate CRD prevalence, including disease burden, in adults in LMICs. Methods We conducted a scoping review to map prevalence surveys conducted in LMICs published between 1995 and 2018. We followed Arksey and O'Malley's six-step framework. The search was conducted in OVID Medline, EMBASE, ISI Web of Science, Global Health, WHO Global Index Medicus and included three domains: CRDs, prevalence and LMICs. After an initial title sift, eight trained reviewers undertook duplicate study selection and data extraction. We charted: country and populations, random sampling strategies, CRD definitions/phenotypes, survey procedure (questionnaires, spirometry, tests), outcomes and assessment of individual, societal and health service burden of disease. Results Of 36 872 citations, 281 articles were included: 132 from Asia (41 from China). Study designs were cross-sectional surveys (n = 260), cohort studies (n = 11) and secondary data analysis (n = 10). The number of respondents in these studies ranged from 50 to 512 891. Asthma was studied in 144 studies, chronic obstructive pulmonary disease (COPD) in 112. Most studies (100/144) based identification of asthma on symptom-based questionnaires. In contrast, COPD diagnosis was typically based on spirometry findings (94/112); 65 used fixed-ratio thresholds, 29 reported fixed-ratio and lower-limit-of-normal values. Only five articles used the term 'phenotype'. Most studies used questionnaires derived from validated surveys, most commonly the European Community Respiratory Health Survey (n = 47). The burden/impact of CRD was reported in 33 articles (most commonly activity limitation). Conclusion Surveys remain the most practical approach for estimating prevalence of CRD but there is a need to identify the most predictive questions for diagnosing asthma and to standardise diagnostic criteria.
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Affiliation(s)
- Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Su-May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chiu-Wan Ng
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rita Isaac
- Christian Medical College, Vellore, India
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Li Ping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Ihsan Abu Bakar
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Pusrawi Hospital Sdn Bhd, Kuala Lumpur, Malaysia
| | - Yong-Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Arasu K, Chang CY, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM, Chee WSS. Design and strategies used for recruitment and retention in a double blind randomized controlled trial investigating the effects of soluble corn fiber on bone indices in pre-adolescent children (PREBONE-Kids study) in Malaysia. Contemp Clin Trials Commun 2021; 22:100801. [PMID: 34195468 PMCID: PMC8233130 DOI: 10.1016/j.conctc.2021.100801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background Recruitment and retention in longitudinal nutrition intervention studies among children is challenging and scarcely reported. This paper describes the strategies and lessons learned from a 1-year randomized double-blind placebo-controlled trial among pre-adolescent children on the effects of soluble corn fiber (SCF) on bone indices (PREBONE-Kids). Methods Participants (9–11 years old) were recruited and randomized into 4 treatment groups (600 mg calcium, 12 g SCF, 12 g SCF plus 600 mg calcium and placebo). Interventions were consumed as a fruit-flavored powdered drink for 1-year. School-based recruitment was effective due to support on study benefits from parents and teachers, peer influence and a 2-weeks study run-in for participants to assess their readiness to commit to the study protocol. Retention strategies focused on building rapport through school-based fun activities, WhatsApp messaging, providing health screening and travel reimbursements for study measurements. Compliance was enhanced by providing direct on-site school feeding and monthly non-cash rewards. Choice of 2 flavors for the intervention drinks were provided to overcome taste fatigue. Satisfaction level on the manner in which the study was conducted was obtained from a voluntary sub-set of participants. Results The study successfully enrolled 243 participants within 6 months and retained 82.7% of the participants at the end of 1 year, yielding a drop-out rate of 17.3%. Compliance to the intervention drink was 85% at the start and remained at 78.7% at the end of 1 year. More than 95% of the participants provided good feedback on intervention drinks, rapport building activities, communication and overall study conduct. Conclusion Successful strategies focused on study benefits, rapport building, frequent communication using social media and non-cash incentives helped improved compliance and retention rate. The lessons learned to maintain a high retention and compliance rate in this study provide valuable insights for future studies in a similar population. PREBONE-Kids contributes to evidence on the effect of soluble corn fiber on bone indices in pre-adolescent Asian children. School-based recruitment, study nature, perceived benefits and study run-in were effective strategies for recruitment. Rapport building, direct on-site feeding and rewarding protocol adherence were critical for good retention and compliance.
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Key Words
- 25-OHD, serum 25-hydroxyvitamin D
- BAP, bone-specific alkaline phosphatase
- BMC, bone mineral content
- BMD, bone mineral density
- CTX, carboxy-terminal collagen crosslinks
- Calcium
- Compliance
- DXA, dual-energy X-ray absorptiometry
- MET, total metabolic equivalent
- OC, osteocalcin
- P1NP, procollagen type 1 amino-terminal propeptide
- PBM, peak bone mass
- Pre-adolescent children
- SCF, soluble corn fibre
- Soluble corn fiber
- Study retention
- iPTH, intact parathyroid hormone
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Affiliation(s)
- Kanimolli Arasu
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Chung Yuan Chang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Soon Yee Wong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Shu Hwa Ong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Wai Yew Yang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Megan Hueh Zan Chong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, 70300, Seremban, Negeri Sembilan, Malaysia
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, 70300, Seremban, Negeri Sembilan, Malaysia
| | - Karuthan Chinna
- Faculty of Health & Medical Sciences, School of Medicine, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
| | | | - Winnie Siew Swee Chee
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, 57000, Bukit Jalil, Kuala Lumpur, Malaysia
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Samy AL, Kamaruzzaman SB, Chinna K, Shunnmugam B, Krishnaswamy S, Low WY. Psychometric assessment of the Bahasa Malaysia version of the Older Americans Resources and Services-Instrumental Activities of Daily Living. Australas J Ageing 2021; 40:423-429. [PMID: 33942961 DOI: 10.1111/ajag.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to determine the psychometric properties of the Bahasa Malaysia (BM) version of the Older Americans Resources and Services-Instrumental Activities of Daily Living (OARS-IADL) questionnaire among older persons in Malaysia. METHODS The English version of OARS-IADL was translated to BM. The psychometric properties of the BM version of OARS-IADL were tested among older persons attending a health-care facility. RESULTS Two hundred and seventy-one older persons participated in the study. The mean age of participants was 67.7 ± 6.1 years. Internal consistency of the items was good (Cronbach's alpha, >0.7). Exploratory factor analysis revealed a single dimension with item factor loadings of >0.5. Confirmatory factor analysis results confirmed a single-factor model (AVE > 50%, CR > 0.7 and CR > AVE). CONCLUSION The BM version of the OARS-IADL questionnaire is a valid and reliable instrument that can be used to assess the IADL among older persons in Malaysia.
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Affiliation(s)
- Alexander Lourdes Samy
- Division of Geriatrics, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Centre for ASEAN Regionalism University of Malaya, Kuala Lumpur, Malaysia.,Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Division of Geriatrics, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Bairave Shunnmugam
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Saroja Krishnaswamy
- Department of Psychiatry, University of Western Sydney, Sydney, NSW, Australia
| | - Wah-Yun Low
- Centre for ASEAN Regionalism University of Malaya, Kuala Lumpur, Malaysia.,Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia.,Dean's Office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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41
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Lee WL, DeWitt D, Chui PL, Sahibudeen AKS, Nurumal MS, Chinna K, Chong MC. Mitigation of COVID-19 Risk Among Older Adults in Nursing Homes: A Public Survey. J Gerontol Nurs 2021; 47:23-28. [PMID: 33626161 DOI: 10.3928/00989134-20210209-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/02/2020] [Indexed: 11/20/2022]
Abstract
The current study examines the public's perception on the mitigation of COVID-19 risk and knowledge of disease symptoms among older adults in nursing homes, with the intention to address gaps in knowledge using mobile technologies. An online survey questionnaire was completed by 611 adults residing in Malaysia. The four domains, derived from factor analysis, affirmed the supportive perception among the public (score range = 4.42 to 4.64/5.0). However, among the gaps identified were the perception toward hand sanitizing and susceptibility of older adults to COVID-19. Public knowledge on symptoms of COVID-19 was limited (e.g., 41.4% to 53.4% incorrect responses to anosmia, diarrhea, confusion). Multivariate analysis of variance found that males and participants with less education had significantly lower supportive perceptions (p < 0.05). With >86% of participants having access to internet communication technology, mobile interventions tailored to gender and educational level are recommended to promote long-term pandemic preparedness among stakeholders and the public. [Journal of Gerontological Nursing, 47(3), 23-28.].
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Karuthan SR, Koh PS, Chinna K, Chan WK. Barcelona Clinic Liver Cancer and Hong Kong Liver Cancer staging systems for prediction of survival among Hepatocellular Carcinoma patients. Med J Malaysia 2021; 76:199-204. [PMID: 33742628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION We aimed to compare the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC) staging systems. MATERIALS AND METHODS This is a retrospective study on patients with newly diagnosed hepatocellular carcinoma (HCC) at the University Malaya Medical Centre between 2011 and 2014. Survival times were analysed using the Kaplan- Meier procedure and comparison between groups was done using the log rank test. RESULTS The data of 190 patients was analysed. Chronic hepatitis B was the most common aetiology for HCC (43.7%), but a large proportion was cryptogenic or non-alcoholic steatohepatitis-related (41.6%). Only 11.1% were diagnosed early (BCLC Stage 0-A) while majority were diagnosed at an intermediate stage (BCLC Stage B, 53.7%). The median survival rate was significantly different between the different groups when either of the staging systems was used (p<0.05 for all comparisons). However, the two staging systems lacked agreement (weighted kappa 0.519, 95%CI: 0.449, 0.589) with significant difference in median survival rates between BCLC Stage A and HKLC Stage 2, and between BCLC Stage C and HKLC Stage 4. CONCLUSION Both staging systems were able to stratify patients according to survival, but they only had moderate agreement with significant differences observed in two groups of the staging systems.
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Affiliation(s)
- S R Karuthan
- University Malaya, Faculty of Medicine, Department of Medicine, Kuala Lumpur, Malaysia
| | - P S Koh
- University Malaya, Faculty of Surgery, Department of Medicine, Kuala Lumpur, Malaysia
| | - K Chinna
- Taylor's University, Faculty of Health and Medical Sciences, School of Medicine, Kuala Lumpur, Malaysia
| | - W K Chan
- University Malaya, Faculty of Medicine, Department of Medicine, Department of Medicine, Kuala Lumpur, Malaysia.
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Baloch GM, Kamaludin K, Chinna K, Sundarasen S, Nurunnabi M, Khoshaim HB, Hossain SFA, Sukayt AA, Baloch LG. Coping with COVID-19: The Strategies Adapted by Pakistani Students to Overcome Implications. Int J Environ Res Public Health 2021; 18:ijerph18041799. [PMID: 33673237 PMCID: PMC7918213 DOI: 10.3390/ijerph18041799] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 has speedily immersed the globe with 72+ million cases and 1.64 million deaths, in a span of around one year, disturbing and deteriorating almost every sphere of life. This study investigates how students in Pakistan have coped with the COVID-19. Zung’s self-rating anxiety scale (SAS) was used for measuring anxiety and the coping strategies were measured on four strategies i.e., seeking social support, humanitarian, acceptance, and mental disengagement. Among 494 respondents, 61% were females and 77.3% of the students were in the age group of 19–25 years. The study findings indicate that approximately 41 percent of students are experiencing some level of anxiety, including 16% with severe to extreme levels. Seeking social support seemed to be the least preferred coping strategy and that female students seek social support, humanitarian, and acceptance coping strategies more than males. Students used both emotion-based and problem-based coping strategies. The variables of gender, age, ethnicity, level and type of study, and living arrangement of the students were associated with usage of coping strategies. Findings showing that students do not prefer to seek social support. The study outcomes will provide basic data for university policies in Pakistan and the other countries with same cultural contexts to design and place better mental health provisions for students.
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Affiliation(s)
- Gul Muhammad Baloch
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, No. 1, Jalan Taylors, Subang Jaya 47500, Selangor, Malaysia;
- Correspondence: ; Tel.: +60-169661676
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, P.O. Box 66833, Riyadh 11586, Saudi Arabia; (K.K.); (S.S.); (M.N.); (A.A.S.)
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, No. 1, Jalan Taylors, Subang Jaya 47500, Selangor, Malaysia;
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, P.O. Box 66833, Riyadh 11586, Saudi Arabia; (K.K.); (S.S.); (M.N.); (A.A.S.)
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, P.O. Box 66833, Riyadh 11586, Saudi Arabia; (K.K.); (S.S.); (M.N.); (A.A.S.)
| | - Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, P.O. Box 66833, Riyadh 11586, Saudi Arabia;
| | - Syed Far Abid Hossain
- College of Business Administration, International University of Business Agriculture and Technology, 4 Embankment Drive Road, Sector-10, Uttara Model Town, Dhaka 1230, Bangladesh;
| | - Areej Al Sukayt
- Department of Accounting, Prince Sultan University, P.O. Box 66833, Riyadh 11586, Saudi Arabia; (K.K.); (S.S.); (M.N.); (A.A.S.)
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Baloch GM, Sundarasen S, Chinna K, Nurunnabi M, Kamaludin K, Khoshaim HB, Hossain SFA, AlSukayt A. COVID-19: exploring impacts of the pandemic and lockdown on mental health of Pakistani students. PeerJ 2021; 9:e10612. [PMID: 33604167 PMCID: PMC7866897 DOI: 10.7717/peerj.10612] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/30/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND As of the present, the twenty-first century is experiencing what may be one of its most devastating events, in respect to infected and dead people by the virus. Now known to the world as COVID-19, the devastating disease of what has become a pandemic started its spread from Wuhan, China and swiftly engulfed the whole world with almost 11 million cases, in a span of around six months. It has not only increased the global burden of disease but has heavily dented many social institutions, including education. METHODS This study investigates how the COVID-19 pandemic and subsequent measures of lockdown, quarantine, and social distancing have affected students. We look specifically into the effects on individuals' mental health, that is, the stress and anxiety levels of college and university students using the Zung Self-rating Anxiety Scale (SAS). RESULTS Among 494 respondents, 61% were females, and the majority (77.3%) of the students were in the age group of 19-25 years. Among the respondents, 125 (25.3%), 45 (9.1%) and 34 (6.9%) experienced minimal to moderate, severe, and most extreme levels of anxiety, respectively. The variables of gender, age and year of study were significant at the 0.25 level by univariate analyses. Nevertheless, the ordinal regression indicates that only gender was significant. The odds of a female student being more anxious are higher compared to a male student (OR = 1.779, 95% CI [1.202-2.634], P = 0.004). The most prominent stressors attained from the qualitative feedback from the Pakistani students are associated with online teaching, concerns about their academic performance and completion of the current semester, uncertainty related to exam dates, and the status of the following semester. CONCLUSIONS This study will add to the existing body of literature on the impacts of the COVID-19 pandemic on the social and psychological health of students. The study outcomes will provide basic data for further applied and action research and a framework for universities and policy makers in Pakistan and the neighboring countries in the region with the same cultural contexts. Thus, relevant health interventions can be designed for better mental health and educational attainments of students from higher educational institutions. This pathological pandemic may well lead to another pandemic of mental and behavioral illness. All stakeholders should join force regardless of pre-existing differences and inequalities to ensure the well-being of future generations, specifically students from higher educational institutions. The long-lasting impacts and the aftermath of this pandemic will unquestionably need further and future investigations. Keywords: Anxiety, students, mental health, COVID-19, Pakistan.
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Affiliation(s)
- Gul Muhammad Baloch
- School of Medicine, Faculty of Medical and Health Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- School of Medicine, Faculty of Medical and Health Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Heba Bakr Khoshaim
- Deanship of Admission and Registration, Prince Sultan University, Riyadh, Saudi Arabia
| | - Syed Far Abid Hossain
- College of Business Administration, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Areej AlSukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
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Yeak ZW, Chuah KA, Tan CH, Ezhumalai M, Chinna K, Sundram K, Karupaiah T. Providing Comprehensive Dietary Fatty Acid Profiling from Saturates to Polyunsaturates with the Malaysia Lipid Study-Food Frequency Questionnaire: Validation Using the Triads Approach. Nutrients 2020; 13:nu13010120. [PMID: 33396230 PMCID: PMC7823982 DOI: 10.3390/nu13010120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 11/17/2022] Open
Abstract
To address limited food frequency questionnaire (FFQ) capacity in public health monitoring in Malaysia, we aimed to develop a semi-quantitative FFQ for an adult multiethnic population for comprehensive fatty acid (FA) profiling inclusive of saturated (SFA), monounsaturated (MUFA), polyunsaturated fatty acids (PUFA), PUFA:SFA ratio, trans fatty acids, omega-3 and omega-6 FAs. A 240-food itemed FFQ used diet records (DR) of Malaysia Lipid Study (MLS) participants and fatty acid composition database from laboratory analyzed foods. The developed MLS-FFQ underwent face and content validation before relative validation in a free-living population (n = 114). Validation was facilitated for macronutrient data comparisons between DR and FFQ via Spearman’s correlation coefficient analyses; and for fatty acid composition data by independent pairing of DR, FFQ and plasma triglyceride using the triads method. Moderate correlation between dietary methods was obtained for macronutrients and FAs (r = 0.225–0.457, p < 0.05) except for ω-3 FAs, presenting good agreement with grossly misclassified nutrients <10%. For fatty acid composition data, the magnitude of validity coefficients (z) for SFA, PUFA, PUFA:SFA ratios and ω-6 FAs by all 3 methods were not significantly different (p > 0.05). In conclusion, the MLS-FFQ was shown to be a valid tool to assess population dietary intakes.
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Affiliation(s)
- Zu-Wei Yeak
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (Z.-W.Y.); (K.-A.C.); (C.-H.T.)
| | - Khun-Aik Chuah
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (Z.-W.Y.); (K.-A.C.); (C.-H.T.)
| | - Choon-Heen Tan
- Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (Z.-W.Y.); (K.-A.C.); (C.-H.T.)
| | - Menagah Ezhumalai
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia;
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia;
| | - Kalyana Sundram
- Malaysian Palm Oil Council, Menara Axis, Petaling Jaya 46100, Malaysia;
| | - Tilakavati Karupaiah
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia
- Correspondence: ; Tel.: +60-19-2731400
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Saleemi MA, Hosseini Fouladi M, Yong PVC, Chinna K, Palanisamy NK, Wong EH. Toxicity of Carbon Nanotubes: Molecular Mechanisms, Signaling Cascades, and Remedies in Biomedical Applications. Chem Res Toxicol 2020; 34:24-46. [PMID: 33319996 DOI: 10.1021/acs.chemrestox.0c00172] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Carbon nanotubes (CNTs) are the most studied allotropic form of carbon. They can be used in various biomedical applications due to their novel physicochemical properties. In particular, the small size of CNTs, with a large surface area per unit volume, has a considerable impact on their toxicity. Despite of the use of CNTs in various applications, toxicity is a big problem that requires more research. In this Review, we discuss the toxicity of CNTs and the associated mechanisms. Physicochemical factors, such as metal impurities, length, size, solubilizing agents, CNTs functionalization, and agglomeration, that may lead to oxidative stress, toxic signaling pathways, and potential ways to control these mechanisms are also discussed. Moreover, with the latest mechanistic evidence described in this Review, we expect to give new insights into CNTs' toxicological effects at the molecular level and provide new clues for the mitigation of harmful effects emerging from exposure to CNTs.
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Affiliation(s)
- Mansab Ali Saleemi
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Mohammad Hosseini Fouladi
- School of Engineering, Faculty of Innovation and Technology, Taylor's University Lakeside Campus, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Phelim Voon Chen Yong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
| | - Navindra Kumari Palanisamy
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia
| | - Eng Hwa Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, 47500 Subang Jaya, Selangor Darul Ehsan, Malaysia
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47
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Khoshaim HB, Al-Sukayt A, Chinna K, Nurunnabi M, Sundarasen S, Kamaludin K, Baloch GM, Hossain SFA. Anxiety Level of University Students During COVID-19 in Saudi Arabia. Front Psychiatry 2020; 11:579750. [PMID: 33362601 PMCID: PMC7759470 DOI: 10.3389/fpsyt.2020.579750] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
COVID-19 is the worst pandemic of this millennium, and it is considered to be the "public enemy number one." This catastrophe has changed the way we live in the blink of an eye. Not only has it threatened our existence and health status, but the damage associated with it could equally affect our economic, social, and educational systems. The focus of this study was on the anxiety level of university students during the COVID-19 pandemic in Saudi Arabia. The study was conducted between March and June 2020. A questionnaire was administered online, and 400 completed questionnaires were returned. In this study, the Zung self-rating anxiety scale was used to determine the anxiety levels among the respondents. The results indicated that about 35% of the students experienced moderate to extreme levels of anxiety. Anxiety was highly associated with age, sex, and level of education. These findings can enlighten government agencies and policy makers on the importance of making prompt, effective decisions to address students' anxiety during the COVID-19 pandemic. Researchers are encouraged to focus their future studies on how to develop strategies to boost students' resilience and enhance their adaptability skills for similar disasters in the future.
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Affiliation(s)
- Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, Riyadh, Saudi Arabia
| | - Areej Al-Sukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Gul Mohammad Baloch
- Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Syed Far Abid Hossain
- College of Business Administration, IUBAT - International University of Business Agriculture and Technology, Dhaka, Bangladesh
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Khoshaim HB, Al-Sukayt A, Chinna K, Nurunnabi M, Sundarasen S, Kamaludin K, Mohammad Baloch G, Far Abid Hossain S. How students in the Kingdom of Saudi Arabia are coping with COVID-19 pandemic. J Public Health Res 2020; 9:1898. [PMID: 33437753 PMCID: PMC7789870 DOI: 10.4081/jphr.2020.1898] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/05/2020] [Indexed: 12/23/2022] Open
Abstract
The novel coronavirus is the worst pandemic of this century. Unfortunately, there is no clear solution for how to cope with such an epidemic. This study examines the coping strategies used by university students in the Kingdom of Saudi Arabia. From March to May 2020, a questionnaire was administered and completed by 400 students. This study used the Zung Self-rating Anxiety Scale (SAS) to examine the respondents' level of anxiety. The results indicate that 35% of students experienced some levels of anxiety. Moreover, there was a moderate use of four types of coping strategies: Seek social support, acceptance, mental disengagement, and humanitarian. These findings can guide policymakers on the importance of developing practical guidelines to handle such lethal diseases. Moreover, the results inform the Saudi community what strategies were used to cope so far with the pandemic. Future research is expected to address the validity and appropriateness of these strategies and encourage other approaches.
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Affiliation(s)
- Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, Riyadh, Saudi Arabia
| | - Areej Al-Sukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Jalan Taylors, Subang Jaya, Selangor, Malaysia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Gul Mohammad Baloch
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Jalan Taylors, Subang Jaya, Selangor, Malaysia
| | - Syed Far Abid Hossain
- College of Business Administration, IUBAT-International University of Business Agriculture and Technology, Dhaka, Bangladesh
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49
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Far Abid Hossain S, Nurunnabi M, Sundarasen S, Chinna K, Kamaludin K, Baloch GM, Khoshaim HB, Sukayt A. Socio-psychological impact on Bangladeshi students during COVID-19. J Public Health Res 2020; 9:1911. [PMID: 33575227 PMCID: PMC7868771 DOI: 10.4081/jphr.2020.1911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/02/2020] [Indexed: 11/22/2022] Open
Abstract
Background: The socio-psychological impact of COVID-19 has affected the whole world. Bangladesh, one of the most dangerous places as stated by WHO, was first infected at the beginning of March 2020, later than other countries. Bangladesh is now one of the 20 most affected countries in the world, but the psychological effects for university students during the epidemic period are not researched. Design and methods: To address this gap, the present study attempts to discover the socio-psychological impact of COVID-19 on university students in Bangladesh. We conducted an online survey using a questionnaire with a simple random sampling technique and we received 474 responses. Results: In this study, numerous psychological concerns were reported. The study is limited to university students, which may affect the generalizability of the research. Conclusions: Our findings suggest a need to build awareness of the mental health implications of the pandemic for university students. Significance for public health Due to COVID-19, the world is facing innumerable difficulties. However, the most crucial difficulty is the socio-psychological pressure on university students. Considering the risk of infection, the university authority and policy-makers adopted secure lockdown and control measures. Although the classes conducted online in many educational institutions, the lack of necessary technological and financial support is a key concern for developing countries such as Bangladesh. This phenomenon is a reason of public health concern in terms of anxiety and coping. Socio-psychological impact is severe but complicated to measure and control. As a result, this could be a threat for ensuring sustainable public health in the society. This research is an attempt to shed lights on ensuring harmony and secure mental health and well-being among the university students during COVID-19.
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Affiliation(s)
- Syed Far Abid Hossain
- College of Business Administration, International University of Business Agriculture and Technology (IUBAT), Uttara Model Town, Dhaka, Bangladesh
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Gul Muhammad Baloch
- Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, Riyadh, Saudi Arabia
| | - Areej Sukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
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50
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Abdullah A, Ng CJ, Liew SM, Ambigapathy S, V P, Chinna K. Prevalence of limited health literacy and its associated factors in patients with type 2 diabetes mellitus in Perak, Malaysia: a cross-sectional study. BMJ Open 2020; 10:e039864. [PMID: 33191262 PMCID: PMC7668359 DOI: 10.1136/bmjopen-2020-039864] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/02/2020] [Accepted: 10/13/2020] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Limited health literacy in patients with type 2 diabetes mellitus (T2DM) led to poorer diabetes knowledge, less medication adherence and increased healthcare cost. The purpose of this paper was to report the prevalence of limited health literacy in patients with T2DM and to identify factors that are associated with it. DESIGN A cross-sectional study was conducted from January to March 2018; data on patients' sociodemographic characteristics, diabetes knowledge, perceived social support and health literacy level were collected. Health literacy level was measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47). SETTING Patients were recruited from four primary care clinics in Perak, Malaysia. PARTICIPANTS Adult patients diagnosed with T2DM who attended the study clinics during the study period. PRIMARY OUTCOME VARIABLE Patients with HLS-EU-Q47 General Index of ≤33 points were classified as having limited health literacy. RESULTS The prevalence of limited health literacy was 65.3% (n=279). In bivariate analysis, patients' ethnicity (p=0.04), highest education level (p<0.001), monthly income (p=0.003), having health insurance (p=0.007), English language fluency (p<0.001), Malay language fluency (p=0.021), attending diabetes education sessions (p<0.001), perceived social support (p<0.001) and diabetes knowledge (p=0.019) were factors associated with limited health literacy. In logistic regression, not being fluent in English was associated with limited health literacy (OR=2.36, 95% CI 1.30 to 4.30) whereas having high perceived social support (OR=0.52, 95% CI 0.40 to 0.69) and having attended diabetes education sessions (OR=0.42, 95% CI 0.27 to 0.68) were associated with adequate health literacy. CONCLUSION The prevalence of limited health literacy is high among patients with T2DM in Perak, Malaysia. Strategies to improve health literacy in these patients must consider the influences of English fluency, attendance at diabetes education sessions and social support, and may need to adopt a universal approach to addressing limited health literacy.
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Affiliation(s)
- Adina Abdullah
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | - Paranthaman V
- Health Clinic Greentown, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Kuala Lumpur, Malaysia
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