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Akhtar S, Nasir JA, Ali A, Asghar M, Majeed R, Sarwar A. Prevalence of type-2 diabetes and prediabetes in Malaysia: A systematic review and meta-analysis. PLoS One 2022; 17:e0263139. [PMID: 35085366 PMCID: PMC8794132 DOI: 10.1371/journal.pone.0263139] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/12/2022] [Indexed: 01/15/2023] Open
Abstract
Objective The main purpose of this study was to investigate the pooled prevalence of prediabetes and type-2 diabetes in the general population of Malaysia. Method We systematically searched Medline (PubMed), Embase, Web of Science, Google Scholar and Malaysian Journals Online to identify relevant studies published between January 1, 1995, and November 30, 2021, on the prevalence of type-2 diabetes in Malaysia. Random-effects meta-analyses were used to obtain the pooled prevalence of diabetes and prediabetes. Subgroup analyses also used to analyze to the potential sources of heterogeneity. Meta- regression was carried to assess associations between study characteristics and diabetes prevalence. Three independent authors selected studies and conducted the quality assessment. The quality of the final evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Of 2689 potentially relevant studies, 786 titles and abstract were screened. Fifteen studies with 103063 individuals were eligible to be included in the meta-analyses. The pooled prevalence of diabetes was 14.39% (95% CI, 12.51%–16.38%; I2 = 98.4%, 103063 participants from 15 studies). The pooled prevalence of prediabetes was 11.62% (95% CI, 7.17%–16.97%; I2 = 99.8, 88702 participants from 9 studies). The subgroup analysis showed statistically significant differences in diabetes prevalence by the ethical sub-populations with highest in Indians (25.10%; 95% CI, 20.19%–30.35%), followed by Malays (15.25%; 95% CI, 11.59%–19.29%), Chinese (12.87%; 95% CI, 9.73%–16.37%), Bumiputeras (8.62%; 95% CI, 5.41%–12.47%) and others (6.91%; 95% CI, 5.71%–8.19%). There was no evidence of publication bias, although heterogeneity was high (I2 ranged from 0.00% to 99·8%). The quality of evidence based on GRADE was low. Conclusions Results of this study suggest that a high prevalence of prediabetes and diabetes in Malaysia. The diabetes prevalence is associated with time period and increasing age. The Malaysian government should develop a comprehensive approach and strategy to enhance diabetes awareness, control, prevention, and treatment. Trial registration Trial registration no. PROSPERO CRD42021255894; https://clinicaltrials.gov/.
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Affiliation(s)
- Sohail Akhtar
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
- * E-mail: ,
| | | | - Aqsa Ali
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Mubeen Asghar
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Rizwana Majeed
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Aqsa Sarwar
- Department of Statistics, GC University Lahore, Lahore, Pakistan
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Azit NA, Sahran S, Voon Meng L, Subramaniam M, Mokhtar S, Mohammed Nawi A. Risk factors of hepatocellular carcinoma in type 2 diabetes patients: A two-centre study in a developing country. PLoS One 2021; 16:e0260675. [PMID: 34882716 PMCID: PMC8659343 DOI: 10.1371/journal.pone.0260675] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is increasingly known as a risk factor of hepatocellular carcinoma (HCC). In this study, we determined the risk factors associated with HCC in T2DM patients. This was a matched case-control study conducted at two hepatobiliary referral centres in a developing country. Patients' sociodemographic, clinical, and biochemical characteristics between 1 January 2012 and 30 June 2018 were extracted from the electronic medical records and analysed using multivariate logistic regression analysis. A total of 212 case-control pairs were included. Significant risk factors included Chinese and Malay ethnicities that interacted with viral hepatitis (adjusted odds ratio [AOR] = 11.77, 95% confidence interval [CI]: 1.39-99.79) and (AOR = 37.94, 95% CI: 3.92-367.61) respectively, weight loss (AOR = 5.28, 95% CI: 2.29-12.19), abdominal pain/ discomfort (AOR = 6.73, 95% CI: 3.34-13.34), alcohol (AOR = 4.08, 95% CI: 1.81-9.22), fatty liver (AOR = 3.29, 95% CI: 1.40-7.76), low platelet (AOR = 4.03, 95% CI:1.90-8.55), raised alanine transaminase (AOR = 2.11, 95% CI: 1.16-3.86). and alkaline phosphatase (ALP) levels (AOR = 2.17, 95% CI: 1.17-4.00). Statins reduced the risk of HCC by 63% (AOR = 0.37, 95% CI: 0.21-0.65). The identification of these factors aids the risk stratification for HCC among T2DM patients for early detection and decision-making in patient management in the primary care setting.
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Affiliation(s)
- Noor Atika Azit
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Shahnorbanun Sahran
- Faculty of Information Science and Technology, National University of Malaysia, Bangi, Selangor, Malaysia
| | - Leow Voon Meng
- Advanced Medical and Dental Institute (AMDI), USM, Kepala Batas, Penang, Malaysia
- Hepato-Pancreato-Biliary Unit, Department of Surgery, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
| | - Manisekar Subramaniam
- Hepato-Pancreato-Biliary Unit, Department of Surgery, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
| | - Suryati Mokhtar
- Hepato-Pancreato-Biliary Unit, Department of Surgery, Hospital Selayang, Ministry of Health Malaysia, Batu Caves, Selangor, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Parthiban N, Boland F, Fadil Azim DH, Pawlikowska T, O’Shea MT, Jaafar MH, Morgan K. Asian medical students' attitudes towards professionalism. Med Educ Online 2021; 26:1927466. [PMID: 33999787 PMCID: PMC8143598 DOI: 10.1080/10872981.2021.1927466] [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] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
Background: Professionalism is the basis of trust in patient-physician relationships; however, there is very limited evidence focusing on attitudes towards professionalism among medical students. Hence, the main aim of our study was to investigate Malaysian medical students' attitudes towards professionalism with specific emphasis on the comparison between pre-clinical and clinical students. Our secondary aim was to compare the differences in perception of medical students in Malaysia (pre-clinical and clinical) with Asian medical students studying in Dublin, IrelandMethods: This study utilized the Professionalism Mini-Evaluation Exercise (P-MEX) instrument which consists of 25 items that represent four skill categories: Doctor-Patient Relationship skills, Reflective skills, Time Management and Inter-Professional Relationship skills. Descriptive statistics were used to describe the demographic information of students and given the ordinal nature of the data, Mann-Whitney U-tests were used.Results: Overall, students have positive attitudes to all the professionalism items with more than 80% of the students agreeing that each of the professionalism attributes is important or very important. There was evidence of a significant difference between Malaysian pre-clinical and clinical students in relation to 'avoiding derogatory language' only (p = 0.015). When comparing between Malaysian and Dublin Asian students, there was a statistically significant difference in relation to 'show interest in patient as a person' (p < 0.003) for clinical students.Conclusion: Our results point to several curriculum implications such as 1) assessing students' attitudes towards professional attributes is essential when developing the professionalism curriculum, 2) integrating more effective clinical modules early in the curriculum and 3) considering geographical and cultural factors when assessing perception towards professional attributes.
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Affiliation(s)
| | - Fiona Boland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | - Mohamad Hasif Jaafar
- Perdana University - Royal College of Surgeons in Ireland, Perdana University, Malaysia
| | - Karen Morgan
- Perdana University - Royal College of Surgeons in Ireland, Perdana University, Malaysia
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Joachimdass RJ, Subramaniam K, Sit NW, Lim YM, Teo CH, Ng CJ, Yusof AS, Loganathan A. Self-management using crude herbs and the health-related quality of life among adult patients with hypertension living in a suburban setting of Malaysia. PLoS One 2021; 16:e0257336. [PMID: 34506588 PMCID: PMC8432735 DOI: 10.1371/journal.pone.0257336] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/28/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine the prevalence of crude herbs' use in the self-management of hypertension and the health-related quality of life (HRQOL) in patients with hypertension. METHODS This cross-sectional study was performed among patients with hypertension attending a government health clinic. Socio-demographic characteristics, lifestyle modifications, medical history and predictors of crude herbs users were obtained. The diversity of crude herbs used was assessed using a modified international complementary and alternative medicine questionnaire (I-CAM-Q) and the HRQOL was assessed using the SF36 instrument. RESULTS Out of the 294 patients recruited, 52.4% were female, 41.5% were Malay and 38.8% were within the 60 to69 age category. The prevalence of crude herbs users was 30.6% and the most common herbs used were pegaga (Centella asiatica), peria (Momordica charantia) and betik (Carica papaya). Using the regression analysis, significantly higher odds of using crude herbs are noted among Malay or Indian patients who have these characteristics: attained secondary education, experienced falls or muscle pain, and had systolic blood pressure of more than 140 mmHg. There was no significant difference in HRQOL domains between the crude herb users and non-users (p>0.05). CONCLUSION Besides taking allopathic medications, certain patients with hypertension use crude herbs as a form of self-management. Although patients are adamant about integrating crude herbs as a form of self-management, the effects of doing so have not been properly investigated. This implies that the healthcare staff members need to communicate with the patients regarding the use of crude herbs together with conventional drugs.
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Affiliation(s)
| | | | - Nam Weng Sit
- Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Yang Mooi Lim
- Department of Pre-Clincal Science, Universiti Tunku Abdul Rahman, Sungai Long, Malaysia
- Centre for Cancer Research, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Chin Hai Teo
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Chu AHY, Bernard JY, Koh D, Müller-Riemenschneider F. Accelerometer Profile of Physical Activity and Sedentary Behavior in a Multi-Ethnic Urban Asian Population. Res Q Exerc Sport 2021; 92:361-368. [PMID: 32154777 DOI: 10.1080/02701367.2020.1734520] [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] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/13/2020] [Indexed: 06/10/2023]
Abstract
Purpose: Variability in accelerometry-data processing decisions limited data comparability across studies. We aimed to examine different accelerometry-data processing rules: varying bout lengths and allowance of 0- and 2-min interruptions on the total and bout-accumulated time spent in moderate-to-vigorous physical activity (MVPA) and sedentary behavior estimates, and describe the distribution of activity time based on counts per min (CPM) in granular categories. Method: Using the Singapore Health 2 survey, this study included 746 adults (41.8% women, median age 45.0 years) who provided valid ActiGraph GT3X+ accelerometer-data (≥4 valid days with ≥10-h/day). Quantile regression analysis adjusting for accelerometry daily wear time, age, and gender was performed to calculate the median and interquartile range of accelerometry estimates. Results: Median MVPA time accumulated in bouts of 1-min versus bouts of 10-min was 39.2 min/day and 6.0 min/day, respectively. MVPA time was higher when considering a 2-min interruption (range: 1.8-39.2 min/day) compared to 0-min interruption (range: 0-35.5 min/day) across bout lengths of 1- to 15-min. Participants were sedentary (≤100 CPM) for a daily median of 7.6 h/day. Median activities min/day on the lower-intensity activity spectrum (100-2499 CPM) decreased from 63.4 to 4.6 min/day, while on the higher-intensity activity spectrum (≥2500 CPM) was ≤2.9 min/day. Men generally spent more time in MVPA than women. Conclusions: This study highlights the differences in accelerometry estimates based on data processing decisions, and the importance of quantifying accelerometry-based activity time across the granular intensity spectrum. More studies are warranted to understand the determinants and health impact of these behaviors.
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Affiliation(s)
- Anne H Y Chu
- National University of Singapore
- Agency for Science, Technology and Research (A*STAR)
| | - Jonathan Y Bernard
- Agency for Science, Technology and Research (A*STAR)
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS)
| | - David Koh
- National University of Singapore
- Universiti Brunei Darussalam
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Kassogue Y, Diakite B, Kassogue O, Konate I, Tamboura K, Diarra Z, Maiga M, Dehbi H, Nadifi S, Traore CB, Kamate B, Dao S, Doumbia S, Dolo G. Distribution of alleles, genotypes and haplotypes of the CYP2B6 (rs3745274; rs2279343) and CYP3A4 (rs2740574) genes in the Malian population: Implication for pharmacogenetics. Medicine (Baltimore) 2021; 100:e26614. [PMID: 34398016 PMCID: PMC8294905 DOI: 10.1097/md.0000000000026614] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/22/2021] [Indexed: 01/04/2023] Open
Abstract
Cytochrome P450 enzymes play a central role in the phase I biotransformation process of a wide range of compounds, including xenobiotics, drugs, hormones and vitamins. It is noteworthy that these enzymes are highly polymorphic and, depending on the genetic makeup, an individual may have impaired enzymatic activity. Therefore, the identification of genetic variants in these genes could facilitate the implementation of pharmacogenetic studies and genetic predisposition to multifactorial diseases. We have established the frequencies of CYP2B6 (rs3745274; rs2279343) and CYP3A4 (rs2740574) alleles and genotypes in 209 healthy Malian subjects using TaqMan drug metabolism genotyping assays for allelic discrimination. Allele frequencies were 37% for CYP2B6 rs3745274; 38% for CYP2B6 rs2279343; and 75% for CYP3A4 rs2740574 respectively. Overall, the frequencies observed in Mali are statistically comparable to those reported across Africa except North Africa. The major haplotypes in CYP2B6 rs3745274 and CYP2B6 rs2279343 were represented by GA (60.24%) followed by TG (35.36%). We noted a strong linkage disequilibrium between CYP2B6 rs3745274 and CYP2B6 rs2279343 with D' = 0.91 and r2 = 0.9. The frequencies of the genotypic combinations were 43.5% (GT/AG), 37.3% (GG/AA) and 11.5% (TT/GG) in the combination of CYP2B6-rs3745274 and CYP2B6-rs2279343; 26.8% (GT/CC), 25.4%, (GT/CT), 17.2% and GG/CT in the combination CYP2B6-rs3745274-CYP3A4-rs2740574; 26.8% (AG/CC), 23.9% (AA/CC), 19.1% (AG/CT), and 11% (AA/CT) in the combination CYP2B6-rs2279343-CYP3A4-rs2740574, respectively. The most common triple genotype was GT/AG/CC with 24.9%, followed by GG/AA/CC with 23.9%, GT/AG/CT with 16.7%, and GG/AA/CT with 10%. Our results provide new insights into the distribution of these pharmacogenetically relevant genes in the Malian population. Moreover, these data will be useful for studies of individual genetic variability to drugs and genetic predisposition to diseases.
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Affiliation(s)
- Yaya Kassogue
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Brehima Diakite
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Oumar Kassogue
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Issa Konate
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Kadidiatou Tamboura
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Zoumana Diarra
- Center of Listening, Care, Animation and Counseling, Bamako, Mali
| | - Mamoudou Maiga
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Hind Dehbi
- Cellular and Molecular Pathology Laboratory, Faculty of Medicine and Pharmacy of Casablanca, University Hassan II, Morocco
| | - Sellama Nadifi
- Cellular and Molecular Pathology Laboratory, Faculty of Medicine and Pharmacy of Casablanca, University Hassan II, Morocco
| | - Cheick Bougadari Traore
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Bakarou Kamate
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sounkalo Dao
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Seydou Doumbia
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Guimogo Dolo
- Faculty of Medicine and Odonstomatology, University of Sciences, Techniques and Technologies of Bamako, Mali
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Tao S, Kichula KM, Harrison GF, Farias TDJ, Palmer WH, Leaton LA, Hajar CGN, Zefarina Z, Edinur HA, Zhu F, Norman PJ. The combinatorial diversity of KIR and HLA class I allotypes in Peninsular Malaysia. Immunology 2021; 162:389-404. [PMID: 33283280 PMCID: PMC7968402 DOI: 10.1111/imm.13289] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 12/16/2022] Open
Abstract
Killer cell immunoglobulin-like receptors (KIRs) interact with polymorphic human leucocyte antigen (HLA) class I molecules, modulating natural killer (NK) cell functions and affecting both the susceptibility and outcome of immune-mediated diseases. The KIR locus is highly diverse in gene content, copy number and allelic polymorphism within individuals and across geographical populations. To analyse currently under-represented Asian and Pacific populations, we investigated the combinatorial diversity of KIR and HLA class I in 92 unrelated Malay and 75 Malaysian Chinese individuals from the Malay Peninsula. We identified substantial allelic and structural diversity of the KIR locus in both populations and characterized novel variations at each analysis level. The Malay population is more diverse than Malay Chinese, likely representing a unique history including admixture with immigrating populations spanning several thousand years. Characterizing the Malay population are KIR haplotypes with large structural variants present in 10% individuals, and KIR and HLA alleles previously identified in Austronesian populations. Despite the differences in ancestries, the proportion of HLA allotypes that serve as KIR ligands is similar in each population. The exception is a significantly reduced frequency of interactions of KIR2DL1 with C2+ HLA-C in the Malaysian Chinese group, caused by the low frequency of C2+ HLA. One likely implication is a greater protection from preeclampsia, a pregnancy disorder associated with KIR2DL1, which shows higher incidence in the Malay than in the Malaysian Chinese. This first complete, high-resolution, characterization of combinatorial diversity of KIR and HLA in Malaysians will form a valuable reference for future clinical and population studies.
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Affiliation(s)
- Sudan Tao
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Blood Center of Zhejiang ProvinceKey Laboratory of Blood Safety Research of Zhejiang ProvinceHangzhouZhejiangChina
| | - Katherine M. Kichula
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Genelle F. Harrison
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Ticiana Della Justina Farias
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - William H. Palmer
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Laura Ann Leaton
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | | | - Zulkafli Zefarina
- School of Medical SciencesUniversiti Sains Malaysia, Health CampusKelantanMalaysia
| | - Hisham Atan Edinur
- School of Health SciencesUniversiti Sains Malaysia, Health CampusKelantanMalaysia
| | - Faming Zhu
- Blood Center of Zhejiang ProvinceKey Laboratory of Blood Safety Research of Zhejiang ProvinceHangzhouZhejiangChina
| | - Paul J. Norman
- Division of Biomedical Informatics and Personalized MedicineDepartment of Immunology and MicrobiologyUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
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Hairol MI, Nordin N, P’ng J, Sharanjeet-Kaur S, Narayanasamy S, Mohd-Ali M, Ahmad M, Kadar M. Association between reduced visual-motor integration performance and socioeconomic factors among preschool children in Malaysia: A cross-sectional study. PLoS One 2021; 16:e0246846. [PMID: 33657109 PMCID: PMC7928473 DOI: 10.1371/journal.pone.0246846] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/26/2021] [Indexed: 12/03/2022] Open
Abstract
Visual-motor integration (VMI) is related to children’s academic performance and school readiness. VMI scores measured using the Beery-Bucktenicka Developmental Test of Visual-Motor Integration (Beery-VMI) can differ due to differences in cultural and socioeconomic backgrounds. This study compared the VMI scores of Malaysian preschoolers with the corresponding US norms and determined the association between their VMI scores and socioeconomic factors. A cross-sectional study was conducted among 435 preschoolers (mean age: 5.95±0.47 years; age range: 5.08–6.83 years) from randomly selected public and private preschools. VMI scores were measured using Beery-VMI in the preschools’ classrooms. Information on the socioeconomic characteristics of the preschoolers was obtained using a parent-report questionnaire. One sample t-test was used to compare their VMI scores with the corresponding US norms. Multivariate logistic regression models were used to explore the influence of socioeconomic factors on the preschoolers’ VMI scores. Overall, Malaysian preschoolers’ VMI performance was similar to the US standardized norms (p>0.05). Children from low-income families were twice likely to obtain lower than average VMI scores than those from higher-income families (OR = 2.47, 95%CI 1.05, 5.86). Children enrolled at public preschools were more likely to obtain a lower than average VMI score than those who enrolled at private preschools (OR = 2.60, 95%CI 1.12, 6.06). Children who started preschool at the age of six were more likely to obtain lower than average VMI scores than those who started at an earlier age (OR = 4.66, 95%CI 1.97, 11.04). Low maternal education level was also associated with lower than average VMI score (OR = 2.60, 95%CI 1.12, 6.06). Malaysian preschoolers’ Beery-VMI performance compared well to their US counterparts. Some socioeconomic factors were associated with reduced VMI scores. Those from disadvantaged socioeconomic backgrounds are more likely to have reduced VMI performance, potentially adversely affecting their school readiness, cognitive performance, and future academic achievements.
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Affiliation(s)
- Mohd Izzuddin Hairol
- Faculty of Health Sciences, Centre for Community Health Studies (ReaCH), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | - Naufal Nordin
- Faculty of Health Sciences, Centre for Community Health Studies (ReaCH), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jacqueline P’ng
- Faculty of Health Sciences, Centre for Community Health Studies (ReaCH), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sharanjeet Sharanjeet-Kaur
- Faculty of Health Sciences, Centre for Rehabilitation & Special Needs Studies (iCaReRehab), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sumithira Narayanasamy
- Faculty of Health Sciences, Centre for Community Health Studies (ReaCH), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Manisah Mohd-Ali
- Faculty of Education, Centre of Community Education & Wellbeing, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Mahadir Ahmad
- Faculty of Health Sciences, Centre for Community Health Studies (ReaCH), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Masne Kadar
- Faculty of Health Sciences, Centre for Rehabilitation & Special Needs Studies (iCaReRehab), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Abdullah N, Ismail N, Abd Jalal N, Mohd Radin F, Othman R, Kamalul Arifin AS, Kamaruddin MA, Jamal R. Prevalence of anaemia and associated risk factors amongst The Malaysian Cohort participants. Ann Hematol 2020; 99:2521-2527. [PMID: 32975589 DOI: 10.1007/s00277-020-04279-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022]
Abstract
This study was aimed at determining the prevalence of anaemia amongst the Malaysian Cohort participants and the associated risk factors. This was a cross-sectional study that involved 102,388 participants from The Malaysian Cohort (TMC) aged between 35 and 70 years old recruited from April 2006 to September 2012. Venous blood was taken for the full blood count. The prevalence of anaemia was 13.8% with majority having the microcytic-hypochromic type (59.7%). Comparison between the ethnic groups showed that Indians have the highest prevalence of anaemia (19.9%), followed by Malays (13.1%), and Chinese (12.0%). The prevalence of anaemia was substantially higher in females (20.1%) compared to males (4.9%). Amongst the female participants, the prevalence of anaemia was highest amongst those who were younger than 49 years old and decreased as the age increased. In contrast, the prevalence of anaemia in males increased with age. Gender, ethnicity, age, marital status, presence of platelet disorders and kidney disease were significant risk factors associated with anaemia and contributed to 14.9% of the risk of developing anaemia in this population. The prevalence of anaemia amongst the Malaysian Cohort participants is 13.8% with the majority having the microcytic and hypochromic type implying iron deficiency as the main cause. It is important that those who have anaemia be further investigated and treated.
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Affiliation(s)
- Noraidatulakma Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Farazela Mohd Radin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Raihannah Othman
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Azwa Shazwani Kamalul Arifin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Mohd Arman Kamaruddin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia.
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10
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Iqbal SP, Ramadas A, Fatt QK, Shin HL, Onn WY, Kadir KA. Relationship of sociodemographic and lifestyle factors and diet habits with metabolic syndrome (MetS) among three ethnic groups of the Malaysian population. PLoS One 2020; 15:e0224054. [PMID: 32191727 PMCID: PMC7082049 DOI: 10.1371/journal.pone.0224054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/21/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives Literature shows a high prevalence of MetS among Malaysians, varying across the major ethnicities. Since sociodemographic characteristics, lifestyle factors and diet habits of such communities have been reported to be diverse, the objective of this study was to investigate the association of various sociodemographic characteristics, lifestyle factors and diet habits with MetS overall, as well as with the three major ethnic communities in Malaysia, specifically. Materials and methods We conducted a cross-sectional study among 481 Malaysians of ages 18 years and above living in the state of Johor, Malaysia. Information on demographics, lifestyle and diet habits were collected using a structured questionnaire. Harmonized criteria were used to assess the status of MetS. Multiple logistic regression was employed to determine any associations between sociodemographic and lifestyle factors and dietary behaviours with MetS. Results MetS was found among 32.2% of the respondents and was more prevalent among the Indians (51.9%), followed by the Malays (36.7%) and the Chinese (20.2%). Overall, increasing age (AOR = 2.44[95%CI = 1.27–4.70] at 40–49 years vs. AOR = 4.14[95%CI = 1.97–8.69] at 60 years and above) and Indian ethnicity (AOR = 1.95[95%CI = 1.12–3.38)] increased the odds of MetS, while higher education (AOR = 0.44[95%CI = 0.20–0.94] decreased the odds of MetS in this population. Quick finishing of meals (AOR = 2.17[95%CI = 1.02–4.60]) and low physical activity (AOR = 4.76[95%CI = 1.49–15.26]) were associated with increased odds of MetS among the Malays and the Chinese, respectively. Conclusion The population of Johor depicts a diverse lifestyle and diet behaviour, and some of these factors are associated with MetS in certain ethnic groups. In the light of such differences, ethnic specific measures would be needed to reduce the prevalence of MetS among those in this population.
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Affiliation(s)
- Saleem Perwaiz Iqbal
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
- * E-mail:
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Quek Kia Fatt
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Ho Loon Shin
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Wong Yin Onn
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Khalid Abdul Kadir
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
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11
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Hakim HM, Khan HO, Ismail SA, Lalung J, Kofi AE, Nelson BR, Abdullah MT, Chambers GK, Edinur HA. Population data for 23 Y chromosome STR loci using the Powerplex® Y23 STR kit for the Kedayan population in Malaysia. Int J Legal Med 2020; 134:1335-1337. [PMID: 31897667 DOI: 10.1007/s00414-019-02237-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/16/2019] [Accepted: 12/11/2019] [Indexed: 11/25/2022]
Abstract
Genetic polymorphisms at 23 Y chromosome short tandem repeat (STRs) loci included in the Powerplex® Y23 PCR kit were successfully scored in 128 unrelated Kedayan individuals living in Sabah, East Malaysia. Complete haplotypes were recorded for all individuals and included 92 different types with 72 being unique to single male subjects. Three important forensic statistics were calculated from these data; haplotype diversity = 0.993, discriminating capacity = 0.719, and match probability = 0.015. The Kedayan appear to be most closely related to Malays and Filipinos in a multidimensional scaling plot and are separated from other mainland Asia populations including Thais and Hakka Han. These new data for Kedayan have been deposited in the YHRD database (accession number: YA004621). Our statistical analyses showed the reliability of Y-STR loci for geographically extended use in forensic casework and for studying human population history.
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Affiliation(s)
- Hashom Mohd Hakim
- DNA Databank Division (D13), Criminal Investigation Department, Royal Malaysia Police, 43200, Cheras, Selangor, Malaysia.
- School of Industrial Technology, Universiti Sains Malaysia, Jalan Sungai 2, 11800, Gelugor, Pulau Pinang, Malaysia.
| | - Hussein Omar Khan
- DNA Databank Division (D13), Criminal Investigation Department, Royal Malaysia Police, 43200, Cheras, Selangor, Malaysia
| | - Siti Afifah Ismail
- DNA Databank Division (D13), Criminal Investigation Department, Royal Malaysia Police, 43200, Cheras, Selangor, Malaysia
| | - Japareng Lalung
- School of Industrial Technology, Universiti Sains Malaysia, Jalan Sungai 2, 11800, Gelugor, Pulau Pinang, Malaysia
| | - Abban Edward Kofi
- Forensic Science Programme, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Bryan Raveen Nelson
- Institute of Tropical Biodiversity and Sustainable Development, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Mohd Tajuddin Abdullah
- Institute of Tropical Biodiversity and Sustainable Development, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Geoffrey Keith Chambers
- School of Biological Sciences, Victoria University of Wellington, P.O. Box 600, Wellington, New Zealand
| | - Hisham Atan Edinur
- Forensic Science Programme, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
- Institute of Tropical Biodiversity and Sustainable Development, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia.
- Environmental Futures Research Institute, Griffith University, Nathan, Queensland, 4111, Australia.
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12
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Moorthy V, Liu W, Chan SP, Chew STH, Ti LK. Elucidation of the novel role of ethnicity and diabetes in poorer outcomes after cardiac surgery in a multiethnic Southeast Asian cohort. J Diabetes 2020; 12:58-65. [PMID: 31210000 DOI: 10.1111/1753-0407.12961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/01/2019] [Revised: 05/20/2019] [Accepted: 06/11/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although diabetes is associated with ethnicity and worse cardiac surgery outcomes, no research has been done to study the effect of both diabetes and ethnicity on cardiac surgery outcomes in a multiethnic Southeast Asian cohort. Hence, this study aimed to delineate the association of ethnicity on outcomes after cardiac surgery among diabetics in a multiethnic Southeast Asian population. METHODS Perioperative data from 3008 adult patients undergoing elective cardiac surgery from 2008 to 2011 at the two main heart centers in Singapore was analyzed prospectively, and confirmatory analysis was conducted with the generalized structural equation model. RESULTS Diabetes was significantly associated with postoperative acute kidney injury (AKI) and postoperative hyperglycemia. Postoperative AKI, Malay ethnicity, and blood transfusion were associated with postoperative dialysis. Postoperative AKI and blood transfusion were also associated with postoperative arrhythmias. In turn, postoperative dialysis and arrhythmias increased the odds of 30-day mortality by 7.7- and 18-fold, respectively. CONCLUSIONS This study identified that diabetes is directly associated with postoperative hyperglycemia and AKI, and indirectly associated with arrhythmias and 30-day mortality. Further, we showed that ethnicity not only affects the prevalence of diabetes, but also postoperative diabetes-related outcomes.
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Affiliation(s)
- Vikaesh Moorthy
- National University of Singapore, Yong Loo Lin School of Medicine, Singapore
| | - Weiling Liu
- Department of Anaesthesia, National University Health System, Singapore
| | - Siew-Pang Chan
- Cardiovascular Research Institute, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Mathematics and Statistics, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | | | - Lian Kah Ti
- Department of Anaesthesia, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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13
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Yong EL, Ganesan G, Kramer MS, Logan S, Lau TC, Cauley JA, Tan KB. Hip fractures in Singapore: ethnic differences and temporal trends in the new millennium. Osteoporos Int 2019; 30:879-886. [PMID: 30671610 DOI: 10.1007/s00198-019-04839-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 07/11/2018] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Abstract
UNLABELLED Despite an increase in absolute numbers, the age-standardized incidence of hip fractures in Singapore declined in the period 2000 to 2017. Among the three major ethnic groups, Chinese women had the highest fracture rates but were the only group to show a temporal decline. INTRODUCTION A study published in 2001 predicted a 30-50% increase in Singapore hip fracture incidence rates over the ensuing 30 years. To test that prediction, we examined the incidence of hip fracture in Singapore from 2000 to 2017. METHODS We carried out a population-based study of hip fractures among Singapore residents aged ≥ 50 years. National medical insurance claims data were used to identify admissions with a primary discharge diagnosis of hip fracture. Age-adjusted rates, based on the age distribution of the Singapore population of 2000, were analyzed separately by sex and ethnicity (Chinese, Malay, or Indian). RESULTS Over the 18-year study period, 36,082 first hip fractures were recorded. Total hip fracture admissions increased from 1487 to 2729 fractures/year in the years 2000 to 2017. Despite this absolute increase, age-adjusted fracture rates declined, with an average annual change of - 4.3 (95% CI - 5.0, - 3.5) and - 1.1 (95% CI - 1.7, - 0.5) fractures/100,000/year for women and men respectively. Chinese women had 1.4- and 1.9-fold higher age-adjusted rates than Malay and Indian women: 264 (95% CI 260, 267) versus 185 (95% CI 176, 193) and 141 (95% CI 132, 150) fractures/100,000/year, respectively. Despite their higher fracture rates, Chinese women were the only ethnic group exhibiting a decline, most evident in those ≥ 85 years, in age-adjusted fracture rate of - 5.3 (95% CI - 6.0, - 4.5) fractures/100,000/year. CONCLUSION Although the absolute number of fractures increased, steep drops in elderly Chinese women drove a reduction in overall age-adjusted hip fracture rates. Increases in the older population will lead to a rise in total number of hip fractures, requiring budgetary planning and new preventive strategies.
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Affiliation(s)
- E L Yong
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore, Singapore.
| | - G Ganesan
- Division of Policy, Research and Evaluation, Ministry of Health, Singapore, Singapore
| | - M S Kramer
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore, Singapore
- Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, H3G 1Y6, Canada
| | - S Logan
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore, Singapore
| | - T C Lau
- Department of Medicine, National University Hospital, National University of Singapore, Singapore, 119228, Singapore
| | - J A Cauley
- Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - K B Tan
- Division of Policy, Research and Evaluation, Ministry of Health, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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Eskin M, AlBuhairan F, Rezaeian M, Abdel-Khalek AM, Harlak H, El-Nayal M, Asad N, Khan A, Mechri A, Noor IM, Hamdan M, Isayeva U, Khader Y, Al Sayyari A, Khader A, Behzadi B, Öztürk CŞ, Hendarmin LA, Khan MM, Khatib S. Suicidal Thoughts, Attempts and Motives Among University Students in 12 Muslim-Majority Countries. Psychiatr Q 2019; 90:229-248. [PMID: 30498939 DOI: 10.1007/s11126-018-9613-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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] [Indexed: 01/27/2023]
Abstract
There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.
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Affiliation(s)
- Mehmet Eskin
- Department of Psychology, College of Social Sciences and Humanities, Koc University, Rumelifeneriyolu 34450 Sariyer, Istanbul, Turkey.
| | - Fadia AlBuhairan
- Al Dara Hospital and Medical Center, Riyadh, Saudi Arabia
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohsen Rezaeian
- Epidemiology and Biostatistics, Rafsanjan Medical School, Rafsanjan, Iran
| | - Ahmed M Abdel-Khalek
- Department of Psychology, Faculty of Arts, Alexandria University, Alexandria, Egypt
| | - Hacer Harlak
- Department of Psychology, Faculty of Arts and Sciences, Adnan Menderes University, Aydin, Turkey
| | - Mayssah El-Nayal
- Department of Psychology, Faculty of Human Sciences, Beirut Arab University, Beirut, Lebanon
| | - Nargis Asad
- Department of Psychiatry, Medical College, Aga Khan University, Karachi, Pakistan
| | - Aqeel Khan
- Faculty of Education, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Anwar Mechri
- Department of Psychiatry, University hospital of Monastir, Monastir, Tunisia
| | | | - Motasem Hamdan
- School of Public Health, Al-Quds University, Jerusalem, Palestine
| | - Ulker Isayeva
- Department of Psychology, Khazar University, Baku, Azerbaijan
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Alaa Al Sayyari
- Population Health Research Section-Hospital-MNGHA, King Abdullah International Medical Research Center / King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Albaraa Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Bahareh Behzadi
- Epidemiology and Biostatistics, Rafsanjan Medical School, Rafsanjan, Iran
| | - Cennet Şafak Öztürk
- Department of Psychology, Faculty of Arts and Sciences, Adnan Menderes University, Aydin, Turkey
| | | | - Murad Moosa Khan
- Department of Psychiatry, Medical College, Aga Khan University, Karachi, Pakistan
| | - Salam Khatib
- Faculty of Health Professions, Department of Nursing, Al-Quds University, Jerusalem, Palestine
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15
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Swami V, Mohd Khatib NA, Toh E, Zahari HS, Todd J, Barron D. Factor structure and psychometric properties of a Bahasa Malaysia (Malay) translation of the Body Appreciation Scale-2 (BAS-2). Body Image 2019; 28:66-75. [PMID: 30594001 DOI: 10.1016/j.bodyim.2018.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 10/08/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 01/07/2023]
Abstract
The 10-item Body Appreciation Scale-2 (BAS-2) is a widely-used measure of a facet of positive body image. Here, we examined the psychometric properties of a Bahasa Malaysia (Malay) translation of the BAS-2 in a community sample of Malaysian Malay and Chinese adults (N = 781). Participants completed the Malay BAS-2 alongside demographic items and measures of subjective happiness, life satisfaction, actual-ideal weight discrepancy (women only), drive for muscularity (men only), and internalisation of appearance ideals. Exploratory factor analyses with a Malay subsample indicated that BAS-2 scores reduced to a single dimension with all 10 items in women and men, although the factor structure was similar but not identical across sex. Confirmatory factor analysis indicated that the one-dimensional factor structure had adequate fit following modifications. BAS-2 scores were partially scalar invariant across sex (with no significant sex differences) and ethnicity (Malay participants had significantly higher body appreciation than Chinese participants), as well as had adequate internal consistency. Evidence of construct and incremental validity was also provided through associations with additional measures and the prediction of subjective happiness over-and-above other variables, respectively. The availability of the Malay BAS-2 should help advance research on the body appreciation construct in Malay-speaking populations.
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Affiliation(s)
- Viren Swami
- Division of Psychology, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia.
| | | | - Evelyn Toh
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | | | - Jennifer Todd
- Division of Psychology, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
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16
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Yeow TP, Aun ESY, Hor CP, Lim SL, Khaw CH, Aziz NA. Challenges in the classification and management of Asian youth-onset diabetes mellitus- lessons learned from a single centre study. PLoS One 2019; 14:e0211210. [PMID: 30682116 PMCID: PMC6347175 DOI: 10.1371/journal.pone.0211210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 01/09/2019] [Indexed: 01/21/2023] Open
Abstract
It remains widely perceived that early-onset Type 2 Diabetes (T2D) in children and adolescents is rare and clinically distinct from Type 1 Diabetes (T1D). We studied the challenges of classifying subtypes of early-onset diabetes using clinical features and biomarkers, and management of these patients. We reviewed retrospectively the record of patients < 25 years old who attended the diabetes clinic in Penang General Hospital, Malaysia between 1st December 2012 and 30th June 2015. We examined their clinical features, C-peptide and pancreatic autoantibodies. Comparisons were made between T1D and T2D for magnitude, demographics, metabolic status and complications. We studied 176 patients with a mean age of 20 ± 3.7 years, 43.2% had T1D, 13.6% had T2D, and 13.6% had mixed features of both. When tested, pancreatic autoantibodies were positive in 59.4% of the T1D. T2D presented two years later than T1D at 14.3 years, 20% were asymptomatic at presentation, and 50% required insulin supplementation despite fasting c-peptide of > 250 pmol/L. HbA1C of ≤ 8.0% (64 mmol/mol) was achieved in 30.3% of T1D, 58.3% of T2D on OAD and 16.7% of T2D on insulin. The T2D had greater cardiovascular risk with higher body mass index, more dyslipidaemia, higher blood pressure and earlier onset of nephropathy. The overlapping clinical features, variable autoimmunity, and beta-cell loss complicate classification of young diabetes. Pancreatic autoantibodies and C-peptide did not always predict diabetes subtypes nor respond to insulin. The poor metabolic control and high cardiovascular risk burden among the T2D highlight the need for population-based study and focused intervention.
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Affiliation(s)
- Toh Peng Yeow
- Department of Medicine, Penang Medical College, Penang, Malaysia
- Department of Medicine, Division of Endocrinology, Penang General Hospital, Penang, Malaysia
- * E-mail:
| | | | - Chee Peng Hor
- Clinical Research Centre, Seberang Jaya Hospital, Penang, Malaysia
- Department of Medicine, Kepala Batas Hospital, Penang, Malaysia
| | - Shueh Lin Lim
- Department of Medicine, Division of Endocrinology, Penang General Hospital, Penang, Malaysia
| | - Chong Hui Khaw
- Department of Medicine, Division of Endocrinology, Penang General Hospital, Penang, Malaysia
| | - Nor Azizah Aziz
- Department of Medicine, Division of Endocrinology, Penang General Hospital, Penang, Malaysia
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17
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Ortolani O, Conti A, Chan YK, Sie MY, Ong GSY. Comparison of Propofol Consumption and Recovery Time in Caucasians from Italy, with Chinese, Malays and Indians from Malaysia. Anaesth Intensive Care 2019; 32:250-5. [PMID: 15957725 DOI: 10.1177/0310057x0403200215] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Differences in sensitivity to anaesthetic drugs may exist among different ethnic groups. Allelic variants for drug metabolizing isoenzymes and pharmacokinetic differences may account for a variable response to some anaesthetic drugs. This study was designed to compare propofol consumption and recovery characteristics in four ethnic groups: Chinese, Malays, and Indians in Malaysia and Caucasians in Italy. Patients undergoing total intravenous anaesthesia with propofol and fentanyl were evaluated for propofol consumption and recovery time. The Bispectral Index (BIS) was used to maintain the same anaesthesia depth in all patients. The BIS value, the response to verbal stimuli and eye-opening time were used to assess recovery. After propofol discontinuation the BIS values returned to baseline in 11±4.2 min for Caucasians, in 12.5±5.1 min for Chinese, 15.9±6.3 min for Malays and 22.1±8.1 for Indians. Time to eye-opening was 11.63±4.2 min in Caucasians, 13.23±4.9 min in Chinese, 16.97±5.2 min in Malays and 22.3±6.6 min in Indians. The propofol consumption was significantly lower in Indians compared to the other three groups (P<0.01). The recovery of Indians was much slower compared to Chinese, Malays and Caucasians. The recovery time of Malays is significantly slower compared to Chinese and Caucasians. Differences in propofol consumption and recovery time were not significant between Chinese and Caucasians, but the ratio recovery time/propofol consumption was significantly lower in Caucasians compared to all the other groups.
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Affiliation(s)
- O Ortolani
- University of Florence, Dipartimento di Area Critica Medico Chirurgica, Sezione di Anestesia e Rianimazione, Unita 'Anestesia e Rianimazione Sperimentali, University of Naples "Federico II", Naples, Italy
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18
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Shah NZ, Malhotra R, Hong CC, Sng JB, Kong CH, Shen L, Nashi N, Krishna L. Ethnic Differences in Preoperative Patient Characteristics and Postoperative Functional Outcomes after Total Knee Arthroplasty among Chinese, Malays and Indians. Ann Acad Med Singap 2018; 47:201-205. [PMID: 29911739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Nadir Zahir Shah
- University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Health System, Singapore
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Abstract
Previous studies have found that individuals from rural areas in Malaysia and in El Salvador prefer heavier women than individuals from urban areas. Several explanations have been proposed to explain these differences in weight preferences but no study has explored familiarity as a possible explanation. We therefore sought to investigate participants' face preferences while also examining the facial characteristics of the actual participants. Our results showed that participants from rural areas preferred heavier-looking female faces than participants from urban areas. We also found that the female faces from the rural areas were rated as looking heavier than the female faces from the urban areas. Our findings are consistent with the hypothesis that familiarity may be contributing to the differences found in face preferences between rural and urban areas given that people from rural and urban areas are exposed to different faces.
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Affiliation(s)
- Carlota Batres
- School of Psychology and Neuroscience, University of St Andrews, Fife, KY16 9JP, UK.
| | - Mallini Kannan
- School of Psychology and Neuroscience, University of St Andrews, Fife, KY16 9JP, UK
| | - David I Perrett
- School of Psychology and Neuroscience, University of St Andrews, Fife, KY16 9JP, UK
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20
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Chi C, Loy SL, Chan SY, Choong C, Cai S, Soh SE, Tan KH, Yap F, Gluckman PD, Godfrey KM, Shek LPC, Chan JKY, Kramer MS, Chong YS. Impact of adopting the 2013 World Health Organization criteria for diagnosis of gestational diabetes in a multi-ethnic Asian cohort: a prospective study. BMC Pregnancy Childbirth 2018; 18:69. [PMID: 29562895 PMCID: PMC5863481 DOI: 10.1186/s12884-018-1707-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 08/23/2017] [Accepted: 03/15/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We assessed the impact of adopting the 2013 World Health Organization (WHO) diagnostic criteria on the rates of gestational diabetes (GDM), pregnancy outcomes and identification of women at future risk of type 2 diabetes. METHODS During a period when the 1999 WHO GDM criteria were in effect, pregnant women were universally screened using a one-step 75 g 2-h oral glucose tolerance test at 26-28 weeks' gestation. Women were retrospectively reclassified according to the 2013 criteria, but without the 1-h glycaemia measurement. Pregnancy outcomes and glucose tolerance at 4-5 years post-delivery were compared for women with GDM classified by the 1999 criteria alone, GDM by the 2013 criteria alone, GDM by both criteria and without GDM by both sets of criteria. RESULTS Of 1092 women, 204 (18.7%) and 142 (13.0%) were diagnosed with GDM by the 1999 and 2013 WHO criteria, respectively, with 27 (2.5%) reclassified to GDM and 89 (8.2%) reclassified to non-GDM when shifting from the 1999 to 2013 criteria. Compared to women without GDM by both criteria, cases reclassified to GDM by the 2013 criteria had an increased risk of neonatal jaundice requiring phototherapy (relative risk (RR) = 2.78, 95% confidence interval (CI) 1.32, 5.86); despite receiving treatment for GDM, cases reclassified to non-GDM by the 2013 criteria had higher risks of prematurity (RR = 2.17, 95% CI 1.12, 4.24), neonatal hypoglycaemia (RR = 3.42, 95% CI 1.04, 11.29), jaundice requiring phototherapy (RR = 1.71, 95% CI 1.04, 2.82), and a higher rate of abnormal glucose tolerance at 4-5 years post-delivery (RR = 3.39, 95% CI 2.30, 5.00). CONCLUSIONS Adoption of the 2013 WHO criteria, without the 1-h glycaemia measurement, reduced the GDM rate. Lowering the fasting glucose threshold identified women who might benefit from treatment, but raising the 2-h threshold may fail to identify women at increased risk of adverse pregnancy and future metabolic outcomes. TRIAL REGISTRATION NCT01174875 . Registered 1 July 2010 (retrospectively registered).
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Affiliation(s)
- Claudia Chi
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, 119074 Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, 229899 Singapore
- Duke-NUS Medical School, Singapore, 169857 Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, 119074 Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, 117609 Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 119228 Singapore
| | - Cherie Choong
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, 119074 Singapore
| | - Shirong Cai
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 119228 Singapore
| | - Shu E. Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, 117609 Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, 229899 Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, 169857 Singapore
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, 229899 Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 636921 Singapore
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, 117609 Singapore
- Liggins Institute, University of Auckland, Auckland, 1142 New Zealand
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, SO16 6YD UK
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, 119074 Singapore
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, 229899 Singapore
- Duke-NUS Medical School, Singapore, 169857 Singapore
| | - Michael S. Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 119228 Singapore
- Department of Pediatrics, McGill University Faculty of Medicine, 845 Rue Sherbrooke Ouest, Montreal, QC, H3A 0G4 Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, 845 Rue Sherbrooke Ouest, Montreal, QC, H3A 0G4 Canada
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, National University Hospital, Singapore, 119074 Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, 117609 Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, 119228 Singapore
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Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review. World J Gastroenterol 2017; 23:6788-6801. [PMID: 29085223 PMCID: PMC5645613 DOI: 10.3748/wjg.v23.i37.6788] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/23/2017] [Accepted: 09/13/2017] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
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Affiliation(s)
- M Masudur Rahman
- Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka 1000, Bangladesh
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
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22
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Chong HY, Mohamed Z, Tan LL, Wu DBC, Shabaruddin FH, Dahlui M, Apalasamy YD, Snyder SR, Williams MS, Hao J, Cavallari LH, Chaiyakunapruk N. Is universal HLA-B*15:02 screening a cost-effective option in an ethnically diverse population? A case study of Malaysia. Br J Dermatol 2017; 177:1102-1112. [PMID: 28346659 PMCID: PMC5617756 DOI: 10.1111/bjd.15498] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND A strong association has been documented between HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Human leucocyte antigen testing is potentially valuable in many countries to facilitate early recognition of patient susceptibility to SCARs. OBJECTIVES To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in an ethnically diverse Malaysian population. METHODS A hybrid model of a decision tree and Markov model was developed to evaluate three strategies for treating newly diagnosed epilepsy among adults: (i) carbamazepine initiation without HLA-B*15:02 screening (current practice); (ii) universal HLA-B*15:02 screening prior to carbamazepine initiation; and (iii) alternative treatment [sodium valproate (VPA)] prescribing without HLA-B*15:02 screening. Base-case analysis and sensitivity analyses were performed over a lifetime time horizon. Incremental cost-effectiveness ratios were calculated. RESULTS Both universal HLA-B*15:02 screening and VPA prescribing were dominated by current practice. Compared with current practice, universal HLA-B*15:02 screening resulted in a loss of 0·0255 quality-adjusted life years (QALYs) at an additional cost of 707 U.S. dollars (USD); VPA prescribing resulted in a loss of 0·2622 QALYs at an additional cost of USD 4127, owing to estimated differences in antiepileptic treatment efficacy. CONCLUSIONS Universal HLA-B*15:02 screening is unlikely to be a cost-effective intervention in Malaysia. However, with the emergence of an ethnically diverse population in many other countries, this may render HLA-B*15:02 screening a viable intervention when an increasing proportion of the population is at risk and an equally effective yet safer antiepileptic drug is available.
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Affiliation(s)
- H Y Chong
- School of Pharmacy, Monash University Malaysia, Malaysia
| | - Z Mohamed
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Malaysia
| | - L L Tan
- Department of Dermatology, University Malaya Medical Center, Malaysia
| | - D B C Wu
- School of Pharmacy, Monash University Malaysia, Malaysia
| | - F H Shabaruddin
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Malaysia
| | - M Dahlui
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Y D Apalasamy
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Malaysia
| | - S R Snyder
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA, U.S.A
| | - M S Williams
- Genomic Medicine Institute, Geisinger Health System, Danville, PA, U.S.A
| | - J Hao
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA, U.S.A
| | - L H Cavallari
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL, U.S.A
| | - N Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Malaysia
- Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
- School of Pharmacy, University of Wisconsin, Madison, WI, U.S.A
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23
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Whitton C, Ho JCY, Tay Z, Rebello SA, Lu Y, Ong CN, van Dam RM. Relative Validity and Reproducibility of a Food Frequency Questionnaire for Assessing Dietary Intakes in a Multi-Ethnic Asian Population Using 24-h Dietary Recalls and Biomarkers. Nutrients 2017; 9:nu9101059. [PMID: 28946670 PMCID: PMC5691676 DOI: 10.3390/nu9101059] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 08/25/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 11/29/2022] Open
Abstract
The assessment of diets in multi-ethnic cosmopolitan settings is challenging. A semi-quantitative 163-item food frequency questionnaire (FFQ) was developed for the adult Singapore population, and this study aimed to assess its reproducibility and relative validity against 24-h dietary recalls (24 h DR) and biomarkers. The FFQ was administered twice within a six-month interval in 161 adults (59 Chinese, 46 Malay, and 56 Indian). Fasting plasma, overnight urine, and 24 h DR were collected after one month and five months. Intra-class correlation coefficients between the two FFQ were above 0.70 for most foods and nutrients. The median correlation coefficient between energy-adjusted deattenuated FFQ and 24 h DR nutrient intakes was 0.40 for FFQ1 and 0.39 for FFQ2, highest for calcium and iron, and lowest for energy and carbohydrates. Significant associations were observed between urinary isoflavones and soy protein intake (r = 0.46), serum carotenoids and fruit and vegetable intake (r = 0.34), plasma eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) and fish/seafood intake (r = 0.36), and plasma odd chain saturated fatty acids (SFA) and dairy fat intake (r = 0.25). Associations between plasma EPA + DHA and fish/seafood intake were consistent across ethnic groups (r = 0.28–0.49), while differences were observed for other associations. FFQ assessment of dietary intakes in modern cosmopolitan populations remains feasible for the purpose of ranking individuals’ dietary exposures in epidemiological studies.
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Affiliation(s)
- Clare Whitton
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Jolene Chien Yee Ho
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Zoey Tay
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Yonghai Lu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 119228, Singapore.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
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24
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Das Gupta E, Ng WR, Wong SF, Bhurhanudeen AK, Yeap SS. Correlation of serum cartilage oligomeric matrix protein (COMP) and interleukin-16 (IL-16) levels with disease severity in primary knee osteoarthritis: A pilot study in a Malaysian population. PLoS One 2017; 12:e0184802. [PMID: 28910372 PMCID: PMC5599033 DOI: 10.1371/journal.pone.0184802] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 03/29/2017] [Accepted: 08/31/2017] [Indexed: 11/19/2022] Open
Abstract
Objective The aim of this study was to investigate the correlations between serum cartilage oligomeric matrix protein (COMP), interleukin-16 (IL-16) and different grades of knee osteoarthritis (KOA) in Malaysian subjects. Methods Ninety subjects were recruited comprising 30 with Kellgren-Lawrence (K-L) grade 2 KOA, 27 with K-L grade 3 KOA, 7 with grade 4 KOA, and 30 healthy controls. All subjects completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Serum COMP and IL-16 levels were measured using ELISA and their values log transformed to ensure a normal distribution. Results There was no significant differences in levels of log serum COMP and IL-16 between healthy controls and KOA patients. There were no significant differences in the log serum COMP and IL-16 levels within the different K-L grades in the KOA patients. In KOA patients, log serum IL-16 levels significantly correlated with the WOMAC score (p = 0.001) and its subscales, pain (p = 0.005), stiffness (p = 0.019) and physical function (p<0.0001). Serum IL-16 levels were significantly higher in Malaysian Indians compared to Malays and Chinese (p = 0.024). Conclusions In this multi-ethnic Malaysian population, there was no difference in serum COMP and IL-16 levels between healthy controls and patients with KOA, nor was there any difference in serum COMP or IL-16 levels across the various K-L grades of KOA. However, there were significant inter-racial differences in serum IL-16 levels.
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Affiliation(s)
- Esha Das Gupta
- Internal Medicine Department, School of Medicine, International Medical University, Seremban, Malaysia
| | - Wei Ren Ng
- Internal Medicine Department, School of Medicine, International Medical University, Seremban, Malaysia
| | - Shew Fung Wong
- Internal Medicine Department, School of Medicine, International Medical University, Seremban, Malaysia
| | - Abdul Kareem Bhurhanudeen
- Internal Medicine Department, School of Medicine, International Medical University, Seremban, Malaysia
| | - Swan Sim Yeap
- Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
- * E-mail:
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25
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Seow KC, Mohamed Yusoff D, Koh YLE, Tan NC. What is the test-retest reliability of the Malay version of the Hypertension Self-Care Profile self efficacy assessment tool? A validation study in primary care. BMJ Open 2017; 7:e016152. [PMID: 28882912 PMCID: PMC5588997 DOI: 10.1136/bmjopen-2017-016152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Self-efficacy and self-care measures are key attributes to optimal control of essential hypertension. Self-efficacy can be measured by the Hypertension Self-Care Profile (HTN-SCP) tool but its utility is dependent on the literacy and understanding of the subjects. A Malay version of the HTN-SCP Tool was developed to assess self-efficacy of Malay-literate patients with hypertension in the multi-ethnic Asian population in Singapore. The study aimed to determine the test-retest reliability of this tool which has been translated in Malay language. METHODS AND MATERIAL 145 Malay-literate patients, aged 41-70 years, with essential hypertension were recruited in a polyclinic (primary care clinic) in Singapore. Forty-three percent of them completed both the first and second HTN SCP tool online, with a period of two weeks in between. The Cronbach's alpha and Intra-class correlation coefficient (ICC) were computed to assess its test-retest reliability and internal consistency. RESULTS The Cronbach's alpha/ICC for "Behavior" (0.851/0.664)), "Motivation" (0.928/0.655) and "Self-efficacy" (0.945/0.682) domains showed high internal consistency, fair to good reliability and stability. No floor or ceiling effect was found for the "behavior" and "motivation" domains. However, the borderline ceiling effect (15.2) for "self-efficacy" suggested limited discriminating power of the tool for patients with high self-efficacy. Positive association was shown between the HTN-SCP score and reported self-care measures but it was not statistically significant. CONCLUSION Overall, the translated HTN-SCP tool showed satisfactory test-retest reliability and internal consistency amongst the Malay-literate study population. Further research is needed for its application in general practice to identify patients with low self-efficacy for possible intervention.
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Affiliation(s)
- Kai Cong Seow
- National University Singapore Yong Loo Lin School of Medicine, Singapore, Singapore
| | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore
- Duke NUS Medical School, Singapore, Singapore
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Tan WSK, Tan SY, Henry CJ. Ethnic Variability in Glycemic Response to Sucrose and Isomaltulose. Nutrients 2017; 9:nu9040347. [PMID: 28368311 PMCID: PMC5409686 DOI: 10.3390/nu9040347] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 03/02/2017] [Revised: 03/23/2017] [Accepted: 03/30/2017] [Indexed: 01/16/2023] Open
Abstract
The aim of this study was to compare the glycemic response of Caucasians and Asians to two disaccharides of different glycemic index (GI), and to examine if ethnic groups that showed the largest glycemic response to sucrose would benefit the most when it is replaced with isomaltulose. Forty healthy participants (10 Chinese; 10 Malays; 10 Caucasians; and 10 Indians) consumed beverages containing 50 g of sucrose or isomaltulose on two separate occasions using a randomized crossover design. Capillary blood glucose was measured in a fasted state and at 15, 30, 45, 60, 90, and 120 min after beverage ingestion. Glycemic response to sucrose was significantly higher in Malays compared to Caucasians (p = 0.041), but did not differ between Caucasians vs. Chinese (p = 0.145) or vs. Indians (p = 0.661). When sucrose was replaced with isomaltulose, glycemic responses were significantly reduced in all ethnic groups, with the largest reduction in glycemic response being observed in Malays. Malays, who had the greatest glycemic response to sucrose, also showed the greatest improvement in glycemic response when sucrose was replaced with isomaltulose. This implies that Malays who are more susceptible to type 2 diabetes mellitus may benefit from strategies that replace high GI carbohydrate with lower GI alternatives to assist in glycemic control.
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Affiliation(s)
- Wei Shuan Kimberly Tan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Centre for Translational Medicine, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, Singapore 117599, Singapore.
| | - Sze-Yen Tan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Centre for Translational Medicine, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, Singapore 117599, Singapore.
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR) and National University Health System, Centre for Translational Medicine, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, Singapore 117599, Singapore.
- Department of Biochemistry, National University of Singapore, 8 Medical Drive, Singapore 117596, Singapore.
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Lim LM, McStea M, Chung WW, Nor Azmi N, Abdul Aziz SA, Alwi S, Kamarulzaman A, Kamaruzzaman SB, Chua SS, Rajasuriar R. Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia. PLoS One 2017; 12:e0173466. [PMID: 28273128 PMCID: PMC5342241 DOI: 10.1371/journal.pone.0173466] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [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: 11/24/2016] [Accepted: 02/22/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Polypharmacy has been associated with increased morbidity and mortality in the older population. OBJECTIVES The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. METHODS This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. RESULTS A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. CONCLUSION A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.
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Affiliation(s)
- Li Min Lim
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Megan McStea
- The Malaysian Elders Longitudinal Research (MELOR) Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
| | - Wen Wei Chung
- Pharmacy Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Nuruljannah Nor Azmi
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Azdiah Abdul Aziz
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Pharmacy, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Syireen Alwi
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adeeba Kamarulzaman
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- The Malaysian Elders Longitudinal Research (MELOR) Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siew Siang Chua
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Reena Rajasuriar
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Peter Doherty Institute for Infection and Immunity, Melbourne University, Melbourne, Australia
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Subramaniam M, Abdin E, Vaingankar JA, Picco L, Seow E, Chua BY, Ng LL, Mahendran R, Chua HC, Heng DM, Chong SA. Comorbid Diabetes and Depression among Older Adults - Prevalence, Correlates, Disability and Healthcare Utilisation. Ann Acad Med Singap 2017; 46:91-101. [PMID: 28417133] [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: 06/07/2023]
Abstract
INTRODUCTION The objectives of this current study were to: 1) examine the prevalence and correlates of diabetes mellitus (DM) among older adults (aged 60 years and above) in a multi-ethnic population; 2) examine the prevalence and correlates of comorbid DM and depression among them; and 3) assess the effect of comorbid depression on disability, cognition and healthcare utilisation. MATERIALS AND METHODS Data for the current study came from the Well-being of the Singapore Elderly (WiSE) study; a single phase, cross-sectional survey conducted among Singapore residents aged 60 years and above. A total of 2565 respondents completed the survey; depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) while a diagnosis of DM was considered if respondents stated that a doctor had diagnosed them with DM. RESULTS DM was reported by 25.5% of the population. The prevalence of depression was significantly higher in those diagnosed with DM than those without DM (6% vs 3%). After adjusting for sociodemographic correlates, smoking and other chronic conditions, DM remained significantly associated with depression and subsyndromal depression. However, after including measures of functioning and cognitive impairment as covariates, DM was not significantly related to depression and subsyndromal depression. Those with comorbid DM and depression were more likely to be of Indian and Malay ethnicity, aged 75 to 84 years (versus 60 to 74 years) and widowed. CONCLUSION Given the significant association of certain sociodemographic groups with comorbid depression among those with DM, targeted interventions for prevention and early diagnosis in these groups should be considered.
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Cai S, Tan S, Gluckman PD, Godfrey KM, Saw SM, Teoh OH, Chong YS, Meaney MJ, Kramer MS, Gooley JJ. Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus. Sleep 2017; 40:2662319. [PMID: 28364489 DOI: 10.1093/sleep/zsw058] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [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] [Accepted: 12/05/2016] [Indexed: 12/20/2022] Open
Abstract
Study Objectives To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population. Methods A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score). Results In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66). Conclusions During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM.
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Affiliation(s)
- Shirong Cai
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Sara Tan
- Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore, Singapore
| | - Peter D Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust Southampton, England
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Oon Hoe Teoh
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Michael J Meaney
- Department of Psychiatry, McGill University Faculty of Medicine, Montreal, Canada
| | - Michael S Kramer
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada
- Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada
| | - Joshua J Gooley
- Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Mohan D, Stephan BCM, Allotey P, Jagger C, Pearce M, Siervo M, Reidpath DD. Protocol of a feasibility study for cognitive assessment of an ageing cohort within the Southeast Asia Community Observatory (SEACO), Malaysia. BMJ Open 2017; 7:e013635. [PMID: 28104710 PMCID: PMC5253595 DOI: 10.1136/bmjopen-2016-013635] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION There is a growing proportion of population aged 65 years and older in low-income and middle-income countries. In Malaysia, this proportion is predicted to increase from 5.1% in 2010 to more than 15.4% by 2050. Cognitive ageing and dementia are global health priorities. However, risk factors and disease associations in a multiethnic, middle-income country like Malaysia may not be consistent with those reported in other world regions. Knowing the burden of cognitive impairment and its risk factors in Malaysia is necessary for the development of management strategies and would provide valuable information for other transitional economies. METHODS AND ANALYSIS This is a community-based feasibility study focused on the assessment of cognition, embedded in the longitudinal study of health and demographic surveillance site of the South East Asia Community Observatory (SEACO), in Malaysia. In total, 200 adults aged ≥50 years are selected for an in-depth health and cognitive assessment including the Mini Mental State Examination, the Montreal Cognitive Assessment, blood pressure, anthropometry, gait speed, hand grip strength, Depression Anxiety Stress Score and dried blood spots. DISCUSSION AND CONCLUSIONS The results will inform the feasibility, response rates and operational challenges for establishing an ageing study focused on cognitive function in similar middle-income country settings. Knowing the burden of cognitive impairment and dementia and risk factors for disease will inform local health priorities and management, and place these within the context of increasing life expectancy. ETHICS AND DISSEMINATION The study protocol is approved by the Monash University Human Research Ethics Committee. Informed consent is obtained from all the participants. The project's analysed data and findings will be made available through publications and conference presentations and a data sharing archive. Reports on key findings will be made available as community briefs on the SEACO website.
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Affiliation(s)
- Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Blossom C M Stephan
- Newcastle University Institute for Ageing & Institute of Health and Society, Newcastle University, UK
| | - Pascale Allotey
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
- South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia
| | - Carol Jagger
- Newcastle University Institute for Ageing & Institute of Health and Society, Newcastle University, UK
| | - Mark Pearce
- Newcastle University Institute for Ageing & Institute of Health and Society, Newcastle University, UK
| | - Mario Siervo
- Newcastle University Institute for Ageing & Institute of Health and Society, Newcastle University, UK
| | - Daniel D Reidpath
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
- South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia
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Abstract
There is a lack of mobile app which aims to improve health screening uptake developed for men. As part of the study to develop an effective mobile app to increase health screening uptake in men, we conducted a needs assessment to find out what do men want from a health screening mobile app. In-depth interviews and focus group discussions were conducted with 31 men from a banking institution in Kuala Lumpur. The participants were purposely sampled according to their job position, age, ethnicity and screening status. The recruitment was stopped once data saturation was achieved. The audio-recorded interviews were transcribed verbatim and analyzed using thematic approach. Three themes emerged from the analysis and they were: content, feature and dissemination. In terms of the content, men wanted the app to provide information regarding health screening and functions that can assess their health; which must be personalized to them and are trustable. The app must have user-friendly features in terms of information delivery, ease of use, attention allocation and social connectivity. For dissemination, men proposed that advertisements, recommendations by health professionals, providing incentive and integrating the app as into existing systems may help to increase the dissemination of the app. This study identified important factors that need to be considered when developing a mobile app to improve health screening uptake. Future studies on mobile app development should elicit users' preference and need in terms of its content, features and dissemination strategies to improve the acceptability and the chance of successful implementation.
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Affiliation(s)
- Chin Hai Teo
- 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
- * E-mail:
| | - Alan White
- Centre for Men’s Health, Leeds Beckett University, Leeds, United Kingdom
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Abstract
A total of 107 Malay primary school girls (8–9 yr. old) completed a set of measurements on eating behavior (ChEAT, food neophobia scales, and dieting experience), the Rosenberg Self-Esteem Scale, body shape satisfaction, dietary intake, weight, and height. About 38% of the girls scored 20 and more on the ChEAT, and 46% of them reported dieting by reducing sugar and sweets (73%), skipping meals (67%), reducing fat foods (60%) and snacks (53%) as the most frequent methods practiced. In general, those girls with higher ChEAT scores tended to have lower self-esteem ( r = .39), indicating they were more unwilling to try new foods (food neophobic) ( r = .29), chose a smaller figure for desired body size ( r = −.25), and were more dissatisfied with their body size ( r = .31).
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Affiliation(s)
- Zalilah Mohd Shariff
- Department of Nutrition and Health Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia.
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Sahimin N, Lim YAL, Ariffin F, Behnke JM, Lewis JW, Mohd Zain SN. Migrant Workers in Malaysia: Current Implications of Sociodemographic and Environmental Characteristics in the Transmission of Intestinal Parasitic Infections. PLoS Negl Trop Dis 2016; 10:e0005110. [PMID: 27806046 PMCID: PMC5091761 DOI: 10.1371/journal.pntd.0005110] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 03/03/2016] [Accepted: 10/14/2016] [Indexed: 11/18/2022] Open
Abstract
A cross-sectional study of intestinal parasitic infections amongst migrant workers in Malaysia was conducted. A total of 388 workers were recruited from five sectors including manufacturing, construction, plantation, domestic and food services. The majority were recruited from Indonesia (n = 167, 43.3%), followed by Nepal (n = 81, 20.9%), Bangladesh (n = 70, 18%), India (n = 47, 12.1%) and Myanmar (n = 23, 5.9.2%). A total of four nematode species (Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis and hookworms), one cestode (Hymenolepis nana) and three protozoan species (Entamoeba histolytica/dispar, Giardia sp. and Cryptosporidium spp.) were identified. High prevalence of infections with A. lumbricoides (43.3%) was recorded followed by hookworms (13.1%), E. histolytica/dispar (11.6%), Giardia sp. (10.8%), T. trichura (9.5%), Cryptosporodium spp. (3.1%), H. nana (1.8%) and E. vermicularis (0.5%). Infections were significantly influenced by socio-demographic (nationality), and environmental characteristics (length of working years in the country, employment sector and educational level). Up to 84.0% of migrant workers from Nepal and 83.0% from India were infected with intestinal parasites, with the ascarid nematode A. lumbricoides occurring in 72.8% of the Nepalese and 68.1% of the Indian population. In addition, workers with an employment history of less than a year or newly arrived in Malaysia were most likely to show high levels of infection as prevalence of workers infected with A. lumbricoides was reduced from 58.2% to 35.4% following a year's residence. These findings suggest that improvement is warranted in public health and should include mandatory medical screening upon entry into the country.
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Affiliation(s)
- Norhidayu Sahimin
- Institute of Biological Science, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Yvonne A. L. Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farnaza Ariffin
- Primary Care Medicine, Faculty of Medicine, University Teknologi Mara Sungai Buloh Campus, Selangor, Malaysia
| | - Jerzy M. Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham, United Kingdom
| | - John W. Lewis
- School of Biological Sciences, University of London, Egham, Surrey, United Kingdom
| | - Siti Nursheena Mohd Zain
- Institute of Biological Science, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
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Lai PSM, Tan SY, Liew SM. Views and Experiences of Malaysian Family Medicine Trainees of Female Sexual Dysfunction. Arch Sex Behav 2016; 45:2081-2089. [PMID: 27502351 DOI: 10.1007/s10508-016-0796-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 06/07/2016] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
Sociocultural factors have been shown to be important influencers of sexual health and sexuality. Hence, the aim of our study was to explore the views and experiences of family medicine trainees regarding female sexual dysfunction (FSD) with a focus on the barriers and facilitators towards the initiation of conversation on this topic. A qualitative study design involving semi-structured focus group discussions (FGDs) was conducted with 19 family medicine trainees in Malaysia. The conceptual framework used was based on the Theory of Planned Behavior. Thematic approach was used to analyze the data. Participants perceived FSD as being uncommon and unimportant. According to our participants, patients often presented with indirect complaints, and doctors were not proactive in asking about FSD. Three main barriers were identified: doctor factors, perceived patient factors, and system factors. Lack of confidence, knowledge, experience, time, and embarrassment were the key barriers identified at the doctors' level. Lack of awareness, among patients regarding FSD, and local cultural and religious norms were the perceived patient barriers. System barriers were lack of time and privacy. Various facilitators, such as continuous medical education and public forums, were suggested as means to encourage family medicine trainees to initiate discussion on sexual matters during consultations. In conclusion, family medicine trainees found it difficult to initiate conversation on FSD with patients. Interventions to encourage conversation on FSD should target this and other identified barriers.
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Affiliation(s)
- Pauline Siew Mei Lai
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Sing Yee Tan
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia.
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Othman SA, Majawit LP, Wan Hassan WN, Wey MC, Mohd Razi R. Anthropometric Study of Three-Dimensional Facial Morphology in Malay Adults. PLoS One 2016; 11:e0164180. [PMID: 27706220 PMCID: PMC5051712 DOI: 10.1371/journal.pone.0164180] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 01/26/2016] [Accepted: 09/21/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To establish the three-dimensional (3D) facial soft tissue morphology of adult Malaysian subjects of the Malay ethnic group; and to determine the morphological differences between the genders, using a non-invasive stereo-photogrammetry 3D camera. MATERIAL AND METHODS One hundred and nine subjects participated in this research, 54 Malay men and 55 Malay women, aged 20-30 years old with healthy BMI and with no adverse skeletal deviation. Twenty-three facial landmarks were identified on 3D facial images captured using a VECTRA M5-360 Head System (Canfield Scientific Inc, USA). Two angular, 3 ratio and 17 linear measurements were identified using Canfield Mirror imaging software. Intra- and inter-examiner reliability tests were carried out using 10 randomly selected images, analyzed using the intra-class correlation coefficient (ICC). Multivariate analysis of variance (MANOVA) was carried out to investigate morphologic differences between genders. RESULTS ICC scores were generally good for both intra-examiner (range 0.827-0.987) and inter-examiner reliability (range 0.700-0.983) tests. Generally, all facial measurements were larger in men than women, except the facial profile angle which was larger in women. Clinically significant gender dimorphisms existed in biocular width, nose height, nasal bridge length, face height and lower face height values (mean difference > 3mm). Clinical significance was set at 3mm. CONCLUSION Facial soft tissue morphological values can be gathered efficiently and measured effectively from images captured by a non-invasive stereo-photogrammetry 3D camera. Adult men in Malaysia when compared to women had a wider distance between the eyes, a longer and more prominent nose and a longer face.
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Affiliation(s)
- Siti Adibah Othman
- Department of Paediatric Dentistry and Orthodontics, University of Malaya, Kuala Lumpur, Malaysia
- Clinical Craniofacial Dentistry Research Group, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Lynnora Patrick Majawit
- Department of Paediatric Dentistry and Orthodontics, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Nurazreena Wan Hassan
- Department of Paediatric Dentistry and Orthodontics, University of Malaya, Kuala Lumpur, Malaysia
- Clinical Craniofacial Dentistry Research Group, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Mang Chek Wey
- Department of Paediatric Dentistry and Orthodontics, University of Malaya, Kuala Lumpur, Malaysia
- Clinical Craniofacial Dentistry Research Group, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Roziana Mohd Razi
- Department of Paediatric Dentistry and Orthodontics, University of Malaya, Kuala Lumpur, Malaysia
- Clinical Craniofacial Dentistry Research Group, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Abstract
The haptoglobin 2-2 genotype is associated with atherosclerosis in type 2 diabetes mellitus. We examined the associations of the haptoglobin 2-2 genotype with C-reactive protein (high-sensitivity C-reactive protein) and carotid artery intima-media thickness, adjusting for age, gender, ethnicity, type 2 diabetes mellitus, smoking status, body mass index, blood pressure, glycated haemoglobin, non-high-density lipoprotein cholesterol and medications via logistic multivariate regression in 200 subjects (160 type 2 diabetes mellitus versus 40 healthy individuals). The prevalence of the haptoglobin 2-2 genotype was 58% (115/200), higher in the Indians than in Chinese (72% versus 45%, p = 0.001). Multivariate analysis showed that the haptoglobin 2-2 genotype was associated with high-sensitivity C-reactive protein [mean: 3.5 ± 3.9 versus 2.2 ± 2.6 mg/L (non-haptoglobin 2-2), p < 0.001], haptoglobin concentration [mean: 116.9 ± 54.4.0 versus 147.2 ± 54.5 mg/dL (non-haptoglobin 2-2), p < 0.001] and average carotid artery intima-media thickness (multiplied by 10) [6.15 ± 1.22 versus 5.98 ± 1.20 mm (non-haptoglobin 2-2), p = 0.013]. This pilot study shows an association of the haptoglobin 2-2 genotype with low-grade inflammation, haptoglobin concentration and carotid artery intima-media thickness in multi-ethnic Singapore.
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Affiliation(s)
- Rinkoo Dalan
- Endocrinology Department, Tan Tock Seng Hospital, Singapore Metabolic Medicine Research Program, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Huiling Liew
- Endocrinology Department, Tan Tock Seng Hospital, Singapore
| | - Liuh Ling Goh
- Clinical Research and Innovation Office, Tan Tock Seng Hospital, Singapore
| | - Xiao Gao
- Clinical Research and Innovation Office, Tan Tock Seng Hospital, Singapore
| | - Daniel Ek Chew
- Endocrinology Department, Tan Tock Seng Hospital, Singapore
| | - Bernhard O Boehm
- Endocrinology Department, Tan Tock Seng Hospital, Singapore Metabolic Medicine Research Program, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Melvin Khee Shing Leow
- Endocrinology Department, Tan Tock Seng Hospital, Singapore Metabolic Medicine Research Program, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore Singapore Institute for Clinical Sciences, A*STAR, Singapore
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Chow WZ, Bon AH, Keating S, Anderios F, Halim HA, Takebe Y, Kamarulzaman A, Busch MP, Tee KK. Extensive Genetic Diversity of HIV-1 in Incident and Prevalent Infections among Malaysian Blood Donors: Multiple Introductions of HIV-1 Genotypes from Highly Prevalent Countries. PLoS One 2016; 11:e0161853. [PMID: 27575746 PMCID: PMC5004849 DOI: 10.1371/journal.pone.0161853] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 06/22/2016] [Accepted: 08/14/2016] [Indexed: 11/21/2022] Open
Abstract
Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs) in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old). Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA). HIV-1 gag-pol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01_AE at 40.9% (61/149), CRF33_01B at 21.5% (32/149), and subtype B at 10.1% (15/149). Newly-described CRFs including CRF54_01B circulated at 4.0%, CRF74_01B at 2.0%, and CRF53_01B and CRF48_01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%), CRF45_cpx (1.3%), CRF02_AG (0.7%) and CRF07_BC (0.7%) from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149) of HIV-infected donors had unique recombinant forms (URFs) including CRF01_AE/B' (4.7%), B'/C (2.7%) and B'/G (1.3%) recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of which were sequenced from recently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries.
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Affiliation(s)
- Wei Zhen Chow
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abdul Hamid Bon
- National Blood Centre of Kuala Lumpur (NBCKL), Kuala Lumpur, Malaysia
| | - Sheila Keating
- Blood Systems Research Institute (BSRI), San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California, San Francisco (UCSF), California, United States of America
| | - Fread Anderios
- National Blood Centre of Kuala Lumpur (NBCKL), Kuala Lumpur, Malaysia
| | | | - Yutaka Takebe
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- AIDS Research Center, National Institute of Infectious Diseases, Toyama, Shinjuku-ku, Tokyo, Japan
| | - Adeeba Kamarulzaman
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael P. Busch
- Blood Systems Research Institute (BSRI), San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California, San Francisco (UCSF), California, United States of America
| | - Kok Keng Tee
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Simon SS, Ramachandra SS, Abdullah DDF, Islam MN, Kalyan CG. Lessons learned from the disruption of dental training of Malaysian students studying in Egypt during the Arab spring. Educ Health (Abingdon) 2016; 29:124-127. [PMID: 27549650 DOI: 10.4103/1357-6283.188753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Political crisis and worsening security situation in Egypt in late 2013 resulted in Malaysian students who were pursuing their dental education in Egypt being recalled home to Malaysia. The Ministry of Higher Education in Malaysia took steps to integrate these students into public and private universities in Malaysia. METHODS We used a questionnaire and informal interviews to learn from students returning from Egypt about their experiences transitioning from dental schools in Egypt to Malaysia. RESULTS We discuss the challenges students faced with regards to credit transfer, pastoral care, the differences in the curriculum between the dental faculties of the two nations, and the financial implications of this disruption of their training. DISCUSSION We live in a fragile world where similar political situations will surely arise again. The approaches used by the Malaysian government and the lessons learned from these students may help others. The perspectives of these students may help educators reintegrate expatriate students who are displaced by political instability back into the education system of their own countries.
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Affiliation(s)
- Sibu Sajjan Simon
- Department of Dental Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | | | | | - Md Nurul Islam
- Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
| | - C G Kalyan
- Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia
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Wang X, Huang Y, Radha Krishna L, Puvanendran R. Role of the Nasogastric Tube and Lingzhi (Ganoderma lucidum) in Palliative Care. J Pain Symptom Manage 2016; 51:794-799. [PMID: 26891608 DOI: 10.1016/j.jpainsymman.2015.11.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/22/2015] [Revised: 11/23/2015] [Accepted: 11/27/2015] [Indexed: 11/17/2022]
Abstract
Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.
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Affiliation(s)
- Xiaohui Wang
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Youyi Huang
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Lalit Radha Krishna
- Duke-NUS Graduate Medical School, Singapore, Singapore; National Cancer Centre, Singapore, Singapore
| | - Rukshini Puvanendran
- Duke-NUS Graduate Medical School, Singapore, Singapore; KK Women's and Children's Hospital, Singapore, Singapore.
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Lo G, Chen J, Wasser T, Portenoy R, Dhingra L. Initial Validation of the Daily Spiritual Experiences Scale in Chinese Immigrants With Cancer Pain. J Pain Symptom Manage 2016; 51:284-91. [PMID: 26476391 DOI: 10.1016/j.jpainsymman.2015.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/09/2015] [Revised: 09/28/2015] [Accepted: 10/06/2015] [Indexed: 11/30/2022]
Abstract
CONTEXT Evaluating religious/spiritual influences in the growing Chinese-American population may inform the development of culturally relevant palliative care interventions. OBJECTIVES We assessed the psychometric properties and acceptability of the Daily Spiritual Experiences Scale-Chinese (DSES-C) in Chinese Americans with cancer-related pain. METHODS The translated 16-item DSES-C was administered as part of a symptom intervention for Chinese-American cancer patients. Patients were recruited from four New York community oncology practices. RESULTS Of 321 patients, 78.7% were born in Mainland China, 79.1% spoke Cantonese, and 70.2% endorsed a religious affiliation (Ancestor worship, 31.7%; Chinese God worship, 29.8%; Buddhism, 17.1%; Christianity, 14.0%). In total, 82.6% completed the DSES-C (mean age = 57.7 years; 60.8% women) and 17.4% declined (mean age = 59.3 years; 52.0% women). Reasons for declining included low religiosity or perceived relevance of the scale items and difficulties separating spirituality from religiosity terms. Individuals having a religious affiliation were more likely to complete the DSES-C, whereas those not engaging in individual spiritual/religious practices or frequent group spiritual/religious practices tended to decline (all P < 0.05). The DSES-C (mean total score = 43.6, SD = 19.3) demonstrated high reliability (alpha = 0.94). Exploratory factor analysis suggested a one-factor solution, with significant loadings (>0.40) across items except Item 14 ("Accept others"). Construct validity was suggested by a positive association between DSES-C scores and having a religious affiliation (P < 0.05). CONCLUSION In Chinese Americans with cancer pain, the DSES-C demonstrated acceptable psychometrics. Some participants experienced linguistic or cultural barriers preventing completion. Future investigations should provide additional validation in different Asian subgroups and those with varied medical conditions.
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Affiliation(s)
- Graciete Lo
- VA Pacific Islands Health Care System, Honolulu, Hawaii, USA
| | - Jack Chen
- MJHS Institute for Innovation in Palliative Care, New York, New York, USA
| | - Thomas Wasser
- Consult-Stat: Complete Statistical Services, Macungie, Pennsylvania, USA
| | - Russell Portenoy
- MJHS Institute for Innovation in Palliative Care, New York, New York, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Lara Dhingra
- MJHS Institute for Innovation in Palliative Care, New York, New York, USA.
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Parvaresh Rizi E, Teo Y, Leow MKS, Venkataraman K, Khoo EYH, Yeo CR, Chan E, Song T, Sadananthan SA, Velan SS, Gluckman PD, Lee YS, Chong YS, Tai ES, Toh SA, Khoo CM. Ethnic Differences in the Role of Adipocytokines Linking Abdominal Adiposity and Insulin Sensitivity Among Asians. J Clin Endocrinol Metab 2015; 100:4249-56. [PMID: 26308293 DOI: 10.1210/jc.2015-2639] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
CONTEXT Among Asian ethnic groups, Chinese or Malays are more insulin sensitive than South Asians, in particular in lean individuals. We have further reported that body fat partitioning did not explain this ethnic difference in insulin sensitivity. OBJECTIVE We examined whether adipocytokines might explain the ethnic differences in the relationship between obesity and insulin resistance among the three major ethnic groups in Singapore. DESIGN AND PARTICIPANTS This was a cross-sectional study of 101 Chinese, 82 Malays, and 81 South Asian men. Insulin sensitivity index (ISI) was measured using hyperinsulinemic euglycemic clamp. Visceral (VAT) and subcutaneous adipose tissue (SAT) volumes were quantified using magnetic resonance imaging. MAIN OUTCOME MEASURES Plasma total and high-molecular-weight adiponectin, leptin, visfatin, apelin, IL-6, fibroblast growth factor 21 (FGF21), retinol binding protein-4 (RBP 4), and resistin were measured using enzyme-linked immunoassays. RESULTS Principle component (PC) analysis on the adipocytokines identified three PCs, which explained 49.5% of the total variance. Adiponectin loaded negatively, and leptin and FGF21 loaded positively onto PC1. Visfatin, resistin, and apelin all loaded positively onto PC2. IL-6 loaded positively and RBP-4 negatively onto PC3. Only PC1 was negatively associated with ISI in all ethnic groups. In the path analysis, SAT and VAT were negatively associated with ISI in Chinese and Malays without significant mediatory role of PC1. In South Asians, the relationship between VAT and ISI was mediated partly through PC1, whereas the relationship between SAT and ISI was mediated mainly through PC1. CONCLUSIONS The relationships between abdominal obesity, adipocytokines and insulin sensitivity differ between ethnic groups. Adiponectin, leptin, and FGF21 play a mediating role in the relationship between abdominal adiposity and insulin resistance in South Asians, but not in Malays or Chinese.
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Affiliation(s)
- Ehsan Parvaresh Rizi
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Yvonne Teo
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Melvin Khee-Shing Leow
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | | | - Eric Yin Hao Khoo
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Chia Rou Yeo
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Edmund Chan
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Tammy Song
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Suresh Anand Sadananthan
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - S Sendhil Velan
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Peter D Gluckman
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Yung Seng Lee
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Yap Seng Chong
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - E Shyong Tai
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Sue-Anne Toh
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
| | - Chin Meng Khoo
- Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597
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Abdullah N, Abdul Murad NA, Attia J, Oldmeadow C, Mohd Haniff EA, Syafruddin SE, Abd Jalal N, Ismail N, Ishak M, Jamal R, Scott RJ, Holliday EG. Characterizing the genetic risk for Type 2 diabetes in a Malaysian multi-ethnic cohort. Diabet Med 2015; 32:1377-84. [PMID: 25711284 DOI: 10.1111/dme.12735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/03/2014] [Accepted: 02/20/2015] [Indexed: 12/12/2022]
Abstract
AIMS To characterize the association with Type 2 diabetes of known Type 2 diabetes risk variants in people in Malaysia of Malay, Chinese and Indian ancestry who participated in the Malaysian Cohort project. METHODS We genotyped 1604 people of Malay ancestry (722 cases, 882 controls), 1654 of Chinese ancestry (819 cases, 835 controls) and 1728 of Indian ancestry (851 cases, 877 controls). First, 62 candidate single-nucleotide polymorphisms previously associated with Type 2 diabetes were assessed for association via logistic regression within ancestral groups and then across ancestral groups using a meta-analysis. Second, estimated odds ratios were assessed for excess directional concordance with previously studied populations. Third, a genetic risk score aggregating allele dosage across the candidate single-nucleotide polymorphisms was tested for association within and across ancestral groups. RESULTS After Bonferroni correction, seven individual single-nucleotide polymorphisms were associated with Type 2 diabetes in the combined Malaysian sample. We observed a highly significant excess in concordance of effect directions between Malaysian and previously studied populations. The genetic risk score was strongly associated with Type 2 diabetes in all Malaysian groups, explaining from 1.0 to 1.7% of total Type 2 diabetes risk variance. CONCLUSION This study suggests there is substantial overlap of the genetic risk alleles underlying Type 2 diabetes in Malaysian and other populations.
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Affiliation(s)
- N Abdullah
- School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N A Abdul Murad
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - J Attia
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - C Oldmeadow
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - E A Mohd Haniff
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - S E Syafruddin
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N Abd Jalal
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N Ismail
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - M Ishak
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R Jamal
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R J Scott
- School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Area Pathology Service, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - E G Holliday
- Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
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Lim KS, Tan AH, Lim CS, Chua KH, Lee PC, Ramli N, Rajahram GS, Hussin FT, Wong KT, Bhattacharjee MB, Ng CC. R54C Mutation of NOTCH3 Gene in the First Rungus Family with CADASIL. PLoS One 2015; 10:e0135470. [PMID: 26270344 PMCID: PMC4535948 DOI: 10.1371/journal.pone.0135470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 07/22/2015] [Indexed: 12/03/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare hereditary stroke caused by mutations in NOTCH3 gene. We report the first case of CADASIL in an indigenous Rungus (Kadazan-Dusun) family in Kudat, Sabah, Malaysia confirmed by a R54C (c.160C>T, p.Arg54Cys) mutation in the NOTCH3. This mutation was previously reported in a Caucasian and two Korean cases of CADASIL. We recruited two generations of the affected Rungus family (n = 9) and found a missense mutation (c.160C>T) in exon 2 of NOTCH3 in three siblings. Two of the three siblings had severe white matter abnormalities in their brain MRI (Scheltens score 33 and 50 respectively), one of whom had a young stroke at the age of 38. The remaining sibling, however, did not show any clinical features of CADASIL and had only minimal changes in her brain MRI (Scheltens score 17). This further emphasized the phenotype variability among family members with the same mutation in CADASIL. This is the first reported family with CADASIL in Rungus subtribe of Kadazan-Dusun ethnicity with a known mutation at exon 2 of NOTCH3. The penetrance of this mutation was not complete during the course of this study.
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Affiliation(s)
- Kheng-Seang Lim
- Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai-Huey Tan
- Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chun-Shen Lim
- Genetics and Molecular Biology Unit, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Kek-Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ping-Chin Lee
- Genetics and Molecular Biology Unit, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Norlisah Ramli
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Kum-Thong Wong
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Meenakshi B. Bhattacharjee
- Department of Pathology and Laboratory Medicine, UT Health Science Center, Houston, TX, United States of America
| | - Ching-Ching Ng
- Genetics and Molecular Biology Unit, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
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Chung WW, Chua SS, Lai PSM, Morisky DE. The Malaysian Medication Adherence Scale (MALMAS): Concurrent Validity Using a Clinical Measure among People with Type 2 Diabetes in Malaysia. PLoS One 2015; 10:e0124275. [PMID: 25909363 PMCID: PMC4409377 DOI: 10.1371/journal.pone.0124275] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 03/12/2015] [Indexed: 01/04/2023] Open
Abstract
Medication non-adherence is a prevalent problem worldwide but up to today, no gold standard is available to assess such behavior. This study was to evaluate the psychometric properties, particularly the concurrent validity of the English version of the Malaysian Medication Adherence Scale (MALMAS) among people with type 2 diabetes in Malaysia. Individuals with type 2 diabetes, aged 21 years and above, using at least one anti-diabetes agent and could communicate in English were recruited. The MALMAS was compared with the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess its convergent validity while concurrent validity was evaluated based on the levels of glycated hemoglobin (HbA1C). Participants answered the MALMAS twice: at baseline and 4 weeks later. The study involved 136 participants. The MALMAS achieved acceptable internal consistency (Cronbach’s alpha=0.565) and stable reliability as the test-retest scores showed fair correlation (Spearman’s rho=0.412). The MALMAS has good correlation with the MMAS-8 (Spearman’s rho=0.715). Participants who were adherent to their anti-diabetes medications had significantly lower median HbA1C values than those who were non-adherence (7.90 versus 8.55%, p=0.032). The odds of participants who were adherent to their medications achieving good glycemic control was 3.36 times (95% confidence interval: 1.09-10.37) of those who were non-adherence. This confirms the concurrent validity of the MALMAS. The sensitivity of the MALMAS was 88.9% while its specificity was 29.6%. The findings of this study further substantiates the reliability and validity of the MALMAS, in particular its concurrent validity and sensitivity for assessing medication adherence of people with type 2 diabetes in Malaysia.
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Affiliation(s)
- Wen Wei Chung
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Pharmacy Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Siew Siang Chua
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Donald E. Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
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Rakrachakarn V, Moschis GP, Ong FS, Shannon R. Materialism and life satisfaction: the role of religion. J Relig Health 2015; 54:413-426. [PMID: 25811060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examines the role of religion and religiosity in the relationship between materialism and life satisfaction. The findings suggests that religion may be a key factor in understanding differences in findings of previous studies regarding the inverserelationship found in the vast majority of previous studies. Based on a large-scale study in Malaysia—a country comprised of several religious subcultures (mainly Muslims, Buddhists, and Hindus), the findings suggest that the influence of religiosity on materialism and life satisfaction is stronger among Malays than among Chinese and Indians, and life satisfaction partially mediates the relationship between religiosity and materialism. The paper discusses implications for theory development and further research.
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Abstract
Introduction Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians. Methods CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years). i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF). Results No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese. Conclusion The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population.
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Affiliation(s)
- May Al-koshab
- Department of Diagnostic and Integrated Dental Practice, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Phrabhakaran Nambiar
- Department of Diagnostic and Integrated Dental Practice, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Jacob John
- Department of Diagnostic and Integrated Dental Practice, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Yap TWC, Chan WK, Leow AHR, Azmi AN, Loke MF, Vadivelu J, Goh KL. Prevalence of serum celiac antibodies in a multiracial Asian population--a first study in the young Asian adult population of Malaysia. PLoS One 2015; 10:e0121908. [PMID: 25799401 PMCID: PMC4370882 DOI: 10.1371/journal.pone.0121908] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 01/15/2015] [Indexed: 02/06/2023] Open
Abstract
Background Celiac disease (CD) is an immune-mediated disorder induced by the ingestion of gluten in genetically susceptible persons. The prevalence of CD in Malaysia is unknown. We aim to determine the seroprevalence of CD antibodies and also investigate the correlation between H. pylori infection and CD in the young and healthy multiracial Malaysian population. Methods Healthy young adult volunteers between the ages of 18–30 years were consecutively recruited from June 2012 to May 2014 at the University of Malaya Medical Centre (UMMC), Kuala Lumpur. Serum samples from all the participants were tested for anti-gliadin antibody immunoglobulin A/immunoglobulin G (IgA/IgG) and anti-tissue transglutaminase antibody (tTG) IgA/IgG. Samples positive for both anti-gliadin and anti-tTG were further validated for anti-human endomysial IgA antibodies (EmA). Serological diagnosis of CD was made when anti-gliadin, anti-tTG and anti-EmA were positive. Results 562 qualified participants with mean age 24 ± 2.4 years old were recruited into our study. CD was found in 7 participants where most of them were asymptomatic and unaware of their CD status. The median of anti-gliadin and anti-tTG IgA/IgG value was 38.2 U/ml (interquartile range, 28.3–60.4 U/ml) and 49.2 U/ml (interquartile range, 41.1–65.9 U/ml), respectively. Seroprevalence of CD antibodies was 1.9% (6 out of 324) in female while only 0.4% (1 out of 238) in male. Seroprevalence among Malay was 0.8% (2 of 236), Chinese was 1.7% (3 of 177) and Indian was 1.3% (2 of 149). Overall, seroprevalence of CD antibodies in healthy asymptomatic adults in the Malaysian population was 1.25% (95% CI, 0.78%-1.72%). No significant relationship was discovered between CD and H. pylori infection. Conclusions The seroprevalence of CD antibodies in healthy young adults in the Malaysian population was 1.25% (1 in 100). CD is underdiagnosed and it could be a much greater problem in Malaysia than previously thought.
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Affiliation(s)
- Theresa Wan-Chen Yap
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Weng-Kai Chan
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Alex Hwong-Ruey Leow
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ahmad Najib Azmi
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mun-Fai Loke
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Jamuna Vadivelu
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Khean-Lee Goh
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- * E-mail:
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Ahmed A, Wan-Yuen C, Marret MJ, Guat-Sim C, Othman S, Chinna K. Child maltreatment experience among primary school children: a large scale survey in Selangor state, Malaysia. PLoS One 2015; 10:e0119449. [PMID: 25786214 PMCID: PMC4364765 DOI: 10.1371/journal.pone.0119449] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 01/29/2015] [Indexed: 11/22/2022] Open
Abstract
Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10–12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.
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Affiliation(s)
- Ayesha Ahmed
- Department of Social and Preventive Medicine, Faculty of Medicine University of Malaya, Kuala Lumpur, Malaysia
- * E-mail: (AA); (CWY)
| | - Choo Wan-Yuen
- Department of Social and Preventive Medicine, Faculty of Medicine University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya (Centre for Clinical Epidemiology and Evidence Based Medicine), University of Malaya, Kuala Lumpur, Malaysia
- * E-mail: (AA); (CWY)
| | - Mary Joseph Marret
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Cheah Guat-Sim
- Paediatric Institute, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Department of Social and Preventive Medicine, Faculty of Medicine University of Malaya, Kuala Lumpur, Malaysia
- Julius Centre University of Malaya (Centre for Clinical Epidemiology and Evidence Based Medicine), University of Malaya, Kuala Lumpur, Malaysia
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Haerian BS, Sha'ari HM, Fong CY, Tan HJ, Wong SW, Ong LC, Raymond AA, Tan CT, Mohamed Z. Contribution of TIMP4 rs3755724 polymorphism to susceptibility to focal epilepsy in Malaysian Chinese. J Neuroimmunol 2015; 278:137-43. [PMID: 25595263 DOI: 10.1016/j.jneuroim.2014.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 08/09/2014] [Revised: 12/13/2014] [Accepted: 12/17/2014] [Indexed: 11/20/2022]
Abstract
Neuroinflammation can damage the brain and plays a critical role in the pathophysiology of epilepsy. Tissue inhibitor of metalloproteinase 4 (TIMP4) is an inflammation-induced apoptosis and matrix turnover factor involved in several neuronal disorders and inflammatory diseases. Evidence has shown linkage disequilibrium between rs3755724 (-55C/T) of this gene with synapsin 2 (SYN2) rs3773364 and peroxisome proliferator-activated G receptor (PPARG) rs2920502 loci, which contribute to epilepsy in Caucasians. The aim of this study was to examine the association of these loci alone or their haplotypes with the risk of epilepsy in the Malaysian population. Genomic DNA of 1241 Malaysian Chinese, Indian, and Malay subjects (670 patients with epilepsy and 571 healthy individuals) was genotyped for the candidate loci by using the Sequenom MassArray method. Allele and genotype association of rs3755724 with susceptibility to epilepsy was significant in the Malaysian Chinese with focal epilepsy under codominant and dominant models (C vs. T: 1.5 (1.1-2.0), p=0.02; CT vs. TT: 1.8 (1.2-2.8), p=0.007 and 1.8 (1.2-2.7), p=0.006, respectively). The T allele and the TT genotype were more common in patients than in controls. No significant association was found between rs2920502 and rs3773364-rs3755724-rs2920502 haplotypes for susceptibility to epilepsy in each ethnicity. This study provides evidence that the promoter TIMP4 rs3755724 is a new focal epilepsy susceptibility variant that is plausibly involved in inflammation-induced seizures in Malaysian Chinese.
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Affiliation(s)
- Batoul Sadat Haerian
- Pharmacogenomics Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Hidayati Mohd Sha'ari
- Pharmacogenomics Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Choong Yi Fong
- Division of Paediatrics Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hui Jan Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sau Wei Wong
- Division of Paediatrics Neurology, Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lai Choo Ong
- Division of Paediatrics Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azman Ali Raymond
- Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chong Tin Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zahurin Mohamed
- Pharmacogenomics Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Lee KH, Chai VY, Kanachamy SS, Say YH. Association of UCP1 -3826A/G and UCP3 -55C/T gene polymorphisms with obesity and its related traits among multi-ethnic Malaysians. Ethn Dis 2015; 25:65-71. [PMID: 25812254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE Our study investigated the association of UCP1 -3826A/G and UCP3 -55C/T single nucleotide polymorphisms (SNPs) with obesity and its related traits among multi-ethnic Malaysians. PARTICIPANTS A total of 447 (225 males; 46 Malays, 339 ethnic Chinese, 62 ethnic Indians; 111 obese) participated. METHODS Demographic and anthropometric data were collected, and genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS The minor allele frequencies (MAFs) for UCP1 according to Malay/Chinese/Indian ethnicities were .61/.55/.52 and .32/.55/.38, respectively. UCP3 genotype and allele distribution was significantly associated with ethnicity and waist-to-hip ratio (WHR), but among non-obese and Chinese participants only, respectively, after stratified analysis. Chinese participants with T allele had significantly lesser risk to be centrally obese [odds ratio =.69 (CI =.48, 1.00; P=.04)], and also had significantly lower WHR compared to those with C allele. The UCP1 or UCP3 SNPs were not associated with obesity/BMI and total body fat (TBF), but combinatory genotype analysis revealed that those having the AA and CC genotype for the former and latter SNPs had significantly highest BMI and TBF compared to other genotype combinations. CONCLUSIONS UCP3 -55C/T SNP was associated with central obesity among Malaysian participants of Chinese descent. Combinatory genotype analysis showed that BMI and TBF were significantly different among UCPI -3826A/G and UCP3 -55C/T genotype combinations, suggesting the existence of a gene interaction between UCP1 and UCP3 in influencing obesity and adiposity.
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