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  1. Chan JY, Li H, Singh O, Mahajan A, Ramasamy S, Subramaniyan K, et al.
    Urol Oncol, 2013 Nov;31(8):1553-60.
    PMID: 22561070 DOI: 10.1016/j.urolonc.2012.02.009
    OBJECTIVES: Recently, several genome-wide association studies have demonstrated a cumulative association of 5 polymorphic variants in chromosomes 8q24 and 17q with prostate cancer (CaP) risk in Caucasians, particularly those harboring aggressive clinicopathologic characteristics. The purpose of this study was to evaluate the influence of these variants on CaP susceptibility in Singaporean Asian men.
    MATERIALS AND METHODS: We performed a case-control study in 289 Chinese CaP patients and 412 healthy subjects (144 Chinese, 134 Malays, and 134 Indians), and examined the association of the 5 single nucleotide polymorphisms (SNPs) with CaP.
    RESULTS: In the healthy subjects, rs16901979 A-allele frequency was highest amongst Chinese (0.32) compared with Malays (0.13; P < 0.0001) or Indians (0.09; P < 0.0001); rs6983267 G-allele was highest in Indians (0.51) compared with Chinese (0.42; P = 0.041) or Malays (0.43; P = 0.077); whereas rs1859962 G-allele frequency was highest amongst Indians (0.56) compared with Chinese (0.40; P = 0.0002) or Malays (0.38; P < 0.0001). Individuals with the rs4430796 TT genotype were at increased CaP risk in the Chinese via a recessive model (odds ratios (OR) = 1.56, 95% CI = 1.04-2.33). Significant associations were observed for rs4430796 TT with Gleason scores of ≥ 7 (OR = 1.76, 95% CI = 1.14-2.73) and prostate-specific antigen (PSA) levels of ≥ 10 ng/ml at diagnosis (OR = 1.63, 95% CI = 1.01-2.63), as well as for rs6983267 GG with stage 3-4 CaPs (OR = 1.91, 95% CI = 1.01-3.61). A cumulative gene interaction influence on disease risk, which approximately doubled for individuals with at least 2 susceptibility genotypes, was also identified (OR = 2.18, 95% CI = 1.10-4.32).
    CONCLUSIONS: This exploratory analysis suggests that the 5 genetic variants previously described may contribute to prostate cancer risk in Singaporean men.
    KEYWORDS: Cancer; Ethnicity; Gleason; Pharmacogenetics; Polymorphism; Prostate
    Matched MeSH terms: Logistic Models
  2. Wong K. H.
    MyJurnal
    Introduction: Breast cancer is the commonest cancer in Malaysia, predominantly among women under age of 60 and they often presented late. Borneo is home to multi-racial indigenous with heterogeneous background and breast cancer profile can be absolutely unique. This study aims to examine the demographic characteristics and stage at presentation in Sandakan women with newly diagnosed breast cancer. Methods: This is a cross-sectional, retrospec-tive study involving those women who were newly diagnosed with breast cancer from January 2016 to December 2018 in Duchess of Kent Hospital, Sandakan identified via hospital cancer registry and patient records. Only breast cancer with epithelial origin was included. Age, ethnicity and stages at presentation of breast cancer were analysed. Logistic regression was used to study their relationships. Results: 110 women were newly diagnosed as breast cancer. Mean age was 53.5 (SD 12.7), the youngest at 30 and the eldest at 97. Majority (64.6%) were local indigenous wom-en, constituted by 25.4% Sungai, 14.1% Kadazan-Dusun, 12.7% Bugis and the minorities. Chinese women are the main local non-indigenous (32.7%) followed by 2.7% Malay. 52.1% presented at late stages (stage III/IV). Subgroup analysis of T-staging revealed 41.7% had advanced symptoms (T3/T4). Indigenous group was more likely to present at younger ages (OR 12.0; 95%CI 1.5-93.8) and with advanced symptoms (OR 3.1; 95%CI 1.2-8.0). Conclusion: Awareness on breast cancer remains inadequate particularly among indigenous women. Difficult healthcare accessi-bility and incline towards traditional medicine could attribute to late presentation. Outreach awareness programmes are warranted in addition to mobile screening services.
    Matched MeSH terms: Logistic Models
  3. Balasundram S, Kovilpillai FJ, Royan SJ, Ma BC, Gunarajah DR, Adnan TH
    J Maxillofac Oral Surg, 2020 Jun;19(2):289-297.
    PMID: 32346242 DOI: 10.1007/s12663-019-01204-1
    Purpose: To ascertain the complications arising from open reduction and internal fixation of mandibular fractures and to elucidate if different osteosynthesis plating systems vary in treatment outcome.

    Materials and Methods: This is a retrospective study. Parameters such as patient data, injury details, osteosynthesis implant system information, stability of fracture fragments, occlusion and complications were evaluated at different time intervals and logistic regression applied to determine the association of these factors with complications.

    Results: Five hundred and ninety-three patients with mandibular fractures were included in this study (male 87.9% and female 12.1%), age range of 13-72 years (median = 22 years). Most fractures were caused by motor vehicle accidents (85.8%), assault (6.2%) and falls (4.7%). Parasymphyseal fractures were the most common (50.1%), followed by angle (35.2%) and body of mandible (25%). Median time interval between injury and intervention was 7 days (IQR 4-10). Median duration of follow-up from date of surgery was 72 days (IQR 30-230). 76.9% (456) were completely free of complications. Most complications (46%) occurred in the intermediate post-surgical period (1-6 weeks). Median interval period between surgery and complication was 15 days (IQR 7-67.5). Nerve injury and surgical site infection were the most common complications at 6.7% and 5.7%, respectively. There was a significant difference between the plating system in terms of complication outcome (p = 0.017).

    Conclusion: Whilst the miniplate dimensions may be similar across different manufacturers, the complication outcome may differ between systems.

    Matched MeSH terms: Logistic Models
  4. Fok D, Aris IM, Ho J, Lim SB, Chua MC, Pang WW, et al.
    Birth, 2016 09;43(3):247-54.
    PMID: 27018256 DOI: 10.1111/birt.12233
    BACKGROUND: Confinement (restrictions placed on diet and practices during the month right after delivery) represents a key feature of Asian populations. Few studies, however, have focused specifically on ethnic differences in confinement practices. This study assesses the confinement practices of three ethnic groups in a multi-ethnic Asian population.

    METHODS: Participants were part of a prospective birth cohort study that recruited 1,247 pregnant women (57.2% Chinese, 25.5% Malay, and 17.3% Indian) during their first trimester. The 1,220 participants were followed up 3 weeks postpartum at home when questionnaires were administered to ascertain the frequency of adherence to the following confinement practices: showering; confinement-specific meals; going out with or without the baby; choice of caregiver assistance; and the use of massage therapy.

    RESULTS: Most participants reported that they followed confinement practices during the first 3 weeks postpartum (Chinese: 96.4%, Malay: 92.4%, Indian: 85.6%). Chinese and Indian mothers tended to eat more special confinement diets than Malay mothers (p < 0.001), and Chinese mothers showered less and were more likely to depend on confinement nannies during this period than mothers from the two other ethnic groups (p < 0.001 for all). Malay mothers tended to make greater use of massage therapy (p < 0.001), whilst Indian mothers tended to have their mothers or mothers-in-law as assistant caregivers (p < 0.001).

    CONCLUSION: Most Singapore mothers follow confinement practices, but the three Asian ethnic groups differed in specific confinement practices. Future studies should examine whether ethnic differences persist in later childrearing practices.

    Matched MeSH terms: Logistic Models
  5. Murphy N, Cross AJ, Abubakar M, Jenab M, Aleksandrova K, Boutron-Ruault MC, et al.
    PLoS Med, 2016 Apr;13(4):e1001988.
    PMID: 27046222 DOI: 10.1371/journal.pmed.1001988
    BACKGROUND: Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown.

    METHODS AND FINDINGS: The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI ≥ 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI ≥ 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [≥80 cm for women and ≥94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of <0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed.

    CONCLUSIONS: These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer.

    Matched MeSH terms: Logistic Models
  6. Jacob M, Sahu S, Singh YP, Mehta Y, Yang KY, Kuo SW, et al.
    Indian J Crit Care Med, 2020 Nov;24(11):1028-1036.
    PMID: 33384507 DOI: 10.5005/jp-journals-10071-23653
    Introduction: Fluid therapy in critically ill patients, especially timing and fluid choice, is controversial. Previous randomized trials produced conflicting results. This observational study evaluated the effect of colloid use on 90-day mortality and acute kidney injury (RIFLE F) within the Rational Fluid Therapy in Asia (RaFTA) registry in intensive care units.

    Materials and methods: RaFTA is a prospective, observational study in Asian intensive care unit (ICU) patients focusing on fluid therapy and related outcomes. Logistic regression was performed to identify risk factors for increased 90-day mortality and acute kidney injury (AKI).

    Results: Twenty-four study centers joined the RaFTA registry and collected 3,187 patient data sets from November 2011 to September 2012. A follow-up was done 90 days after ICU admission. For 90-day mortality, significant risk factors in the overall population were sepsis at admission (OR 2.185 [1.799; 2.654], p < 0.001), cumulative fluid balance (OR 1.032 [1.018; 1.047], p < 0.001), and the use of vasopressors (OR 3.409 [2.694; 4.312], p < 0.001). The use of colloids was associated with a reduced risk of 90-day mortality (OR 0.655 [0.478; 0.900], p = 0.009). The initial colloid dose was not associated with an increased risk for AKI (OR 1.094 [0.754; 1.588], p = 0.635).

    Conclusion: RaFTA adds the important finding that colloid use was not associated with increased 90-day mortality or AKI after adjustment for baseline patient condition.

    Clinical significance: Early resuscitation with colloids showed potential mortality benefit in the present analysis. Elucidating these findings may be an approach for future research.

    How to cite this article: Jacob M, Sahu S, Singh YP, Mehta Y, Yang K-Y, Kuo S-W, et al. A Prospective Observational Study of Rational Fluid Therapy in Asian Intensive Care Units: Another Puzzle Piece in Fluid Therapy. Indian J Crit Care Med 2020;24(11):1028-1036.

    Matched MeSH terms: Logistic Models
  7. Tan PH, Teng XX, Gan ZY, Tan SQ
    Malays J Med Sci, 2020 Jul;27(4):139-146.
    PMID: 32863753 MyJurnal DOI: 10.21315/mjms2020.27.4.13
    Background: Appendicitis complicated with appendiceal perforation is common among children. The delay in diagnosis of appendicitis is due to children's varied presentations and their difficulty in communicating symptoms. We aimed to identify clinical factors that aid in predicting acute appendicitis (AA) and perforated appendicitis (PA) among children.

    Methods: This retrospective study involved 215 children aged 12 years and below with the initial diagnosis of AA and PA. Clinical factors studied were demographics, presenting symptoms, body temperature on admission (BTOA), white cell count (WCC), absolute neutrophil count (ANC), platelet count and urinalysis. Simple and multiple logistic regressions were used to determine the odds ratio of the statistically significant clinical factors. Results: The mean age of the included children was 7.98 ± 2.37 years. The odds of AA increased by 2.177 times when the age was ≥ 8 years (P = 0.022), 2.380 times when duration of symptoms ≥ 2 days (P = 0.011), 2.447 times with right iliac fossa (RIF) pain (P = 0.007), 2.268 times when BTOA ≥ 38 °C (P = 0.020) and 2.382 times when neutrophil percentage was ≥ 76% (P = 0.045). It decreased by 0.409 times with non-RIF pain (P = 0.007). The odds of PA was increased by 4.672 times when duration of symptoms ≥ 2 days (P = 0.005), 3.611 times when BTOA ≥ 38 °C (P = 0.015) and 3.678 times when neutrophil percentage ≥ 76% (P = 0.016). There was no significant correlation between WCC and ANC with AA and PA.

    Conclusion: Older children with longer duration of symptoms, RIF pain and higher BTOA are more likely to have appendicitis. The risk of appendiceal perforation increases with longer duration of symptoms and higher BTOA.

    Matched MeSH terms: Logistic Models
  8. Chan PY, Latip LS
    Med J Malaysia, 2011 Dec;66(5):456-61.
    PMID: 22390101 MyJurnal
    Matched MeSH terms: Logistic Models
  9. Abdul Rahman HI, Shah SA, Alias H, Ibrahim HM
    Asian Pac J Cancer Prev, 2008 Oct-Dec;9(4):649-52.
    PMID: 19256754
    BACKGROUND: In Malaysia, acute leukemia is the most common cancer among children below the age of 15. A case-control study was here conducted for cases from the Klang Valley, Malaysia, who received treatment at the National University of Malaysia Hospital (HUKM) and Kuala Lumpur General Hospital (GHKL). The main objective was to determine any association with environmental factors.

    METHODS: Case subjects were children aged below 15 years and diagnosed with acute leukemia in HUKM and GHKL between January 1, 2001 and May 30, 2007. Control subjects were children aged below 15 years who were diagnosed with any non-cancerous acute illnesses in these hospitals. A total of 128 case subjects and 128 control subjects were enrolled in this study. The information was collected using a structured questionnaire and a global positioning system (GPS) device. All factors were analyzed using unmatched logistic regression.

    RESULTS: The analysis showed that the occurrence of acute leukemia among children was strongly determined by the following factors: family income (odds ratio (OR) 0.19, 95% confidence interval (CI): 0.09-0.42), father with higher social contact (OR 7.61, 95% CI: 3.78-15.4), number of elder siblings (OR 0.36, 95% CI: 0.18-0.77), father who smokes (OR 2.78, 95% CI: 1.49-5.16), and the distance of the house from a power line (OR 2.30, 95% CI: 1.18-4.49).

    CONCLUSIONS: Some socioeconomic, demographic, and environmental factors are strong predictors of the occurrence of acute leukemia among children in Klang Valley, Malaysia. In terms of environmental factors, it is recommended that future housing areas should be developed at least 200 m away from power lines.
    Matched MeSH terms: Logistic Models
  10. Yip KT, Das PK, Suria D, Lim CR, Ng GH, Liew CC
    J Exp Clin Cancer Res, 2010;29:128.
    PMID: 20846378 DOI: 10.1186/1756-9966-29-128
    BACKGROUND: Colorectal cancer (CRC) screening is key to CRC prevention and mortality reduction, but patient compliance with CRC screening is low. We previously reported a blood-based test for CRC that utilizes a seven-gene panel of biomarkers. The test is currently utilized clinically in North America for CRC risk stratification in the average-risk North American population in order to improve screening compliance and to enhance clinical decision making.
    METHODS: In this study, conducted in Malaysia, we evaluated the seven-gene biomarker panel validated in a North American population using blood samples collected from local patients. The panel employs quantitative RT-PCR (qRT-PCR) to analyze gene expression of the seven biomarkers (ANXA3, CLEC4D, TNFAIP6, LMNB1, PRRG4, VNN1 and IL2RB) that are differentially expressed in CRC patients as compared with controls. Blood samples from 210 patients (99 CRC and 111 controls) were collected, and total blood RNA was isolated and subjected to quantitative RT-PCR and data analysis.
    RESULTS: The logistic regression analysis of seven-gene panel has an area under the curve (AUC) of 0.76 (95% confidence interval: 0.70 to 0.82), 77% specificity, 61% sensitivity and 70% accuracy, comparable to the data obtained from the North American investigation of the same biomarker panel.
    CONCLUSIONS: Our results independently confirm the results of the study conducted in North America and demonstrate the ability of the seven biomarker panel to discriminate CRC from controls in blood samples drawn from a Malaysian population.
    Matched MeSH terms: Logistic Models
  11. Mat Ariffin N, Islahudin F, Kumolosasi E, Makmor-Bakry M
    BMC Infect Dis, 2017 12 08;17(1):759.
    PMID: 29216842 DOI: 10.1186/s12879-017-2868-9
    BACKGROUND: Recurrence rates of Plasmodium vivax infections differ across various geographic regions. Interestingly, South-East Asia and the Asia-Pacific region are documented to exhibit the most frequent recurrence incidences. Identifying patients at a higher risk for recurrences gives valuable information in strengthening the efforts to control P. vivax infections. The aim of the study was to develop a tool to identify P. vivax- infected patients that are at a higher risk of recurrence in Malaysia.

    METHODS: Patient data was obtained retrospectively through the Ministry of Health, Malaysia, from 2011 to 2016. Patients with incomplete data were excluded. A total of 2044 clinical P. vivax malaria cases treated with primaquine were included. Data collected were patient, disease, and treatment characteristics. Two-thirds of the cases (n = 1362) were used to develop a clinical risk score, while the remaining third (n = 682) was used for validation.

    RESULTS: Using multivariate analysis, age (p = 0.03), gametocyte sexual count (p = 0.04), indigenous transmission (p = 0.04), type of treatment (p = 0.12), and incomplete primaquine treatment (p = 0.14) were found to be predictors of recurrence after controlling for other confounding factors; these predictors were then used in developing the final model. The beta-coefficient values were used to develop a clinical scoring tool to predict possible recurrence. The total scores ranged between 0 and 8. A higher score indicated a higher risk for recurrence (odds ratio [OR]: 1.971; 95% confidence interval [CI]: 1.562-2.487; p ≤ 0.001). The area under the receiver operating characteristic (ROC) curve of the developed (n = 1362) and validated model (n = 682) was of good accuracy (ROC: 0.728, 95% CI: 0.670-0.785, p value 

    Matched MeSH terms: Logistic Models
  12. Aziz H, Hatah E, Makmor-Bakry M, Islahudin F, Ahmad Hamdi N, Mok Pok Wan I
    Malays Fam Physician, 2018;13(2):2-9.
    PMID: 30302177 MyJurnal
    Background: Limited efforts have been made to evaluate medication adherence among subsidized and self-paying patients.

    Objective: To investigate medication adherence among patients with and without medication subsidies and to identify factors that may influence patients' adherence to medication. Setting: Government healthcare institutions in Kuala Lumpur, Selangor, and Negeri Sembilan and private healthcare institutions in Selangor and Negeri Sembilan, Malaysia.

    Methods: This cross-sectional study sampled patients with and without medication subsidies (self-paying patients). Only one of the patient's medications was re-packed into Medication Event Monitoring Systems (MEMS) bottles, which were returned after four weeks. Adherence was defined as the dose regimen being executed as prescribed on 80% or more of the days. The factors that may influence patients' adherence were modelled using binary logistic regression. Main outcome measure: Percentage of medication adherence.

    Results: A total of 97 patients, 50 subsidized and 47 self-paying, were included in the study. Medication adherence was observed in 50% of the subsidized patients and 63.8% of the self-paying patients (χ2=1.887, df=1, p=0.219). None of the evaluated variables had a significant influence on patients' medication adherence, with the exception of attending drug counselling. Patients who attended drug counselling were found to be 3.3 times more likely to adhere to medication than those who did not (adjusted odds ratio of 3.29, 95% CI was 1.42 to 7.62, p = 0.006).

    Conclusion: There is no significant difference in terms of medication adherence between subsidized and self-paying patients. Future studies may wish to consider evaluating modifiable risk factors in the examination of non-adherence among subsidized and self-paying patients in Malaysia.

    Matched MeSH terms: Logistic Models
  13. Awosolu OB, Yahaya ZS, Farah Haziqah MT, Simon-Oke IA, Fakunle C
    Heliyon, 2021 Jan;7(1):e05975.
    PMID: 33521357 DOI: 10.1016/j.heliyon.2021.e05975
    Background: Malaria is a severe global public health challenge that causes significant morbidity and mortality worldwide, particularly in sub-Saharan Africa. This study was designed to determine the prevalence, parasite density, and risk factors associated with malaria infection transmission among residents of two urban communities of Ibadan, southwestern Nigeria.

    Materials and methods: A cross-sectional hospital-based study was carried out on 300 participants. Blood samples were obtained. Thick and thin blood films were prepared and viewed using the standard parasitological technique of microscopy. Moreover, data on sociodemographic and environmental variables were obtained using a pre-tested standard questionnaire.

    Results: Of the 300 participants examined, a total of 165 (55.0%) were found positive for Plasmodium falciparum with a mean (S.D) parasite density of 1814.70 (1829.117) parasite/μL of blood. The prevalence and parasite density of malaria infection vary significantly (P < 0.05) with age group. Children <5 years old were more likely to have malaria infection and high parasite densities than adults (p < 0.05). Similarly, in relation to gender, males significantly (P < 0.05) had a higher prevalence (60.2%) and mean (S.D) parasite density of malaria infection [2157.73 (1659.570) parasite/μL of blood] compared to females. Additionally, those without formal education had the highest prevalence (73.0%) and mean (S.D) parasite density of infection [2626.96 (2442.195) parasite/μL of blood]. The bivariate logistic regression analysis shows that age group 6-10 (Crude Odds Ratio, COR 0.066, 95% CI: 0.007-0.635), presence of streams/rivers (COR 0.225, 95% CI: 0.103-0.492), distance from streams/rivers within ≤1 km (COR 0.283, 95% CI: 0.122-0.654) and travel to rural area (COR 4.689, 95% CI: 2.430-9.049) were the significant risk factors.

    Conclusions: Malaria infection is prevalent in the study area and was greatly influenced by traveling activities from the rural areas to urban centers and vice versa. Multifaceted and integrated control strategy should be adopted. Health education on mosquito prevention and chemoprophylaxis before and during travel to rural areas are essential.

    Matched MeSH terms: Logistic Models
  14. Teh KX, Henien NPB, Wong LS, Wong ZKH, Raja Ismail RZ, Achok HN, et al.
    PLoS One, 2020;15(7):e0235674.
    PMID: 32649723 DOI: 10.1371/journal.pone.0235674
    BACKGROUND: Non-adherence to anti-seizure medication (ASM) therapy is an important contributing factor to the higher mortality rate and treatment failure of epilepsy. This study aimed to determine the rate and factors associated with non-adherence to ASM therapy through the WHO five dimensions of medication adherence framework.

    METHODS: We conducted a cross-sectional study at an outpatient Neurology Clinic of a tertiary government hospital in Malaysia. Between March and July 2019, we identified 217 patients with a confirmed diagnosis of epilepsy, receiving oral ASM therapy and able to administer their medications. We performed a semi-structured interview to gather information on sociodemographic background, clinical and medication history, and perceptions on healthcare services. Adherence to ASM therapy was evaluated using the Medication Compliance Questionnaire (MCQ). Patient's illness perception was assessed by the Brief Illness Perception Questionnaire (B-IPQ).

    RESULTS: 208 patients participated in this study. The median age of the study participants was 35 years (IQR 26-44). 58.2% were females and majority, 55.8%, were from the Malay ethnic group. Based on the MCQ scoring, 89 patients (42.8%) were non-adherent. Multiple logistic regression demonstrated that being employed or students (adjusted odds ratio [aOR] 2.26, 95%CI: 1.19-4.29 p = 0.012) and having an average or below average perceived access to pharmacy services (aOR 2.94, 95%CI: 1.38-6.24, p = 0.005) were significant contributors to non-adherence.

    CONCLUSION: Being employed or students and having an average or below average perceived access to pharmacy services were associated with ASM non-adherence Efforts to improve ASM adherence should adopt a comprehensive approach considering the success of adherence is contingent on the interrelationship of multiple dimensions.

    Matched MeSH terms: Logistic Models
  15. Mohan D, Iype T, Varghese S, Usha A, Mohan M
    BMJ Open, 2019 03 20;9(3):e025473.
    PMID: 30898818 DOI: 10.1136/bmjopen-2018-025473
    OBJECTIVES: To assess the prevalence and factors associated with mild cognitive impairment (MCI) among older adults in an urban area of South India.

    SETTING: The study was conducted in the capital city of Thiruvananthapuram in the South Indian state of Kerala.

    PARTICIPANTS: The study participants were community-dwelling individuals aged 60 years and above.

    PRIMARY OUTCOME MEASURE: MCI was the primary outcome measure and was defined using the criteria by European Alzheimer's Disease Consortium. Cognitive assessment was done using the Malayalam version of Addenbrooke's Cognitive Examination tool. Data were also collected on sociodemographic variables, self-reported comorbidities like hypertension and diabetes, lifestyle factors, depression, anxiety and activities of daily living.

    RESULTS: The prevalence of MCI was found to be 26.06% (95% CI of 22.12 to 30.43). History of imbalance on walking (adjusted OR 2.75; 95 % CI of 1.46 to 5.17), presence of depression (adjusted OR 2.17, 95 % CI of 1.21 to 3.89), anxiety (adjusted OR 2.22; 95 % CI of 1.21 to 4.05) and alcohol use (adjusted OR 1.99; 95 % CI of 1.02 to 3.86) were positively associated with MCI while leisure activities at home (adjusted OR 0.33; 95 % CI of 0.11 to 0.95) were negatively associated.

    CONCLUSION: The prevalence of MCI is high in Kerala. It is important that the health system and the government take up urgent measures to tackle this emerging public health issue.

    Matched MeSH terms: Logistic Models
  16. Chang SW, Merican AFMA, Rosnah Zain, Kareem SA
    Sains Malaysiana, 2014;43:567-573.
    There are very few prognostic studies that combine both clinicopathologic and genomic data. Most of the studies use only clinicopathologic factors without taking into consideration the tumour biology and molecular information, while some studies use genomic markers or microarray information only without the clinicopathologic parameters. Thus, these studies may not be able to prognoses a patient effectively. Previous studies have shown that prognosis results are more accurate when using both clinicopathologic and genomic data. The objectives of this research were to apply hybrid artificial intelligent techniques in the prognosis of oral cancer based on the correlation of clinicopathologic and genomic markers and to prove that the prognosis is better with both markers. The proposed hybrid model consisting of two stages, where stage one with ReliefF-GA feature selection method to find an optimal feature of subset and stage two with ANFIS classification to classify either the patients alive or dead after certain years of diagnosis. The proposed prognostic model was experimented on two groups of oral cancer dataset collected locally here in Malaysia, Group 1 with clinicopathologic markers only and Group 2 with both clinicopathologic and genomic markers. The results proved that the proposed model with optimum features selected is more accurate with the use of both clinicopathologic and genomic markers and outperformed the other methods of artificial neural network, support vector machine and logistic regression. This prognostic model is feasible to aid the clinicians in the decision support stage and to identify the high risk markers to better predict the survival rate for each oral cancer patient.
    Matched MeSH terms: Logistic Models
  17. J Paediatr Child Health, 1997 Feb;33(1):18-25.
    PMID: 9069039
    OBJECTIVE: To determine the risk factors associated with mortality in very low birthweight (VLBW) infants admitted to the neonatal intensive care units (NIUC) in Malaysia.

    METHOD: A prospective observational study of outcome of all VLBW infants born between 1 January 1993 and 30 June 1993 and admitted to the NICU.

    RESULTS: Data of 868 VLBW neonates from 18 centres in Malaysia were collected. Their mean birthweight was 1223 g (95% confidence intervals: 1208-1238 g). Thirty-seven point four per cent (325/868) of these infants died before discharge. After exclusion of all infants with congenital anomalies (n = 66, and nine of them also had incomplete records) and incomplete records (n = 82), stepwise logistic regression analysis of the remaining 720 infants showed that the risk factors that were significantly associated with increased mortality before discharge were: delivery in district hospitals, Chinese race, lower birthweight, lower gestation age, persistent pulmonary hypertension of the newborn, pulmonary airleak, necrotizing enterocolitis of stage 2 or 3, confirmed sepsis, hypotension, hypothermia, acute renal failure, intermittent positive pressure ventilation, and umbilical arterial catheterization. Factors that were significantly associated with lower risk of mortality were: use of antenatal steroid, oxygen therapy, surfactant therapy and blood transfusion.

    CONCLUSION: The mortality of VLBW infants admitted to the Malaysian NICU was high and was also associated with a number of preventable risk factors.

    Matched MeSH terms: Logistic Models
  18. Rampal L, Rampal S, Khor GL, Zain AM, Ooyub SB, Rahmat RB, et al.
    Asia Pac J Clin Nutr, 2007;16(3):561-6.
    PMID: 17704038
    A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index >= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged >= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996.
    Study name: National study on Cardio-Vascular Disease Risk Factors 2004
    Matched MeSH terms: Logistic Models
  19. Müller-Sienerth N, Shilts J, Kadir KA, Yman V, Homann MV, Asghar M, et al.
    Malar J, 2020 Jan 17;19(1):31.
    PMID: 31952523 DOI: 10.1186/s12936-020-3111-5
    BACKGROUND: Malaria remains a global health problem and accurate surveillance of Plasmodium parasites that are responsible for this disease is required to guide the most effective distribution of control measures. Serological surveillance will be particularly important in areas of low or periodic transmission because patient antibody responses can provide a measure of historical exposure. While methods for detecting host antibody responses to Plasmodium falciparum and Plasmodium vivax are well established, development of serological assays for Plasmodium knowlesi, Plasmodium ovale and Plasmodium malariae have been inhibited by a lack of immunodiagnostic candidates due to the limited availability of genomic information.

    METHODS: Using the recently completed genome sequences from P. malariae, P. ovale and P. knowlesi, a set of 33 candidate cell surface and secreted blood-stage antigens was selected and expressed in a recombinant form using a mammalian expression system. These proteins were added to an existing panel of antigens from P. falciparum and P. vivax and the immunoreactivity of IgG, IgM and IgA immunoglobulins from individuals diagnosed with infections to each of the five different Plasmodium species was evaluated by ELISA. Logistic regression modelling was used to quantify the ability of the responses to determine prior exposure to the different Plasmodium species.

    RESULTS: Using sera from European travellers with diagnosed Plasmodium infections, antigens showing species-specific immunoreactivity were identified to select a panel of 22 proteins from five Plasmodium species for serological profiling. The immunoreactivity to the antigens in the panel of sera taken from travellers and individuals living in malaria-endemic regions with diagnosed infections showed moderate power to predict infections by each species, including P. ovale, P. malariae and P. knowlesi. Using a larger set of patient samples and logistic regression modelling it was shown that exposure to P. knowlesi could be accurately detected (AUC = 91%) using an antigen panel consisting of the P. knowlesi orthologues of MSP10, P12 and P38.

    CONCLUSIONS: Using the recent availability of genome sequences to all human-infective Plasmodium spp. parasites and a method of expressing Plasmodium proteins in a secreted functional form, an antigen panel has been compiled that will be useful to determine exposure to these parasites.

    Matched MeSH terms: Logistic Models
  20. Rampal, G.R. Lekhraj, Sanjay, R., Azhar, M.Z., Sherina, M.S., Ambigga, D., Rahimah, A.
    MyJurnal
    Objective: This study was conducted to determine prevalence and factors associated with obesity in Selangor, Malaysia. Methods: A population-based cross-sectional study was conducted in all districts of Selangor State. All individuals, 15 years and above in the selected households, were included. A pre-tested structured questionnaire was used to collect the data. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. Statistical analysis was performed using Stata 8.2 taking into account the complex survey design. Results: The overall mean age of the 2219 respondents was 36.6(95% CI 35.7 – 37.6) years. There was no significant difference in the mean age of the males and females (p=0.697). The majority of the respondents were Malays (52.9%), followed by Chinese (30.9%), Indians (15.4%) and
    other races (0.9%). The overall mean BMI was 24.1 kg/m2 (95% CI=23.8- 24.4). The overall prevalence of obesity was 12.2% (95% CI 10.6%, 14.0%). There was no significant difference in the prevalence of obesity in the males compared to females (p>0.05). The prevalence of obesity increased with age up to the ages of 40-59 years and then decreased after 60 years. The highest prevalence of obesity was in the 40-59 years age groups in both sexes. The overall prevalence of obesity was significantly higher amongst the Malays (15.2%) compared to the Indians (11.6%) and Chinese (7.3%). Multivariate logistic regression analysis showed that only age and ethnicity were associated with obesity. Sex and educational level were not associated with obesity.
    Matched MeSH terms: Logistic Models
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