Displaying publications 1 - 20 of 1245 in total

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  1. Ab Rahman A, Ahmad Z, Naing L, Sulaiman SA, Hamid AM, Daud WN
    PMID: 18613559
    The objective of this case-control study was to determine the association between herbal medicine use during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia. Cases were mothers who gave birth from June 2002 to June 2005 with a history of perinatal mortality, while controls were those without a history of perinatal infant mortality. A total of 316 mothers (106 cases and 210 controls) were interviewed. The use of unidentified herbs prepared by traditional midwives and other types of herbal medicines during the first trimester of pregnancy were positively associated with perinatal mortality (OR = 5.24, 95% CI = 1.13; 24.23 and OR = 8.90, 95%, CI = 1.35; 58.53, respectively). The use of unidentified "Orang Asli" herbs and coconut oil during the third trimester of pregnancy were negatively associated with perinatal mortality in Tumpat (OR = 0.10, 95% CI = 0.02; 0.59 and OR = 0.48, 95% CI = 0.25; 0.92, respectively). These findings suggest the use of unidentified "Orang Asli" herbs and coconut oil in late pregnancy are protective against perinatal mortality, while the use of unidentified herbs prepared by traditional midwives and other types of herbal medicines in early pregnancy has an increased risk of perinatal infant mortality. Pharmacological studies to confirm and identify the compounds in these herbs and their effects on the fetus should be conducted in the future.
    Matched MeSH terms: Phytotherapy/mortality; Perinatal Mortality/trends*
  2. Abas AB, Mohd Said DA, Aziz Mohammed MA, Sathiakumar N
    Am. J. Ind. Med., 2013 Jan;56(1):65-76.
    PMID: 22544443 DOI: 10.1002/ajim.22056
    BACKGROUND: In Malaysia, surveillance of fatal occupational injuries is fragmented. We therefore analyzed an alternative data source from Malaysia's Social Security organization, the Pertubuhan Keselamatan Sosial (PERKESO).
    METHODS: We conducted a secondary data analysis of the PERKESO database comprised of 7 million employees from 2002 to 2006.
    RESULTS: Overall, the average annual incidence was 9.2 fatal occupational injuries per 100,000 workers. During the 5-year period, there was a decrease in the absolute number of fatal injuries by 16% and the incidence by 34%. The transportation sector reported the highest incidence of fatal injuries (35.1/100,000), followed by agriculture (30.5/100,000) and construction (19.3/100,000) sectors. Persons of Indian ethnicity were more likely to sustain fatal injuries compared to other ethnic groups.
    CONCLUSIONS: Government and industry should develop rigorous strategies to detect hazards in the workplace, especially in sectors that continuously record high injury rates. Targeted interventions emphasizing worker empowerment coupled with systematic monitoring and evaluation is critical to ensure success in prevention and control measures.
    Matched MeSH terms: Accidents, Occupational/mortality*; Occupational Injuries/mortality*
  3. Abbas SA, Sharma JN, Yusof AP
    Immunopharmacology, 1999 Oct 15;44(1-2):93-8.
    PMID: 10604530
    It is known that BK does play a role in the cardioprotective effect of angiotensin converting enzyme (ACE) inhibitors. The present study therefore was conducted to examine the effects of bradykinin (BK) and its antagonist on survival time in spontaneously hypertensive rats (SHR) with coronary artery ligation for 15 min and continuously. We also evaluated the heart rate and blood pressure (BP) in the presence and absence of BK and BK2 receptor antagonist, D-Arg-[Hyp-D-Phe7]BK. Coronary artery was ligated in anaesthetized rats and they were artificially ventilated with room air (stroke volume, 4 ml; 48 strokes/min) as described by the previous investigators. Lead II elecrocardiogram (ECG) was recorded from subcutaneous steel needle electrodes. Results of this investigation indicated that BK treatment 4 microg/kg (i.v.) and 8 microg/kg (i.v.) caused significant (P < 0.05) increase in survival time in SHR with coronary artery ligation for 15 min and continuously as compare to their respective saline-treated controls. However, BK antagonist treatment 4 microg/kg (i.v.) abolished the increase in survival time caused by BK treatment. The mean values of survival time between the saline-treated and BK antagonist plus BK-treated rats did not differ significantly (P > 0.05). The heart rate and BP responses were greatly reduced (P < 0.001) in the presence of coronary artery ligation. These findings suggest that BK might have cardioprotective effect to increase the survival time in rats by activating BK2 receptors after coronary artery ligation.
    Matched MeSH terms: Coronary Disease/mortality*; Hypertension/mortality
  4. Abd Rahman, R., Ismail, N.M., Yassin, M.A., Sulaiman, A.S.
    MyJurnal
    Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the deadline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%.This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100,000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.
    Matched MeSH terms: Maternal Mortality
  5. Abd Wahab NA, Lajis NH, Abas F, Othman I, Naidu R
    Nutrients, 2020 Mar 02;12(3).
    PMID: 32131560 DOI: 10.3390/nu12030679
    Prostate cancer (PCa) is a heterogeneous disease and ranked as the second leading cause of cancer-related deaths in males worldwide. The global burden of PCa keeps rising regardless of the emerging cutting-edge technologies for treatment and drug designation. There are a number of treatment options which are effectively treating localised and androgen-dependent PCa (ADPC) through hormonal and surgery treatments. However, over time, these cancerous cells progress to androgen-independent PCa (AIPC) which continuously grow despite hormone depletion. At this particular stage, androgen depletion therapy (ADT) is no longer effective as these cancerous cells are rendered hormone-insensitive and capable of growing in the absence of androgen. AIPC is a lethal type of disease which leads to poor prognosis and is a major contributor to PCa death rates. A natural product-derived compound, curcumin has been identified as a pleiotropic compound which capable of influencing and modulating a diverse range of molecular targets and signalling pathways in order to exhibit its medicinal properties. Due to such multi-targeted behaviour, its benefits are paramount in combating a wide range of diseases including inflammation and cancer disease. Curcumin exhibits anti-cancer properties by suppressing cancer cells growth and survival, inflammation, invasion, cell proliferation as well as possesses the ability to induce apoptosis in malignant cells. In this review, we investigate the mechanism of curcumin by modulating multiple signalling pathways such as androgen receptor (AR) signalling, activating protein-1 (AP-1), phosphatidylinositol 3-kinases/the serine/threonine kinase (PI3K/Akt/mTOR), wingless (Wnt)/ß-catenin signalling, and molecular targets including nuclear factor kappa-B (NF-κB), B-cell lymphoma 2 (Bcl-2) and cyclin D1 which are implicated in the development and progression of both types of PCa, ADPC and AIPC. In addition, the role of microRNAs and clinical trials on the anti-cancer effects of curcumin in PCa patients were also reviewed.
    Matched MeSH terms: Prostatic Neoplasms/mortality
  6. Abd-Elhay FA, Elhusseiny KM, Kamel MG, Low SK, Sang TK, Mehyar GM, et al.
    Clin Breast Cancer, 2018 12;18(6):e1293-e1310.
    PMID: 30093263 DOI: 10.1016/j.clbc.2018.07.003
    BACKGROUND: Male breast cancer (MBC) is usually diagnosed at late stages and therefore has a worse prognosis than female breast cancer (FBC). MBC is also more likely to have lymph node (LN) involvement than FBC.

    MATERIALS AND METHODS: We sought to determine the prognostic role of the examined lymph node (LN), negative LN (NLN), and positive LN counts and the LN ratio (LNR), defined as (positive LNs/ENLs), on the survival rate among MBC patients. We performed a large population-based study using the data from the Surveillance, Epidemiology, and End Results program.

    RESULTS: Older age, black race, stage IV disease, ≤ 1 NLN, and a > 31.3% LNR were significantly associated with worse survival across all prediction models. Moreover, we demonstrated a decreased risk of mortality in MBC patients across the MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.998; P = .03) and 10-year MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.999; P = .04).

    CONCLUSION: MBC has had an augmented incidence over the years. We found several independent predictors of MBC survival, including age, race, stage, NLNs, and the LNR. We strongly suggest adding the NLN count and/or LNR into the current staging system. Further studies are needed to provide information on the mechanisms underlying the association between the NLN count and MBC survival and the LNR and MBC survival.

    Matched MeSH terms: Lymph Node Excision/mortality*; Breast Neoplasms, Male/mortality*
  7. Abdelhafez MM, Ahmed KA, Daud MN, Eldiasty AM, Amri MF, Jeffree MS, et al.
    Afr J Reprod Health, 2023 May;27(5):81-94.
    PMID: 37584933 DOI: 10.29063/ajrh2023/v27i5.8
    This review aims to provide the mother carers with the most recent evidence-based guidelines in the context of managing of pregnancy-associated VTE, where an extensive search through the medical journals addressing the topic including the medical database such as Pubmed, Medline, Sience direct,Embase and others using the title and key-words in order to gather the most concerned as well as the up-to-date publications concerned with the problem under research, the search resulted in recognising pregnancy as a significant risk factor for the development of VTE, both during the prenatal and postnatal periods, with an estimated increased likelihood risk of five and sixty times, respectively and concluded that venous thromboembolism (VTE) is one of the leading causes of maternal mortality hence, all pregnant women should be assessed for the risk of developing the condition as early as possible (when scheduling a booking antenatal appointment) or even in the pre-pregnancy clinic.
    Matched MeSH terms: Maternal Mortality
  8. Abdul Aziz AA, Md Salleh MS, Yahya MM, Zakaria AD, Ankathil R
    Asian Pac J Cancer Prev, 2021 Apr 01;22(4):1319-1324.
    PMID: 33906328 DOI: 10.31557/APJCP.2021.22.4.1319
    BACKGROUND: Triple negative breast cancer (TNBC) which is treated with taxane, adriamycin and cyclophosphamide (TAC) chemotherapy regimen show variation in treatment response. CYP1B1 4326 C>G polymorphism has been implicated in contributing to the differences in treatment response in various types of cancers.

    AIM: The objective of the present study was to investigate whether this polymorphism modulate the risk of disease recurrence in TNBC patients undergoing TAC chemotherapy regimen.

    METHODS: Blood samples of 76 immunohistochemistry confirmed TNBC patients were recruited. The genotyping of CYP1B1 4326 C>G polymorphism was carried out using PCR-RFLP technique. The genotype patterns were categorized into homozygous wildtype, heterozygous and homozygous variant. Kaplan-Meier analysis followed by Cox proportional hazard regression model were performed to evaluate the TNBC patients' recurrence risk.

    RESULTS: Out of 76 TNBC patients, 25 (33.0%) showed disease recurrence after one-year evaluation. Kaplan Meier analysis showed that TNBC patients who are carriers of CYP1B1 4326 GG variant genotypes (37.0%) had a significantly lower probability of disease-free rates as compared to TNBC patients who are carriers of CYP1B1 4326 CC/CG genotypes (71.0%). Univariate and multivariate Cox analysis demonstrated that TNBC patients who carried CYP1B1 4326 GG variant genotype had a significantly higher risk of recurrence with HR: 2.50 and HR: 4.18 respectively, even after adjustment as compared to TNBC patients who were carriers of CYP1B1 4326 CC and CG genotypes.

    CONCLUSION: Our results demonstrate the potential use of CYP1B1 4325 GG variant genotype as a candidate biomarker in predicting risk of recurrence in TNBC patients undergoing TAC chemotherapy regimen.

    Matched MeSH terms: Triple Negative Breast Neoplasms/mortality*
  9. Abdul Kader H
    Malays J Reprod Health, 1983 Jan;1(1):11-8.
    PMID: 12279886
    Matched MeSH terms: Infant Mortality*; Mortality*
  10. Abdul Kader H
    Malays J Reprod Health, 1983 Dec;1(2):139-52.
    PMID: 12313335
    Matched MeSH terms: Infant Mortality*; Mortality*
  11. Abdul Wahab S, Hassan A, Latif MT, Vadiveel Y, Jeyabalan T, Soo CI, et al.
    Asian Pac J Cancer Prev, 2019 07 01;20(7):1959-1965.
    PMID: 31350951 DOI: 10.31557/APJCP.2019.20.7.1959
    Objective: Epidemiological studies have reported the close relationship between risk for lung cancers and air pollution
    in particular, for non-smoking related lung cancers. However, most studies used residential address as proxies which may
    not estimate accurately an individual’s air pollution exposure. Therefore, the aim of this study was to identify risk factors
    such as occupation and mode of transportation associated with lung cancer diagnosis and death. Methods: Subjects
    with lung cancer (n=514) were evaluated both by chart reviews for clinical data and interviews to determine residential
    address for ten years, main occupation and main mode of transportation. Annual particulate matter with diameter size
    less than 2.5 micrometre (PM2.5) concentration were calculated based on particulate matter with diameter size less than
    10 micrometre (PM10) data recorded by Malaysian Department of Environment. Logistic regression analysis, cluster
    analysis and the Cox regression analysis were performed to the studied variables. Results: This study concurred with
    previous studies that lung adenocarcinoma were diagnosed in predominantly younger, female non-smokers compared
    to the other types of lung cancers. Lung adenocarcinoma subjects had annual PM2.5 that was almost twice higher than
    squamous cell carcinoma, small cell carcinoma and other histological subtypes (p=0.024). Independent of smoking,
    the κ -means cluster analysis revealed two clusters in which the high risk cluster involves occupation risk with air
    pollution of more than four hours per day, main transportation involving motorcycle and trucks and mean annual PM2.5
    concentration of more than 30 based on residential address for more than ten years. The increased risk for the high-risk
    cluster was more than five times for the diagnosis of lung adenocarcinoma (OR=5.69, 95% CI=3.14-7.21, p<0.001).
    The hazard ratio for the high-risk cluster was 3.89 (95% CI=2.12-4.56, p=0.02) for lung adenocarcinoma mortality at
    1 year. Conclusion: High-risk cluster including PM2.5, occupation risk and mode of transportation as surrogates for
    air-pollution exposure was identified and highly associated with lung adenocarcinoma diagnosis and 1-year mortality.
    Matched MeSH terms: Lung Neoplasms/mortality*
  12. Abdul-Aziz MH, Abd Rahman AN, Mat-Nor MB, Sulaiman H, Wallis SC, Lipman J, et al.
    Antimicrob Agents Chemother, 2016 01;60(1):206-14.
    PMID: 26482304 DOI: 10.1128/AAC.01543-15
    Doripenem has been recently introduced in Malaysia and is used for severe infections in the intensive care unit. However, limited data currently exist to guide optimal dosing in this scenario. We aimed to describe the population pharmacokinetics of doripenem in Malaysian critically ill patients with sepsis and use Monte Carlo dosing simulations to develop clinically relevant dosing guidelines for these patients. In this pharmacokinetic study, 12 critically ill adult patients with sepsis receiving 500 mg of doripenem every 8 h as a 1-hour infusion were enrolled. Serial blood samples were collected on 2 different days, and population pharmacokinetic analysis was performed using a nonlinear mixed-effects modeling approach. A two-compartment linear model with between-subject and between-occasion variability on clearance was adequate in describing the data. The typical volume of distribution and clearance of doripenem in this cohort were 0.47 liters/kg and 0.14 liters/kg/h, respectively. Doripenem clearance was significantly influenced by patients' creatinine clearance (CL(CR)), such that a 30-ml/min increase in the estimated CL(CR) would increase doripenem CL by 52%. Monte Carlo dosing simulations suggested that, for pathogens with a MIC of 8 mg/liter, a dose of 1,000 mg every 8 h as a 4-h infusion is optimal for patients with a CL(CR) of 30 to 100 ml/min, while a dose of 2,000 mg every 8 h as a 4-h infusion is best for patients manifesting a CL(CR) of >100 ml/min. Findings from this study suggest that, for doripenem usage in Malaysian critically ill patients, an alternative dosing approach may be meritorious, particularly when multidrug resistance pathogens are involved.
    Matched MeSH terms: Gram-Negative Bacterial Infections/mortality; Sepsis/mortality
  13. Abdul-Razak S, Azzopardi PS, Patton GC, Mokdad AH, Sawyer SM
    J Adolesc Health, 2017 Oct;61(4):424-433.
    PMID: 28838752 DOI: 10.1016/j.jadohealth.2017.05.014
    PURPOSE: A rapid epidemiological transition in developing countries in Southeast Asia has been accompanied by major shifts in the health status of children and adolescents. In this article, mortality estimates in Malaysian children and adolescents from 1990 to 2013 are used to illustrate these changes.

    METHODS: All-cause and cause-specific mortality estimates were obtained from the 2013 Global Burden of Disease Study. Data were extracted from 1990 to 2013 for the developmental age range from 1 to 24 years, for both sexes. Trends in all-cause and cause-specific mortality for the major epidemiological causes were estimated.

    RESULTS: From 1990 to 2013, all-cause mortality decreased in all age groups. Reduction of all-cause mortality was greatest in 1- to 4-year-olds (2.4% per year reduction) and least in 20- to 24-year-olds (.9% per year reduction). Accordingly, in 2013, all-cause mortality was highest in 20- to 24-year-old males (129 per 100,000 per year). In 1990, the principal cause of death for 1- to 9-year boys and girls was vaccine preventable diseases. By 2013, neoplasms had become the major cause of death in 1-9 year olds of both sexes. The major cause of death in 10- to 24-year-old females was typhoid in 1990 and neoplasms in 2013, whereas the major cause of death in 10- to 24-year-old males remained road traffic injuries.

    CONCLUSIONS: The reduction in mortality across the epidemiological transition in Malaysia has been much less pronounced for adolescents than younger children. The contribution of injuries and noncommunicable diseases to adolescent mortality suggests where public health strategies should focus.

    Matched MeSH terms: Accidents, Traffic/mortality; Communicable Diseases/mortality; Infant Mortality/trends; Neoplasms/mortality; Wounds and Injuries/mortality
  14. Abdullah A, Mahmood JH, Adeeb N
    J Obstet Gynaecol (Tokyo 1995), 1995 Jun;21(3):299-303.
    PMID: 8590370
    This paper analyses maternal mortality as seen in the Obstetric Unit of the University Kebangsaan Malaysia. During the 10 year study period, the maternal mortality rate was 74/100,000 total births. Women who were non-booked, aged above 40 years, gradmultiparous and of India ethnicity were at the highest risk of maternal death. The commonest causes of death were hemorrhage, hypertension, embolism and sepsis. Post-mortem examinations were performed in only 8.2% of women who died.
    Matched MeSH terms: Maternal Mortality*
  15. Abdullah F, Su TT
    Asian Pac J Cancer Prev, 2010;11(5):1359-66.
    PMID: 21198293
    INTRODUCTION: Cervical cancer has long been known as a preventable disease. Yet it still is a prime women's health issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, has been found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providers perceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia.

    METHODS: 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were explored on current and organized cervical screening program based on their expertise and experience.

    RESULTS: The results highlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reduce cervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack of commitment by health care providers, nature of the program, an improper follow-up system, limited resources and other competing needs. Complementarily, all interviewees perceived an organized cervical screening program as an alternative approach both feasible and acceptable by women and government to practice in Malaysia.

    CONCLUSION: Better screening coverage depends on an effective screening program that incorporates a behaviour-based strategy. A new program should be focused in the policy-making context to improve screening coverage and to effectively combat cervical cancer.

    Matched MeSH terms: Uterine Cervical Neoplasms/mortality
  16. Abdullah JM, Farizan A, Asmarina K, Zainuddin N, Ghazali MM, Jaafar H, et al.
    Asian J Surg, 2006 Oct;29(4):274-82.
    PMID: 17098662
    The pattern of allelic loss of heterozygosity (LOH) and PTEN mutations appear to be associated with the progression of gliomas leading to a decrement in the survival rate of patients. This present study was carried out to determine the LOH and PTEN mutational status in glioma patients and its association with patients' survival.
    Matched MeSH terms: Brain Neoplasms/mortality*; Glioma/mortality*
  17. Abdullah MM, Foo YC, Yap BK, Lee CML, Hoo LP, Lim TO
    Asian Pac J Cancer Prev, 2019 06 01;20(6):1701-1708.
    PMID: 31244290 DOI: 10.31557/APJCP.2019.20.6.1701
    Objective: This report focuses on a private medical centre cancer care performance as measured by patient survival
    outcome for up to 5 years. Methods: All patients with nasopharyngeal cancer treated at SJMC between 2008 and 2012
    were enrolled for this observational cohort study. Mortality outcome was ascertained through record linkage with
    national death register, linkage with hospital registration system and finally through direct contact by phone. Result:
    266 patients treated between 2008 and 2012 were included for survival analysis. 31% of patients were diagnosed with
    Early NPC Cancer (Stage I or II), another 44% with Locally Advanced Cancer (Stage III) and 25% with late stage IV
    metastatic cancer. 2%, 27% and 67% had WHO Class I, II and III NPC respectively. The overall survival at 5 years
    was 100% for patients with Stage I disease, 91% for Stage II disease, 72% for Stage III disease, and decreasing to
    44% for Stage IV disease. Overall survival at 5 years for all stages was 73%. Conclusion: SJMC is among the first
    hospitals in Malaysia to embark on routine measurement of the performance of its cancer care services and its results
    are comparable to any leading centers in developed countries.
    Matched MeSH terms: Nasopharyngeal Neoplasms/mortality*; Chemoradiotherapy/mortality*
  18. Abdullah NA, Wan Mahiyuddin WR, Muhammad NA, Ali ZM, Ibrahim L, Ibrahim Tamim NS, et al.
    Asian Pac J Cancer Prev, 2013;14(8):4591-4.
    PMID: 24083707
    Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This population- based retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from 1st Jan 2000 to 31st December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan- Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.
    Matched MeSH terms: Breast Neoplasms/mortality*
  19. Abdullah NA, Rushdan MN
    Med J Malaysia, 2012 Feb;67(1):71-6.
    PMID: 22582552 MyJurnal
    This study was undertaken to evaluate the reproductive and oncologic outcomes of patients diagnosed with Ovarian Germ Cell Malignancy (OGCM) who underwent fertility preserving surgery and adjuvant chemotherapy treated in Gynaecology Oncology Unit, Sultanah Bahiyah Hospital, Kedah, Malaysia.
    Matched MeSH terms: Neoplasms, Germ Cell and Embryonal/mortality; Ovarian Neoplasms/mortality
  20. Abootalebi S, Aertker BM, Andalibi MS, Asdaghi N, Aykac O, Azarpazhooh MR, et al.
    J Stroke Cerebrovasc Dis, 2020 Sep;29(9):104938.
    PMID: 32807412 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104938
    BACKGROUND AND PURPOSE: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic.

    METHODS: This is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center.

    CONCLUSION: The proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.

    Matched MeSH terms: Pneumonia, Viral/mortality; Hospital Mortality/trends; Coronavirus Infections/mortality; Stroke/mortality
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