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  1. A life saved at the cost of hand injury - A case of hand burn due to airbag deployment
    Fadzullah NA, Kasthuri S, Basiron N
    Med J Malaysia, 2019 Oct;74(5):452-453.
    PMID: 31649230
    According to the Malaysian Department of Statistics motor vehicle accidents are the third leading cause of death in Malaysia and accounts for 7.4% of premature deaths in 2016. With the invention of the airbag, the number of serious injuries and fatalities have been reduced significantly. However, there has also been a corresponding increase in the number of injuries attributable to these devices. The patient narrated in this case report sustained a mixed dermal thickness burn over the upper limb as a result of an airbag deployment. She recovered without other life threatening injuries.
    Matched MeSH terms: Mortality, Premature
  2. Achieving the targets of sustainable development goals (2030 agenda) for congenital disorders in Asia: Bottlenecks and interventions
    Thong MK
    Am J Med Genet C Semin Med Genet, 2019 06;181(2):254-261.
    PMID: 30801969 DOI: 10.1002/ajmg.c.31690
    The United Nations General Assembly adopted the 2030 Agenda for Sustainable Development in November 2015 which included a set of 17 measurable "sustainable development goals" (SDGs). The SDGs included targets to end preventable deaths of newborns and children under 5 years of age by 2030, universal health care coverage, reduction of premature mortality from noncommunicable diseases (NCDs) by 33% as well as support the development and research for medicines for both communicable and NCDs. Although some successes were achieved in combating communicable diseases and improved childhood mortality rates, health systems in Asia are generally characterized by lack of accurate epidemiological information on congenital disorders, lack of human and financial resources, and inadequate focus on public health strategies to ensure targeted interventions, low level knowledge on congenital disorders amongst the community and healthcare providers and the ethical dilemma of managing rare congenital disorders in an environment of low national health expenditures. These bottlenecks must be addressed systematically and interventions such as the use of innovative epidemiological tools to overcome lack of data, increased efforts to standardize rare disease nomenclature and classification and renewed interest in birth defects registries by countries in the region must be considered. Targeted curative and public health approaches currently used in thalassaemia and neural tube defects may be used for other congenital disorders in Asian countries. The implementation of congenital disorders-related research, prevention, care, and treatment delivery services must be integrated into existing health systems in order to be effective to achieve the targets of SDG2030.
    Matched MeSH terms: Mortality, Premature
  3. Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review
    Christiani Y, Dhippayom T, Chaiyakunapruk N
    Glob Health Action, 2016 Dec;9(1):32505.
    PMID: 28795917 DOI: 10.3402/gha.v9.32505
    Background Inequalities in access to medications among people diagnosed with diabetes in low- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death. Objective To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs. Design We conducted a systematic review of the literature using the PRISMA-Equity guidelines. A search of five databases - PubMed, Cochrane, CINAHL, PsycINFO, and EMBASE - was conducted from inception to November 2015. Using deductive content analysis, information extracted from the selected articles was analysed according to the PRISMA-Equity guidelines, based on exposure variables (place of residence, race/ethnicity, occupation, gender, religion, education, socio-economic status, social capital, and others). Results Fifteen articles (seven quantitative and eight qualitative studies) are included in this review. There were inconsistent findings between studies conducted in different countries and regions although financial and geographic barriers generally contributed to inequalities in access to diabetes medications. The poor, those with relatively low education, and people living in remote areas had less access to diabetes medications. Furthermore, we found that the level of government political commitment through primary health care and in the provision of essential medicines was an important factor in promoting access to medications. Conclusions The review indicates that inequalities exist in accessing medication among diabetic populations, although this was not evident in all LMICs. Further research is needed to assess the social determinants of health and medication access for people with diabetes in LMICs.
    Matched MeSH terms: Mortality, Premature
  4. Fulltext Burden of disease attributable to overweight and obesity in Malaysia
    Foo, Lee Peng, Hanny Zurina Hamzah, Norashidah Mohamed Nor, Rusmawati Said
    Malaysian Journal of Public Health Medicine, 2018;18(1):0-0.
    MyJurnal
    The overweight and obese population may affect the population health which can lead to economic stability and development of the countries to be compromised. Thus, this study estimates the burden of disease attributable to overweight and obesity in Malaysia for adults aged 20-59 years old. Population attribution fraction (PAF) and disability-adjusted life year (DALY) have been used to quantify years of life lost from premature death and number of years lost due to disability resulting from obesity and overweight. The burden of disease attributable to overweight was 1582 and 1146 PYs per 1000 persons for male and female, respectively. Meanwhile, the burden of disease attributable to obesity was 2951 PYs per 1000 persons with women in the lead at 1657 PYs per 1000 persons. The burden of overweight and obesity among Malaysian adults is substantial. The outcome of this study is crucial as it gives a comprehensive information on the burden of overweight and obesity in Malaysia. The information from this study also enables the authorities to develop activities and programs to combat obesity and tomaintain healthy lifestyle among Malaysian.
    Matched MeSH terms: Mortality, Premature
  5. Fulltext Burden of premature mortality in Malaysia
    Ummi Nadiah Yusoff, Diana Mahat, Azahadi Omar, Teh, Chien Huey, Norzawati Yoep, Riyanti Saari
    Int J Public Health Res, 2013;3(1):249-258.
    MyJurnal
    Mortality estimates are important parameters for health monitoring and are routinely used as evidence for health policy and planning. This study aimed to estimate the mortality component of Burden of Disease in Malaysia in 2008. The 2008 mortality data from the Statistics Department were used to estimate cause-specific mortality (by age and sex) in Malaysia. Data were coded using the ICD10 (International Classification of Disease) coding. Calculation of mortality component of Burden of Disease (ie: Years of Life Lost (YLL) was done using the standard Global Burden of Disease Methodology. The total estimated deaths in Malaysia in 2008 were 124,857, of which 72,202 (57.8%) were males. The total years of life lost (YLL) for the Malaysian population in 2008 was 1.51 million in which 0.92 million (60.7%) was among males. Almost three quarter (68%) of the burden of premature deaths resulted from non-communicable diseases, followed by communicable diseases (20%) and injury (12%). Among the top three leading causes of YLL were ischaemic heart disease (17.1%), stroke (9.6%) and road traffic injuries (8.3%). In Malaysia, premature mortality mainly contributed by non-communicable diseases followed by communicable diseases and injury. A multi-agency collaboration is needed to prevent premature death and to improve quality of life.
    Matched MeSH terms: Mortality, Premature
  6. Fulltext Chronic disease management in primary care - a review of evidence
    Ramli AS
    Medical Health Reviews, 2008;2008(1):63-79.
    MyJurnal
    Primary care practice with its defining features of continuity, comprehensiveness and coordination, is the cornerstone to provide high quality community-based chronic disease management. Poor chronic disease prevention and control at the primary care level will lead to the massive burden of treating complications at secondary care, burden to the patients and their families with regards to morbidity and premature death, and burden to the country with regards to the loss of human capital. Compelling evidence showed that there are innovative and cost-effective interventions to reduce the morbidity and mortality attributable to chronic diseases, but these are rarely translated into high quality population-wide chronic disease care. Primary health care systems around the world were developed in response to acute problems and have remained so despite the increasing prevalence of chronic conditions. An evolution of primary health care system beyond the acute care model to embrace the concept of caring for long term health problems is imperative in the wake of the rising epidemic of chronic diseases. This paper aims to review the evidence supporting high quality and innovative chronic disease management models in primary care and the applicability of this approach in low and middle income countries.
    Matched MeSH terms: Mortality, Premature
  7. Fulltext Dietary fatty acids and edible fruit oil: Potential therapy for heart
    Noor Atiqah Aizan Abd Kadir, Azrina Azlan
    The Pertanika Journal of Scholarly Research Reviews, 2017;3(2):45-55.
    MyJurnal
    Cardiovascular disease (CVD) is a major cause of disability and premature death throughout the world. This disease is commonly experienced by people with unhealthy lifestyle, stress and physical inactivity. Cholesterol has received the most attention as single risk factor of CVD. Reducing the intake of cholesterol, saturated fat, and trans faty acids may be beneficial, yet controversy is still lingering to what constituents more beneficial dietary fats. The purpose of this article is to give an overview on the impact of major dietary fatty acids on cardiovascular morbidity and mortality and to give an insightful information regarding fatty acids composition in selected fruits oils in search for novel oils as potential therapy against CVD.
    Matched MeSH terms: Mortality, Premature
  8. Fulltext Factors associated with uncontrolled hypertension among hypertensive patients in Tuaran, Sabah, Malaysia: a cross-sectional study
    Rosfina Ghazali, Khamisah Awang Lukman, Daw Khin Saw Naing, Fairrul Kadir, Mohammad Saffree Jeffree, Fredie Robinson, et al.
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):19-19.
    MyJurnal
    Introduction: Hypertension prevalence is increasing globally and has become a major issue of disease as it is a major cause for cerebrovascular, kidney and cardiovascular diseases. Even among treated patients, there is a dispropor-tional of blood pressure control causing a major public health challenge. This study is aimed to decide on the prev-alence of uncontrolled hypertension and its associated factors among hypertensive patient attending hypertension clinic at primary health clinics in Tuaran district. This study is justified by the fact that uncontrolled hypertension leads to high mortality, morbidity and even premature death. Methods: This study is a cross-sectional study among 460 hypertensive patients attending three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires through interviews, physical examinations and patient’s medical records. Types of data collected include socio-demography, lifestyle behavior, physical examination, co-morbidity status and med-ical adherence. Data analysis done using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that factors significantly associated with uncontrolled hypertension with p
    Matched MeSH terms: Mortality, Premature
  9. Fulltext Four nucleotide deletions of exon 47 in Dystrophin gene: a case report of a Kelantanese Duchenne Muscular Dystrophy patient
    Fatimah Azman, Rose Adzrianee Adnan, Norhafizah Che Abdul Razak, Nazihah Mohd Yunus, Sarina Sulong, Rozita Abdullah, et al.
    Journal of Biomedical and Clinical Sciences, 2017;2(202):11-13.
    MyJurnal
    Muscular dystrophy is a group of diseases that result in progressive muscle weakness and atrophy. Duchenne Muscular Dystrophy (DMD) is classified as dystrophinopathy and is an X-linked recessive disease. It is caused by alterations in the dystrophin gene at Xp21.2 encoding 79 exons [1]. It is characterised by progressive muscle wasting that begins at 3 to 5 years, delay in motor development and eventually wheelchair confinement followed by premature death at about 30 years from cardiac or respiratory complications [2]. Genetic etiology of cases of DMD in Malaysia are still scarcely reported. Here, we report the genetic cause in the case of an 11-year-old Kelantanese Malay boy who has progressive muscle weakness since 5 years old. He has difficulty in getting up from sitting and supine position also in climbing up stairs until 1st floor. He has a strong family history of DMD and musculoskeletal problems. His younger brother was diagnosed with DMD by molecular analysis and his maternal uncle died at the age of 16 with musculoskeletal problems but was never investigated. Physical examination revealed no dysmorphic features, positive Gower sign with absent tounge fasciculation. On neurological examination, tendon reflexes and muscle tone for limbs were normal. Muscle power for bilateral upper limbs were normal, however, bilateral lower limbs showed slight reduction in muscle power with calf hypertrophy.
    Matched MeSH terms: Mortality, Premature
  10. Fulltext Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
    GBD 2015 Mortality and Causes of Death Collaborators
    Lancet, 2016 Oct 08;388(10053):1459-1544.
    PMID: 27733281 DOI: 10.1016/S0140-6736(16)31012-1
    BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.
    METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).
    FINDINGS: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.
    INTERPRETATION: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
    FUNDING: Bill & Melinda Gates Foundation.
    Malaysian collaborators: Southern University College, Skudai, Malaysia (Y J Kim PhD); School of Medical Sciences, University of Science Malaysia, Kubang Kerian, Malaysia (K I Musa MD); Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia (R Sahathevan PhD); Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia (C T Sreeramareddy MD); WorldFish, Penang, Malaysia (A L Thorne-Lyman ScD)
    Matched MeSH terms: Mortality, Premature
  11. Gone Too Soon: priorities for action to prevent premature mortality associated with mental illness and mental distress
    O'Connor RC, Worthman CM, Abanga M, Athanassopoulou N, Boyce N, Chan LF, et al.
    Lancet Psychiatry, 2023 Jun;10(6):452-464.
    PMID: 37182526 DOI: 10.1016/S2215-0366(23)00058-5
    Globally, too many people die prematurely from suicide and the physical comorbidities associated with mental illness and mental distress. The purpose of this Review is to mobilise the translation of evidence into prioritised actions that reduce this inequity. The mental health research charity, MQ Mental Health Research, convened an international panel that used roadmapping methods and review evidence to identify key factors, mechanisms, and solutions for premature mortality across the social-ecological system. We identified 12 key overarching risk factors and mechanisms, with more commonalities than differences across the suicide and physical comorbidities domains. We also identified 18 actionable solutions across three organising principles: the integration of mental and physical health care; the prioritisation of prevention while strengthening treatment; and the optimisation of intervention synergies across social-ecological levels and the intervention cycle. These solutions included accessible, integrated high-quality primary care; early life, workplace, and community-based interventions co-designed by the people they should serve; decriminalisation of suicide and restriction of access to lethal means; stigma reduction; reduction of income, gender, and racial inequality; and increased investment. The time to act is now, to rebuild health-care systems, leverage changes in funding landscapes, and address the effects of stigma, discrimination, marginalisation, gender violence, and victimisation.
    Matched MeSH terms: Mortality, Premature
  12. Fulltext Hepatocellular Carcinoma in Malaysia and Its Changing Trend
    Raihan R, Azzeri A, H Shabaruddin F, Mohamed R
    Euroasian J Hepatogastroenterol, 2018 05 01;8(1):54-56.
    PMID: 29963463 DOI: 10.5005/jp-journals-10018-1259
    Hepatocellular carcinoma (HCC) is one of the leading causes of death globally. In Malaysia liver cancer is the eighth most common cause of cancer for both gender and fifth most common cause of cancer for males. Liver cancer is a cause of premature death in Malaysia: The trend from 1990 to 2010 was observed upward. Since 1990, the annual years of life lost (YLLs) from liver cancer have increased by 31.5%. Older persons are at higher risk and there is male predominance observed. Curative surgical resection, liver transplantation, and supportive symptomatic care, including percutaneous ethanol injection and radiofrequency ablation (RFA), and noncurative transarterial chemoembolization (TACE) are among available treatment facilities. Yet the survival rate is very poor as majority of patients present at very advanced stage. Hepatitis B virus (HBV) remained the leading cause of HCC in Malaysia. Several studies showed cryptogenic causes, which are mainly nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) among the predominant causes of HCC in Malaysia than hepatitis C virus (HCV), alcohol, or any other reason. This mainly correlates with the increasing incidence of diabetes and obesity in Malaysia. How to cite this article: Raihan R, Azzeri A, Shabaruddin FH, Mohamed R. Hepatocellular Carcinoma in Malaysia and Its Changing Trend. Euroasian J Hepato-Gastroenterol 2018;8(1):54-56.
    Matched MeSH terms: Mortality, Premature
  13. Fulltext Implementation of MPOWER approach for tobacco control in Malaysia: findings from the Global Adult Tobacco survey (GATs)
    Lim Kuang Hock, Heng Pei Pei, Muhammad Fadhli Mohd Yusoff, Teh Chien Huey, Sumarni Mohamad Ghazali, Lim Hui Li, et al.
    Malaysian Journal of Medicine and Health Sciences, 2020;16(1):144-154.
    MyJurnal
    Introduction: Tobacco induced illness remains a major contribution to premature death and global burden of dis- eases. The introduction of MPOWER policies by World Health Organization held the value to monitor the imple- mentation of the anti-smoking measures in all signatory countries. This paper aimed to investigate the application of the six MPOWER indicators among Malaysia population. Methods: We utilized the data of Global Adult Tobacco Survey-Malaysia (GATS-M) which recruited 5112 nationally representative samples of Malaysians of 15 years old and above. Descriptive statistical analysis was used to illustrate the social demographic characteristic of the respon- dents while cross tabulation was employed to describe all elements of the MPOWER indicators. Results: About one quarter (23.1%) of Malaysian adults were current tobacco users. The SHS exposure at home (38.4%) and restaurant (42.1%) were high. Approximately eight in ten (80.2%) of the smokers intended to quit, while for those attempted to quit in past one year, 9.0% utilized pharmacotherapy and 4.4% attended counseling. The awareness about tobacco related diseases was generally excellent. The overall tax make up of the cigarettes’ retail price ranging from 41.7% up to 80%. Conclusion: Tobacco consumption remains prevalent and plateau among Malaysian adults over the last two decades with substantial proportion of the population exposed to SHS. The inadequacy in the current anti-smoking policies needs urgent improvement in order to reduce the smoking norms among Malaysians population besides to achieve the ultimate goal of tobacco control end game by year 2045.
    Matched MeSH terms: Mortality, Premature
  14. Malaysian burden of disease: years of life lost due to premature deaths
    Khaw WF, Chan YM, Nasaruddin NH, Alias N, Tan L, Ganapathy SS
    BMC Public Health, 2023 Jul 18;23(1):1383.
    PMID: 37464344 DOI: 10.1186/s12889-023-16309-z
    BACKGROUND: In Malaysia, the previous mortality burden has been a significant concern, particularly due to the high prevalence of noncommunicable diseases (NCDs) as the leading cause of death. Estimates of mortality are key indicators for monitoring population health and determining priorities in health policies and health planning. The aim of this study was to estimate the disease burden attributed to 113 major diseases and injuries in Malaysia in 2018 using years of life lost (YLL) method.

    METHODS: This study included all deaths that occurred in Malaysia in 2018. The YLL was derived by adding the number of deaths from 113 specific diseases and multiplying it by the remaining life expectancy for that age and sex group. Data on life expectancy and mortality were collected from the Department of Statistics Malaysia.

    RESULTS: In 2018, there were 3.5 million YLL in Malaysia. Group II (NCDs) caused 72.2% of total YLL. Ischaemic heart disease was the leading cause of premature mortality among Malaysians (17.7%), followed by lower respiratory infections (9.7%), road traffic injuries (8.7%), cerebrovascular disease (stroke) (8.0%), and diabetes mellitus (3.9%).

    CONCLUSIONS: NCDs are a significant health concern in Malaysia and are the primary contributor to the overall burden of disease. These results are important in guiding the national health systems on how to design and implement effective interventions for NCDs, as well as how to prioritise and allocate healthcare resources. Key strategies to consider include implementing health promotion campaigns, adopting integrated care models, and implementing policy and regulatory measures. These approaches aim to enhance health outcomes and the managements of NCDs in Malaysia.

    Matched MeSH terms: Mortality, Premature
  15. Management of Dyslipidemia in Individuals with Low-to-Moderate Cardiovascular Risk: Role of Nutraceuticals
    Dolzhenko MM, Barnett OY, Grassos C, Dragomiretska NV, Goloborodko BI, Ilashchuk TO, et al.
    Adv Ther, 2020 11;37(11):4549-4567.
    PMID: 32979190 DOI: 10.1007/s12325-020-01490-z
    Cardiovascular diseases (CVDs) are the leading cause of premature deaths globally and in Ukraine. Dyslipidemia is a recognized risk factor for the development of CVD. Therefore, early detection and appropriate management of dyslipidemia are essential for the primary prevention of CVDs. However, currently, there is a lack of Ukraine-specific guideline recommendations focusing on the management of dyslipidemia in individuals with low-to-moderate CV risk, thus creating an urgent need for structured and easily implementable clinical recommendations/guidelines specific to the country. An expert panel of cardiologists, endocrinologists, and family physicians convened in Ukraine in March 2019. The expert panel critically reviewed and analyzed the current literature and put forth the following recommendations for the management of dyslipidemia in individuals with low-to-moderate risk of CVDs specific to Ukraine: (1) family physicians have the greatest opportunities in carrying out primary prevention; (2) lipid-lowering interventions are essential for primary prevention as per guidelines; (3) a number of nutraceuticals and nutraceutical combinations with clinically established lipid-lowering properties can be considered for primary prevention; they also have a suggested role as an alternative therapy for statin-intolerant patients; (4) on the basis of clinical evidence, nutraceuticals are suggested by guidelines for primary prevention; (5) red yeast rice has potent CV-risk-lowering potential, in addition to lipid-lowering properties; (6) in patients with low-to-moderate cardiovascular risk, a nutraceutical combination of low-dose red yeast rice and synergic lipid-lowering compounds can be used as integral part of guideline-recommended lifestyle interventions for effective primary prevention strategy; (7) nutraceutical combination can be used in patients aged 18 to 75+ years; its use is particularly appropriate in the age group of 18-44 years; (8) it is necessary to attract the media (websites, etc.) to increase patient awareness on the importance of primary prevention; and (9) it is necessary to legally separate nutraceuticals from dietary supplements. These consensus recommendations will help physicians in Ukraine effectively manage dyslipidemia in individuals with low-to-moderate CV risk.
    Matched MeSH terms: Mortality, Premature
  16. Fulltext Measures of population health: general perspective on quality adjusted life years (QALYs) and disability adjusted life years (DALYs)
    Natrah, S., Sharifa Ezat, W.P.
    Malaysian Journal of Public Health Medicine, 2011;11(2):27-31.
    MyJurnal
    Impact of health care on the population health has been measured in terms of morbidity and mortality but this measurement doesn’t distinguish between children, adults and the elderly. It does not also take into account the losses that occur because of handicap, pain, or other disability. Therefore, measures of population health which combine information on mortality and non-fatal healthboutcomes to represent the health of a particular population as a single number was introduced. QALYs and DALYs are both common outcome measures in economic evaluations of health interventions. QALYs is the comprehensive measure of health outcome because it can simultaneously capture gains from reduced morbidity (quality gains) and reduced mortality (quantity gains) and combine these into a single measure. DALYs is primarily a measure of disease burden where it combines losses from premature death and loss of healthy life resulting from disability. Although QALYs and DALYs are almost similar in their basic concept but there are few distinct differences which must be paid attention to in order to correctly utilize these measures.
    Matched MeSH terms: Mortality, Premature
  17. Fulltext Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
    Muller DC, Murphy N, Johansson M, Ferrari P, Tsilidis KK, Boutron-Ruault MC, et al.
    BMC Med, 2016 Jun 14;14:87.
    PMID: 27296932 DOI: 10.1186/s12916-016-0630-6
    BACKGROUND: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death.

    METHODS: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models.

    RESULTS: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers.

    CONCLUSIONS: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.

    Matched MeSH terms: Mortality, Premature*
  18. Mortality in adult epilepsy patients in Malaysia: a hospital-based study
    Khor SB, Lim KS, Fong SL, Ho JH, Koh MY, Tan CT
    Seizure, 2021 May;88:56-59.
    PMID: 33812309 DOI: 10.1016/j.seizure.2021.03.024
    BACKGROUND: The standardized mortality ratio (SMR) of epilepsy in Asia ranges from 2.5 to 5.1. However, there are no such published data in Malaysia to date. Understanding the mortality rate and related factors will allow us to better assess and monitor the health status of PWE, thereby, preventing premature deaths among PWE. Hence, this study aimed to determine the mortality rate of adults with epilepsy (PWE) at the University Malaya Medical Centre (UMMC), a tertiary hospital in Malaysia.

    METHOD: A total of 2218 PWE were recruited retrospectively into this study. Deceased cases from 2009-2018 were identified from the National Registry Department of Malaysia. Age-, gender-, and ethnic-specific SMR were calculated.

    RESULT: There was a total of 163 deaths, of which 111 (68.1%) were male. The overall case-fatality rate (CFR) was 7.3%. Male PWE had higher CFR (9.2%) compared to females (5.1%, p<0.001). The annual death rate of PWE was 867 per 100, 000 persons. The overall all-cause SMR was 1.6 (CI 95% 1.3-1.8). The SMR for younger age groups (15-19 and 20-29 years) were higher (5.4-5.5) compared to other age groups (0.4-2.5). Overall SMR for male PWE (1.8, 95% CI 1.5-2.1) was higher than females (1.2, 95% CI 0.9-1.6). However, the SMR for female PWE in the younger age groups (15-19, 20-29 and 30-39 years) was higher. SMR among the Indian PWE was the highest (1.6, 95% CI 1.2-2.0) compared to the Chinese (1.5, 95% CI 1.2-1.9) and the Malays (1.4, 95% 1.0-1.9). The CFR was higher in those with focal epilepsy (8.5% vs. 2.5-3.7% in genetic and other generalized epilepsies, p=0.003), epilepsy with structural cause (9.5% vs. 5.9% in others, p=0.005) and uncontrolled seizures (7.9% vs. 5.2% in seizure-free group, p<0.001).

    CONCLUSION: The mortality rate of PWE in Malaysia is higher than that of the general population but lower compared to other Asian countries. Specifically, the rates are higher in the younger age group, male gender, and Indian ethnicity. Those with focal epilepsy, structural causes and uncontrolled seizures have higher mortality rates.

    Matched MeSH terms: Mortality, Premature
  19. Fulltext Predictor of cardiovascular risks in end stage renal failure patients on maintenance dialysis
    Lim CT, Yap XH, Chung KJ, Khalid MA, Yayha N, Latiff LA, et al.
    Pak J Med Sci, 2015 Nov-Dec;31(6):1300-5.
    PMID: 26870086 DOI: 10.12669/pjms.316.8039
    OBJECTIVE: Cardiovascular disease (CVD) is the main cause of morbidity and premature mortality in end stage renal failure patients (ESRD) receiving dialysis. The aim of our study was to evaluate the impact of various risk factors in this group of high CVD risk patients in local population.
    METHODS: We carried out a cross-sectional retrospective study in a single hospital. A total of 136 ESRF patients, consisted of 43 haemodialysis (HD) and 93 continuous ambulatory peritoneal dialysis (CAPD) patients, were recruited and followed up for 36 months duration. Midweek clinical and laboratory data were collected. The occurrence of existing and new CVD events was recorded.
    RESULTS: Multiple Logistic Regression showed pre-existing cardiovascular event (odds ratio, 4.124; 95% confidence interval [CI], 0.990 to 17.187), elevated total cholesterol level (odds ratio, 0.550; 95% CI, 0.315 to 0.963), elevated serum phosphate level (odds ratio, 5.862; 95% CI, 1.041 to 33.024) and elevated random blood glucose level (odds ratio, 1.193; 95% CI, 1.012 to 1.406) were significantly associated with occurrence of CVD events.
    CONCLUSIONS: History of cardiovascular event before the initiation of dialysis, elevated level of serum phosphate and random blood glucose levels are the risk factors of CVD whereas paradoxically a high total cholesterol level has CVD protective effect towards the ESRF patients.
    KEYWORDS: CVD risk; End Stage Renal Failure (ESRF); Haemodialysis; Peritoneal dialysis
    Matched MeSH terms: Mortality, Premature
  20. Fulltext Prevalence and modifiable risk factors of noncommunicable diseases among Jakun orang asli at Tasik Chini, Pekan, Pahang
    Wong, C.M., Faiz D., Diana Safraa S., Raja Mohd Azim R.H., Siti Zubaidah A.R.
    International Medical Journal Malaysia, 2018;17(3):3-16.
    MyJurnal
    Introduction: Non-communicable disease accounted for 73% of premature death in year 2015 Malaysian national survey. The orang asli population may be affected similarly. The prevention of non-communicable diseases should start as early as modifiable risk factors prevention, as proposed by STEPWISE approach of WHO. This study aims to identify the prevalence of hypertension, diabetes mellitus and dyslipidaemia among Jakun orang asli population and examine the association with risk factors. Methods: This is a cross-sectional study analysing 72 case reports of General health screening done in year 2015. The study population was adult Jakun orang asli Tasik Chini using cluster sampling followed by simple random sampling methods. Chi Square test was used for bivariate analysis of relationship each variable has with the diseases, and binary logistic regression was used to analyse association of covariates with each disease. Results: The prevalence was 41.7% for hypertension, 25% for Diabetes mellitus, 6.9% for dyslipidaemia. Education level was significantly related to hypertension, X2 = 11.565 (1), p =0.001; obesity was significantly related to diabetes, X 2 = 8.333 (1), p=0.004. After adjusted for covariates, low education level has 13.379 odds of getting hypertension. Obesity has 7.384 odds of getting diabetes mellitus; female gender has higher odds of getting dyslipidaemia while younger age, physically active and not smoking are protective factors. Conclusion: Higher prevalence of hypertension and diabetes mellitus was found among Tasik Chini orang asli population. Lower sociodemographic characteristics and unhealthy lifestyle factors are associated with the diseases.
    Matched MeSH terms: Mortality, Premature
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