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Objectively Measured Physical Activity, Sedentary Behavior, and Metabolic Syndrome in Adults: Systematic Review of Observational Evidence

Amirfaiz S, Shahril MR

Metab Syndr Relat Disord, 2019 Feb;17(1):1-21.
PMID: 30272527 DOI: 10.1089/met.2018.0032

Objective measurement of physical activity (PA) and sedentary behavior (SB) associated with metabolic syndrome (MetS) has gained more attention among researchers in recent years. Although almost similar trends of results have been reported worldwide, they were not always statistically significant. This systematic review summarizes the evidence of observational studies reporting the associations between objectively measured PA, SB, and MetS in adults. Registration in PROSPERO was made (CRD42017078929). Literature search was conducted in the PubMed database for observational studies associating objectively measured PA and SB with MetS among adults. Secondary manual search was also conducted to find more related studies. A total of 44 studies were included in this systematic review. The quality score of studies obtained using National Institutes of Health Quality Assessment Tool ranged between 4 and 11. For total PA, most studies showed negative association with MetS. Similar association with MetS was reported in most studies assessing moderate-to-vigorous PA (MVPA) (total, bouts, sporadic), vigorous-intensity PA (VPA) (total, bouts), moderate-intensity PA (MPA) (total, bouts), and light-intensity PA (LIPA) bouts. However, more studies assessing LIPA total and LIPA sporadic found no significant association with MetS, with only a few studies reporting negative association. Meanwhile, all studies assessing step counts reported negative association with MetS. In contrast, MetS was positively associated in all studies investigating physical inactivity. MetS was also positively associated in most studies reporting sedentary (SED) time and bouts, while SED breaks showed no significant association with MetS. Further studies are required to ascertain the interaction and independent contribution of objectively measured PA and SB to the overall risk of MetS.
Fulltext Correction to: Effectiveness and sustainability of a structured group-based educational program (MEDIHEALTH) in improving medication adherence among Malay patients with underlying type 2 diabetes mellitus in Sarawak State of Malaysia: study protocol of a randomized controlled trial

Ting CY, Adruce SAZ, Hassali MA, Ting H, Lim CJ, Ting RS, et al.

Trials, 2019 05 10;20(1):267.
PMID: 31077233 DOI: 10.1186/s13063-019-3348-x

After publication of the original article [1], the authors have notified us that there are changes to the primary outcome of the study, instrument, subject's inclusion criteria, the funding and acknowledgements. These changes were made during the recruitment of participants and after approved by the Medical Research and Ethics Committee (MREC), National Institutes of Health Malaysia, on 16th November 2018.
Fulltext Workforce Mobilization From the National Institutes of Health for the Ministry of Health Malaysia: A COVID-19 Pandemic Response

Muhammad Nur Amir AR, Binti Amer Nordin A, Lim YC, Binti Ahmad Shauki NI, Binti Ibrahim NH

Front Public Health, 2021;9:574135.
PMID: 33643985 DOI: 10.3389/fpubh.2021.574135

The COVID-19 pandemic that emerged in 2019 has inflicted numerous clinical and public health challenges worldwide. It was declared a public health emergency by the World Health Organization and activated response teams at almost all Malaysian healthcare facilities. Upon activation of the National Crisis Preparedness and Response Center in January 2020, the National Institutes of Health Malaysia established a COVID-19 operation room at the facility level to address the rise in COVID-19 infection cases each day. The National Institutes of Health COVID-19 operation room committee formed a workforce mobilization team for an effective and efficient mobilization system to fulfill requests received for human resource aid within the Ministry of Health Malaysia facilities. Selected personnel would be screened for health and availability before mobilization letters and logistics arrangements if necessary. The workforce from the National Institutes of Health, consisting of various job positions, were mobilized every week, with each deployment cycle lasting 2 weeks. A total of 128 personnel from the six institutes under the National Institutes of Health were mobilized: tasks included fever screening, active case detection, health management at quarantine centers, and management of dead bodies. A well-organized data management system with a centralized online system integration could allow more rapid deployment and answer some of the key questions in managing a similar pandemic in the future. With improving infected COVID-19 cases throughout the country, the National Institutes of Health COVID-19 operation room was effectively closed on June 15, 2020, following approval from the Deputy Director-General of Health.

Matched MeSH terms: National Institutes of Health (U.S.)*
Fulltext Predictors of stroke-associated pneumonia after the first episode of acute ischaemic stroke

Nor Adina, A.T., Ahmad, M.A., Uduman, A., Hamidon, B.B.

Malaysian Journal of Medicine and Health Sciences, 2012;8(1):37-43.
MyJurnal

Pneumonia is one of the most common complications of stroke with significant impact on patients’ outcome. The aim of this study is to look for the predictors of stroke-associated pneumonia (SAP) and its 30-day mortality and to analyse the survival of ischaemic stroke patients with pneumonia. Methodology: This is a prospective observational study, involving all acute first time ischaemic stroke patients admitted to a tertiary hospital that fulfilled the inclusion and exclusion criteria over a 6-month period. Demographic data were obtained on admission. Patients were reassessed for SAP, on day 5 and day 30. Assessment was done using the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index and modified Rankin scale (MRS). All patients with pneumonia were assessed with the pneumonia severity index (PSI) for SAP. Results: One hundred and twenty patients were enrolled consecutively within the 6-month study period. 15.8% developed SAP. Independent predictors of SAP were clinical dysphagia (OR 76.32; 95%CI 4.46 to 1307.05), random blood glucose (RBS) on admission (OR 1.34; 95%CI 1.06 to 1.68) and NIHSS score on admission (OR 1.15; 95%CI 1.02 to 1.30). Independent predictors for 30-day mortality were NIHSS score on day 5 (OR 1.20; 95%CI 1.08 to 1.33) and occurrence of pneumonia (OR 14.90; 95% CI 3.34 to 66.42). There was a significant difference in mean survival between SAP and non-SAP patients. Conclusions: Clinical dysphagia, RBS on admission and NIHSS score on admission were independent predictors of SAP. NIHSS score on day 5 and pneumonia were independent predictors of 30-day mortality. SAP patients had shorter survival
time compared to non-SAP patients.
Fulltext Inconsistency in race and ethnic classification in pharmacogenetics studies and its potential clinical implications

Zhang F, Finkelstein J

Pharmgenomics Pers Med, 2019;12:107-123.
PMID: 31308725 DOI: 10.2147/PGPM.S207449

Introduction: Racial and ethnic categories are frequently used in pharmacogenetics literature to stratify patients; however, these categories can be inconsistent across different studies. To address the ongoing debate on the applicability of traditional concepts of race and ethnicity in the context of precision medicine, we aimed to review the application of current racial and ethnic categories in pharmacogenetics and its potential impact on clinical care.
Methods: One hundred and three total pharmacogenetics papers involving the CYP2C9, CYP2C19, and CYP2D6 genes were analyzed for their country of origin, racial, and ethnic categories used, and allele frequency data. Correspondence between the major continental racial categories promulgated by National Institutes of Health (NIH) and those reported by the pharmacogenetics papers was evaluated.
Results: The racial and ethnic categories used in the papers we analyzed were highly heterogeneous. In total, we found 66 different racial and ethnic categories used which fall under the NIH race category "White", 47 different racial and ethnic categories for "Asian", and 62 different categories for "Black". The number of categories used varied widely based on country of origin: Japan used the highest number of different categories for "White" with 17, Malaysia used the highest number for "Asian" with 24, and the US used the highest number for "Black" with 28. Significant variation in allele frequency between different ethnic subgroups was identified within 3 major continental racial categories.
Conclusion: Our analysis showed that racial and ethnic classification is highly inconsistent across different papers as well as between different countries. Evidence-based consensus is necessary for optimal use of self-identified race as well as geographical ancestry in pharmacogenetics. Common taxonomy of geographical ancestry which reflects specifics of particular countries and is accepted by the entire scientific community can facilitate reproducible pharmacogenetic research and clinical implementation of its results.
Fulltext Computed tomography perfusion in detecting malignant middle cerebral artery infarct

Lee CL, Kandasamy R, Mohammad Raffiq MAB

Surg Neurol Int, 2019;10:159.
PMID: 31528494 DOI: 10.25259/SNI_64_2019

Background: Computed tomography perfusion (CTP) is an emerging modality which produces maps of time-to- peak (TTP), cerebral blood flow (CBF), and cerebral blood volume (CBV), with a computerized automated map of the infarct and penumbra. This modality provides a better evaluation of the extent of infarction, making it a potential method for assessing patients suffering from large middle cerebral artery (MCA) infarctions.
Methods: A prospective cohort study of all patients in Hospital Kuala Lumpur, Malaysia, who presented with the clinical diagnosis of a large MCA infarction within 48 h of onset were subjected to CT brain, and CTP scans on admission and were followed up to determine the development of malignant infarction requiring surgical decompression.
Results: CTP parameters were generally lower in patients with malignant brain infarct (MBI) group compared to the nonMBI group. The largest mean difference between the group was noted in the TTP values (P = 0.005). CTP parameters had a comparable positive predictive value (83%-90%) and high net present value (88-93). CBF with cutoff value of >32.85 of the hemisphere could accurately predict malignant infarctions in 81.4% of cases. The National Institutes of Health Stroke Scale score of more than 13.5 was also found to be able to accurately determine malignant infarct (97.6%). Functional outcome of patients based on Glasgow outcome scale was similar on discharge, however, showed improvement at 6 months during reviewed base on modified Rankin scale (P < 0.001).
Conclusion: CTP parameters should be included in the initial evaluation of patients to predict malignant brain infarction and facilitate surgical treatment of large MCA infarctions.
Key messages: CT perfusion parameters have an important role in predicting malignant brain infarction and should be included in the initial evaluation of patients to facilitate the early identification and surgical treatment of large middle cerebral artery infarctions, to improve patient's prognosis.
An International Working Conference on Nutrition and Infection

Gordon JE, Scrimsha NS

Arch. Environ. Health, 1969 Aug;19(2):199-216.
PMID: 5817545
Reliability and validity of the National Institutes of Health: Chronic Prostatitis Symptom Index in a Malaysian population

Cheah PY, Liong ML, Yuen KH, Lee S, Yang JR, Teh CL, et al.

World J Urol, 2006 Feb;24(1):79-87.
PMID: 16465553 DOI: 10.1007/s00345-005-0037-z

The objective of the study is to determine the short- and long-term utility of the Chinese, Malay and English versions of the National Institutes of Health--Chronic Prostatitis Symptom Index (NIH-CPSI) in our ethnically diverse population. The NIH-CPSI was translated into Chinese and Malay, and then verified by back translation into English. Subjects included 100 new chronic prostatitis/chronic pelvic pain (CP/CPPS) patients, 71 new benign prostatic hyperplasia patients and 97 healthy individuals. Reliability was evaluated with test-retest reproducibility (TR) by calculating intraclass correlation coefficients (ICC). Internal consistency was evaluated by calculating Cronbach's alpha (alpha). Validity assessments included discriminant and construct validity. (Presented in the order of Chinese, Malay then English). ICC values for short-term (1 week) TR were 0.90, 0.80 and 0.89, while ICC values for long-term (14 weeks) TR were 0.54, 0.61 and 0.61. Cronbach's alpha values were 0.63, 0.62 and 0.57. The NIH-CPSI total score discriminated CP/CPPS patients (P<0.001) from the control groups with receiver operating curve values of 0.95, 0.98 and 0.94, respectively. Construct validity, reflected by the correlation coefficient values between the International Prostate Symptom Score and the NIH-CPSI of CP/CPPS patients were 0.72, 0.49 and 0.63 (all P<0.05). The Chinese, Malay and English versions of the NIH-CPSI each proved effective in our population. Short-term TR and discriminant validity were excellent for all three versions. However, long-term TR was only moderate, which might reflect variation in patients' perceptions of symptoms over time.