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Fulltext Geographical variation of cardiovascular risk factors in Malaysia

Nuur Amalina AG, Jamaiyah H, Selvarajah S, NHMS Cohort Study Group

Med J Malaysia, 2012 Feb;67(1):31-8.
PMID: 22582546 MyJurnal

The purpose of this study was to describe differences in cardiovascular risk factor prevalences and clustering patterns among the states and federal territories of Malaysia. Risk factors considered were abdominal obesity, diabetes, hypertension, hypercholesterolemia and smoking. Using data from the third National Health and Morbidity Survey (NMHS III) in 2006, we estimated the states and federal territories risk factor prevalences and clustering patterns to map the cardiovascular burden distribution in Malaysia. There was a clear geographical variation in the distribution of the individual risk factors as well as in its clustering with remarkable impact seen in Peninsular Malaysia. Perlis, Kedah and Kelantan were the most affected states overall.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Risk Factors
Fulltext Prevalence and risk factors of intestinal helminth infection among rural malay children

Huat LB, Mitra AK, Jamil NI, Dam PC, Mohamed HJ, Muda WA

J Glob Infect Dis, 2012 Jan;4(1):10-4.
PMID: 22529621 DOI: 10.4103/0974-777X.93753

Soil-transmitted intestinal helminth infection is prevalent in rural communities of Malaysia. Risk factors contributing to helminth infections are largely unknown in the country.

Matched MeSH terms: Risk Factors
Identification of genetic and non-genetic risk factors for nasopharyngeal carcinoma in a Southeast Asian population

Nor Hashim NA, Ramzi NH, Velapasamy S, Alex L, Chahil JK, Lye SH, et al.

Asian Pac J Cancer Prev, 2012;13(12):6005-10.
PMID: 23464394

BACKGROUND: Nasopharyngeal carcinoma (NPC) is endemic in Southern Chinese and Southeast Asian populations. Geographical and ethnic clustering of the cancer is due to genetic, environmental, and lifestyle risk factors. This case-control study aimed to identify or confirm both genetic and non-genetic risk factors for NPC in one of the endemic countries, Malaysia.
MATERIALS AND METHOD: A panel of 768 single-nucleotide polymorphisms (SNPs) previously associated with various cancers and known non-genetic risk factors for NPC were selected and analyzed for their associations with NPC in a case-control study.
RESULTS: Statistical analysis identified 40 SNPs associated with NPC risk in our population, including 5 documented previously by genome-wide association studies (GWAS) and other case-control studies; the associations of the remaining 35 SNPs with NPC were novel. In addition, consistent with previous studies, exposure to occupational hazards, overconsumption of salt-cured foods, red meat, as well as low intake of fruits and vegetables were also associated with NPC risk.
CONCLUSIONS: In short, this study confirmed and/or identified genetic, environmental and dietary risk factors associated with NPC susceptibility in a Southeast Asian population.

Matched MeSH terms: Risk Factors
Fulltext Melioidosis in Malaysia

Puthucheary SD

Med J Malaysia, 2009 Dec;64(4):266-74.
PMID: 20954549 MyJurnal

Melioidosis is an important cause of sepsis in the tropics, is caused by an environmental saprophyte--B. pseudomallei. It affects mainly adults with underlying predisposing condition such as diabetes. The range of symptoms varies from benign and localized abscesses, to severe community-acquired pneumonia to acute fulminating septicaemia with multiple abscesses often leading to death. B. pseudomallei is an intracellular pathogen and some of the virulence mechanisms that govern the complex interaction between the organism and the host have been elucidated. Isolation of B. pseudomallei from bodily fluids of patients remains the "gold standard" in diagnosis but a sensitive and specific serological test can lend support to the diagnosis of melioidosis. Ceftazidime is the treatment of choice for severe melioidosis, but the response is slow. Maintenance or eradication therapy for a prolonged period is necessary to prevent relapse and recurrence. Monitoring IgG antibody levels may be useful as a guideline to determine the duration of eradication therapy.

Matched MeSH terms: Risk Factors
Fulltext Risk factors associated with low birth weight infants in the Malaysian population

Boo NY, Lim SM, Koh KT, Lau KF, Ravindran J

Med J Malaysia, 2008 Oct;63(4):306-10.
PMID: 19385490 MyJurnal

This study aimed to identify the risk factors which were significantly associated with low birth weight (LBW, <2500 g) infants among the Malaysian population. This was a case-control study carried out at the Tuanku Jaafar Hospital, Seremban, Malaysia over a five-month period. Cases were all infants born with birth weight less than 2500 g. Control infant were selected with the help a random sampling table from among infants with birth weight of > or =2500 g born on the same day in the hospital. Of 3341 livebirths delivered in the hospital, 422 (12.6%) were LBW infants. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with infants of LBW were gestational age (adjusted odds ratio (OR)=0.6, 95% C.I.: 0.5, 0.6; < 0.0001), maternal pre-pregnancy weight (adjusted OR = 0.97, 95% C.I.: 0.95, 0.99; p < 0.0001), nulliparity (adjusted OR = 3.4, 95% C.I.: 2.2, 5.1; p < 0.0001), previous history of LBW infants (adjusted OR = 2.3, 95% C.I.: 1.4, 3.8; p=0.001) and PIH during current pregnancy (adjusted OR=3.3, 95% C.I.: 1.6, 6.6; p = 0.001). A number of potentially preventable or treatable risk factors were identified to be associated with LBW infants in Malaysia.

Matched MeSH terms: Risk Factors
Leprosy in sarawak, East malaysian borneo

Yap FB

Scand. J. Infect. Dis., 2009;41(4):320.
PMID: 19117243 DOI: 10.1080/00365540802680409
Matched MeSH terms: Risk Factors
Gamma-glutamyltransferase level in pregnancy is an independent risk factor for gestational diabetes mellitus

Tan PC, Mubarak S, Omar SZ

J Obstet Gynaecol Res, 2008 Aug;34(4):512-7.
PMID: 18937705 DOI: 10.1111/j.1447-0756.2008.00815.x

AIM:
To evaluate the relationship between gamma-glutamyltransferase (GGT) level in pregnant women at oral glucose tolerance test (OGTT) and the diagnosis of gestational diabetes (GDM).

METHODS:
Blood was taken for analyzing GGT level from women at high risk of GDM at the time of their scheduled OGTT. GDM was diagnosed according to World Health Organization 1999 criteria.

RESULTS:
GGT level correlated positively with the 2-hour glucose level (Spearman's rho = 0.112: P < 0.05). GGT values that were stratified into quartiles demonstrated a significant trend with diagnosis of GDM (chi(2) for trend; P = 0.03). Multivariable logistic regression analysis taking into account maternal age, gestational age at OGTT, body mass index and a positive 50-g glucose challenge test (GCT) indicated that high GGT was an independent risk factor for GDM (adjusted odds ratio [AOR] 2.1 95% CI 1.2-3.8: P = 0.01). In the subset of women identified by a positive GCT, on multivariable logistic regression analysis, only high GGT was an independent risk factor for GDM (AOR 2.3 95% CI 1.3-4.2: P = 0.007).

CONCLUSION:
Raised GGT level is an independent risk factor for GDM in high risk pregnant women undergoing OGTT.

Matched MeSH terms: Risk Factors
Fulltext A man with contracted fingers

Loh KY, Kew ST

Aust Fam Physician, 2008 Mar;37(3):150.
PMID: 18345365

An Indian man from Malaysia presented with contracture of his hands. He is 55 years of age and has a history of chronic alcohol consumption. Examination revealed bilateral thickened structure at the palms.

Matched MeSH terms: Risk Factors
Fulltext Risk factors associated with chronic lung disease in Malaysian very low birthweight infants

Ameenudeen SA, Boo NY, Chan LG

Med J Malaysia, 2007 Mar;62(1):40-5.
PMID: 17682569 MyJurnal

To determine the significant risk factors associated with development of chronic lung disease (CLD) in Malaysian very low birthweight (VLBW, < 1501g) infants. A prospective observational study was carried out at the Sarawak General Hospital (SGH) in Kuching, over a period of 29 months from 1 April 2003 to 31 August 2005. Infants with birthweight between 600g to 1500g admitted to this hospital were recruited. The progress of these infants was followed till discharge. CLD was defined as the persistent need for oxygen therapy to maintain oxygen saturation above 88% at 36 weeks of postmenstrual age. Of the 224 infants recruited, 36 (14.8%) had CLD. Logistic regression analysis showed that lower birth weight (adjusted odds ratio (OR) = 0.996, 95% confidence intervals (CI) = 0.994, 0.998; p = 0.001), male infants (adjusted OR = 3.9, 95% CI = 1.6, 11.7; p = 0.02), chorioamnionitis (adjusted OR = 9.0, 95% CI = 1.6, 50.8; p = 0.01), severe respiratory distress syndrome of grades 3 or 4 (adjusted OR = 4.6, 95% CI =1.6, 13.2; P = 0.005) and patent ductus arteriosus (adjusted OR = 4.3, 95% CI = 1.5, 12.8; p = 0.007) were significant risk factors associated with development of CLD. A number of treatable conditions are associated with development of CLD in Malaysian VLBW infants.

Matched MeSH terms: Risk Factors
Noninvasive assessment of cutaneous vascular function in vivo using capillaroscopy, plethysmography and laser-Doppler instruments: its strengths and weaknesses

Yvonne-Tee GB, Rasool AH, Halim AS, Rahman AR

Clin. Hemorheol. Microcirc., 2006;34(4):457-73.
PMID: 16687786

Given that functional abnormalities of the microcirculation are one of the primary abnormalities in cardiovascular disease pathogenesis, various noninvasive clinical tools have been developed recently to assess the microvascular function, particularly at the skin. The common techniques used to assess cutaneous microvascular function in vivo include capillaroscopy, venous occlusion plethysmography, and laser-Doppler instruments (laser-Doppler fluximetry and laser-Doppler imaging). These noninvasive techniques can be used as an early measure of functional abnormalities within the microvascular tree, predominantly in population at high risk for cardiovascular events. This review discusses some underlying application principle of these techniques, including its clinical significance, method reproducibility and limitations.

Matched MeSH terms: Risk Factors
Fulltext Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia

Cheong AT, Sazlina SG, Tong SF, Azah AS, Salmiah S

Malays Fam Physician, 2015;10(1):19-25.
PMID: 26425291 MyJurnal

INTRODUCTION: Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.
MATERIALS AND METHODS: A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg.
RESULTS: A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control.
CONCLUSION: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.

Matched MeSH terms: Risk Factors
Novel Approaches in Primary Cardiovascular Disease Prevention: The HOPE-3 Trial Rationale, Design, and Participants' Baseline Characteristics

Lonn E, Bosch J, Pogue J, Avezum A, Chazova I, Dans A, et al.

Can J Cardiol, 2016 Mar;32(3):311-8.
PMID: 26481083 DOI: 10.1016/j.cjca.2015.07.001

Cholesterol and blood pressure (BP) can be effectively and safely lowered with statin drugs and BP-lowering drugs, reducing major cardiovascular (CV) events by 20%-30% within 5 years in high-risk individuals. However, there are limited data in lower-risk populations. The Heart Outcomes Prevention Evaluation-3 (HOPE-3) trial is evaluating whether cholesterol lowering with a statin drug, BP lowering with low doses of 2 antihypertensive agents, and their combination safely reduce major CV events in individuals at intermediate risk who have had no previous vascular events and have average cholesterol and BP levels.

Matched MeSH terms: Risk Factors
Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer: Analysis From the International Pancreatic Cancer Case-Control Consortium (PanC4)

Lujan-Barroso L, Zhang W, Olson SH, Gao YT, Yu H, Baghurst PA, et al.

Pancreas, 2016 11;45(10):1401-1410.
PMID: 27088489

OBJECTIVES: We aimed to evaluate the relation between menstrual and reproductive factors, exogenous hormones, and risk of pancreatic cancer (PC).
METHODS: Eleven case-control studies within the International Pancreatic Cancer Case-control Consortium took part in the present study, including in total 2838 case and 4748 control women. Pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a 2-step logistic regression model and adjusting for relevant covariates.
RESULTS: An inverse OR was observed in women who reported having had hysterectomy (ORyesvs.no, 0.78; 95% CI, 0.67-0.91), remaining significant in postmenopausal women and never-smoking women, adjusted for potential PC confounders. A mutually adjusted model with the joint effect for hormone replacement therapy (HRT) and hysterectomy showed significant inverse associations with PC in women who reported having had hysterectomy with HRT use (OR, 0.64; 95% CI, 0.48-0.84).
CONCLUSIONS: Our large pooled analysis suggests that women who have had a hysterectomy may have reduced risk of PC. However, we cannot rule out that the reduced risk could be due to factors or indications for having had a hysterectomy. Further investigation of risk according to HRT use and reason for hysterectomy may be necessary.

Matched MeSH terms: Risk Factors
Falls and Fear of Falling After Stroke: A Case-Control Study

Goh HT, Nadarajah M, Hamzah NB, Varadan P, Tan MP

PM R, 2016 12;8(12):1173-1180.
PMID: 27268565 DOI: 10.1016/j.pmrj.2016.05.012

BACKGROUND: Falls are common after stroke, with potentially serious consequences. Few investigations have included age-matched control participants to directly compare fall characteristics between older adults with and without stroke. Further, fear of falling, a significant psychological consequence of falls, has only been examined to a limited degree as a risk factor for future falls in a stroke population.
OBJECTIVE: To compare the fall history between older adults with and without a previous stroke and to identify the determinants of falls and fear of falling in older stroke survivors.
DESIGN: Case-control observational study.
SETTING: Primary teaching hospital.
PARTICIPANTS: Seventy-five patients with stroke (mean age ± standard deviation, 66 ± 7 years) and 50 age-matched control participants with no previous stroke were tested.
METHODS: Fall history, fear of falling, and physical, cognitive, and psychological function were assessed. A χ2 test was performed to compare characteristics between groups, and logistic regression was performed to determine the risk factors for falls and fear of falling.
MAIN OUTCOME MEASURES: Fall events in the past 12 months, Fall Efficacy Scale-International, Berg Balance Scale, Functional Ambulation Category, Fatigue Severity Scale, Montreal Cognitive Assessment, and Patient Healthy Questionnaire-9 were measured for all participants. Fugl-Meyer Motor Assessment was used to quantify severity of stroke motor impairments.
RESULTS: Twenty-three patients and 13 control participants reported at least one fall in the past 12 months (P = .58). Nine participants with stroke had recurrent falls (≥2 falls) compared with none of the control participants (P < .01). Participants with stroke reported greater concern for falling than did nonstroke control participants (P < .01). Female gender was associated with falls in the nonstroke group, whereas falls in the stroke group were not significantly associated with any measured outcomes. Fear of falling in the stroke group was associated with functional ambulation level and balance. Functional ambulation level alone explained 22% of variance in fear of falling in the stroke group.
CONCLUSIONS: Compared with persons without a stroke, patients with stroke were significantly more likely to experience recurrent falls and fear of falling. Falls in patients with stroke were not explained by any of the outcome measures used, whereas fear of falling was predicted by functional ambulation level. This study has identified potentially modifiable risk factors with which to devise future prevention strategies for falls in patients with stroke.
LEVEL OF EVIDENCE: III.

Matched MeSH terms: Risk Factors
Position of document holder and work related risk factors for neck pain among computer users: a narrative review

Ambusam S, Baharudin O, Roslizawati N, Leonard J

Clin Ter, 2015 Nov-Dec;166(6):256-61.
PMID: 26794814 DOI: 10.7417/CT.2015.1898

Document holder is used as a remedy to address occupational neck pain among computer users. An understanding on the effects of the document holder along with other work related risk factors while working in computer workstation requires attention. A comprehensive knowledge on the optimal location of the document holder in computer use and associated work related factors that may contribute to neck pain reviewed in this article. A literature search has been conducted over the past 14 years based on the published articles from January 1990 to January 2014 in both Science Direct and PubMed databases. Medical Subject Headings (MeSH) keywords for search were neck muscle OR head posture OR muscle tension' OR muscle activity OR work related disorders OR neck pain AND/OR document location OR document holder OR source document OR copy screen holder.Document holder placed lateral to the screen was most preferred to reduce neck discomfort among occupational typists. Document without a holder was placed flat on the surface is least preferred. The head posture and muscle activity increases when the document is placed flat on the surface compared to when placed on the document holder. Work related factors such as static posture, repetitive movement, prolong sitting and awkward positions were the risk factors for chronic neck pain. This review highlights the optimal location for document holder for computer users to reduce neck pain. Together, the importance of work related risk factors for to neck pain on occupational typist is emphasized for the clinical management.

Matched MeSH terms: Risk Factors
Anatomical variants of surgically important landmarks in the sphenoid sinus: a radiologic study in Southeast Asian patients

Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM, Ramiza RR

Surg Radiol Anat, 2015 Dec;37(10):1183-90.
PMID: 25990686 DOI: 10.1007/s00276-015-1494-8

Failure of a surgeon to understand the local variations of the anatomical landmarks of the sphenoid sinus is a potential risk factor to cause damage to the optic nerve (ON) or internal carotid artery (ICA) that lies on the walls of the sphenoid sinus. The aim of this study was to identify the anatomical variants of the sphenoid sinus and its related surrounding structures among the Southeast Asian (SEA) population, based on computed tomography (CT) scans.

Matched MeSH terms: Risk Factors
Gastro-oesophageal reflux disease in Asia

Goh KL, Chang CS, Fock KM, Ke M, Park HJ, Lam SK

J Gastroenterol Hepatol, 2000 Mar;15(3):230-8.
PMID: 10764021

Gastro-oesophageal reflux disease (GORD) occurs more frequently in Europe and North America than in Asia but its prevalence is now increasing in many Asian countries. Many reasons have been given for the lower prevalence of GORD in Asia. Low dietary fat and genetically determined factors, such as body mass index and maximal acid output, may be important. Other dietary factors appear to be less relevant. Increased intake of carbonated drinks or aggravating medicines may influence the increasing rates of GORD in some Asian countries but no strong evidence links other factors, such as the age of the population, smoking or alcohol consumption, to GORD. The management of GORD in Asia is similar to that in Europe and North America but the lower incidence of severe oesophagitis in Asia may alter the approach slightly. Also, because Asians tend to develop stomach cancer at an earlier age, endoscopy is used routinely at an earlier stage of investigation. Gastro-oesophageal reflux disease is essentially a motility disorder, so short-term management of the disease can usually be achieved using prokinetic agents (or histamine (H2)-receptor antagonists). More severe and recurrent GORD may require proton pump inhibitors (PPI) or a combination of prokinetic agents and PPI. The choice of long-term treatment may be influenced by the relative costs of prokinetic agents and PPI.

Matched MeSH terms: Risk Factors
Fulltext Is snoring a health risk?

Liam CK

Med J Malaysia, 1999 Mar;54(1):155-9; quiz 160.
PMID: 10972023
Matched MeSH terms: Risk Factors
Fulltext Effects of palm oil on cardiovascular risk

Chong YH, Ng TKW

Med J Malaysia, 1991 Mar;46(1):41-50.
PMID: 1836037

A major public health concern of affluent nations is the excessive consumption of dietary fats which are now closely linked to coronary heart disease. Against this scenario, the tropical oils and palm oil in particular, have been cast as major villains in the U.S.A., despite the fact that palm oil consumption there is negligible. The unsuspecting public may not realise that the call to avoid palm oil is nothing more than a trade ploy since in recent years palm oil has been very competitive and has gained a major share of the world's edible oils and fats market. Many also lose sight of the fact that, palm oil, like other edible oils and fats, is an important component of the diet. The allegation that palm oil consumption leads to raised blood cholesterol levels and is therefore atherogenic is without scientific foundation. Examination of the chemical and fatty acid composition of palm oil or its liquid fraction should convince most nutritionists that the oil has little cholesterol-raising potential. The rationale for these are: it is considered cholesterol free. its major saturated fatty acid, palmitic acid (16:0) has recently been shown to be neutral in its cholesterolaemic effect, particularly in situations where the LDL receptors have not been down-regulated by dietary means or through a genetic effect. palm oil contains negligible amounts (less than 1.5%) of the hypercholesterolemic saturated fatty acids, namely lauric acid (12:0) and myristic acid (14:0). it has moderately rich amounts of the hypocholesterolaemic, monounsaturated oleic acid (18:1, omega-9) and adequate amounts of linoleic acid. (18:2, omega-6). It contains minor components such as the vitamin E tocotrienols which are not only powerful antioxidants but are also natural inhibitors of cholesterol synthesis. Feeding experiments in various animal species and humans also do not support the allegation that palm oil is atherogenic. On the contrary, palm oil consumption reduces blood cholesterol in comparison with the traditional sources of saturated fats such as coconut oil, dairy and animal fats. In addition, palm oil consumption may raise HDL levels and reduce platelet aggregability. As with all nutrients, there is a need to obtain a balance of different fatty acids found in fats in edible oils and other food sources. There is no single ideal source of fat that answers to the recent American Heart Association's call to reflect a 1:1:1 ratio of saturated, monounsaturated and polyunsaturated fats in relation to the recommended dietary fat intake of 30% of calories or less.(ABSTRACT TRUNCATED AT 400 WORDS)

Matched MeSH terms: Risk Factors
Fulltext The risk of neonatal infection following prolonged rupture of the fetal membranes

Boo NY

Med J Malaysia, 1989 Mar;44(1):35-40.
PMID: 2626112

Over a seven month period in 1986, 164 (1.1%) of a total 15,131 neonates delivered in the Maternity Hospital, Kuala Lumpur were born to mothers with prolonged rupture of the fetal membranes. Septic work-ups were performed on 163 of these babies shortly after birth, 77 of them had no bacteriological, radiological or other clinical evidence of infection. The remaining 86 had additional history of illness. Nine of these 86 babies had proven infection: four with septicemia, one with meningitis and four others with congenital pneumonia. This study showed that neonates had risk of infection only when maternal history of prolonged rupture of the fetal membranes was associated with other clinical evidence of infection. However, even in this group of neonates at risk, 89.5% of them were not infected. Therefore, there is still a need to develop a simple, rapid, reliable and cheap laboratory method to help early identification of the infected from the non-infected neonates in order to prevent unnecessary antibiotic treatment and hospital stay.

Matched MeSH terms: Risk Factors

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