Displaying publications 2141 - 2160 of 3449 in total

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  1. Tocharoenvanich P, Yipintsoi T, Choomalee K, Boonwanno P, Rodklai A
    J Med Assoc Thai, 2008 Apr;91(4):471-8.
    PMID: 18556854
    To determine the mortality rate and risk factors for death in a selected population in Songkhla province in southern Thailand.
    Matched MeSH terms: Risk Factors
  2. Rahman S, Ismail AA, Ismail SB, Naing NN, Rahman AR
    Diabetes Res Clin Pract, 2008 May;80(2):253-8.
    PMID: 18249457 DOI: 10.1016/j.diabres.2007.12.010
    Type II diabetes patients have increased risk of macrovascular complications compared with the general population. Arterial stiffness is considered as an independent predictor of macrovascular events. This study investigated arterial stiffness in newly diagnosed never treated diabetes and impaired glucose tolerance (IGT) patients without any traditional cardiovascular diseases (CVD) risk factors. After preliminary screening of 1620 individuals, 30 diabetic and 30 IGT patients were recruited and compared with age- and sex-matched 30 normoglycaemic subjects. The subjects were newly diagnosed, never treated, normotensive, non-obese, non-hyperlipidaemic and non-smoker. Haemodynamic variables, pulse wave velocity (PWV) and augmentation index (AI) were measured. The PWV was significantly higher in diabetic patients (10.37+/-2.64m/s vs. 8.70+/-1.29m/s; p=0.035) and was of borderline significant in IGT subjects (9.54+/-1.56m/s vs.8.70+/-1.29m/s, p=0.078) compared to normoglycaemic individuals. Augmentation index was higher of borderline significant in diabetic (134.53+/-17.32% vs. 129.17+/-11.18%, p=0.055) and IGT patients (132.02+/-16.11% vs. 129.17+/-11.18%, p=0.059) compared to normoglycaemic individuals. The study demonstrated that newly diagnosed never treated diabetic patients without any CV complications had early manifestation of macrovascular diseases as evident by increased arterial stiffness. The findings also revealed early manifestations of preclinical vasculopathy and potentially increased risk for development of macrovascular diseases at an early age in diabetic patients.
    Matched MeSH terms: Risk Factors
  3. Pua KC, Khoo AS, Yap YY, Subramaniam SK, Ong CA, Gopala Krishnan G, et al.
    Med J Malaysia, 2008 Sep;63 Suppl C:59-62.
    PMID: 19230249
    Nasopharyngeal carcinoma (NPC) is a cancer which is common in Asia. We report the establishment and early results of a multi-institutional prospective study of nasopharyngeal carcinoma, which seeks to systematically collect data as well as blood and tumour tissue samples from patients diagnosed with nasopharyngeal cancer at six centres in Malaysia. A total of 484 confirmed NPC cases were reported from the six participating centres between 1st July 2007 and 29th February 2008. Of these, 225 were newly diagnosed cases, 53 were recurrent cases and 206 were in remission at the time of reporting. Amongst the newly diagnosed cases, the most common presenting symptom was the presence of neck lumps (42%). Ophthalmo-neurologic symptoms were the presenting symptoms of 11% of the new cases. The majority of cases (75%) presented at stage III/IV.
    Matched MeSH terms: Risk Factors
  4. Goh PP, National Eye Database Study Group
    Med J Malaysia, 2008 Sep;63 Suppl C:24-8.
    PMID: 19230243
    Diabetic Eye Registry, a web based registry hosted at the National Eye Database (www.acrm.org.my/end) collects data in a systematic and prospective nature on status of diabetic retinopathy (DR) among diabetics seen for the first time at Ministry of Health ophthalmology clinics. The 2007 report on 10,586 diabetics revealed that 63.3% of eyes examined had no DR, 36.8% had any form of DR, of which 7.1% had proliferative diabetic retinopathy. Up to 15.0% of eyes had vision threatening DR requiring laser or surgery at their first visit. Data on diabetic eye registry is useful in monitoring the quality of diabetic management, particularly in eye screening as reflected by the proportion of patients with severe DR needing intervention at the first visit to Ophthalmology clinics.
    Matched MeSH terms: Risk Factors
  5. Loh KY, Shong KH, Lan SN, Lo WY, Woon SY
    Asia Pac J Public Health, 2008;20(3):251-7.
    PMID: 19124319 DOI: 10.1177/1010539508317130
    Osteoporosis is a silent disease and becomes clinically significant in the presence of fragility fracture. Identifying risk factors that are associated with osteoporosis in the community is important in reducing the incidence of fragility fracture. The aim of this study is to identify risk factors associated with fragility fracture in the Seremban District of Malaysia. This is a population comparison study between orthopedic ward patients and outpatients attending a community health clinic for 6 months. Epidemiological data and the possible risk factors for osteoporosis were collected by direct interview. This study demonstrates that advancing age, low body weight, smoking, lack of regular exercise, low consumption of calcium containing foods, and using bone depleting drugs (steroids, thyroid hormone, and frusemides) are major risk factors for fragility fracture. Most of these risk factors are modifiable through effective lifestyle intervention.
    Study site: Klinik Kesihatan Seremban; Hospital Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Risk Factors
  6. Sidi H, Midin M, Puteh SE, Abdullah N
    Asia Pac J Public Health, 2008;20(4):298-306.
    PMID: 19124324 DOI: 10.1177/1010539508322810
    AIM: The aim of this study was to investigate the prevalence of orgasmic dysfunction and the potential risk factors that may be associated with orgasmic dysfunction among women at a primary care setting in Malaysia.
    METHODS: A validated questionnaire for sexual function was used to assess orgasmic function. A total of 230 married women aged 18 to 70 years participated in this study. Their sociodemographic and marital profiles were compared between those who had orgasmic dysfunction and those who did not, and the risk factors were examined.
    RESULTS: The prevalence of orgasmic dysfunction in the primary care population was 51.9%. Women with orgasmic dysfunction were found to be significantly higher in the following groups: age >45 years, being non-Malay, having lower academic status, married longer, having more children, married to an older husband, and being at menopausal state.
    CONCLUSION: Women with infrequent sexual intercourse are less likely to be orgasmic (odds ratio = 0.29, 95% confidence interval = 0.11-0.74).
    Matched MeSH terms: Risk Factors
  7. Khatoon R, Khoo EM
    Med J Malaysia, 2007 Jun;62(2):130-3.
    PMID: 18705445 MyJurnal
    The aims of the study were to determine the prevalence of peripheral arterial disease (PAD) in diabetic patients and in different ethnic groups at a primary care setting, and to evaluate risk factors associated with PAD in these diabetic patients. A cross sectional study of 200 diabetic patients over 18 years old who attended a primary care clinic at a teaching hospital in Kuala Lumpur, Malaysia was carried out. Face-to-face interviews were conducted using structured questionnaires for demographic characteristics and risk factors evaluation. Blood pressure measurements, assessment of peripheral neuropathy and ankle brachial pressures were performed. PAD was diagnosed by an ankle brachial pressure index (ABPI) of <0.9 on either leg. The overall prevalence of PAD was 16% in this diabetic population. The prevalence of PAD was 5.8% in Malays, 19.4% in Chinese and 19.8% in Indians. The prevalence of peripheral neuropathy was 41%, foot ulcer 9.5%, and gangrene 3.0%. The presence of foot ulcer was weakly associated with PAD (P=0.052). No significant relationships were found between age, gender, smoking status, duration of diabetes mellitus, hypertension, dyslipidaemia, and PAD. PAD is common in the diabetic population of this study.
    Study site: primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Risk Factors
  8. Cheung N, Lim L, Wang JJ, Islam FM, Mitchell P, Saw SM, et al.
    Am J Ophthalmol, 2008 Oct;146(4):620-4.
    PMID: 18639861 DOI: 10.1016/j.ajo.2008.05.033
    To examine the prevalence and risk factors of retinal arteriolar emboli, a risk predictor of stroke, in an Asian population.
    Matched MeSH terms: Risk Factors
  9. Ariza A
    PMID: 19058602
    Melioidosis is endemic in Malaysia. Cutaneous melioidosis is one manifestation and it may progress to necrotizing fasciitis. The case highlights a 46-year-old male, a chicken-seller who presented with scalp cellulitis which later progressed to necrotizing fasciitis and pneumonia are presented here. It illustrates several key features of the presentation, prompt laboratory diagnosis and early treatment of melioidosis which saved the patient's life.
    Matched MeSH terms: Risk Factors
  10. Hamid S, Yang YH, Peng KN, Ismail SM, Zain RB, Lim KP, et al.
    Oral Oncol, 2009 Jun;45(6):496-500.
    PMID: 18804411 DOI: 10.1016/j.oraloncology.2008.06.003
    The MDM2 SNP309 has been associated with increased expression of the protein which could suppress p53 function, and has been shown to modulate risk to cancer. We have previously shown that overexpression of MDM2 is a common event in oral cancers. In the present study, we determined the association between the MDM2 SNP309 polymorphism and oral cancer in 207 oral cancer patients and 116 normal subjects. We genotyped the MDM2 SNP309 by PCR-RFLP. Logistic regression was adapted to calculate odds ratios for MDM2 SNP309 polymorphism from univariate and multivariable adjusted models. Our results suggest that MDM2 SNP309 does not confer increased risk to oral cancer (OR=1.55, 95% CI=0.77-3.11). However, the GG/TG genotype was associated with later disease onset in women above 55 years of age. Collectively, our data suggests that MDM2 SNP309 may modulate the risk to oral cancer and is a modifier of the age at oral cancer onset in women above the age of 55 years.
    Matched MeSH terms: Risk Factors
  11. Subahir MN, Shah SA, Zainuddin ZM
    Asian Pac J Cancer Prev, 2009;10(6):1015-20.
    PMID: 20192575
    INTRODUCTION: In Malaysia, prostate cancer is ranked 6th among male cancer and expected to increase in the future. Several factors have shown to be related to prostate cancer such as sociodemographic, lifestyle, diet, occupational exposure, medical and health status. This is the first time a similar study was conducted in Malaysia to recognize the risk factors for prostate cancer patients who came for treatment at University Kebangsaan Malaysia Medical Centre (UKMMC).

    METHODS: Prostate cancer cases diagnosed between 2003 and 2008 which met with the inclusion criteria were included in the study. One hundred and twelfth (112) pairs of cases and controls matched by age and ethnicity were analysed. McNemar Odds Ratios (OR(M)) were calculated using McNemar Calculator software for univariate analysis while conditional logistic regression was used for multivariate analysis, both using SPSS version 12.0.

    RESULTS: Most of the prostate cancer patients (68.8%) that came for treatment in UKMMC were above 70 years old. The majority were Chinese (50.0%) followed by Malay (46.4%) and Indian (3.6%). Multivariate analysis showed cases were more likely to have a first-degree relative with a history of cancer (OR= 3.77, 95% CI= 1.19-11.85), to have been exposed to pesticides (OR= 5.57, 95% CI= 1.75-17.78) and consumed more meat (OR= 12.23, 95% CI= 3.89-39.01). Significantly reduced risks of prostate cancer were noted among those consuming more vegetables (OR= 0.12, 95% CI= 0.02-0.84), more tomatoes (OR= 0.35, 95% CI= 0.13-0.93) and those who had frequent sexual intercourse (OR= 0.44, 95% CI= 0.19-0.96).

    CONCLUSION: Some lifestyle and occupation factors are strong predictors of the occurrence of prostate cancer among patients in UKMMC. More importantly, with the identification of the potentially modifiable risk factors, proper public health intervention can be improved.

    Matched MeSH terms: Risk Factors
  12. Al-Naggar RA, Isa ZM, Shah SA, Nor MI, Chen R, Ismail F, et al.
    Asian Pac J Cancer Prev, 2009;10(6):1075-8.
    PMID: 20192587
    Survival after diagnosis of cancer is one of the major outcome measurements and a key criterion for assessing quality of cancer control related to both the preventive and the therapeutic level. The purpose of this study was to determine the 8-year survival time in Malaysia based on socio-demographic and clinical characteristics. A retrospective study of 472 Malaysian women with breast cancer from the Medical Record Department at University Kebangsaan Malaysia Medical Centre (UKMMC) was therefore performed with survival analysis carried out using the Kaplan-Meier with log-rank test for univariate analysis and Cox-regression for multivariate analysis. Women who had cancer or family history of cancer had a longer 8-year survival time (p = 0.008) compared with others who did not have such a history. Tamoxifen use, positive oestrogen receptor status, and race were prognostic indicators for 8-year survival time (p = 0.036, p = 0.018, p = 0.053, respectively) in univariate analysis. Multivariate analysis showed that being Malays and having no family history of cancer were independent prognostic factors for shorter survival time (p = 0.008, p = 0.012, respectively). In conclusion, being Chinese and having a family history of cancer are predictors of longer survival among the Malaysian breast cancer women.
    Matched MeSH terms: Risk Factors
  13. Lim JS, Tang SP, Siar CH
    Asian Pac J Cancer Prev, 2009;10(6):1071-4.
    PMID: 20192586
    BACKGROUND: Conventional methods for writing case notes detailing the progress of oral lichen planus (OLP), a precancerous condition that requires long-term surveillance, is both time-consuming and tedious for the busy clinician.

    OBJECTIVES: To design and perform a simple surveillance on OLP patients based on colour-coded topography mouth maps (TMM).

    MATERIALS AND METHODS: Three colour-coded TMM were employed: red for OLP in high risk oral mucosal sites, yellow for cases showing improvement and green for asymptomatic lesions at each recall visit. In this preliminary study, these were applied on 30 histologically confirmed OLP individuals attending the Oral Medicine Clinic at the Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya. The sites and extent of OLP lesions were charted on either red, yellow or green TMM based on defined criteria. This surveillance evaluated OLP in relation to patientandapos;s age, race, gender, underlying systemic conditions, oral habits, initial onset of OLP, oral manifestations and presence/absence of clinically suspicious areas.

    RESULTS: Study sample comprised 4 (13.3%) Malays, 9 (30.0%) Chinese and 17 (56.7%) Indians. Most OLP patients belong to the green TMM (n= 14, 46.6%) group followed by red (n= 11, 36.7%) and yellow (n= 5, 16.7%) groups. Of the 11 cases with red TMM, rebiopsy was performed on 4 cases but no dysplasia was detected. Any local confounding factors namely periodontal disease or faulty dental restorations were managed accordingly.

    CONCLUSIONS: TMM is simple to use and aided the clinicians in terms of time saving and patient management. Hence, follow-up of OLP patients can be carried out more efficiently and appropriately. TMM can be used for surveillance of other oral precancerous lesions and conditions.

    Matched MeSH terms: Risk Factors
  14. Sahadevan S, Saw SM, Gao W, Tan LC, Chin JJ, Hong CY, et al.
    J Am Geriatr Soc, 2008 Nov;56(11):2061-8.
    PMID: 19016940 DOI: 10.1111/j.1532-5415.2008.01992.x
    To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians.
    Matched MeSH terms: Risk Factors
  15. Sia SF, Tan KS, Waran V
    Med J Malaysia, 2007 Oct;62(4):308-12.
    PMID: 18551935 MyJurnal
    Primary intracerebral haemorrhage (ICH) results in significant morbidity and mortality among patients. There is a paucity of epidemiological data on this condition in Malaysia. The purpose of this hospital based study was to define the clinical profile in patients with primary spontaneous intracerebral haemorrhage at University of Malaya Medical Centre (UMMC) and to determine the mortality rate of intracerebral haemorrhage at the time of discharge, the prognostic factors and one year outcome of this cohort of patients. Sixty-six patients were admitted at the Neurosurgical unit of University of Malaya Medical Centre for a period of 13 months from March 2002 to March 2003. Fifty percent of the subjects were female. The mean age was 61.6 +/- 16.7 years. Among our patients with intracerebral haemorrhage, the common risk factors were: hypertension (80.3%), diabetes mellitus (25.7%) and smoking (27.2%). Common presenting features for our series were: weakness (61.8%), LOC (58.5%), headache (56.3%) and speech disturbances (45.3%). On neuroimaging, the lesions were seen in basal ganglia/thalamus (45.1%), lobar (32.9%), brainstem (13.4%) and cerebelli (8.5%). The overall 30 days mortality rate for intracerebral haemorrhage (ICH) was 43.9%. The important predictors of for mortality were the GCS score on admission (p < 0.0001), haematoma volume > 30 mls (p < 0.0001), evidence of intraventricular extension (p = 0.011) and ICH score (p < 0.0001). At one year follow up, 48.5% (n = 32) were dead, 33.3% (n = 11) obtained good recovery, 36.4% (n = 12) moderate disability, 18.2% (n = 6) severe disability and 3% remain vegetative state. The overall mortality rate for our series of patients with primary intracerebral haemorrhage is quite similar to previously published epidemiological studies. ICH scoring is useful in the prognostication.
    Matched MeSH terms: Risk Factors
  16. Pavai S, Jayaranee S, Sargunan S
    Med J Malaysia, 2007 Oct;62(4):303-7.
    PMID: 18551934
    Anaemia of chronic disease (ACD) is a frequent complication of rheumatoid arthritis (RA). A diagnostic difficulty in RA is the distinction between iron deficiency anaemia (IDA) and ACD. The aim of our study was to evaluate the usefulness of serum soluble transferrin receptor (sTfR) and sTfR/log ferritin (TfR-F) index to diagnose iron deficiency in RA patients with anaemia. Routine laboratory indices of anaemia and sTfR were measured in 20 healthy persons to form the control group, 30 patients with iron deficiency anaemia and 28 RA patients with anaemia. Serum sTfR levels were significantly elevated above the cut-off value in patients with IDA and those in the iron depleted RA subgroup (ferritin < 60 microg/L) compared with those in the control and iron repleted RA subgroup (ferritin > 60 microg/L). The same was observed for TfR-F index. However, five patients in the iron repleted RA sub group had an elevated sTfR level, of which two had increased TfR-F index. Serum sTfR correlated well with the markers of anaemia and not with ESR. Ferritin had no correlation with markers of anaemia but correlated well with ESR. Measurement of sTfR and TfR-F index are good indicators of iron deficiency in RA patients with anaemia. To be cost effective, sTfR can be estimated in RA patients with anaemia when the ferritin level is more than 60 microg/L.
    Matched MeSH terms: Risk Factors
  17. Fairuz AR, Maniam T, Khalid BA
    Med J Malaysia, 2007 Oct;62(4):290-3.
    PMID: 18551931 MyJurnal
    This is a cross-sectional study to determine the prevalence of insulin resistance and its associated factors in Hospital UKM patients with schizophrenia using the Homeostatic Model Assessment (HOMA) model. Fasting glucose and insulin from 85 patients were obtained. Fasting glucose revealed 15% of the patients were diabetic, while another 15% had impaired fasting glucose. Using the HOMA model, 68% of the patients had insulin resistance. Univariate analyses found BMI (p < 0.001) and waist circumference (p < 0.001) to be associated with insulin resistance. The statistical significance disappeared after multivariate analyses. All patients with schizophrenia should be screened and managed as a group at high risk for development of diabetes with emphasis on body weight management.
    Study site: inpatient and outpatients, Psychiatric department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Risk Factors
  18. Thai AC, Mohan V, Khalid BA, Cockram CS, Pan CY, Zimmet P, et al.
    Diabetes Res Clin Pract, 2008 May;80(2):224-30.
    PMID: 18207602 DOI: 10.1016/j.diabres.2007.12.003
    In this paper, the islet autoimmunity status and relation to clinical characteristics, beta cell function and cardio-metabolic risk factors in young-onset Asian diabetic patients are evaluated at baseline. The study population consisted of 912 patients (from China, India, Malaysia and Singapore) with age 12-40 years and diabetes duration <12 months. Autoantibodies to glutamic acid decarboxylase (GADA) and tyrosine phosphatase (IA-2A), beta cell function and cardio-metabolic risk parameters were assessed. Among our young patient cohort, 105 (11.5%) patients were GADA and/or IA-2A positives (Ab +ve). Ab +ve patients were younger, leaner, had more severe hyperglycaemia and lower beta cell function. The frequency of metabolic syndrome was significantly lower in Ab +ve patients (27%) compared to Ab -ve patients (54%). However, a substantial proportion of patients in both groups of patients had atherogenic dyslipidaemia, hypertension and albuminuria (micro or macro). In our study cohort, only one in 10 Asian youth with new-onset diabetes had evidence of islet autoimmunity. At least 60% of Ab +ve and 50% of Ab -ve patients demonstrated classical features of type 1 and type 2 diabetes respectively. Regardless of autoimmunity status, the cardio-metabolic risk factors, in particular atherogenic dyslipidaemia, hypertension and albuminuria were common in our patients with young-onset diabetes.
    Matched MeSH terms: Risk Factors
  19. Liu WJ, Chew TF, Chiu AS, Zaki M
    Med J Malaysia, 2006 Dec;61(5):540-6.
    PMID: 17623953 MyJurnal
    The aims of this retrospective analysis were (i) to examine the trends of quality of life (QoL) scores and (ii) to identify the risk factors for QoL scores among 6908 dialysis patients entering dialysis between 1997 and 2002. The Spitzer QoL Index was the instrument used by the National Renal Registry of Malaysia to assess the QoL amongst dialysis patients. Demographic and biochemical data were analysed to identify risk factors for poor QoL. The median QoL-index score ranged between 9 and 10. Significant risk factors for poor QoL were female gender, age > 40, diabetes, cohort starting dialysis 2001-2002, haemodialysis modality, body mass index < 18.5, albumin < 30g/dL, cholesterol < 3.2 mmol/L, haemoglobin < 10 g/dL, diastolic blood pressure of > 90 mHg, iPTH < 100 pg/ml. The overall QoL of dialysis patients is satisfactory. The negative impact of diabetes and haemodialysis on QoL warrants further evaluation as each factor involves 50% and 90% of our dialysis population.
    Matched MeSH terms: Risk Factors
  20. Hamidon BB, Nabil I, Raymond AA
    Med J Malaysia, 2006 Dec;61(5):553-7.
    PMID: 17623955 MyJurnal
    Dysphagia occurs frequently after a stroke. It is a major problem as patients are at risk of malnutrition and aspiration pneumonia. We aimed to identify the risk factors for and outcome of dysphagia over the first one month after an acute ischaemic stroke. Patients with acute first-ever ischaemic stroke admitted to the medical ward of Hospital Universiti Kebangsaan Malaysia (HUKM) between July 2004 and December 2004 were prospectively examined. Observation was done using pre-defined criteria. Demographic data, risk factors, and type of stroke were recorded on admission. The assessment of dysphagia was made using standardized clinical methods. All patients were followed up for three months. One hundred and thirty four patients were recruited in the study. Fifty-five patients (41%) had dysphagia at presentation. This number was reduced to 29 (21.6%) patients at one month. Logistic regression analysis revealed that age of more than 75 years [OR 5.20 (95% CI 1.89 - 14.30)], diabetes mellitus [OR 2.91 (95% CI 1.07 - 7.91)] and MCA infarct [OR 2.48 (95% CI 1.01-6.14)] independently predicts the occurrence of dysphagia after an acute stroke. Dysphagia at presentation was found to be an independent predictor of mortality at one-month [OR 5.28 (95% CI 1.51-18.45)] post ischaemic infarct. Dysphagia occurred commonly in ischaemic stroke. Advance age, diabetes mellitus and large infarcts were independently associated with the presence of dysphagia. Early stroke mortality can be independently predicted by the presence of dysphagia.
    Matched MeSH terms: Risk Factors
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