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Fulltext Exploratory analysis of traditional risk factors of ischemic heart disease (IHD) among predominantly Malay Malaysian women

Rashid NA, Nawi AM, Khadijah S

BMC Public Health, 2019 Jun 13;19(Suppl 4):545.
PMID: 31196022 DOI: 10.1186/s12889-019-6855-5

BACKGROUND: The risk factors of ischemic heart disease (IHD) specific for women are less well studied. However, knowing the risk factors of IHD for women will empower women themselves to be better informed and thus can help them in decision making concerning their health condition. The objective of this study is to explore the commonly studied risk factors of ischemic heart disease (IHD) among a group of Malaysian women.
METHODS: A case control study was conducted among 142 newly diagnosed IHD women patients registered in government hospitals in Terengganu, Malaysia and their 1:1 frequency matched population controls. Data on sociodemographic and socioeconomic profile, co-morbidities, lifestyle factors related to physical activities, dietary fat intake, stress, passive smoking history, anthropometric measurements and biochemical markers were obtained.
RESULTS: Middle aged women were recruited with women diagnosed with diabetes (aOR = 1.92, 95% CI: 1.11-3.31), having low HDL-C (aOR = 3.30, 95% CI: 1.28-8.27), those with positive family history of IHD (aOR = 1.92, 95% CI:1.13-3.26) and passive smokers (aOR = 2.99, 95% CI:1.81-4.94) were at higher odds of IHD.
CONCLUSIONS: The findings are useful for public health interventions and policy making focusing on specific women population.

Matched MeSH terms: Risk Factors
Fulltext Epidemiological profile and outcomes of snakebite injuries treated in emergency departments in South Korea, 2011-2016: a descriptive study

Senek MZF, Kong SY, Shin SD, Sun KM, Kim J, Ro YS

Trans R Soc Trop Med Hyg, 2019 10 11;113(10):590-598.
PMID: 31225621 DOI: 10.1093/trstmh/trz050

BACKGROUND: Snakebite is a global public health crisis, but there are no nationwide data on snakebite in South Korea. The aim of this study was to describe the epidemiological profile and outcomes of snakebite cases in South Korea seasonally.
METHODS: The selected subjects were patients of all ages with a chief complaint of snakebite who presented to participating emergency departments (EDs) between 1 January 2011 and 31 December 2016.
RESULTS: A total of 1335 patients were eligible for the study. There were an average of 223 snakebite cases reported each year. Most snakebites occurred during the summer months (55.9%) in patients aged 40-59 y (36.3%) and males (61.5%). Snakebites occurred most frequently on Mondays (22.9%) between 12:00 and 17:59 h (42.0%) outdoors (57.9%) and in farm areas (20.7%). Over 82% of the bites were by venomous snakes across all seasons, and 66% of the patients visited EDs without using emergency medical services. Based on the excess mortality ratio-adjusted injury severity score, 88, 9.2 and 2.8% had mild, moderate and severe injuries, respectively. There were 10 fatalities during the study period.
CONCLUSION: This study provides essential information to understand and assess the burden and distribution of snakebites in South Korea and provides valuable information for developing appropriate prevention and control interventions to address it.

Matched MeSH terms: Risk Factors
Diabetes, arthritis, urinary incontinence, poor self-rated health, higher body mass index and lower handgrip strength are associated with falls among community-dwelling middle-aged and older adults: Pooled analyses from two cross-sectional Malaysian datasets

Singh DKA, Shahar S, Vanoh D, Kamaruzzaman SB, Tan MP

Geriatr Gerontol Int, 2019 Aug;19(8):798-803.
PMID: 31237103 DOI: 10.1111/ggi.13717

AIM: The identification of risk factors associated with comorbidities and physical fitness might provide pathways for planning therapeutic targets for future falls prevention. Results from large datasets that examined falls risk factors in Asia have been limited. The aim of the present study was to identify the risk factors for falls by pooling data consisting of medical history, physical performance and self-rated health from two large Malaysian epidemiological studies.
METHODS: Matching variables from the Towards Useful Aging and Malaysian Elders Longitudinal Research datasets related to falls, physical performance and determinants of falls were identified and pooled for analysis. The Timed Up and Go test and dominant handgrip strength tests were used as physical performance measures. Falls were self-reported, and functional status was assessed using activities of daily living.
RESULTS: Data of 3935 participants, mean age 68.9 ± 6.8 years, 2127 (54.0%) women and 1807 (46.0%) men were extracted for analyses. In an adjusted model, independent risk factors for falls from this cohort studies were diabetes (OR 1.258), arthritis (OR 1.366), urinary incontinence (OR 1.346), poor self-rated health (OR 1.293), higher body mass index (OR 1.029) and lower handgrip strength (OR 1.234).
CONCLUSIONS: Although the risk factors that emerged from our analyses were similar to available studies among older adults, the Timed Up and Go test did not appear as one of the risk factors in the present study that included middle-aged adults. Our findings will require confirmation in a prospective study. Geriatr Gerontol Int 2019; 19: 798-803.

Matched MeSH terms: Risk Factors
Fulltext Comparison of Factors Associated with Disordered Eating between Male and Female Malaysian University Students

Chin YS, Appukutty M, Kagawa M, Gan WY, Wong JE, Poh BK, et al.

Nutrients, 2020 Jan 25;12(2).
PMID: 31991785 DOI: 10.3390/nu12020318

Disordered eating is prevalent among university students, especially females. Whilst literature suggests that factors associated with disordered eating may differ according to gender, such an association has not been studied in Malaysia. This cross-sectional study aims to compare factors associated with disordered eating between male and female university students. A total of 716 university students (male: 27.4%; female: 72.6%) were recruited in Kuala Lumpur and Selangor, Malaysia. All participants completed a set of self-administered questionnaires and their body weight and height were recorded. About one in five of the university students (20.3%) were found to have disordered eating. There were more female students (22.9%) disordered eating compared to males (13.3%, χ² = 8.16, p < 0.05). In male students (β = 0.228, p < 0.01), depressive symptoms were the only significant predictor for disordered eating. In females, the strongest predictor was depressive symptoms (β = 0.214, p < 0.001), followed by body size satisfaction (β = -0.145, p < 0.01) and body appreciation (β = -0.101, p < 0.05). These findings suggest that there are gender differences in the factors associated with disordered eating among Malaysian university students. Intervention programmes that address disordered eating should take into account these sex differences and its contributing factors.

Matched MeSH terms: Risk Factors
Fulltext The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Appannah G, Bindels J, et al.

PLoS One, 2020;15(1):e0227246.
PMID: 31923230 DOI: 10.1371/journal.pone.0227246

Generally, dietary patterns (DP)s have been linked to the risk of diabetes mellitus, however, only few studies examined the associations between DPs in early pregnancy and the risk of gestational diabetes mellitus (GDM). This study aims to determine the association between DPs before and during pregnancy and risk of GDM in Malaysian pregnant women. DPs were derived using principal component analysis of consumed 126 food and beverage items assessed using a validated semi-quantitative food frequency questionnaire collecting data retrospectively for pre-pregnancy, but prospectively for the first and second trimester. Three different DPs were identified at each time point and labelled as DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), and DP 7-9 (second trimester). About 10.6% (n = 48) of pregnant women were diagnosed with GDM in our cohort. Women with high adherence (HA) to DP 2 (adjusted OR: 0.45, 95% CI: 0.20-0.91) and DP 5 (adjusted OR: 0.28, 95% CI: 0.11-0.68) showed a significantly reduced risk of GDM compared to women with low adherence (LA). Other DPs were not significantly associated with GDM risk. Compared to women with GDM, non-GDM women showed HA scores for all DPs throughout pregnancy. Overall, a relative low percentage of women with GDM was found in this cohort. The risk was lower in women with HA to a relatively unhealthy dietary pattern, i.e. DP 2 and DP 5. The lower body mass index (BMI) status and energy intake of women showing a HA to DP 2 in the first trimester may underlie the observed association with a lower GDM risk. Additionally, genetic variance might explain the less susceptibility to GDM despite HA to unhealthy DPs among non-GDM women.

Matched MeSH terms: Risk Factors
Perceptions of risk factors for phlebitis among Malaysian nurses

Ying CX, Yusuf A, Keng SL

Br J Nurs, 2020 Jan 23;29(2):S18-S23.
PMID: 31972104 DOI: 10.12968/bjon.2020.29.2.S18

BACKGROUND: Intravenous therapy is an integral part of professional nursing practice. Nurses have a responsibility to recognise risk factors for phlebitis.
AIMS: To investigate nurses' perceptions of risk factors for phlebitis in a tertiary teaching hospital in north-east Peninsular Malaysia.
METHODS: A cross-sectional study of 199 randomly selected nurses were surveyed for their perceptions of risk factors for phlebitis using a self-administered questionnaire.
FINDINGS: More than half of the nurses (56.8%) had a good perception levels of risk factors for phlebitis. There was a significant association between the clinical area and nurses' perceptions of risk factors for phlebitis (p=0.04). Nurses working in medical, orthopaedic, and surgical areas had slightly better perceptions than nurses working in multidisciplinary and oncology areas.
CONCLUSION: These findings suggest that nurses need to continually improve their knowledge about risk factors for phlebitis to ensure safer nursing practice.

Matched MeSH terms: Risk Factors
Fulltext RAAS blockers in hypertension posing a higher risk toward the COVID-19

Singh Y, Gupta G, Satija S, Negi P, Chellappan DK, Dua K

Dermatol Ther, 2020 Jul;33(4):e13501.
PMID: 32359088 DOI: 10.1111/dth.13501
Matched MeSH terms: Risk Factors
Fulltext Risk factors associated with nosocomial infections among end stage renal disease patients undergoing hemodialysis: A systematic review

Abbasi SH, Aftab RA, Chua SS

PLoS One, 2020;15(6):e0234376.
PMID: 32569265 DOI: 10.1371/journal.pone.0234376

BACKGROUND: Profound healthcare challenges confront societies with an increase in prevalence of end-stage renal disease (ESRD), which is one of the leading causes of morbidity and mortality worldwide. Due to several facility and patient related factors, ESRD is significantly associated with increased morbidity and mortality attributed to infections.
AIMS AND OBJECTIVE: The aim of this study was to assess systematically the characteristics of patients and risk factors associated with nosocomial infections among ESRD patients undergoing hemodialysis.
METHODS: A systematic literature search was performed to identify eligible studies published during the period from inception to December 2018 pertaining to risk factors associated with nosocomial infections among hemodialysis patients. The relevant studies were generated through a computerized search on five databases (PubMed, EBSCOhost, Google Scholar, ScienceDirect and Scopus) using the Mesh Words: nosocomial infections, hospital acquired infections, healthcare associated infections, end stage renal disease, end stage renal failure, hemodialysis, and risk factors. The complete protocol has been registered under PROSPERO (CRD42019124099).
RESULTS: Initially, 1411 articles were retrieved. Out of these, 24 were duplicates and hence were removed. Out of 1387 remaining articles, 1337 were removed based on irrelevant titles and/or abstracts. Subsequently, the full texts of 50 articles were reviewed and 41 studies were excluded at this stage due to lack of relevant information. Finally, nine articles were selected for this review. Longer hospital stay, longer duration on hemodialysis, multiple catheter sites, longer catheterization, age group, lower white blood cell count, history of blood transfusion, and diabetes were identified as the major risk factors for nosocomial infections among hemodialysis patients.
CONCLUSION: The results of this review indicate an information gap and potential benefits of additional preventive measures to further reduce the risk of infections in hemodialysis population. Moreover, several patient-related and facility-related risk factors were consistently observed in the studies included in this review, which require optimal control measures.

Matched MeSH terms: Risk Factors
Fulltext Metabolic Syndrome in First Episode Schizophrenia, Based on the National Mental Health Registry of Schizophrenia (NMHR) in a General Hospital in Malaysia: A 10-Year Retrospective Cohort Study

Lee AMH, Ng CG, Koh OH, Gill JS, Aziz SA

Int J Environ Res Public Health, 2018 05 07;15(5).
PMID: 29735938 DOI: 10.3390/ijerph15050933

Schizophrenia has been linked with various medical comorbidities, particularly metabolic syndrome. The number of studies on this aspect is lacking in Malaysia. (1) Objective: To investigate metabolic syndrome rates and its associated factors. (2) Method: This is the first 10-year retrospective-outcome study of patients with first episode schizophrenia in Malaysia. Out of 394 patients diagnosed with first episode schizophrenia and registered with the National Mental Health Registry of Schizophrenia (NMHR) in the General Hospital Kuala Lumpur (GHKL) in 2004⁻2005, 174 patients consented to participate in the study. They were interviewed using a Schizophrenia outcome questionnaire and the International Physical Activity Questionnaire (IPAQ). The diagnosis of metabolic syndrome was made using the National Cholesterol Education Program—Third Adult Treatment Panel (NCEP ATP III). (3) Results: All patients’ weight, body mass index, fasting blood sugar, and blood pressure are significantly increased. Sixty-three subjects (36.2%) developed metabolic syndrome while 36 (23.2%) were hypertensive, and 41 (28.1%) were diabetic. Use of fluphenthixol depot (CI = 1.05⁻5.09, OR: 0.84, p = 0.039), reduced physical activity (CI = 0.13⁻1.00, OR: −1.04, p = 0.049), and substance use disorder (CI = 1.40, 13.89, OR: 1.48, p = 0.012) were significantly associated with metabolic syndrome based on univariate analysis. In further multivariate analysis, comorbid substance abuse was the only significant factor associated with metabolic syndrome after adjusting for physical activity and intramuscular depot. (4) Conclusion: Patients with schizophrenia are at high risk of metabolic syndrome. It is important to address substance use problems as an important risk factor of this comorbidity.

Matched MeSH terms: Risk Factors
The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study

Lear SA, Hu W, Rangarajan S, Gasevic D, Leong D, Iqbal R, et al.

Lancet, 2017 Dec 16;390(10113):2643-2654.
PMID: 28943267 DOI: 10.1016/S0140-6736(17)31634-3

BACKGROUND: Physical activity has a protective effect against cardiovascular disease (CVD) in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational. We examined whether different amounts and types of physical activity are associated with lower mortality and CVD in countries at different economic levels.

METHODS: In this prospective cohort study, we recruited participants from 17 countries (Canada, Sweden, United Arab Emirates, Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa, China, Colombia, Iran, Bangladesh, India, Pakistan, and Zimbabwe). Within each country, urban and rural areas in and around selected cities and towns were identified to reflect the geographical diversity. Within these communities, we invited individuals aged between 35 and 70 years who intended to live at their current address for at least another 4 years. Total physical activity was assessed using the International Physical Activity Questionnaire (IPQA). Participants with pre-existing CVD were excluded from the analyses. Mortality and CVD were recorded during a mean of 6·9 years of follow-up. Primary clinical outcomes during follow-up were mortality plus major CVD (CVD mortality, incident myocardial infarction, stroke, or heart failure), either as a composite or separately. The effects of physical activity on mortality and CVD were adjusted for sociodemographic factors and other risk factors taking into account household, community, and country clustering.

FINDINGS: Between Jan 1, 2003, and Dec 31, 2010, 168 916 participants were enrolled, of whom 141 945 completed the IPAQ. Analyses were limited to the 130 843 participants without pre-existing CVD. Compared with low physical activity (<600 metabolic equivalents [MET] × minutes per week or <150 minutes per week of moderate intensity physical activity), moderate (600-3000 MET × minutes or 150-750 minutes per week) and high physical activity (>3000 MET × minutes or >750 minutes per week) were associated with graded reduction in mortality (hazard ratio 0·80, 95% CI 0·74-0·87 and 0·65, 0·60-0·71; p<0·0001 for trend), and major CVD (0·86, 0·78-0·93; p<0·001 for trend). Higher physical activity was associated with lower risk of CVD and mortality in high-income, middle-income, and low-income countries. The adjusted population attributable fraction for not meeting the physical activity guidelines was 8·0% for mortality and 4·6% for major CVD, and for not meeting high physical activity was 13·0% for mortality and 9·5% for major CVD. Both recreational and non-recreational physical activity were associated with benefits.

INTERPRETATION: Higher recreational and non-recreational physical activity was associated with a lower risk of mortality and CVD events in individuals from low-income, middle-income, and high-income countries. Increasing physical activity is a simple, widely applicable, low cost global strategy that could reduce deaths and CVD in middle age.

FUNDING: Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, Ontario SPOR Support Unit, Ontario Ministry of Health and Long-Term Care, AstraZeneca, Sanofi-Aventis, Boehringer Ingelheim, Servier, GSK, Novartis, King Pharma, and national and local organisations in participating countries that are listed at the end of the Article.

Matched MeSH terms: Risk Factors
Fulltext Fine-mapping of 150 breast cancer risk regions identifies 191 likely target genes

Fachal L, Aschard H, Beesley J, Barnes DR, Allen J, Kar S, et al.

Nat Genet, 2020 01;52(1):56-73.
PMID: 31911677 DOI: 10.1038/s41588-019-0537-1

Genome-wide association studies have identified breast cancer risk variants in over 150 genomic regions, but the mechanisms underlying risk remain largely unknown. These regions were explored by combining association analysis with in silico genomic feature annotations. We defined 205 independent risk-associated signals with the set of credible causal variants in each one. In parallel, we used a Bayesian approach (PAINTOR) that combines genetic association, linkage disequilibrium and enriched genomic features to determine variants with high posterior probabilities of being causal. Potentially causal variants were significantly over-represented in active gene regulatory regions and transcription factor binding sites. We applied our INQUSIT pipeline for prioritizing genes as targets of those potentially causal variants, using gene expression (expression quantitative trait loci), chromatin interaction and functional annotations. Known cancer drivers, transcription factors and genes in the developmental, apoptosis, immune system and DNA integrity checkpoint gene ontology pathways were over-represented among the highest-confidence target genes.

Matched MeSH terms: Risk Factors
Fulltext Interleukin 6 and Development of Heart Failure With Preserved Ejection Fraction in the General Population

Chia YC, Kieneker LM, van Hassel G, Binnenmars SH, Nolte IM, van Zanden JJ, et al.

J Am Heart Assoc, 2021 06;10(11):e018549.
PMID: 33998283 DOI: 10.1161/JAHA.120.018549

Background The cause of heart failure with preserved ejection fraction (HFpEF) is poorly understood, and specific therapies are lacking. Previous studies suggested that inflammation plays a role in the development of HFpEF. Herein, we aimed to investigate in community-dwelling individuals whether a higher plasma interleukin 6 (IL-6) level is associated with an increased risk of developing new-onset heart failure (HF) over time, and specifically HFpEF. Methods and Results We performed a case-cohort study based on the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study, a prospective general population-based cohort study. We included 961 participants, comprising 200 participants who developed HF and a random group of 761 controls. HF with reduced ejection fraction or HFpEF was defined on the basis of the left ventricular ejection fraction of ≤40% or >40%, respectively. In Cox proportional hazard regression analyses, IL-6 levels were statistically significantly associated with the development of HF (hazard ratio [HR], 1.28; 95% CI, 1.02-1.61; P=0.03) after adjustment for key risk factors. Specifically, IL-6 levels were significantly associated with the development of HFpEF (HR, 1.59; 95% CI, 1.16-2.19; P=0.004), whereas the association with HF with reduced ejection fraction was nonsignificant (HR, 1.05; 95% CI, 0.75-1.47; P=0.77). In sensitivity analyses, defining HFpEF as left ventricular ejection fraction ≥50%, IL-6 levels were also significantly associated with the development of HFpEF (HR, 1.47; 95% CI, 1.04-2.06; P=0.03) after adjustment for key risk factors. Conclusions IL-6 is associated with new-onset HFpEF in community-dwelling individuals, independent of potential confounders. Our findings warrant further research to investigate whether IL-6 might be a novel treatment target to prevent HFpEF.

Matched MeSH terms: Risk Factors
Post-era mass drug administration: an update on intestinal parasitic infections in urban poor communities in Peninsular Malaysia

Sahimin N, Abd Khalil NS, Lewis JW, Mohd Zain SN

Trop Biomed, 2020 Jun 01;37(2):363-371.
PMID: 33612805

The health impact of a Malaysian national helminth control program which provided school-based anthelmintic chemotherapy from 1974 to 1983 was re-visited after three decades post MDA and associated risk factors amongst urban poor communities identified. Stool samples collected were screened using the formalin ethyl-acetate concentration technique recovered at least one species of helminth and/or protozoan. Despite a steady decline observed between 1974-1983 however, post MDA infections continue to persist in pockets of communities moderately (18.9%; n=39/206) with higher infection recorded amongst PPR flat residents (22.5%, n=16/71). Among risk factors identified, waste management method was the primary factor for Ascaris lumbricoides infections (n=33; 16.0%), whereas age, education, employment and source of drinking water were significant risk factors for cryptosporidiosis. Despite the government's efforts to improve health through the provision of basic amenities to the general public, higher prevalence values amongst PPR flat dwellers suggests the need to implement targeted chemotherapeutic treatment of, once a year deworming as recommended by World Health Organization when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, in addition to preventive measures though improvements in health awareness programs and improved waste management methods.

Matched MeSH terms: Risk Factors
Current trends of Hepatitis C virus genotypes and associated risk factors in hemophilia patients in Pakistan

Yaqoob M, Khan S, Atta S, Khan SN

Trop Biomed, 2020 Dec 01;37(4):1000-1007.
PMID: 33612752 DOI: 10.47665/tb.37.4.1000

Hemophilia is a rare bleeding disorder that needs plasma or clotting factor concentrate transfusion. Therefore chances of blood-borne pathogens like HCV transmission increase due to high prevalence in healthy donors. This study was aimed to determine the prevalence of HCV genotypes and associated risk factors in hemophilia patients of Khyber Pakhtunkhwa, Pakistan. Blood samples and data were collected from 672 hemophiliacs after proper consent obtained from each patient. Samples were analyzed for anti-HCV, HCV RNA and HCV genotype/s detection. Of the total, 22.32% (150) were anti-HCV positive, of which HCV RNA was detected in 18.45% (124) individuals. HCV genotype 3a was found with significantly higher prevalence (p<0.05) (19.35%) as compared to 2a (16.13%) and 1a (12.90%). HCV-3b and HCV-4 were found each in 3.22% samples. Dual infection of genotypes was found in 22.58% of individuals and 22.58% HCV RNA positive sampels were not typed. A total of 572 (85.12%) subjects had hemophilia A and 100 (14.88%) had hemophilia B. In hemophiliacs A the most dominant genotype was 3a (19.27%) while in hemophilia B, genotype 1a was prevalent (26.67%). Whole blood and plasma transfusion were observed as the main risk factors of HCV. It is concluded that HCV genotype 3a and 2a are prevalent in hemophilia patients of Khyber Pakhtunkhwa Pakistan and the main risk factor observed was an unscreened whole blood transfusion.

Matched MeSH terms: Risk Factors
Fulltext Concordance of recommendations across clinical practice guidelines for the management of hypertension in Southeast Asia with internationally reputable sources

Kow CS, Hasan SS, Wong PS, Verma RK

BMC Cardiovasc Disord, 2021 07 28;21(1):354.
PMID: 34320925 DOI: 10.1186/s12872-021-02054-x

OBJECTIVES: This study aimed to assess the rate of concordance, and to investigate sources of non-concordance of recommendations in the management of hypertension across CPGs in Southeast Asia, with internationally reputable clinical practice guidelines (CPGs).
METHODS: CPGs for the management of hypertension in Southeast Asia were retrieved from the websites of the Ministry of Health or cardiovascular specialty societies of the individual countries of Southeast Asia during November to December 2020. The recommendations for the management of hypertension specified in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline and the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guideline were selected to be the reference standards; the recommendations concerning the management of hypertension in the included CPGs in Southeast Asia were assessed if they were concordant with the reference recommendations generated from both the 2017 ACC/AHA guideline and the 2018 ESC/ESH guideline, using the population (P)-intervention (I)-comparison (C) combinations approach.
RESULTS: A total of 59 reference recommendations with unique and unambiguous P-I-C specifications was generated from the 2017 ACC/AHA guideline. In addition, a total of 51 reference recommendations with unique and unambiguous P-I-C specifications was generated from the 2018 ESC/ESH guideline. Considering the six included CPGs from Southeast Asia, concordance was observed for 30 reference recommendations (50.8%) out of 59 reference recommendations generated from the 2017 ACC/AHA guideline and for 31 reference recommendations (69.8%) out of 51 reference recommendations derived from the 2018 ESC/ESH guideline.
CONCLUSIONS: Hypertension represents a significant issue that places health and economic strains in Southeast Asia and demands guideline-based care, yet CPGs in Southeast Asia have a high rate of non-concordance with internationally reputable CPGs. Concordant recommendations could perhaps be considered a standard of care for hypertension management in the Southeast Asia region.

Matched MeSH terms: Risk Factors
Fulltext Incidence, clearance, persistence and factors related with high-risk anal HPV persistence in South-East Asian MSM and transgender women

Yunihastuti E, Teeratakulpisarn N, Jeo WS, Nilasari H, Rachmadi L, Somia IKA, et al.

AIDS, 2020 11 01;34(13):1933-1941.
PMID: 32773478 DOI: 10.1097/QAD.0000000000002654

OBJECTIVES: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence.
DESIGN: Prospective cohort study.
METHODS: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence.
RESULTS: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence.
CONCLUSION: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.

Matched MeSH terms: Risk Factors
Risk factors associated with dyspepsia in a rural Asian population and its impact on quality of life

Mahadeva S, Yadav H, Rampal S, Goh KL

Am J Gastroenterol, 2010 Apr;105(4):904-12.
PMID: 20179699 DOI: 10.1038/ajg.2010.26

The epidemiology and impact of dyspepsia in rural Asia remains uncertain. We aimed to determine the prevalence epidemiology and impact of dyspepsia in a rural Malaysian community.

Matched MeSH terms: Risk Factors
Ethnicity and H. pylori as risk factors for gastric cancer in Malaysia: A prospective case control study

Goh KL, Cheah PL, Md N, Quek KF, Parasakthi N

Am J Gastroenterol, 2007 Jan;102(1):40-5.
PMID: 17100981

To determine the risk factors for gastric cancer (GCA), with particular emphasis on ethnicity in our multiracial population.

Matched MeSH terms: Risk Factors
Opposing trends in incidence of esophageal squamous cell carcinoma and adenocarcinoma in a multi-ethnic Asian country

Fernandes ML, Seow A, Chan YH, Ho KY

Am J Gastroenterol, 2006 Jul;101(7):1430-6.
PMID: 16863543

To describe the incidence trends in esophageal squamous cell carcinoma (SCC) and adenocarcinoma among the three major ethnic groups in Singapore from 1968 to 2002.

Matched MeSH terms: Risk Factors
Dietary Patterns and Risk of Inflammatory Bowel Disease in Europe: Results from the EPIC Study

Racine A, Carbonnel F, Chan SS, Hart AR, Bueno-de-Mesquita HB, Oldenburg B, et al.

Inflamm Bowel Dis, 2016 Feb;22(2):345-54.
PMID: 26717318 DOI: 10.1097/MIB.0000000000000638

BACKGROUND: Specific nutrients or foods have been inconsistently associated with ulcerative colitis (UC) or Crohn's disease (CD) risks. Thus, we investigated associations between diet as a whole, as dietary patterns, and UC and CD risks.
METHODS: Within the prospective EPIC (European Prospective Investigation into Cancer) study, we set up a nested matched case-control study among 366,351 participants with inflammatory bowel disease data, including 256 incident cases of UC and 117 of CD, and 4 matched controls per case. Dietary intake was recorded at baseline from validated food frequency questionnaires. Incidence rate ratios of developing UC and CD were calculated for quintiles of the Mediterranean diet score and a posteriori dietary patterns produced by factor analysis.
RESULTS: No dietary pattern was associated with either UC or CD risks. However, when excluding cases occurring within the first 2 years after dietary assessment, there was a positive association between a "high sugar and soft drinks" pattern and UC risk (incidence rate ratios for the fifth versus first quintile, 1.68 [1.00-2.82]; Ptrend = 0.02). When considering the foods most associated with the pattern, high consumers of sugar and soft drinks were at higher UC risk only if they had low vegetables intakes.
CONCLUSIONS: A diet imbalance with high consumption of sugar and soft drinks and low consumption of vegetables was associated with UC risk. Further studies are needed to investigate whether microbiota alterations or other mechanisms mediate this association.

Matched MeSH terms: Risk Factors

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