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Fulltext Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia

Sohn AH, Lumbiganon P, Kurniati N, Lapphra K, Law M, Do VC, et al.

AIDS, 2020 08 01;34(10):1527-1537.
PMID: 32443064 DOI: 10.1097/QAD.0000000000002583

OBJECTIVE: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents.
DESIGN: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study.
METHODS: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses.
RESULTS: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9-13) years; median CD4 cell count was 73 (16-325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 cell count and better weight-for-age z-score were protective against death.
CONCLUSION: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.

Matched MeSH terms: Regression Analysis
Poverty and mortality among the elderly: measurement of performance in 33 countries 1960-92

Wang J, Jamison DT, Bos E, Vu MT

Trop Med Int Health, 1997 Oct;2(10):1001-10.
PMID: 9357491

This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.

Matched MeSH terms: Regression Analysis
Dentoalveolar Cleft Treatment Outcome Using Modified Huddart-Bodenham Index and Regression Analysis of Associated Factors

Arshad AI, Alam MK, Khamis MF

Cleft Palate Craniofac J, 2018 05;55(5):682-687.
PMID: 29518343 DOI: 10.1177/1055665618758278

OBJECTIVES: The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome.
DESIGN: Retrospective observational study.
SETTING: Two regional cleft-referral centers.
MAIN OUTCOME MEASURES: In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives. Each occlusal relationship from central incisor till the first permanent molars were scored except the lateral incisor. Sum of 10 occlusal relationships in each study sample gave a total occlusion score. The primary outcome was the mean total occlusion score.
RESULTS: According to MHB, a mean (standard deviation) total occlusion score of -8.92 (6.89) was determined. Based on treatment outcome, 66 cases were favorable (grades 1, 2, and 3) and 35 cases were unfavorable (grades 4 and 5). Chi-square tests indicated, difference of cheiloplasty ( P = .001) and palatoplasty ( P < .001) statistically significant. Five variables-gender, family history of cleft, cleft side, cheiloplasty, and palatoplasty-were analyzed with a logistic regression model.
CONCLUSIONS: Final model indicated that cases treated with modified Millard technique (cheiloplasty) and Veau-Wardill-Kilner method (palatoplasty) had higher odds of unfavorable treatment outcome.

Matched MeSH terms: Regression Analysis
Knowledge, Attitudes, and Practices of Antimicrobial Uses and Resistance Among Public University Students in Bangladesh

Marzan M, Islam DZ, Lugova H, Krishnapillai A, Haque M, Islam S

Infect Drug Resist, 2021;14:519-533.
PMID: 33603416 DOI: 10.2147/IDR.S289964

Background: Antibiotics are lifesaving drugs, and inappropriate uses lead to the resistance that renders them ineffective. This study aims to understand knowledge, attitude, and practice (KAP) concerning antibiotic use and resistance among university students in Bangladesh.
Methods: A cross-sectional study was performed from January to April 2020 among students at Jahangirnagar University (JU), Bangladesh. Purposive sampling was conducted through an in-person interview using a structured questionnaire. Students from the faculties of biological sciences and non-biology background were included. The univariate ordinal regression technique was used to analyze the relationship between predictors and good knowledge about the antibiotics. A two-tailed p-value was calculated to determine statistical association.
Results: Out of 205 study participants, 92 and 113 responders were from biological science faculty and non-biology disciplines, respectively. Less than half of the students (42.4%) showed a good knowledge level (scores higher than 80%). Biology-background students possess better knowledge than non-biology students [odds ratio (OR) = 4.44, 95% confidence level (CL) (2.56, 7.70), p < 0.001]. A better attitude was noticed among all students. The self-medication rate was quite low, and more than 90% of students were found to consume antibiotics according to the physician's prescription. Lack of treatment adherence was recorded, and students admitted to stop-taking antibiotics when symptoms disappeared (48.67% biology and 36.26% non-biology). Multivariate regression analysis was unable to detect any significant association between self-medication and gender, student category or the level of knowledge about antibiotics.
Conclusion: Students of biological science background possessed better knowledge indicating the importance of appropriate curriculum imparted in knowledge buildup. Introducing a short course about the risk and development of antibiotic resistance will grow the students' awareness to avoid the resistance phenomenon.

Matched MeSH terms: Regression Analysis
Prevalence of dementia and quality of life of caregivers of people living with dementia in Malaysia

Ganapathy SS, Sooryanarayana R, Ahmad NA, Jamaluddin R, Abd Razak MA, Tan MP, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:16-20.
PMID: 33370858 DOI: 10.1111/ggi.14031

AIM: Dementia is the major cause of disability among older persons and leading physical and psychological sequelae for both the person living with dementia (PLwD) and their caregivers. The aim of this study was to determine the prevalence of dementia in Malaysia and identify the factors influencing quality of life (QoL) of caregivers of PLwD.
METHODS: A nationwide survey was conducted among individuals aged ≥60 years. Cognition was assessed with the Identification and Intervention for Dementia in Elderly Africans (IDEA) tool. QoL of older caregivers was assessed using the Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire.
RESULTS: The prevalence of dementia among older adults aged ≥60 years in Malaysia was found to be 8.5%. The prevalence was found to be higher among females, those with no formal education and those in rural areas in Malaysia. The mean QoL of family caregivers of PLwD was significantly lower than the caregivers of older adults without dementia were (P

Matched MeSH terms: Regression Analysis
Quality of life and its associated factors among older persons in Malaysia

Abdul Mutalip MH, Abdul Rahim FA, Mohamed Haris H, Yoep N, Mahmud AF, Salleh R, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:92-97.
PMID: 33370851 DOI: 10.1111/ggi.13961

AIM: Quality of life (QoL) among the older persons provides valuable insights into the potential modifiable risk factors that affect well-being in later life. This study aimed to describe the QoL and psychosocial factors of QoL of older persons in Malaysia.
METHODS: We used the 19-item Control, Autonomy, Self-realization and Pleasure scale, a validated instrument that measures psychological well-being related to QoL in older persons. Scores range from 0 to 57, and higher scores indicate better QoL. We included several factors as covariates. Analysis of complex samples was carried out using Stata 15. Descriptive analysis was carried out to determine QoL by sociodemographic characteristics and other factors. Linear regression analysis was used to identify psychosocial factors that influence QoL.
RESULTS: A total of 3444 individuals aged ≥60 years completed all 19-item Control, Autonomy, Self-realization and Pleasure items. The estimated mean QoL score was 47.01 (95% CI 46.30-47.72). Adjusted for confounders, QoL was lower among individuals with no formal education (-2.554, 95% CI -3.684, -1.424), probable depression (-1.042, 95% CI -1.212, -0.871) and food insecurity (-0.815, 95% CI -1.083, -0.548). QoL continued to improve with improved ADL score (0.302, 95% CI 0.052, 0.552), IADL score (0.646, 95% CI 0.382, 0.909) and better social support (0.308, 95% CI 0.187, 0.429).
CONCLUSIONS: Lower education, depression, food insecurity, presence of limited functional status and poor social support negatively influenced QoL in older Malaysians. This study identified potentially modifiable factors that could be targeted for interventions to enhance QoL of older persons in Malaysia. Geriatr Gerontol Int 2020; 20: 92-97.

Matched MeSH terms: Regression Analysis
Relationship between urinary incontinence and quality of life of older persons in Malaysia

Taufik Ramli MH, Lodz NA, Abdul Aziz FA, Maw Pin T, Alias N, Abdul Mutalip MH, et al.

Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:38-42.
PMID: 33370861 DOI: 10.1111/ggi.14028

AIMS: As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia.
METHODS: This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities.
RESULTS: Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities.
CONCLUSION: UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

Matched MeSH terms: Regression Analysis
Fulltext Regular meals with family and its association with children’s BMI In Kota Kinabalu, Sabah

Alvin Oliver Payus, Constance Liew Sat Lin, Chandrika Murugaiah, Symeon Mandrinos, Rajesh Kumar Muniandy, Malehah Mohd Noh, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):32-0.
MyJurnal

Introduction: Nutrition is an issue of great academic and public importance. However, there is evidence that parents do not have family breakfast, lunch or dinner with their children. This study aims to assess the prevalence of having regular family breakfast, lunch, dinner among primary school children age 7 to 12 years in Kota Kinabalu and its association with children’s weight status. Methods: The study is based on 485 children (mean age: 11.5+/-0.7 years, 54% girls) randomly selected in five primary schools in Kota Kinabalu who participated in a cross-sectional school- based survey in 2019. Data on family meals were self-reported by the parents by answering a validated question- naire. Children’s height and weight were measured to determine BMI status. Binary regression analyses assessed the associations of having regular family meals with children’s obesity status and to assess potential differences in having family meals according to gender and parental education. Results: The mean BMI male gender 24.3 ± 4.05 versus mean BMI female gender 17.9 ± 3.62 from 7 to 12 years old. The father mean BMI was 33.2 ± 8.24 versus 26.17 ±
9.63 mean BMI in mother from 32 to 52 years old. The prevalence of obesity within five (5) selected schools in Kota Kinabalu was only 13.2%. Regarding potential socio-demographic determinants, children of higher educated parents (STPM, DIPLOMA)[OR = 1.85 (95% CI 1.20–2.85)] were more likely to have breakfast together, while children of lower educated parents (SRP, SPM) [OR = 1.08 (95% CI 0.91–1.44)] were more likely to have dinner together. No significant associations of having family meals with gender observed. The prevalence of regular family meals was 94.6%, 74.17% and 93.8% for breakfast, lunch and dinner respectively. Conclusion: This study showed that having regular family breakfast, lunch and dinner was associated with children normal BMI between 18.50-24.99.

Matched MeSH terms: Regression Analysis
Fulltext Determination of factors associated with physical activity levels among adolescents attending school in Kuantan, Malaysia

Dan SP, Mohd NM, Zalilah MS

Malays J Nutr, 2011 Aug;17(2):175-87.
PMID: 22303572 MyJurnal

Introduction: Findings from the National Health and Morbidity Survey III (MOH, 2008) indicate a 43.7% prevalence of physical inactivity among Malaysian adults. This sedentary lifestyle can also be observed among children and adolescents.
Methods: A cross-sectional study was conducted to determine factors associated with physical activity levels of four hundred, 13 year-old adolescents in Kuantan, Pahang. Data on socio-demographic, health-related, and psychosocial factors were collected using a self-administered questionnaire while physical activity level was assessed using the Physical Activity Questionnaire for Older Children (PAQ-C).
Results: About one-third of the respondents were in the low physical activity level category, 61.5% were in the moderate category and only 3.0% of the adolescents were in the high physical activity level category. Males were more physically active than females (χ2=23.667, p=0.0001) with female adolescents (45.1%) twice as likely as male adolescents (22.1%) to be in the low physical activity level category. The associations between physical activity level with socio-demographic and health-related factors, perception of weight status and body parts satisfaction were not significant. However, physical activity was found to be positively correlated with physical activity self-efficacy (r=0.496,p=0.0001), peer influence (r=0.468, p=0.0001), family influence (r=0.298, p=0.0001) and beliefs in physical activity outcomes (r=0.207, p=0.0001). Negative relationships were found between physical activity with depression (r=-0.116, p=0.021) and body size discrepancy (r=-0.143, p<0.01). Respondents who had a better perception of their current health status were more physically active (χ2=21.062, p=0.0001). Multivariate analyses for the prediction of physical activity showed that physical activity self-efficacy, sex and peer influence were the most significant contributors in explaining physical activity among adolescents.
Conclusion: Physical activity interventions should include psychosocial components as mediator variables in interventions designed to promote regular physical activity in adolescence.
Key words: Adolescents, physical activity, psychosocial factors, health-related factors and socio-demographic factors

Matched MeSH terms: Regression Analysis
Diastolic dysfunction in patients with liver cirrhosis: A short-term, observational study at a Malaysian hospital

Abdul Aziz KA, Draman N, Wan Isa WYH, Mustaffa N

Med J Malaysia, 2020 07;75(4):396-399.
PMID: 32724001

Cirrhotic cardiomyopathy is a recognised complication of liver cirrhosis and predicts poor outcomes. Detection of diastolic dysfunction, an early indicator of left ventricular dysfunction can help identify those patients at risk of disease progression. In our study we showed that there was a high prevalence of diastolic dysfunction amongst patients with liver cirrhosis at our outpatient clinic, with the majority being Child-Pugh A/low MELD score. Multiple regression analysis indicated that age and sodium levels were significantly associated with the presence of diastolic dysfunction. This further reinforces the importance of dietary sodium restriction amongst patients with liver cirrhosis.

Matched MeSH terms: Regression Analysis
Intrinsic vs. extrinsic influences on life history expression: metabolism and parentally induced temperature influences on embryo development rate

Martin TE, Ton R, Niklison A

Ecol Lett, 2013 Jun;16(6):738-45.
PMID: 23473270 DOI: 10.1111/ele.12103

Intrinsic processes are assumed to underlie life history expression and trade-offs, but extrinsic inputs are theorised to shift trait expression and mask trade-offs within species. Here, we explore application of this theory across species. We do this based on parentally induced embryo temperature as an extrinsic input, and mass-specific embryo metabolism as an intrinsic process, underlying embryonic development rate. We found that embryonic metabolism followed intrinsic allometry rules among 49 songbird species from temperate and tropical sites. Extrinsic inputs via parentally induced temperatures explained the majority of variation in development rates and masked a relationship with metabolism; metabolism explained a minor proportion of the variation in development rates among species, and only after accounting for temperature effects. We discuss evidence that temperature further obscures the expected interspecific trade-off between development rate and offspring quality. These results demonstrate the importance of considering extrinsic inputs to trait expression and trade-offs across species.

Matched MeSH terms: Regression Analysis
Fulltext Approximate Bayesian analysis of Drosophila melanogaster polymorphism data reveals a recent colonization of Southeast Asia

Laurent SJ, Werzner A, Excoffier L, Stephan W

Mol Biol Evol, 2011 Jul;28(7):2041-51.
PMID: 21300986 DOI: 10.1093/molbev/msr031

Southeast Asian populations of the fruit fly Drosophila melanogaster differ from ancestral African and derived European populations by several morphological characteristics. It has been argued that this morphological differentiation could be the result of an early colonization of Southeast Asia that predated the migration of D. melanogaster to Europe after the last glacial period (around 10,000 years ago). To investigate the colonization process of Southeast Asia, we collected nucleotide polymorphism data for more than 200 X-linked fragments and 50 autosomal loci from a population of Malaysia. We analyzed this new single nucleotide polymorphism data set jointly with already existing data from an African and a European population by employing an Approximate Bayesian Computation approach. By contrasting different demographic models of these three populations, we do not find any evidence for an early divergence between the African and the Asian populations. Rather, we show that Asian and European populations of D. melanogaster share a non-African most recent common ancestor that existed about 2,500 years ago.

Matched MeSH terms: Regression Analysis
The applicability of using a protease extracted from cashew fruits (Anacardium occidentale), as possible meat tenderizer: An experimental design approach

Ahmad MN, Shuhaimen MS, Normaya E, Omar MN, Iqbal A, Ku Bulat KH

J Texture Stud, 2020 10;51(5):810-829.
PMID: 32401337 DOI: 10.1111/jtxs.12529

Meat tenderness is one of the most important organoleptic properties in determining consumer acceptance in meat product marketability. Therefore, an effective meat tenderization method is sought after by exploring plant-derived proteolytic enzymes as meat tenderizer. In this study, a novel protease from Cashew was identified as a new alternative halal meat tenderizer. The extraction of cashew protease was optimized using response surface methodology (R2 = 0.9803) by varying pH, CaCl2 concentration, mixing time, and mass. pH 6.34, 7.92 mM CaCl2 concentration, 5.51 min mixing time, and 19.24 g sample mass were the optimal extraction conditions. There was no significant difference (n = 3; p

Matched MeSH terms: Regression Analysis
Integration of the free liquid membrane into electrokinetic supercharging - capillary electrophoresis for the determination of cationic herbicides in environmental water samples

Chui MQ, Thang LY, See HH

J Chromatogr A, 2017 Jan 20;1481:145-151.
PMID: 28017568 DOI: 10.1016/j.chroma.2016.12.042

A new approach based on the integration of the free liquid membrane (FLM) into electrokinetic supercharging (EKS) was demonstrated to be a new powerful tool used in order to enhance online preconcentration efficiency in capillary electrophoresis (CE). A small plug of water immiscible organic solvent was used as a membrane interface during the electrokinetic sample injection step in EKS in order to significantly enhance the analyte stacking efficiency. The new online preconcentration strategy was evaluated for the determination of paraquat and diquat present in the environmental water samples. The optimised FLM-EKS conditions employed were as follows: hydrodynamic injection (HI) of 20mM potassium chloride as leading electrolyte at 50mbar for 75s (3% of the total capillary volume) followed by the HI of tris(2-ethylhexyl) phosphate (TEHP) as FLM at a 1mm length (0.1% of the capillary volume). The sample was injected at 10kV for 360s, followed by the HI of 20mM cetyl trimethylammonium bromide (CTAB) as terminating electrolyte at 50mbar for 50s (2% of the total capillary volume). The separation was performed in 12mM ammonium acetate and 30mM NaCl containing 20% MeOH at +25kV with UV detection at 205nm. Under optimised conditions, the sensitivity was enhanced between 1500- and 1866-fold when compared with the typical HI at 50mbar for 50s. The detection limit of the method for paraquat and diquat was 0.15-0.20ng/mL, with RSDs below 5.5%. Relative recoveries in spiked river water were in the range of 95.4-97.5%. A comparison was also made between the proposed approach with sole preconcentration of the field-enhanced sample injection (FASI) and EKS in the absence of the FLM.

Matched MeSH terms: Regression Analysis
Fulltext Bipolar disorder and other associated factors in postnatal depression

Ng, C.G.

Malaysian Journal of Psychiatry, 2009;18(2):1-11.
MyJurnal

Postnatal depression is common and affects 10-15% of postpartum women. While there are many studies on the depressive episode in the postnatal period, its association with the bipolar spectrum disorder is often go unrecognized and undiagnosed.
Objective: To study the rate of bipolar spectrum disorder in mothers presented with postpartum depression and its associated factors.
Method: This is a cross sectional study on the women who visited the postnatal clinic in University Malaya Medical Centre. Subjects who consented were asked to complete a short questionnaire looking at the socio-demographic details and asked to answer the Multidimensional Scale of Perceived Social Support (MSPSS), Mood Disorder questionnaire (MDQ) and Edinburgh Postnatal Depression Scale (EPDS) whish assess the perceived social support and mood disorder.
Result: A total of 93 women were recruited into the study. Independent t-test and stepwise regression analysis identified that unemployment and baby with health problem were the only associated factors for postnatal depression. 28.6% of the mother with possible postnatal depression (EPDS = 12) might have bipoar spectrum disorder (MDQ = 7).
Conclusion: Postnatal depression as part of bipolar spectrum disorder needed additional attention. Postnatal check with screening tools may help to identify mood disturbance in postpartum women
Study site: Postnatal clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Regression Analysis
Fulltext Psychological insulin resistance (PIR) among type 2 diabetes patients at public health clinics in Federal Territory of Malaysia

Nur Azmiah Z, Zulkarnain AK, Tahir A

International Medical Journal Malaysia, 2011;10(2):7-12.
MyJurnal

Introduction: Insulin has been viewed as a treatment option of last resort in type 2 diabetes management. The decision to start insulin therapy is often difﬁ cult. Patients are usually reluctant to begin insulin and many cases delay the initiation of insulin therapy. The aim of this study is to determine the magnitude of insulin refusal or recognize as psychological insulin resistance (PIR) and to identify its predictors. Materials and Methods: This is a cross-sectional study and data was collected from two primary public health clinics in Kuala Lumpur and Putrajaya. The study sample consisted of 404 insulin naive patients with type 2 diabetes. A self-administered questionnaire was used to obtain demographic and clinical information. Results: Fifty-one percent of patients with type 2 diabetes were found to be unwilling to take insulin. Regression analysis revealed that females were 2.7 times more likely to resist insulin treatment compared to males and those with uncontrolled diabetes were 1.8 times more likely to resist insulin treatment compared to controlled diabetics. Patients will refuse insulin if they perceived their diabetes worsen with insulin use. After controlling for other attitudinal belief factors in the model, an increase in one unit of perceived disease severity will increase the likelihood of PIR around 2 times. Conclusion: Several misconceptions regarding insulin therapy were identiﬁed and speciﬁ c education intervention is recommended for successful transition to insulin therapy.

Matched MeSH terms: Regression Analysis
Fulltext Hypophosphatemia in the intensive care unit: incidence, predictors and management.

Basri, M.N., Janattul, A.J., Azrina, M.R., Abdul Hadi, M.

International Medical Journal Malaysia, 2012;11(1):31-36.
MyJurnal

Introduction: Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective observational study assessing adults admitted to ICU in between March and May 2009. All patients without baseline phosphate level and renal failure were excluded. They were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41). Gender and
creatinine clearance was found to be significantly different between normophosphatemia and
hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate, creatinine clearance and pH were significant predictors to the serum levels. A significant difference of mean serum phosphate was seen after repletion by total dose of 10, 20 and 40 mmols in the treatment subgroups. Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum levels.

Matched MeSH terms: Regression Analysis
Fulltext Factors associated with dental caries among selected urban school children in Kuala Lumpur, Malaysia

Kaur, Satvinder, MaykanathaN, Dhivyalosini, Lyn, Ng Kai

Archives of Orofacial Sciences, 2015;10(1):24-33.
MyJurnal

This study aimed to assess the nutritional status (BMI), oral health behaviour, sugar consumption and the associated factors with dental caries among a group of 7 to 11 years old children in Kuala Lumpur, Malaysia. Three hundred and twelve students were recruited from February to July 2013. Information gathered were their socio-demographic characteristics, body mass index, sugar consumption, oral-health behaviour, oral hygiene index and decay-missing-filled teeth (dmft) index. Anthropometry measurements and sugar intake was measured using verified tools. Meanwhile, dmft was examined using the World Health Organization (WHO) criteria. 53.7% of the children were of the normal body weight with mean sugar consumption of 31.81±4.24 g/day. Prevalence of dental caries was reported at 44.6% (95% CI: 42.2, 53.3) with a mean (SD) dmft of 1.27(1.84). No association was found between dental caries and weight status distribution. Most children tend to brush their teeth 2 times or more in a day (75%), however, they spent lesser time in tooth brushing (5.4%) and do not practice flossing (78%). Regression analysis showed that age (p

Matched MeSH terms: Regression Analysis
Fulltext The prevalence and associated factors of psychiatric early readmission in a teaching hospital, Malaysia

Ng, C.G., Yee, H.A., Zainal, N.Z., Loh, H.S.

Malaysian Journal of Psychiatry, 2012;21(1):0-0.
MyJurnal

Objective: The aim of the study was to determine the early readmission rate among the psychiatric patients discharged from a teaching hospital in Malaysia. The associated factors were also examined. Methods: This is a prospective and observational study. The socio-demographic and clinical data of 202 patients from the psychiatric ward were collected on discharge along with the administration of instruments including Brief Psychiatric Rating Scale (BPRS), Life Events Questionnaire (LEQ), and Multidimensional Scale of Perceived Social Support (MSPSS). Assessment of compliance to medication and substance use was reliant on self-report data. Medication compliance was categorized as “poor” vs “good”, whereas poor compliance was the complete discontinuation of medication for at least two weeks. The patients were followed up to determine whether they were readmitted within 6 months. Results: At the end of 6 months follow-up, 32.2% of the subjects were readmitted. Univariate regression analysis indicated that patients with psychotic disorder, past episodes, previous admission, poor compliance, on conventional or depot injectable antipsychotic and higher BPRS scores on discharge were significantly associated with early readmission (p

Matched MeSH terms: Regression Analysis
Fulltext Physical activity and cardiovascular risk factors among Malays in selected rural and urban communities in Sarawak

Cheah, Whye Lian, Helmy Hazmi, Chang, Ching Thon, Wan Manan Wan Muda

Malaysian Journal of Public Health Medicine, 2015;15(3):104-111.
MyJurnal

The objective of this study was to describe the differences in physical activity with socio-demographic factors and its association with cardiovascular risk factors. It was a cross-sectional study among selected urban and rural Malays communities in Kuching and Samarahan. Physical activity data was obtained using International Physical Activity Questionnaire (IPAQ) short version. Assessment of cardiovascular risk factors was based on blood pressure, fasting cholesterol and glucose and body mass index (BMI). Data was analysed using SPSS version 20. A total of 223 participated with higher response from rural areas (60.1%) and females (61.9%). More than half of the respondents (58.5%) were overweight and obese, with a mean BMI of 25.9 kg/m2 (SD=4.9). About 25% of the respondents were found to have blood pressure in the at-risk range. The prevalence of at-risk blood glucose was 52.3% with a mean value of 7.3mmol/L (SD=3.46). The prevalence of at-risk cholesterol were lower with 31.8%, mean value of 3.5 mmol/L (SD=2.94). There were more active respondents living in rural area (p=0.02). Logistics regression analysis showed that urban area (OR=1.988 95% CI 1.082 to 3.652), systolic blood pressure (OR1.020 95% CI 1.003 to 1.037) and blood cholesterol (OR0.884 95% CI 0.785 to 0.996) were associated with physical activity level. Change of physical activity due to urbanization can increase the risk of obesity and other chronic diseases. Efforts to include physical activity in intervention programme should be more intensified, with more provision of suitable built environment.

Matched MeSH terms: Regression Analysis

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