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A national study of risk factors associated with mortality in very low birthweight infants in the Malaysian neonatal intensive care units. Malaysian Very Low Birth Weight Study Group

J Paediatr Child Health, 1997 Feb;33(1):18-25.
PMID: 9069039

OBJECTIVE: To determine the risk factors associated with mortality in very low birthweight (VLBW) infants admitted to the neonatal intensive care units (NIUC) in Malaysia.
METHOD: A prospective observational study of outcome of all VLBW infants born between 1 January 1993 and 30 June 1993 and admitted to the NICU.
RESULTS: Data of 868 VLBW neonates from 18 centres in Malaysia were collected. Their mean birthweight was 1223 g (95% confidence intervals: 1208-1238 g). Thirty-seven point four per cent (325/868) of these infants died before discharge. After exclusion of all infants with congenital anomalies (n = 66, and nine of them also had incomplete records) and incomplete records (n = 82), stepwise logistic regression analysis of the remaining 720 infants showed that the risk factors that were significantly associated with increased mortality before discharge were: delivery in district hospitals, Chinese race, lower birthweight, lower gestation age, persistent pulmonary hypertension of the newborn, pulmonary airleak, necrotizing enterocolitis of stage 2 or 3, confirmed sepsis, hypotension, hypothermia, acute renal failure, intermittent positive pressure ventilation, and umbilical arterial catheterization. Factors that were significantly associated with lower risk of mortality were: use of antenatal steroid, oxygen therapy, surfactant therapy and blood transfusion.
CONCLUSION: The mortality of VLBW infants admitted to the Malaysian NICU was high and was also associated with a number of preventable risk factors.

Matched MeSH terms: Logistic Models
Risk factors for developing neonatal septicaemia at a Malaysian hospital

Wong NA, Hunt LP, Marlow N

J Trop Pediatr, 1997 02;43(1):54-8.
PMID: 9078832 DOI: 10.1093/tropej/43.1.54

A case-control study of antecedents of neonatal septicaemia was performed using 50 cases of neonatal septicaemia and 73 comparison infants from a Malaysian hospital nursery. Multivariate analysis indicated the following independent risk factors: maternal primiparity, pre-eclampsia, prolonged rupture of membranes, twin pregnancy, prematurity, assisted ventilation, umbilical catheterization, and formula feeding. Although the spectrum of causative organisms varied between our study and past studies from Western countries, the risk factors for developing neonatal septicaemia were strikingly similar. Therefore, preventative guidelines based on risk factors described in Western countries, should help reduce the incidence of neonatal septicaemia at this Malaysian hospital.

Matched MeSH terms: Logistic Models
Risk factors for accidental poisoning in urban Malaysian children

Azizi BH, Zulkifli HI, Kasim MS

Ann Trop Paediatr, 1993;13(2):183-8.
PMID: 7687115

In a case control study, 70 children consecutively hospitalized for acute ingestion of poisons were compared with 140 other hospitalized children matched for age. Children aged less than 3 years and boys were most often the victims. Univariate analysis identified Indian race, having a parent younger than 21 years, residing at present address for less than 1 year and living in a household with more than five occupants as significant risk factors. Experience of a recent stressful event in the family barely failed to reach the level of significance. Logistic regression analysis confirmed that Indian race, having a parent younger than 21 years and residing less than 1 year at the present address were independent predictors of acute poisoning. Positive interactions were noted between Indian race and duration of residence and between parental age and duration of residence. Knowledge of risk factors and their interactions may be useful in planning preventive measures against childhood poisoning.

Matched MeSH terms: Logistic Models
Breastfeeding at 6 weeks and predictive factors

Chye JK, Zain Z, Lim WL, Lim CT

J Trop Pediatr, 1997 10;43(5):287-92.
PMID: 9364127 DOI: 10.1093/tropej/43.5.287

Despite the numerous changes made in accordance with the Baby Friendly Hospital Initiative at the University Hospital, Kuala Lumpur, the low rates of breastfeeding have persisted. This study aims to examine the current trend in infant feeding, and the influences of some perinatal and sociodemographic factors on breastfeeding. Five-hundred mothers with singleton pregnancies and healthy infants were interviewed at 6 weeks post-partum. Only 124 (25 per cent) mothers were practising exclusive breastfeeding (EBF), and 132 (26 per cent) mothers were using exclusive infant formula feeding (EIF). On logistic regression analyses, mothers who followed EBF were more likely to have had antenatal plans to breastfeed (Odds ratio 2.44, 95 per cent confidence interval 1.75-3.45), not in paid employment post-natally (OR 1.76, 95 per cent CI 1.31-2.36), of older age group (> 27 years) (OR 1.48, 95 per cent CI 1.13-1.93), had female infants (OR 1.38, 95 per cent CI 1.05-1.80) and of Indian ethnicity (compared to Chinese) (OR 3.87, 95 per cent CI 2.16-6.89). Breastfeeding difficulties were associated with decreased odds of EBF (OR 0.21, 95 per cent CI 0.13-0.34). Parental education, fathers' ages and incomes, primigravida status, Caesarean section, present of episiotomy, late first breastfeed, phototherapy, and length of hospital stay were not significant predictors of failure of EBF. In comparison, predictive factors for increased use of EIF were mothers who have had breastfeeding difficulties, < or = 9 years of schooling, and of Chinese descent. In conclusions, the overall rate of EBF by 6 weeks of age in infants born in this urban hospital had remained poor. The adverse factors for EBF identified in this study warrant further in-depth studies to determine effective ways of improving EBF rates.

Matched MeSH terms: Logistic Models
Brachial plexus injuries in Malaysian neonates: incidence and associated risk factors

Boo NY, Lye MS, Kanchanamala M, Ching CL

J Trop Pediatr, 1991 12;37(6):327-30.
PMID: 1791654 DOI: 10.1093/tropej/37.6.327

A prospective study was carried out on 26,176 Malaysian neonates born in the Maternity Hospital, Kuala Lumpur over a 12-month period to determine the incidence and associated risk factors of brachial plexus injuries. This condition was found in 42/26,176 neonates (1.6 per 1000 livebirths). Multiple logistic regression analysis of affected and control neonates from a nested case-control study showed that increasing birth weights and breech deliveries were the significant risk factors. Our study suggests that to reduce the occurrence of this condition, there is a need for: (i) better assessment of fetal size and maternal pelvimetry to enable earlier diagnosis of cephalo-pelvic disproportion, and (ii) review of the indications and techniques of breech delivery.

Matched MeSH terms: Logistic Models
Living arrangements of the elderly in Fiji, Korea, Malaysia, and the Philippines

Martin LG

Demography, 1989 Nov;26(4):627-43.
PMID: 2583321

Using logit techniques and data from surveys of the elderly conducted in 1984 under the auspices of the World Health Organization, this article investigates socioeconomic, cultural, and demographic determinants of living arrangements of the elderly. Having a spouse or children with whom to live has important effects on living arrangements. The results provide only weak support, however, for hypotheses based on modernization theory and point to the need for detailed data on transitions in living arrangements and for information about the younger generation as well as the older generation, both of which are involved in deciding who lives with whom.

Matched MeSH terms: Logistic Models
Unhealthy travelers present challenges to sustainable primate ecotourism

Muehlenbein MP, Martinez LA, Lemke AA, Ambu L, Nathan S, Alsisto S, et al.

Travel Med Infect Dis, 2010 May;8(3):169-75.
PMID: 20541137 DOI: 10.1016/j.tmaid.2010.03.004

Ecotourism can function as a powerful tool for species conservation. However, a significant proportion of travelers at wildlife sanctuaries may be ill and potentially infectious, creating unnecessary risk of pathogen transmission to wildlife.

Matched MeSH terms: Logistic Models
Fulltext Determinants of overweight and obesity among undergraduate students residing in Universiti Putra Malaysia

Zaahirah Mohammad, Norliza Ahmad, Halimatus Sakdiah Minhat

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):71-71.
MyJurnal

Introduction: Overweight and obesity among adults, especially young adults have been increasing for the past 20 years and is an emerging public health concern all over the world, including Malaysia. This study aims to explore the determinants of overweight and obesity among undergraduate students residing in Universiti Putra Malaysia. Methods: A cross-sectional study using random sampling was conducted in three residential colleges. Independent variables include socio-demographic factors, knowledge on physical activity and dietary intake, lifestyle (physical activity, dietary intake, sleep duration and quality and smoking status) and stress. Data was collected using a vali-dated and reliable self-administered questionnaire and anthropometric measurement (weight and height were mea-sured to determine body mass index). IBM Statistical Package for Social Science (SPSS) version 23 was used for data analysis. Multiple logistic regression was employed to find the determinants of overweight and obesity among the respondents. Significant level was set at less than 0.05. Results: A total of 494 respondents participated with 98.8% response rate. Overweight and obesity prevalence among the respondents was 38.1% with 22.9% and 15.9% of the respondents were overweight and obese respectively. The significant associated factors were age group of 24 years and above (AOR=2.671, p=0.04), male (AOR=1.818, p=0.04), Malay ethnicity (AOR=5.34, p=0.008) and Indian ethnicity (AOR=7.155, p = 0.018). Conclusion: Overweight and obesity prevalence among undergraduate students were more than one third. Programmes and policies should be directed to these high-risk groups as identified in this study.

Matched MeSH terms: Logistic Models
Fulltext Prevalence of undernutrition and its associated factors among under-five Orang Asli children in a selected Orang Asli settlement in Kuantan, Pahang

Karimah Hanim Abd. Aziz, Hafizah Pasi, Jamalludin Ab. Rahman, Razman Mohd. Rus, Hashima R. Nasreen, Farhan Rusl, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):84-84.
MyJurnal

Introduction: Undernutrition among under-five children is a very common issue in Malaysia, especially among the Orang Asli population. Therefore, identifying the prevalence and factors associated with undernutrition will assist in tackling the issue of undernutrition and reducing the morbidity and mortality rate associated with it. Methods: A total of 47 conveniently selected Orang Asli children aged 6 to 59 months from Kampung Paya Bungor, Gambang, Kuantan, Pahang participated in this cross-sectional study. A face-to-face interview was carried out by using the validated Questionnaire for the Study of Malnutrition in Rural Malaysia 2009. The weight and height of the children were measured and plotted on the growth chart. All the data were analyzed using IBM SPSS Statistics Version 24.0. Descriptive statistics was used to describe the background characteristics of the respondents and univariate analyses were used to identify suitable factors to be included in multivariate analysis. Binary logistic regression was done to determine independent factors associated with undernutrition. Results: The overall prevalence of undernutrition was 55.3%. The prevalence of underweight, stunting and wasting was 34.0%, 34.0% and 14.9% respectively. This research also revealed that gender (p=0.042) and family size (p=0.024) was shown to have a statistically significant association with undernutrition. However, there were no significant associations between undernutrition with other factors. Conclusion: The prevalence of undernutrition among under-five Orang Asli children was a concern. It was found that the factors associated with undernutrition were female children and children from small families. Prompt interventions aimed at the Orang Asli community should be done to overcome these problems.

Matched MeSH terms: Logistic Models
Fulltext Factors associated with optimum child health record book use among parents attending government health clinics in Putrajaya

Siti Hafsah Abdul Halim, Nor Afiah Mohamad Zulkefli

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):9-9.
MyJurnal

ntroduction: The child health record book was long established in Malaysia, but no evaluation study on the util-isation of the book has ever been done. The objectives of the study were to determine the proportion of optimum record book use and the factors associated with it. Methods: A cross-sectional study was conducted among 415 ran-domly selected parents of children aged below six years old attending government health clinics in Putrajaya using a self-administered questionnaire. Optimum use of child health record book was defined by respondents reading all the sections and recording comments in the book. Factors studied were sociodemographic characteristics; ante-natal and breastfeeding history; child’s health and immunisation status; perceptions and level of knowledge on the book and child health; and healthcare providers’ performance. Multiple logistic regression was used to identify the determinants of optimum use. Results: In total, 36.1% of respondents optimally used the record book. The five de-terminants of optimum use identified were mother’s age group between 35-39 years and ≥40 years old (AOR: 2.24, 95% CI 1.13-4.44; AOR: 3.36, 95% CI 1.24-9.07), a mother with a higher level of education (AOR: 2.67, 95% CI 1.43-5.00), delivered in a government hospital (AOR: 3.01, 95% CI 1.11-8.16), had good level of knowledge on the record book and on general child health (AOR: 3.69, 95% CI 2.08-6.56; AOR: 2.07, 95% CI 1.19-3.60). Conclusion: The proportion of optimum child health record book use is relatively low. Based on the findings, improving the par-ents’ knowledge on the child health record book utilisation is vital to increase the optimum usage particularly among mothers with low education level, aged less than 30 years old and those who delivered in non-government hospitals.

Matched MeSH terms: Logistic Models
Fulltext Risk perception for developing diabetes among gestational diabetes mellitus patients in Johor Bahru

Tengku Alina Tengku Ismail, Suhaily Mohd Hairon, Siti Suhaila Mohd Yusoff, Fatin Aina Abu Bakar

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):16-16.
MyJurnal

Introduction: Gestational diabetes mellitus is one of the most common complications during pregnancy which affects 15% of pregnant women globally. Gestational diabetes mellitus patients have seven times lifetime risk of developing type 2 diabetes compared to women with normal pregnancies. Despite these facts, gestational diabetes mellitus patients may not perceive themselves to be at risk for future diabetes. Thus, this study aimed to determine the perception of risk for developing diabetes and factors associated with high risk perception among gestational di-abetes mellitus patients in Johor Bahru. Methods: A cross sectional study was conducted between April to May 2019 among 200 gestational diabetes mellitus patients attending primary health clinics in Johor Bahru, Malaysia. Data was collected using Malay translated and validated Risk Perception Survey on Developing Diabetes questionnaire. Multiple logistic regression analysis was performed using SPSS version 24.0. Results: There were 200 cases which fulfilled the inclusion and exclusion criteria in this study. The mean (SD) age of gestational diabetes mellitus patients in this study was 32.2 (4.8) years. Majority of them were from Malay ethnicity (74.5%) and 42.5% obtained higher education. Of these, 77.0% perceived themselves as high risk for developing diabetes. Higher knowledge scores and greater personal control were significantly associated with high perceived risk for developing diabetes (Adj. OR 2.08; 95% CI: 1.02,4.25; p=0.045 and Adj. OR 2.32; 95% CI: 1.16,4.63; p=0.017 respectively). Conclusion: Majority of gestational diabetes mellitus patients in this study accurately perceived themselves as having a high risk to develop diabetes in the future. Nevertheless, health education needs to be individualized and strengthened to ensure more patients are aware of the risk. In addition, further studies are needed to translate perceived risk into preventive health behaviours.

Matched MeSH terms: Logistic Models
Fulltext Food Security and Hygiene Practice among Adolescent Girls in Maiduguri Metropolitan Council, Borno State, Nigeria

Charles Shapu R, Ismail S, Ahmad N, Lim PY, Abubakar Njodi I

Foods, 2020 Sep 10;9(9).
PMID: 32927593 DOI: 10.3390/foods9091265

Inadequate food security contributes to poor health outcome for all, including adolescent girls. The study aims at determining the level of food security and hygiene among adolescent girls. A school-based cross-sectional study was carried out among adolescent girls aged 10 to 19 years old from six schools in Maiduguri Metropolitan Council, Borno State. The instrument for data collection was a questionnaire using KoBoCollect Toolbox between June and July 2019. Multivariable logistic regression was used to identify the predictors of food security and hygiene among respondents. A majority of the respondents (73.5%) were in a very low food security level. Three factors were significantly associated with food security level, these included schools (p = 0.007), age of mother (p = 0.004), and occupation of mother (p < 0.001). School (p = 0.003), age (father p = 0.017; mother; p = 0.012), hygiene (p = 0.005), and occupation of mother (p = 0.002) were predictors of food security. About (46.6%) of respondents had poor hygiene practice, school (p = 0.016) was significantly associated with hygiene practice. School (p = 0.019; and p = 0.005) and food security (p = 0.009) were predictors of hygiene practice. This study reveals a high prevalence of low food security among adolescent girls.

Matched MeSH terms: Logistic Models
Fulltext Dengue prevention practices and their associated factors among wet market in Hilir Perak District, Malaysia

Nur Intan Kartiniewatie Kamaruddin, Salmiah Md Said, Hayati Kadir @ Shahar, Lim Poh Ying

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):46-46.
MyJurnal

Introduction: Wet markets are predisposed to Aedes breeding due to nature of daily activities that involve frequent water storage and usage of water collecting containers. Large numbers of visitors patronising wet markets could cause rapid spread of dengue infection. This study aimed to determine the level of dengue prevention practices among wet market traders in Hilir Perak District and their associated socioecological factors. Methods: A cross sectional study using stratified sampling method was conducted where 246 wet market traders were interviewed to collect data on dengue prevention practices (prevention of Aedes mosquitoes breeding and prevention of mosquito bites), and so-cioecological factors. Chi square test and logistic regression modelling were performed to identify socioecological factors associated with dengue prevention practices. Results: Response rate for this study was 88.9%. Majority of the respondents were male, above 40 years old, had secondary education and above, had monthly income of above MYR2000, were owner of the shop lots, was or had ever married and sold fish, vegetable or groceries products. Most of the respondents had high level of dengue prevention practices (78%). Those who were owner of shop lots, had high perceived susceptibility, high family support, and high perceived dengue prevention and control laws and reg-ulations were predicted to have high level of dengue prevention practices. Conclusion: Level of dengue prevention practices is determined not only by individual factors, but also other factors from relationship to societal level which must also be considered in planning or evaluating current dengue control programmes.

Matched MeSH terms: Logistic Models
Fulltext Prostaglandin-endoperoxide synthase (PTGS2) and defensin beta 1 (DEFB1) gene polymorphism in Malaysian Malay chronic periodontitis subjects

Jasmin Kaur Jagender Singh, Ching Ching Ng, Nor Adinar Baharuddin, Syarida Hasnur Safii, Rathna Devi Vaithilingam

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):31-31.
MyJurnal

Introduction:PTGS2 and DEFB1 single nucleotide polymorphisms (SNP) have been validated to be associated with chronic periodontitis (CP) in European, Japanese and Chinese populations. Polymorphisms of these genes play a role in the pathogenesis of CP. Thus far, no study has been done on the Malay ethnic group. Hence, this study assessed the allele and genotype frequencies of PTGS2 and DEFB1 variants in subjects with chronic periodontitis and healthy individuals in Malaysian Malays. Methods: Malay CP subjects and periodontally-healthy controls were obtained from Malaysian Periodontal Database and Biobanking system (MPDBS) for this case-control study. Diagnosis for cas-es was based on case definition by Eke et al (2012). DNA samples were genotyped for 4 candidate SNPs, rs689466, rs5275, rs20417 (PTGS2) and rs1047031 (DEFB1). Genotyping was carried out using Taqman genotyping method. The association between SNPs and study groups were assessed using logistic regression analysis. Results: DNA sam-ples from 140 individuals, 76 CP cases and 64 healthy controls were genotyped. Logistic regression results demon-strated that rs689466 for PTGS2 gene was associated with CP susceptibility in the Malay study group (p=0.03; OR: 1.80; 95% CI=1.05-3.07). The dominant and additive model test showed significant association with rs689466 (C/T) (pdominant-adjusted=0.02; OR: 2.22; 95% CI=1.11-4.43;padditive-adjusted=0.03; OR:1.85; 95% CI=1.07-3.19) after controlling for age and smoking. However, no significant association with CP was observed with other SNPs. Conclusion: The results suggest that rs689466 of PTGS2 gene may contribute to CP susceptibility in Malaysian Malay population in our preliminary study.

Matched MeSH terms: Logistic Models
Fulltext Cardiovascular disease risk factors among older people: Data from the National Health and Morbidity Survey 2015

Sazlina SG, Sooryanarayana R, Ho BK, Omar MA, Krishnapillai AD, Mohd Tohit N, et al.

PLoS One, 2020;15(10):e0240826.
PMID: 33085718 DOI: 10.1371/journal.pone.0240826

Study on cardiovascular disease (CVD) risk factors and their prevalence among the older people in Malaysia is limited. We aimed to determine the prevalence and factors associated with CVD risk factors using the non-laboratory Framingham Generalized 10-Year CVD risk score among older people in Malaysia. This was a population-based cross-sectional study using data of 3,375 participants aged ≥60 years from the National Health and Morbidity Survey 2015. Sociodemographic, health factors and clinical assessments (anthropometry and blood pressure) were included. Complex survey analysis was used to obtain prevalence with 95% confidence intervals (CI). We applied ordinal regression to determine the factors associated with CVD risk. The prevalence for the high 10-year CVD risk was 72.1%. Body mass index was higher among those aged 60-69 years in men (25.4kg/m2, 95%CI 25.1-25.8) and women (26.7kg/m2, 95%CI 26.3-27.1) than the other age groups. The factors associated with moderate and high 10-year CVD risk were Malay ethnicity (Odds Ratio(OR) 0.76, 95%CI 0.63-0.92, p = 0.004), unmarried status (OR 1.55, 95%CI 1.22-1.97, p<0.001) and physically inactive (OR 0.72, 95%CI 0.55-0.95, p = 0.020). There is a need for future study to evaluate preventive strategies to improve the health of older people in order to promote healthy ageing.

Matched MeSH terms: Logistic Models
Fulltext Predictors of Nonalcoholic Fatty Liver Disease Among Middle-Aged Iranians

Etminani R, Manaf ZA, Shahar S, Azadbakht L, Adibi P

Int J Prev Med, 2020;11:113.
PMID: 33088441 DOI: 10.4103/ijpvm.IJPVM_274_19

Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran.
Methods: A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria.
Results: The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; P < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women (P < 0.05 for all variables).
Conclusions: The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy.

Matched MeSH terms: Logistic Models
Fulltext Can post-treatment oral cancer patients' concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation?

Aminnudin AN, Doss JG, Ismail SM, Chai MB, Abidin MZ, Basri CSJM, et al.

Ecancermedicalscience, 2020;14:1118.
PMID: 33209109 DOI: 10.3332/ecancer.2020.1118

Background: Oral cancer and its treatment impact patients' post-treatment outcomes, challenging clinicians to manage them optimally. Addressing patients' concerns is central to holistic patient-centred care.
Objectives: This study aimed to determine post-treatment oral cancer patients' concerns and its relationship with patients' clinical characteristics, health-related quality of life (HRQoL), psychological distress and patient satisfaction with the follow-up consultation.
Methods: A total of 85 oral cancer patients were recruited from a three-armed pragmatic RCT study on the patient concerns inventory for head and neck cancer (PCI-H&N), which was conducted at six hospital-based oral maxillofacial specialist clinics throughout Malaysia. Malaysians aged 18 years and above and on follow-ups from 1 month to 5 years or more were eligible. Patients completed the PCI-H&N, functional assessment of cancer therapy -H&N v4.0 and Distress Thermometer at pre-consultation and satisfaction questionnaire at post-consultation. The data were analysed descriptively; multiple linear regression and multivariate logistic regression analyses were used to determine possible predictors of patients' HRQoL and psychological distress.
Results: 'Recurrence or fear of cancer coming back' (31.8%) was most frequently selected. 43.5% of patients selected ≥4 concerns. A significantly high number of concerns were associated with patients of '1-month to 1-year post-treatment' (n = 84%; p = 0.001). A significant association existed between 'time after treatment completed' and patients' concerns of 'chewing/eating', 'mouth opening', 'swelling', 'weight', 'ability to perform', 'cancer treatment' and 'supplement/diet-related'. 'Chewing/eating' was predicted for low HRQoL (p < 0.0001) followed by 'appearance' and 'ability to perform recreation activities' (personal functions domain). Patients with high psychological distress levels were 14 times more likely to select 'ability to perform recreation activities' and seven times more likely to select 'feeling depressed'. No significant association was identified between patients' concerns and patients' satisfaction with the consultation.
Conclusion: Routine follow-up consultations should incorporate the PCI-H&N prompt list to enhance patient-centred care approach as the type and number of patients' concerns are shown to reflect their HRQoL and psychological distress.TRIAL REGISTRATION: NMRR-18-3624-45010 (IIR).

Matched MeSH terms: Logistic Models
Fulltext Genetic polymorphisms in neuroendocrine disorder-related candidate genes associated with pre-pregnancy obesity in gestational diabetes mellitus patients by using a stratification approach

Lee KW, Ching SM, Devaraj NK, Hoo FK

Ann Transl Med, 2020 Sep;8(17):1060.
PMID: 33145279 DOI: 10.21037/atm-20-1579

Background: Certain candidate genes have been associated with obesity. The goal of this study is to determine the association between thirteen neuroendocrine disorder-related candidate genes and pre-pregnancy obesity among gestational diabetes mellitus (GDM) patients using the stratification approach defined the Asian and International criteria-based body mass index (BMI).
Methods: This was a post-hoc case-control exploratory sub-analysis of a cross-sectional study among GDM women to determine which candidate single nucleotide polymorphisms (SNPs) related to neuroendocrine disorders may be associated with obesity. Factors were adjusted for socio-demographic characteristics and concurrent medical problems in this particular population. Pre-pregnancy BMI and concurrent medical profiles were obtained from maternal health records. Obesity is defined as BMI of ≥27.5 kg/m2 for Asian criteria-based BMI and >30 kg/m2 for International criteria-based BMI. Thirteen candidate genes were genotyped using Agena® MassARRAY and examined for association with pre-pregnancy obesity using multiple logistic regression analysis. The significant difference threshold was set at P value <0.05.
Results: Three hundred and twelve GDM women were included in this study; 60.9% and 44.2% of GDM patients were obese using Asian and International criteria-based BMI, respectively. GDM patients with AA or AG genotypes in specific SNP of brain-derived neurotrophic factor (BDNF) (G > A in rs6265) are more likely to be obese (adjusted odd ratio =2.209, 95% CI, 1.305, 3.739, P=0.003) compared to those who carry the GG genotype in the SNP adjusted for parity, underlying with asthma, heart disease, anaemia, education background in the International criteria-based BMI stratification group. On the other hand, there were no associations between other candidate genes (NRG1, FKBP5, RORA, OXTR, PLEKHG1, HTR2C, LHPP, SDK2, TEX51, EPHX2, NPY5R and ANO2) and maternal obesity.
Conclusions: In summary, BDNF rs6265 is significantly associated with pre-pregnancy obesity among GDM patients. The exact role of BDNF adjusted for diet intake and lifestyle factors merits further investigation.

Matched MeSH terms: Logistic Models
Fulltext Predictors for Anterior Cruciate Ligament (ACL) Re-injury after Successful Primary ACL Reconstruction (ACLR)

Gupta R, Singhal A, Malhotra A, Soni A, Masih GD, Raghav M

Malays Orthop J, 2020 Nov;14(3):50-56.
PMID: 33403062 DOI: 10.5704/MOJ.2011.009

Introduction: Few authors have addressed risk factors related to an ipsilateral graft rupture and contralateral anterior cruciate ligament (ACL) injury after return to sports (RTS) following primary ACL reconstruction.
Material and Methods: Patients with ACL re-injury to either knee after successful primary ACLR were included in Group I and those with no further re-injury were included in Group II. Variables including age, gender, side, body mass index (BMI), thigh atrophy, anterior knee laxity difference between both knees measured by KT-1000 arthrometer, mean time of return to sports (RTS), graft type, type of game, mode of injury, Tegner Activity Score, hormone levels, femoral tunnel length (FTL), posterior tibial slope (PTS) and notch width index (NWI) were studied. Binary logistic regression was used to measure the relative association.
Results: A total of 128 athletes were included with 64 in each group. Mean age in Group I and II were 24.90 and 26.47 years respectively. Mean follow-up of Group I and Group II were 24.5 and 20.11 months respectively. Significant correlation was present between ACL re-injury and following risk factors; PTS of >10º, KT difference of >3.0mm, thigh atrophy of >2.50cm and time to RTS <9.50 months P value <0.05). No correlation was found with age, sex, BMI, type of game, Tegner Activity Score, mode of injury, NWI, size of graft, FTL and hormone levels.
Conclusion: Possible risk factors include PTS of ≥ 10º, KT difference of ≥ 3.0mm at 1 year follow-up, thigh atrophy of ≥ 2.50cm at 1 year follow-up and RTS <9.5 months after primary ACLR.

Matched MeSH terms: Logistic Models
Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry

Schwenkglenks M, Gerbershagen HJ, Taylor RS, Pogatzki-Zahn E, Komann M, Rothaug J, et al.

Pain, 2014 Jul;155(7):1401-1411.
PMID: 24785269 DOI: 10.1016/j.pain.2014.04.021

Patient ratings of satisfaction with their postoperative pain treatment tend to be high even in those with substantial pain. Determinants are poorly understood and have not previously been studied in large-scale, international datasets. PAIN OUT, a European Union-funded acute pain registry and research project, collects patient-reported outcome data on postoperative day 1 using the self-reported International Pain Outcome Questionnaire (IPO), and patient, clinical, and treatment characteristics. We investigated correlates of satisfaction and consistency of effects across centres and countries using multilevel regression modelling. Our sample comprised 16,868 patients (median age 55 years; 55% female) from 42 centres in 11 European countries plus Israel, USA, and Malaysia, who underwent a wide range of surgical procedures, for example, joint, limb, and digestive tract surgeries. Median satisfaction was 9 (interquartile range 7-10) on a 0-10 scale. Three IPO items showed strong associations and explained 35% of the variability present in the satisfaction variable: more pain relief received, higher allowed participation in pain treatment decisions, and no desire to have received more pain treatment. Patient factors and additional IPO items reflecting pain experience (eg, worst pain intensity), pain-related impairment, and information on pain treatment added little explanatory value, partially due to covariate correlations. Effects were highly consistent across centres and countries. We conclude that satisfaction with postoperative pain treatment is associated with the patients' actual pain experience, but more strongly with impressions of improvement and appropriateness of care. To the degree they desire, patients should be provided with information and involved in pain treatment decisions.

Matched MeSH terms: Logistic Models

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