MyMedR

Prevalence and risk factors of non-alcoholic fatty liver disease in a multiracial suburban Asian population in Malaysia

Goh SC, Ho EL, Goh KL

Hepatol Int, 2013 Jun;7(2):548-54.

PMID: 26201786 DOI: 10.1007/s12072-012-9359-2

BACKGROUND: The prevalence of non-alcoholic fatty liver disease (NAFLD) in the Malaysian population is not known. Malaysia has a multiracial Asian population with three major Asian races: Malay, Chinese, and Indian living together. The aim of the study is to determine the prevalence and risk factors in a suburban Malaysian population.

METHODS: Consecutive subjects who came for a health checkup at a suburban medical facility were recruited for the study. All individuals had clinical assessments, anthropometric measurements, blood tests, and ultrasonography of the liver performed. Those with significant alcohol consumption and history of chronic liver disease were excluded.

RESULTS: Of the 1,621 "health screened" individuals analyzed, 368 (22.7 %) were found to have NAFLD. They comprised Chinese 1,269 (78.3 %), Malay 197 (12.1 %), and Indian 155 (9.6 %). Males and "older" age group ≥45 years had high prevalence rates with the highest in Indian (68.2 %) and Malay (64.7 %) males. Chinese females <45 years had the lowest prevalence of 5.2 %. A significant increase in the prevalence of fatty liver between age <45 years and ≥45 years was seen in female of all three races but in male, this increase was seen only among the Indians. NAFLD was strongly associated with diabetes mellitus, glucose intolerance, body mass index ≥23, low high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension.

CONCLUSION: NAFLD is common in suburban Malaysian population. Older Indian and Malay males have an inordinately high prevalence of the disease.

Matched MeSH terms: Non-alcoholic Fatty Liver Disease

Rate of decline of kidney function in patients with type 2 diabetes mellitus and the associated factors: a 10-year retrospective cohort study

Tan SF, Chia YC, Chinna K

Asia Pac J Public Health, 2015 Mar;27(2):NP640-9.

PMID: 23761589 DOI: 10.1177/1010539513490193

This study examines the rate of decline of estimated glomerular filtration rate (eGFR) over a 10-year period and the associated risk factors in type 2 diabetes mellitus (T2DM) patients. Medical records of T2DM patients were randomly selected. The rate of fall in eGFR (simplified modification of diet in renal disease formula) was used as a measure of decline. Univariate and multivariate analysis were performed to determine the factors associated with decline of kidney function. A total of 504 patients were selected. Mean age was 57.8 ± 9 years; 65.3% were females. The mean decline rate of eGFR was 0.89 ± 2.16 mL/min/1.73 m(2)/y. Baseline proteinuria, glycosylated hemoglobin level, duration of T2DM, and Malay race were associated with faster decline in eGFR. The expected greater deterioration in kidney function in this cohort was not seen. Treatment of proteinuria and glycemia should be optimized early to retard the decline in kidney function in patients with T2DM.
Study site: Primary care clinics, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Disease Progression

OPRM1 rs1799971 polymorphism and opioid dependence: evidence from a meta-analysis

Haerian BS, Haerian MS

Pharmacogenomics, 2013 May;14(7):813-24.

PMID: 23651028 DOI: 10.2217/pgs.13.57

The OPRM1 gene encodes the µ-opioid receptor, which is the primary site of action of most opioids. Several studies and three meta-analyses have examined a possible link between the exonic OPRM1 A118G (rs1799971) polymorphism and opioid dependence; however, results have been inconclusive. Therefore, a systematic review and meta-analysis have been carried out to examine whether this polymorphism is associated with opioid dependence. Thirteen studies (n = 9385), comprising 4601 opioid dependents and 4784 controls, which evaluated association of the OPRM1 rs1799971 polymorphism with susceptibility to opioids, were included in this study. Our meta-analysis showed significant association between this polymorphism and susceptibility to opioid dependence in overall studies under a codominant model, as well as susceptibility to opioid dependence or heroin dependence in Asians under an autosomal dominant model. The nonsynonymous OPRM1 rs1799971 might be a risk factor for addiction to opioids or heroin in an Asian population.

Matched MeSH terms: Genetic Predisposition to Disease

Ano-coccygeal support in the treatment of idiopathic chronic posterior anal fissure: a prospective non-randomised controlled pilot trial

Gee T, Hisham RB, Jabar MF, Gul YA

Tech Coloproctol, 2013 Apr;17(2):181-6.

PMID: 22983551 DOI: 10.1007/s10151-012-0894-6

Idiopathic chronic anal fissure is believed to be a consequence of a traumatic acute anodermal tear followed by recurrent inflammation and poor healing due to relative tissue ischaemia secondary to internal sphincter spasm. This pilot trial compared the efficacy of a novel manufactured ano-coccygeal support attached to a standard toilet seat (Colorec) to the standard procedure of lateral internal sphincterotomy (LIS) for chronic anal fissure.

Matched MeSH terms: Chronic Disease

Acute flaccid paralysis with chronic cough

Chai CH, Yuki N, Nor HM, Goh KJ, Shahrizaila N

Pract Neurol, 2012 Oct;12(5):328-31.

PMID: 22976064 DOI: 10.1136/practneurol-2011-000205

Matched MeSH terms: Chronic Disease

Fulltext Iatrogenic ureter injuries: eleven years experience in a tertiary hospital

Mahendran HA, Singam P, Ho C, Goh EH, Tan GH, Zuklifli MZ

Med J Malaysia, 2012 Apr;67(2):169-72.

PMID: 22822637 MyJurnal

Iatrogenic ureteric injuries are rare complications of abdomino-pelvic surgery but associated with high morbidity from infection and possible loss of renal function. A successful repair is related to the timing of diagnosis, site of injury and method of repair. This study was a retrospective review of outcomes of iatrogenic ureteric injury and factors contributing to successful operative repair. Twenty consecutive cases referred to the Urology Unit of the UKM Medical Center during an 11-year period from 1998 to 2009 were reviewed. Thirteen patients were diagnosed intraoperatively and underwent immediate repair. Seven patients had delayed diagnosis but also underwent immediate repair. In our series, there was no significant difference in outcome between injuries diagnosed intraoperatively versus injuries with delayed diagnosis. There was significant difference in the outcomes between methods of ureteric repair where ureter reimplantation via psoas hitch or Boari flap yielded better results than primary end-to-end anastomosis Three patients suffered loss of renal function from unsuccessful ureter repair. We conclude that all iatrogenic ureteric injury should be repaired immediately in the absence of overt sepsis. Ureter reimplantation using a Boari flap or psoas hitch is preferred to the end-to-end anastomosis especially when there is delayed diagnosis

Matched MeSH terms: Iatrogenic Disease

Fulltext Cutaneous side-effects of epidermal growth factor receptor-tyrosine kinase inhibitor (TKI) in the treatment of lung cancer: description and its management

Ong CK, Tan WC, Chan LC, Abdul Razak M

Med J Malaysia, 2012 Apr;67(2):222-3.

PMID: 22822651 MyJurnal

Epidermal growth factor receptor (EGFR)--tyrosine kinase inhibitors (TKI) like erlotinib and gefitinib have been approved as monotherapy for the treatment of patients with locally advanced or metastatic non small cell lung cancer (NSCLC) after failure of at least one prior chemotherapy regimen. The use of EGFR-TKI is associated with unique and dramatic dermatologic side effects. We report 2 patients with NSCLC developing a typical acneiform (papulo-pustular) eruption shortly after initiation of EGFR-TKI.

Matched MeSH terms: Disease Progression

Acute bilateral medial medullary infarct with hypoplastic vertebral artery

Tai ML, Katiman E, Rahmat K, Tan CT

Clin Neurol Neurosurg, 2012 Dec;114(10):1365-7.

PMID: 22512947 DOI: 10.1016/j.clineuro.2012.03.031

Matched MeSH terms: Acute Disease

Unmet needs among disabled elderly Malaysians

Momtaz YA, Hamid TA, Ibrahim R

Soc Sci Med, 2012 Sep;75(5):859-63.

PMID: 22632847 DOI: 10.1016/j.socscimed.2012.03.047

Unmet need as a significant factor affecting quality of life in later life has recently received considerable attention in gerontological research. The main aim of this study was to identify the prevalence, predicting factors, and negative consequence of unmet need among older Malaysians. The findings may be useful to reduce unmet need and the burden of its adverse consequence. The sample for this study consists of 400 functionally disabled elderly people aged 60 and over was obtained from a large national survey. Unmet need was operationally defined based on Manton's (1989) criteria. The findings from the present study showed about 18.0% of functionally disabled older Malaysians suffer from unmet need. Logistic regression revealed that gender (being male) and chronic health conditions are statistically associated with increased odds of unmet need after adjusting for other possible risk factors. Further results indicated that unmet need statistically increases odds of fall as a negative consequence of unmet need. The high prevalence rates of unmet need among disabled elderly men and chronically ill older persons suggest that policy makers should pay more attention to this vulnerable group to achieve good quality of life. The implications and limitations of the present study are discussed.

Matched MeSH terms: Chronic Disease

Fulltext Use of newly available febuxostat in a case of chronic tophaceous gout contraindicated to allopurinol and probenecid

Abdullah H, Asmahan MI, Rosman A

Med J Malaysia, 2012 Feb;67(1):125-6.

PMID: 22582566 MyJurnal

Urate lowering therapy in this country has mainly been achieved by the use of allopurinol and probenecid. A new xanthine oxidase inhibitor called febuxostat has been approved in 2009 for treatment of hyperuricaemia in gout. In this report, we describe the management of a patient with chronic tophaceous gout using febuxostat. The reduction in serum uric acid to target levels was rapid, and the tophi size had also reduced significantly while on therapy. There was no unwanted side effect observed during the therapy. Therefore, febuxostat would be a useful alternative drug in the treatment of hyperuricaemia in gout patients who have contraindications to allopurinol and probenecid.
Study site: Rheumatology clinic, Selayang Hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Chronic Disease

Association of TGFβ1 and SMAD4 variants in the etiology of keloid scar in the Malay population

Emami A, Halim AS, Salahshourifar I, Yussof SJ, Khoo TL, Kannan TP

Arch. Dermatol. Res., 2012 Sep;304(7):541-7.

PMID: 22805880 DOI: 10.1007/s00403-012-1262-0

Keloid is a complex condition with environmental and genetic risk-contributing factors. Two candidate genes, TGFβ1 and SMAD4, located in the same signaling pathway are highly expressed in the keloid fibroblast cells. In a case-control design, TGFβ1 haplotypes showed association with the risk of keloid in the present study. The CC haplotype, composed of both c.29C>T and -509T>C variants, was observed more frequently among cases (Corrected p = 0.037, OR = 2.07, 95 % CI = 0.87-4.93), showing a 4.5-fold increased risk for keloid. The AG genotype of the SMAD4 c.5131A>G variant showed a trend of significance (p = 0.0573, OR = 1.75, 95 % CI = 0.99-3.13). Taken together, either of these variants is most probably causative at the expression level or is in linkage disequilibrium with other causative variants in a complex pattern together with the environmental factors that contribute to the condition. To the best of our knowledge, there is only one documented report on a relationship between TGFβ1 and keloid with no association within the Caucasian population, while there have not been any reports for SMAD4. Therefore, the present study is likely the first research showing a significant association between TGFβ1 variants and keloids in the Malay population.

Matched MeSH terms: Genetic Predisposition to Disease

Management of diarrhoea cases by community pharmacies in 3 cities of Pakistan

Hussain A, Ibrahim MI

East Mediterr Health J, 2012 Jun;18(6):635-40.

PMID: 22888622

Community pharmacies are valued for their potential role in the management of common ailments. This cross-sectional study aimed to document the management of diarrhoea by community pharmacies in 3 cities in Pakistan. Visits were performed to 371 randomly selected pharmacies to request advice for a simulated paediatric case of diarrhoea. The pharmacy's management was scored on a checklist including history taking and provision of advice and information. Customers were served by a salesperson in 97.3% of visits and by a pharmacist in only 2.2%. Medication was dispensed in 77.1% of visits. Of the medications dispensed, 58.7% were antiamoebics, 14.0% antibiotics and 18.9% antidiarrhoeals; only 8.4% were oral rehydration salts. None of the regimens matched with a standard prescription. The dosage regimen was explained to the customer in only 52.6% of cases. Drug safety, unqualified personnel, lack of history taking, inappropriate treatment and lack of counselling are concerns to be addressed.

Matched MeSH terms: Disease Management

Deleted in Colorectal Cancer (DCC) gene polymorphism is associated with H. pylori infection among susceptible Malays from the north-eastern region of Peninsular Malaysia

Maran S, Lee YY, Xu S, Rajab NS, Hasan N, Mustaffa N, et al.

Hepatogastroenterology, 2013 Jan-Feb;60(121):124-8.

PMID: 22829558

Using genome-wide case-control association approach, the current study aimed to determine whether genetic polymorphism(s) is/are associated with H. pylori infection among ethnic Malays from the north-eastern region of Peninsular Malaysia, a region with an exceptionally low prevalence for H. pylori infection and gastric cancer.

Matched MeSH terms: Genetic Predisposition to Disease

Fulltext The association between dyslipidaemia and types of antipsychotic medications among patients with chronic schizophrenia

Ruzanna ZZ, Ong LY, Cheah YC, Fairuz A, Midin M

Med J Malaysia, 2012 Feb;67(1):39-44.

PMID: 22582547 MyJurnal

This cross sectional study aimed to explore the association between dyslipidaemia and types of antipsychotics in 100 patients with chronic schizophrenia. Lipid profile, weight, height and waist circumference together with other relevant factors were measured. We found there was a high rate of dyslipidaemia among patients with chronic schizophrenia treated with antipsychotics (66%), however there was no significant difference found between typical or atypical antipsychotics (OR=1). All sociodemographic and clinical factors were not significantly associated with dyslipidaemia. Only non-Malays were found to have significant dyslipidaemia (p<0.1). Effective management is needed to deal with the dyslipidaemia in this group.

Matched MeSH terms: Chronic Disease

Prevalence of piriformis syndrome in chronic low back pain patients. A clinical diagnosis with modified FAIR test

Kean Chen C, Nizar AJ

Pain Pract, 2013 Apr;13(4):276-81.

PMID: 22863240 DOI: 10.1111/j.1533-2500.2012.00585.x

Piriformis syndrome is a collection of symptoms and signs of pain from piriformis muscle and is characterized by pain in buttock with variable involvement of sciatic nerve. This syndrome is often overlooked in clinical practice because its presentation has similarities with other spine pathologies. A major problem with the clinical diagnosis of piriformis syndrome is the lack of consistent objective findings and an absence of single test that is specific for piriformis syndrome. Therefore, a precise and reliable clinical method of diagnosing piriformis syndrome should be developed by clinicians.

Matched MeSH terms: Chronic Disease

Effectiveness of a video-based therapy program at home after acute stroke: a randomized controlled trial

Redzuan NS, Engkasan JP, Mazlan M, Freddy Abdullah SJ

Arch Phys Med Rehabil, 2012 Dec;93(12):2177-83.

PMID: 22789773 DOI: 10.1016/j.apmr.2012.06.025

To evaluate the effectiveness of an intervention using video to deliver therapy at home for patients with stroke.

Matched MeSH terms: Acute Disease

Quality of life in breast cancer survivors: 2 years post self-management intervention

Loh SY, Chew SL, Lee SY, Quek KF

Asian Pac J Cancer Prev, 2011;12(6):1497-501.

PMID: 22126488

INTRODUCTION: Today, cancer survivors have an added new role to self manage living with the medical, emotional and role tasks that can affect their quality of life (QOL). The purpose of the study was to evaluate the QOL of women two years after participating in a self-management intervention program.

METHOD: The clinical trial was conducted at University Malaya Medical Centre between 2006 and 2008. The experimental group underwent a 4-week self management program, and the control group underwent usual care. Two years after the intervention, questionnaires were randomly posted out to the participants.

RESULTS: A total of 51 questionnaires returned. There were statistically differences between groups in psychological, self-care, mobility and participation aspects in PIPP (p<0.05). The experimental group reported having higher confidence to live with breast cancer compared to control group (p<0.05). There were significant between-group changes in anxiety scores at T2 (immediately after intervention) to T4 (two years later), and the differences in anxiety scores within groups between time point T2 and T4 were significantly different (p<0.05).

CONCLUSION: The SAMA program is potentially capable to serve as a model intervention for successful transition to survivorship following breast cancer treatment. The program needs to be further tested for efficacy in a larger trial involving more diverse populations of women completing breast cancer treatment.

Matched MeSH terms: Disease Management

Isolation of Aggregatibacter aphrophilus from a patient with acute appendicitis

Aye AM, Law CW, Sabet NS, Karunakaran R, Hanifah YA, Jafar FL, et al.

Eur Rev Med Pharmacol Sci, 2011 Jul;15(7):845-7.

PMID: 21780555

Acute appendicitis is a common surgical emergency. The etiology and pathophysiology of appendicitis have been well investigated. Aggregatibacter aphrophilus is a fastidious gram-negative coccobacilli. Detection of this organism in clinical samples and its differentiation from Haemophilus aphrophilus or from Aggregatibacter actinomycetemcomitans in routine microbiology settings could be difficult.

Matched MeSH terms: Acute Disease

Safe zone for bone harvesting from the interforaminal region of the mandible

Al-Ani O, Nambiar P, Ha KO, Ngeow WC

Clin Oral Implants Res, 2013 Aug;24 Suppl A100:115-21.

PMID: 22233422 DOI: 10.1111/j.1600-0501.2011.02393.x

The mandibular incisive nerve can be subjected to iatrogenic injury during bone graft harvesting. Using cone beam computed tomography (CBCT), this study aims to determine a safe zone for bone graft harvesting that avoids injuring this nerve.

Matched MeSH terms: Iatrogenic Disease

Fulltext Intraocular nematode with diffuse unilateral subacute neuroretinitis: case report

Yusoff M, Alwi AA, Said MM, Zakariah S, Ghani ZA, Zunaina E

BMC Ophthalmol, 2011;11:15.

PMID: 21679403 DOI: 10.1186/1471-2415-11-15

Live intraocular nematode is a rare occurrence. Nematode can migrate actively within the eye, creating visual symptoms and damaging ocular tissue.

Matched MeSH terms: Acute Disease

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