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Fulltext Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia - a cross-sectional study

Chai CS, Mos SB, Ng DL, Goh GM, Su AT, Ibrahim MAB, et al.

BMC Pulm Med, 2020 Sep 29;20(1):254.
PMID: 32993591 DOI: 10.1186/s12890-020-01295-4

BACKGROUND: The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients' health-related quality of life (HRQoL) according to their COPD phenotypes.
METHODS: This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George's Respiratory Questionnaire for COPD (SGRQ-c).
RESULTS: Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p

Matched MeSH terms: Asthma
Fulltext Hamman’s syndrome: a rare benign syndrome

Aida Abdul Rahim, Mohd Taufiq Yahaya1, Siti Nor Farhana Mohd Shafie, Laila Mastura Ahmad Apandi

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):357-359.
MyJurnal

Hamman’s syndrome by definition is spontaneous pneumomediastinum with the exclusion of thoracic trauma or iatrogenic cause. It is rare and is more common in adolescence male. Amongst the risk factors are underlying lung condition such as asthma and interstitial lung disease, drug inhalation and parturient woman. Patient usually pres- ents with sudden onset of shortness of breath and chest pain with subcutaneous emphysema on examination. The diagnosis is confirmed with chest radiograph. The prognosis of Hamman’s syndrome is excellent. Most cases are self-limiting and resolve spontaneously. However, Hamman’s syndrome is a poorly recognised disease due to its rarity. Therefore, the patient may be subjected to misdiagnosis and treatment. This is a case report of Hamman’s syn- drome misdiagnosed and treated as pneumothorax. The objective of this case report is to highlight the importance of differentiating this benign syndrome with life threatening differentials which may have similar clinical presentation. Thus, avoiding unnecessary costly investigation, treatment and invasive procedures.

Matched MeSH terms: Asthma
Self-perceived disease control in childhood eczema

Lam PH, Hon KL, Leung K, Leong KF, Li CK, Leung TF

J Dermatolog Treat, 2020 Sep 22.
PMID: 32962454 DOI: 10.1080/09546634.2020.1826395

BACKGROUND: Atopic eczema (AE) is a common relapsing inflammatory skin disease in children which is often associated with chronicity and poor quality of life. Unlike atopic asthma, control of AE is seldom assessed in therapeutics.
AIM: To investigate the utility of a Traffic Light Control (TLC) system as a measurement/assessment of self-perceived eczema control.
METHODS: This is a prospectively study of all Chinese children (aged 6 to 18 years old) with eczema attending the paediatric dermatology clinic of a tertiary hospital from Jan to June 2020. Eczema control, eczema severity, quality of life and biophysical skin condition of consecutive patients at the paediatric dermatology clinic of a teaching hospital were evaluated with the validated Chinese versions of Depressive, Anxiety, Stress Scales (DASS-21), Patient Oriented Eczema Measure (POEM), transepidermal water loss (TEWL), and stratum corneum skin hydration (SH), respectively. With a visual TLC analogy, patients were asked if their eczema is under control (green light), worsening (yellow) or in flare-up (red light).
RESULTS: Among AE patients (n = 36), self-perceived TLC as green (under control), amber (worsening) and red (flare up) reflected acute and chronic severity (SCORAD, NESS, POEM) and quality of life (CDLQI) (p< 0.0001), but not SH, TEWL or Depression, anxiety and stress.
CONCLUSIONS: Eczema control can be semi-quantified with a child-friendly TLC self-assessment system. AE patients reporting worse eczema control have worse acute and chronic eczema severity, more impairment of quality of life; but not the psychologic symptoms of depression, anxiety and stress or skin hydration or transepidermal water loss. TLC can be linked to an eczema action plan to guide patient management.

Matched MeSH terms: Asthma
Fulltext Potential Nutraceutical Benefits of In Vivo Grown Saffron (Crocus sativus L.) As Analgesic, Anti-inflammatory, Anticoagulant, and Antidepressant in Mice

Khan A, Muhamad NA, Ismail H, Nasir A, Khalil AAK, Anwar Y, et al.

Plants (Basel), 2020 Oct 22;9(11).
PMID: 33105854 DOI: 10.3390/plants9111414

Crocus sativus, a medicinally important herbaceous plant, has been traditionally used to cure coughs, colds, insomnia, cramps, asthma, and pain. Moreover, the therapeutic applications of saffron include its immunomodulatory and anticancer properties. The current experimental analysis was performed to explore the potential nutraceutical efficacy of corm, leaf, petal, and stigma of saffron ethanolic extracts as analgesic, anti-inflammatory, anticoagulant, and antidepressant using hot plate, carrageenan-induced paw edema, capillary tube and forced swim test, respectively in mice. The results indicated that among all the extracts, stigma ethanolic extract (SEE) represented maximum latency activity (72.85%) and edema inhibition (77.33%) followed by petal ethanolic extract (PEE) with latency activity and edema inhibition of 64.06 and 70.50%, respectively. Corm ethanolic extract (CEE) and leaf ethanolic extract (LEE) displayed mild analgesic activity of 22.40% and 29.07%, respectively. Additionally, LEE (53.29%) and CEE (47.47%) exhibited mild to moderate response against inflammation. The coagulation time of SEE (101.66 s) was almost equivalent to the standard drug, aspirin (101.66 s), suggesting a strong anticoagulant effect followed by PEE (86.5 s). LEE (66.83 s) represented moderate inhibitory effect on coagulation activity while CEE (42.83 s) showed neutral effect. Additionally, PEE and SEE also expressed itself as potential antidepressants with immobility time ≤76.66 s, while CEE (96.50 s) and LEE (106.83 s) indicated moderate to mild antidepressant efficacy. Based on the in vivo activities, saffron extract, particularly SEE and PEE, can be used as a potential nutraceutical and therapeutic agent due to its significant pharmacological activities.

Matched MeSH terms: Asthma
Fulltext A Synthetic Curcuminoid Analogue, 2,6-Bis-4-(Hydroxyl-3-Methoxybenzylidine)-Cyclohexanone (BHMC) Ameliorates Acute Airway Inflammation of Allergic Asthma in Ovalbumin-Sensitized Mice

Tham CL, Yeoh SY, Ong CH, Harith HH, Israf DA

Mediators Inflamm, 2021;2021:9725903.
PMID: 33883974 DOI: 10.1155/2021/9725903

2,6-Bis-(4-hydroxyl-3-methoxybenzylidine) cyclohexanone (BHMC), a synthetic curcuminoid analogue, has been shown to exhibit anti-inflammatory properties in cellular models of inflammation and improve the survival of mice from lethal sepsis. We further evaluated the therapeutic effect of BHMC on acute airway inflammation in a mouse model of allergic asthma. Mice were sensitized and challenged with ovalbumin (OVA), followed by intraperitoneal administration of 0.1, 1, and 10 mg/kg of BHMC. Bronchoalveolar lavage fluid, blood, and lung samples were collected, and the respiratory function was measured. OVA sensitization and challenge increased airway hyperresponsiveness (AHR) and pulmonary inflammation. All three doses of BHMC (0.1-10 mg/kg) significantly reduced the number of eosinophils, lymphocytes, macrophages, and neutrophils, as well as the levels of Th2 cytokines (IL-4, IL-5 and IL-13) in bronchoalveolar lavage fluid (BALF) as compared to OVA-challenged mice. However, serum level of IgE was not affected. All three doses of BHMC (0.1-10 mg/kg) were effective in suppressing the infiltration of inflammatory cells at the peribronchial and perivascular regions, with the greatest effect observed at 1 mg/kg which was comparable to dexamethasone. Goblet cell hyperplasia was inhibited by 1 and 10 mg/kg of BHMC, while the lowest dose (0.1 mg/kg) had no significant inhibitory effect. These findings demonstrate that BHMC, a synthetic nonsteroidal small molecule, ameliorates acute airway inflammation associated with allergic asthma, primarily by suppressing the release of inflammatory mediators and goblet cell hyperplasia to a lesser extent in acute airway inflammation of allergic asthma.

Matched MeSH terms: Asthma
Fulltext Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait

Almazeedi S, Al-Youha S, Jamal MH, Al-Haddad M, Al-Muhaini A, Al-Ghimlas F, et al.

EClinicalMedicine, 2020 Jul;24:100448.
PMID: 32766546 DOI: 10.1016/j.eclinm.2020.100448

Background: In Kuwait, prior to the first case of COVID-19 being reported in the country, mass screening of incoming travelers from countries with known outbreaks was performed and resulted in the first identified cases in the country. All COVID-19 cases at the time and subsequently after, were transferred to a single center, Jaber Al-Ahmad Al-Sabah Hospital, where the patients received standardized investigations and treatments. The objective of this study was to characterize the demographics, clinical manifestations, and outcomes in this unique patient population.
Methods: This retrospective cohort study was conducted between 24th February 2020 and 20th April 2020. All consecutive patients in the entire State of Kuwait diagnosed with COVID-19 according to WHO guidelines and admitted to Jaber Al-Ahmad Al-Sabah Hospital were included. Patients received standardized investigations and treatments. Multivariable analysis was used to determine the associations between risk factors and outcomes (admission to intensive care and/or mortality).
Findings: Of 1096 patients, the median age was 41 years and 81% of patients were male. Most patients were asymptomatic on admission (46.3%), of whom 35 later developed symptoms, and 59.7% had no signs of infection. Only 3.6% of patients required an ICU admission and 1.7% were dead at the study's cutoff date. On multivariable analysis, the risk factors found to be significantly associated with admission to intensive care were age above 50 years old, a qSOFA score above 0, smoking, elevated CRP and elevated procalcitonin levels. Asthma, smoking and elevated procalcitonin levels correlated significantly with mortality in our cohort.

Matched MeSH terms: Asthma
Emerging concepts and directed therapeutics for the management of asthma: regulating the regulators

Shastri MD, Chong WC, Dua K, Peterson GM, Patel RP, Mahmood MQ, et al.

Inflammopharmacology, 2021 Feb;29(1):15-33.
PMID: 33152094 DOI: 10.1007/s10787-020-00770-y

Asthma is a common, heterogeneous and serious disease, its prevalence has steadily risen in most parts of the world, and the condition is often inadequately controlled in many patients. Hence, there is a major need for new therapeutic approaches. Mild-to-moderate asthma is considered a T-helper cell type-2-mediated inflammatory disorder that develops due to abnormal immune responses to otherwise innocuous allergens. Prolonged exposure to allergens and persistent inflammation results in myofibroblast infiltration and airway remodelling with mucus hypersecretion, airway smooth muscle hypertrophy, and excess collagen deposition. The airways become hyper-responsive to provocation resulting in the characteristic wheezing and obstructed airflow experienced by patients. Extensive research has progressed the understanding of the underlying mechanisms and the development of new treatments for the management of asthma. Here, we review the basis of the disease, covering new areas such as the role of vascularisation and microRNAs, as well as associated potential therapeutic interventions utilising reports from animal and human studies. We also cover novel drug delivery strategies that are being developed to enhance therapeutic efficacy and patient compliance. Potential avenues to explore to improve the future of asthma management are highlighted.

Matched MeSH terms: Asthma
Fulltext Anti-Inflammatory Potential of Hexane Extract of Mud Lobster (Thalassina anomala) in Lipopolysaccharide-Stimulated RAW 264.7 Macrophages

Zakaria NN, Malahubban M, Fakurazi S, And WSC, Rajaee AH

Trop Life Sci Res, 2021 Mar;32(1):145-162.
PMID: 33936556 DOI: 10.21315/tlsr2021.32.1.9

Mud lobsters are crustaceans from the genus Thalassina which are lesser known and seldom seen but are nevertheless an important organism to the mangrove ecosystem. In Malaysia and Thailand, mud lobsters are eaten by locals as treatment for asthma. It is traditionally believed that they are effective in reducing the number of asthma attacks and severity of asthma symptoms. However, the therapeutic potential of mud lobster extract remains unclear and has not been fully elucidated or reported in any scientific study. The objectives of this study are to investigate the anti-inflammatory potential of mud lobster, Thalassina anomala extracts (hexane, chloroform and methanol) in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages, and to identify the potential bioactive compounds involved. An MTT assay was performed to determine the cytotoxicity of the T. anomala extracts on RAW 264.7 macrophages. Nitrite quantification assay and enzyme-linked immunosorbent assay (ELISA) were conducted to investigate the ability of the T. anomala extracts to suppress the secretion and expression of nitric oxide (NO), Prostaglandin E2 (PGE2) and proinflammatory cytokines (TNF-α, IL-6 and IL-1β) in LPS-stimulated macrophages. GC-MS analysis was done to identify putative metabolites. The hexane extract of T. anomala showed anti-inflammatory activity by significantly inhibiting the LPS-induced production of NO, PGE2, interleukin- (IL-) 6, IL-1β and tumour necrosis factor-alpha (TNF-α) in a concentration-dependent manner. Hexane extract treatment with 100 μg/mL has decreased the NO secretion into 37 μM. Meanwhile, hexane extract at concentration of 100 μg/mL able to significantly suppressed PGE2,TNF-α, IL-6 and IL-1β production into 2015 pg/mL, 2406 pg/mL, 460 pg/mL and 9.6 pg/mL, respectively. GC-MS analysis of the hexane extract revealed the presence of 19 putative compounds. The identified compounds were reported to have anti-inflammatory, antioxidant and antibacterial activities. These results suggest that the hexane extract of T. anomala potentially has anti-inflammatory properties and concentration dependently suppressed NO, PGE2 and proinflammatory cytokines' production in LPS-stimulated macrophages. The findings provide a rational basis of the traditional use of mud lobster for inflammation-associated ailments.

Matched MeSH terms: Asthma
Fulltext Metagenomic characterization of indoor dust fungal associated with allergy and lung inflammation among school children

Isa KNM, Jalaludin J, Elias SM, Than LTL, Jabbar MA, Saudi ASM, et al.

Ecotoxicol Environ Saf, 2021 Sep 15;221:112430.
PMID: 34147866 DOI: 10.1016/j.ecoenv.2021.112430

The exposure of school children to indoor air pollutants has increased allergy and respiratory diseases. The objective of this study were to determine the toxicodynamic interaction of indoor pollutants exposure, biological and chemical with expression of adhesion molecules on eosinophil and neutrophil. A self-administered questionnaire, allergy skin test, and fractional exhaled nitric oxide (FeNO) analyser were used to collect information on health status, sensitization to allergens and respiratory inflammation, respectively among school children at age of 14 years. The sputum induced were analysed to determine the expression of CD11b, CD35, CD63 and CD66b on eosinophil and neutrophil by using flow cytometry technique. The particulate matter (PM2.5 and PM10), NO2, CO2, and formaldehyde, temperature, and relative humidity were measured inside the classrooms. The fungal DNA were extracted from settled dust collected from classrooms and evaluated using metagenomic techniques. We applied chemometric and regression in statistical analysis. A total of 1869 unique of operational taxonomic units (OTUs) of fungi were identified with dominated at genus level by Aspergillus (15.8%), Verrucoconiothyrium (5.5%), and Ganoderma (4.6%). Chemometric and regression results revealed that relative abundance of T. asahii were associated with down regulation of CD66b expressed on eosinophil, and elevation of FeNO levels in predicting asthmatic children with model accuracy of 63.6%. Meanwhile, upregulation of CD11b expressed on eosinophil were associated with relative abundance of A. clavatus and regulated by PM2.5. There were significant association of P. bandonii with upregulation of CD63 expressed on neutrophil and exposure to NO2. Our findings indicate that exposure to PM2.5, NO2, T. asahii, P.bandonii and A.clavatus are likely interrelated with upregulation of activation and degranulation markers on both eosinophil and neutrophil.

Matched MeSH terms: Asthma
Seropositivity and risk factors of Toxocara canis infection in adult asthmatic patients

Rouhani-Rankouhi SZ, Kow KS, Liam CK, Lau YL

Trop Biomed, 2020 Sep 01;37(3):599-608.
PMID: 33612775 DOI: 10.47665/tb.37.3.599

This cross-sectional study involving 86 adult asthmatic patients aimed to determine the relationship between Toxocara seropositivity and severity of asthma in adult asthmatics and investigate the risk factors for Toxocara infection. In all cases, T. canis IgG level was measured using an anti-Toxocara IgG enzyme-linked immunosorbent assay kit. Total serum IgE and eosinophil count were also determined. The anti-Toxocara IgG seropositivity was 68.6% among asthmatic patients. There were no statistically significant associations between Toxocara seroprevalence and other risk factors, clinical symptoms of asthma and high level of total serum IgE and eosinophilia. Pet ownership could be an important risk factor for Toxocariasis. Having a pet at home and wheezing were significantly associated with Toxocara seropositivity in adult asthmatic patients.

Matched MeSH terms: Asthma
The relationship between Kuala Lumpur haze and asthmatic attacks in children

Zailina Hashim, Juliana Jalaludin, Norzila Muhamad Zainudin, Azizi Omar, Jamal H. Hashim

Malaysian Journal of Child Health, 1997;9(2):151-159.
MyJurnal

A study on 30 asthmatic children was conducted in Kuala Lumpur. The objective of this study was to study the relationship between respirable particulate (PM10), sulphur dioxide, ozone and various meteorological factors such as humidity, level ofrainfall and temperature with asthma attacks. This study was conducted from 1st September to 31 December 1994. Patients were selected from the Paediatric Unit, Kuala Lumpur Hospital. Questionnaires were used to obtain information from their parents on the history and severity ofasthmatic attacks ofthese patients. Questionnaires were also used to determine if the indoor sources contributed to the attack. Diary cards were used to collect information on the frequency of asthmatic attacks. Each patient's progress was followed through every week during the study period and the attacks were recorded. The data on air quality on the PM10, sulphur dioxide, nitrogen dioxide, carbon monoxide and ozone were collected hourly using the microcomputer system of air monitoring unit from the Universiti Pertanian Malaysia air quality monitoring station located at the City Hall, Kuala Lumpur. The meteorological parameters such as temperature, relative humidity and rain-fall levels were also monitored daily. The asthmatic attack percentage was obtained by dividing the number of attacks in a day with the total number of sample and multiplying by a hundred. Statistical tests indicated that there was a significant correlation between asthmatic attacks and the PM10 concentrations (r=0.73), nitrogen dioxide (r=0.57) and.carbon monoxide (r=0.53) throughout the study period. During the haze episode, more significant correlations between asthmatic attacks, PM10 concentra-tions (0.86), carbon monoxide (0.79) and nitrogen oxide (0.53) were found. Multiple regression statistical test showed that PM10 had the greatest influence on the asthmatic attack rate. The minute respirable particulate which entered the respiratory system of the asthmatics triggered attacks on these patients.

Matched MeSH terms: Asthma
Fulltext Secondhand smoke exposure at home and respiratory symptoms among primary school children in Kota Bharu, Kelantan

Sharina, D., Zulkifli, A., Nyi, N.N.

Malaysian Journal of Public Health Medicine, 2007;7(2):59-63.
MyJurnal

In recent years, there has been concern that non-smokers may also be at risk from secondhand smoke exposure, especially children. This study was done to determine the prevalence of secondhand smoke exposure at home and the association between secondhand smoke exposure and respiratory symptoms among primary schoolchildren in Kota Bharu, Kelantan. This was a comparative cross-sectional study involving children, aged 10·12 years. A structured questionnaire was used to obtain the information on sociodemographic, respiratory symptoms and smokers in the house. A random sample of 10 from 95 primary schools in Kota Bharu was included. Six classes were randomly selected from each school, two classes each from each school year of primary 4·6. A total of 795 children completed the questionnaire during September 2003 till March 2004. 386 of children (48.6%) were boys and 409 children (51.4%) were girls. Most of the children were Malay (99.9%). A total of 442 (55.6%) children lived with at least 1 smoker in the house mainly from the smoking fathers. Significantly increased odds ratios due to secondhand smoke exposure were observed for most of the respiratory symptoms. The odds ratios (95% confidence interval) were 1.67 (1.18, 2.39) for cough in the morning, 1.59 (1.10, 2.30) for cough at night, 1.76 (1.16, 2.65) for cough most days for the previous 3 months, 1.57 (1.14, 2.17) for phlegm in the morning, 1.49 (1.08, Z.07) for phlegm during daytime or at night, 1.38 (1.03, 1.86) for nose problems in the morning, 1.40 (1.03, 1.90) for nose problems at night and 1.78 (1.14, 2.78) for throat problems at night, 1.55 (1.06, 2.26) for ever wheeze or diagnosed asthma by doctor, 1.57 (1.05, 2.36) for throat problems in the morning and 1.81 (1.15, 2.85) for throat problems during daytime. The odds ratios increased with increasing number of smokers at home for cough in the morning, cough most days for the previous 3 months, phlegm in the morning, ever wheeze or diagnosed asthma by doctor, throat problems in the morning, throat problems during daytime and throat problems at night. In view of the significant health risks posed to children by secondhand smoke, public health policies are needed to protect this vulnerable population. The aim of such policies Ls to ensure the right of every child to grow up in an environment free of tobacco smoke.

Matched MeSH terms: Asthma
Fulltext Prevalence and risk factors associated with otitis media with effusion in children visiting tertiary care centre in Malaysia

Tikaram A, Chew YK, Zulkiflee AB, Chong AW, Prepageran N

International Medical Journal Malaysia, 2012;11(1):37-40.
MyJurnal

Introduction: The aim of this study is to determine the prevalence of otitis media with effusion (OME) in Malaysian children between three months to twelve years of age and to identify the risk factors associated with it.
Materials and methods: This is a cross-sectional study consists of 153 children selected by stratified random sampling method. Parents of these children were interviewed with a structured questionnaire. Clinical examination, including otoscopic examination and tympanometry was performed for each child.
Results: The prevalence of OME was 18.3%. There was no statistical significant relationship between OME and gender, race, household size, attendance to daycare center, breast feeding, and exposure to passive smoking, allergy, and asthma.
Conclusion: The prevalence of OME is 18.3% in Malaysian children between three months to twelve years of age. Frequency of AOM is a statistically significant factor to the development of OME later in life. The different risk factors associated with OME are still controversial.

Matched MeSH terms: Asthma
Risk factors for acute lower respiratory tract infections in hospitalised children in Kelantan

Choo, C.M., Quah, B.S., Rostenberghe, H.V., Choo, K.E.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):1-7.
MyJurnal

A case control study was conducted to identify the risk factors for acute lower respiratory tract infections (ALRI) in hospitalised children in Kelantan. One hun-dred and twenty children aged one month to five years hospitalised for ALRI were matched by age with 120 children as controls. Data on demography and expo-sure to putative risk factors were collected by interview-ing parents or caretakers. Anthropometric measure-ments were also carried out to assess the nutritional sta-tus of the children. For each risk factor studied, the odds ratios for exposure and disease were calculated by using univariate analysis followed by multiple logistic regression analysis to determine those factors which remained significant.
The presence of sibling(s) who coughed at home (OR 12.1, 95% CI 5.2-28.1), crowding in bedroom (OR 4.4, 95% CI 2.1-9.0), weight-for-age < 3rd percentile (OR 9.0, 95% CI 3.1-25.8), lack of breast feeding (OR 9.4, 95% CI 2.3-38.4) and incomplete immunisation (OR 4.5, 95% CI 1.7-12.1) were significant indepen-dent risk factors for ALRI. Other factors like poverty, maternal education level, male sex, low birth weight, history of atopy, family history of asthma and indoor air pollution were not associated with an increased risk of ALRI.
This study showed that poor nutritional status, inap-propriate child care practices and poor living conditions, particularly those related to crowding, predispose to ALRI in Kelantanese children necessitating hospital admission. A change in these factors may reduce the morbidity and mortality of childhood ALRI in Kelantan.

Matched MeSH terms: Asthma
Fulltext An audit of bronchial asthma control at a primary public health care facility

Usha Devi B, Hairul Izwan AR, Munjeet KPS, Rosidah CP

Malaysian Journal of Public Health Medicine, 2011;11(2):22-26.
MyJurnal

A study was conducted at Greentown Health Clinic, Ipoh to assess and classify asthma by levels of control based on the Global Initiative for Asthma (GINA). The secondary objective was to identify those patients whose control was suboptimal. A total of 102 patients were included in this study based on random sampling between 25th April 2008 and 6th June 2008. Standard Asthma Control Questionnaires were used to classify asthma and levels of control. Baseline Peak Expiratory Flow Rate (PEFR) measurements and PEFR at audit visits were also recorded. All data were analysed using SPSS version 13. The study showed that only 39.2 % of the patients were classified as having controlled asthma, 34.3 % had asthma that was partly controlled and 26.5 % of the patients had uncontrolled asthma. Among those patients who had inadequate asthma control, more than half of them had nocturnal attacks and exacerbations. These findings demonstrate the need by the attending doctor to improve assessment of the patient’s control of asthma by actively questioning the patients and subsequently improving management to achieve optimal control of asthma.
Study site: Klinik Kesihatan Greentown, Ipoh, Perak, Malaysia

Matched MeSH terms: Asthma
Fulltext Non-compliance with inhaled corticosteroid (ICS) among asthma patients in Yazd City, Iran

Azam Rahim, Maimaiti, Namaitijiag, Abuduli, Maihebureti, Zafar Ahmed

Malaysian Journal of Public Health Medicine, 2013;13(2):77-87.
MyJurnal

Asthma is one of the most common chronic diseases in the world. It is estimated that around 300 million people in the world currently have asthma. The prevalence of asthma is increasing in most of countries, especially among children. The burden of severe asthma is considerable high in the Middle East courtiers including Iran. This study to investigate the effect of patients' knowledge about Inhaled Corticosteroids (ICS), attitude and health beliefs toward ICS, and behavioral intention to adhere to prescribed ICS in adult asthmatic patients in Yazd city, Iran. A cross sectional study was conducted from August 2008 to January 2009 in three private allergy and asthma clinics, located in Yazd city of Iran, using Structured face to face interviews using a questionnaire by the researcher. The results showed that the majority of patients (55.5%) were not adherent to their prescribed ICS. Patients’ knowledge toward ICS did not have effect on medication adherence behavior, while patients with positive attitude toward ICS were better adherent with their medication. Linear regression model identifies intention to comply with treatment and positive attitude toward ICS as predictors for adherence behavior. This study shows the relationship between medications beliefs, attitude, behavioral intention, and medication adherence. A better understanding of patient's medication beliefs, and attitude and their effect on compliance may help health care system to promote adherence.

Matched MeSH terms: Asthma
Fulltext A diagnostic workup of perioperative anaphylaxis reveals a selective type 1 hypersensitivity to cefazolin

Meera Thalayasingam, Shek, Lynette Pei-Chi

International e-Journal of Science, Medicine & Education, 2015;9(2):37-39.
MyJurnal

Anaphylaxis in the operating room although infrequent can be potentially fatal. The diagnosis of perioperative anaphylaxis is complex due to a multitude of factors. Firstly, patients under anesthesia cannot verbalize their complaints, the anesthetic agents themselves can alter vital parameters (e.g. heart rate and blood pressure) and cutaneous signs in a completely draped patient may be missed. Secondly, the differential diagnosis of intraoperative anaphylaxis is wide. Conditions such as asthma exacerbation, arrhythmia, hemorrhage, angioedema, mastocytosis, acute myocardial infarction, drug overdose, pericardial tamponade, pulmonary edema, pulmonary embolus, sepsis, tension pneumothorax, vasovagal reaction, venous air embolism, laryngospasm, blood transfusion reaction and malignant hyperthermia need to be considered. Thirdly, the diagnostic workup is challenging due to the multiple medications administered and other exposures encountered such as latex and chlorhexidene. However, through a timely allergy consultation and a systematic approach, identification of the culprit agent and safe alternatives can be established to prevent future occurrences as illustrated in the case below.

Matched MeSH terms: Asthma
Fulltext Association between house dust mite (HDM) sensitisation and asthma control using skin prick test and HDM antigen specific IgE levels in saliva of Malaysian children

Teo, Keat Seong, Cheah, Cheong Wooi, Mak, Joon Wah

International e-Journal of Science, Medicine & Education, 2015;9(2):3-12.
MyJurnal

Background: Sensitisation to house dust mite (HDM) has been regarded as a major risk factor for development of asthma. This study was carried out to investigate the profiles of HDM sensitisation among Malaysian children with asthma.
Material and Methods: The association between HDM sensitisation and control and severity of asthma was investigated. The salivary HDM specific IgE levels were quantified in different grades of control and severity of asthma in 125 unselected asthmatic children aged 5-12 years old attending the asthma follow-up clinic in Hospital Tuanku Ja’afar Seremban. An additional 29 non-asthmatic patients were selected as control. The skin prick test to assess sensitisation to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) was performed on all the participants. A questionnaire regarding the control and severity of asthmatic symptoms of the subject was administered. Saliva was collected by voluntary spitting and ELISA was used to quantify the IgE specific to HDM antigen.
Results: There was a significant association between sensitisation to DP and DF and the control of asthma. The association between DP sensitisation and severity of asthma just failed to reach a significant level although there is a clear trend for this. Significant association was found between DF sensitisation and severity. The HDM specific IgE in the saliva was significantly higher in asthmatic patients compared to non-asthmatic patients. There was no significant difference between the specific IgE levels in patients with different severity status of asthma.
Conclusion: Salivary IgE levels may not be an appropriate indicator of the patients’ asthmatic condition in this study. However, it can be concluded that there is significant association between the sensitisation of HDM and the control and severity of asthma.
Study site: Asthma clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia

Matched MeSH terms: Asthma
Fulltext A brief review on multimedia-based health education applications: current trend and future potential

Lua Pei Lin, Nor Khaira Wahida Khairuzzaman

Education in Medicine Journal, 2014;6(4):0-0.
MyJurnal

Objective: This paper intended to review and analyse relevant published articles which have studied or applied multimedia as the educational medium for patients or their caregivers. The benefits were also recorded.

Method: The search was performed across the databases EBSCO Host, Springer Link, Science Direct and PubMed for relevant studies. Only full-text articles using English as a language of publication were included. Eligible articles included any usage of multimedia intervention as health information delivery for patients or caregivers. No restriction for publication date was set to permit a wider capture.

Result: Twenty articles met the inclusion criteria involving a total of 1,797 respondents. The studies have been conducted in various countries mostly in North American region followed by Europe. The focused disease for each study varied from asthma to cognitive impairment but most were on cancer. Problems in caregiving and depression were also reported. The overall data suggested that the multimedia-based education had generated modest improvement in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Cost benefits were also recorded. Additionally, patients’ behavioural changes were well maintained in parallel with the intervention programme.

Conclusion: The evolution of multimedia as an educational medium is growing and its incorporation has benefited health education management especially in improving patients’ and their family’s psychosocial outcomes. However, due to still limited scientific evidence to support its value, further multimedia-based interventions should be developed out of the need to share information and knowledge among patients as well as caregivers.

Matched MeSH terms: Asthma
Fulltext Allergens derived from shrimp

Mary Margaret, P.D.S., Jinap, S., Ahmad Faizal, A.R.

International Food Research Journal, 2015;22(5):1751-1754.
MyJurnal

Allergy caused by food is usually type 1 allergy of four types of allergic reactions. One of the most widespread allergic is those that are caused by crustacean shellfish. Crustaceans are classified among arthropods which include crab, crayfish, lobster, prawn and shrimp. Shrimp which are broadly consumed as nutritional food is one of the most important food that contribute to allergy. Thus, reducing the allergenicity of shrimp allergen will be helpful to individuals who are sensitive to shrimp and for this reason the characteristics of each allergen need to be studied. Those sensitized individuals can develop urticaria, angiodema, laryngospasm, asthma and life threatening anaphylaxis. To date, four main allergens contribute to allergic reactions. They are tropomyosin (TM), a highly conserved and heat stable myofibrillar protein of 35-38 kDa followed by arginine kinase (AK) which is also known as Pen m 2 or Lit v 2 with 40 kDa. Two other contributing allergens are sarcoplasmic calcium-binding protein (SCP) also known as Lit v 4 with 22 kDa and myosin light chain (MLC) which is also termed as Lit v 3 with 20 kDa. This mini-review will provide a better understanding of each allergen derived from shrimp which subsequently will help to reduce the allergenicity.

Matched MeSH terms: Asthma

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