Displaying publications 21 - 40 of 1117 in total

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  1. Goh KL
    J Gastroenterol Hepatol, 2018 Jun;33(6):1177-1184.
    PMID: 29498759 DOI: 10.1111/jgh.14131
    The study of Helicobacter pylori in Malaysia has given several important insights into the epidemiology of the infection and pathogenesis of disease. Malaysia has a multiracial Asian population with three major Asian races living together-Malay, Chinese, and Indian. Races remain fairly distinct because of a paucity of interracial marriages. The "Racial Cohort Hypothesis" proposes that the infection occurs within racial groups rather than between. As such, the high prevalence among Indians (> 50%) and Chinese (40-50%) reflects the high prevalence in their countries of origin even though migration had taken place more than two generations before. The Malays have a comparatively low prevalence of about 10-20%. Despite the high prevalence of H. pylori, the Indians have a low gastric cancer incidence of less than 10 per 100 000 per year. This is in contrast to the Chinese who has an incidence in excess of 20 per 100 000 per year. We have called this the "Indian Enigma." The reason for this enigma is unclear and is the result of interaction between bacterial virulence factors, host susceptibility, and environmental factors. Phylogenetically, Chinese bacterial strains are distinct from Indians and Malays and are predominantly hpEastAsia/hsp EAsia. CagA EPIYA motifs among Chinese belong predominantly to the more virulent ABD motif. There is no clear distinguishing profile among host genetic factors. Environmental factors particularly diet may play an important role. Indians consume chilies and curries, which may be gastro protective, whereas Chinese consume more preserved and salted foods, which are thought to be carcinogenic.
    Matched MeSH terms: China/ethnology
  2. Chi C, Loy SL, Chan SY, Choong C, Cai S, Soh SE, et al.
    BMC Pregnancy Childbirth, 2018 03 21;18(1):69.
    PMID: 29562895 DOI: 10.1186/s12884-018-1707-3
    BACKGROUND: We assessed the impact of adopting the 2013 World Health Organization (WHO) diagnostic criteria on the rates of gestational diabetes (GDM), pregnancy outcomes and identification of women at future risk of type 2 diabetes.

    METHODS: During a period when the 1999 WHO GDM criteria were in effect, pregnant women were universally screened using a one-step 75 g 2-h oral glucose tolerance test at 26-28 weeks' gestation. Women were retrospectively reclassified according to the 2013 criteria, but without the 1-h glycaemia measurement. Pregnancy outcomes and glucose tolerance at 4-5 years post-delivery were compared for women with GDM classified by the 1999 criteria alone, GDM by the 2013 criteria alone, GDM by both criteria and without GDM by both sets of criteria.

    RESULTS: Of 1092 women, 204 (18.7%) and 142 (13.0%) were diagnosed with GDM by the 1999 and 2013 WHO criteria, respectively, with 27 (2.5%) reclassified to GDM and 89 (8.2%) reclassified to non-GDM when shifting from the 1999 to 2013 criteria. Compared to women without GDM by both criteria, cases reclassified to GDM by the 2013 criteria had an increased risk of neonatal jaundice requiring phototherapy (relative risk (RR) = 2.78, 95% confidence interval (CI) 1.32, 5.86); despite receiving treatment for GDM, cases reclassified to non-GDM by the 2013 criteria had higher risks of prematurity (RR = 2.17, 95% CI 1.12, 4.24), neonatal hypoglycaemia (RR = 3.42, 95% CI 1.04, 11.29), jaundice requiring phototherapy (RR = 1.71, 95% CI 1.04, 2.82), and a higher rate of abnormal glucose tolerance at 4-5 years post-delivery (RR = 3.39, 95% CI 2.30, 5.00).

    CONCLUSIONS: Adoption of the 2013 WHO criteria, without the 1-h glycaemia measurement, reduced the GDM rate. Lowering the fasting glucose threshold identified women who might benefit from treatment, but raising the 2-h threshold may fail to identify women at increased risk of adverse pregnancy and future metabolic outcomes.

    TRIAL REGISTRATION: NCT01174875 . Registered 1 July 2010 (retrospectively registered).

    Matched MeSH terms: China/ethnology
  3. Zhan X, Adnan A, Zhou Y, Khan A, Kasim K, McNevin D
    Sci Rep, 2018 03 16;8(1):4673.
    PMID: 29549272 DOI: 10.1038/s41598-018-22975-6
    The Xinjiang Uyghur Autonomous Region of China (XUARC) harbors 47 ethnic groups including the Manchu (MCH: 0.11%), Mongols (MGL: 0.81%), Kyrgyz (KGZ: 0.86%) and Uzbek (UZK: 0.066%). To establish DNA databases for these populations, allele frequency distributions for 15 autosomal short tandem repeat (STR) loci were determined using the AmpFlSTR Identifiler PCR amplification kit. There was no evidence of departures from Hardy-Weinberg equilibrium (HWE) in any of the four populations and minimal departure from linkage equilibrium (LE) for a very small number of pairwise combinations of loci. The probabilities of identity for the different populations ranged from 1 in 1.51 × 1017 (MCH) to 1 in 9.94 × 1018 (MGL), the combined powers of discrimination ranged from 0.99999999999999999824 (UZK) to 0.9999999999999999848 (MCH) and the combined probabilities of paternal exclusion ranged from 0.9999979323 (UZK) to 0.9999994839 (MCH). Genetic distances, a phylogenetic tree and principal component analysis (PCA) revealed that the MCH, KGZ and UZK are genetically closer to the Han population of Liaoning and the Mongol population of Mongolia while the MGL are closer to Han, Japanese, Korean, Malaysian, Hong Kong Han and Russians living in China.
    Matched MeSH terms: China/ethnology
  4. Vaingankar JA, Subramaniam M, Tan LWL, Abdin E, Lim WY, Wee HL, et al.
    BMC Med Res Methodol, 2018 03 15;18(1):29.
    PMID: 29544448 DOI: 10.1186/s12874-018-0487-9
    BACKGROUND: Measures of mental well-being and positive mental health (PMH) have been largely developed and used in Western populations, however, data on representative Asian communities are lacking. Using data from a population sample, this study sought to establish psychometric properties and norms of the PMH Instrument (PMH-I), a measure of positive mental health developed in Singapore.

    METHODS: We conducted a nationally representative survey among 1925 adults aged 18-79 years of Chinese, Malay, Indian or other ethnicity. Participants reported socio-demographic characteristics and completed the PMH-I along with measures of health-related quality of life (HRQoL) and psychological distress. Construct validity of the PMH-I was assessed using confirmatory factor analysis and concurrent validity was tested through correlation with other psychological measures. Normative PMH values and differences in population subgroups were estimated.

    RESULTS: The six-factor-higher-order structure of the PMH-I comprising six subscales of general coping, emotional support, spirituality, interpersonal skills, personal growth and autonomy and global affect was confirmed. Concurrent validity was shown through significant positive correlation of the total PMH score and its subscales with HRQoL and an inverse correlation with psychological distress. Weighted age, gender and ethnicity-specific norms were derived for the Singapore population. Total PMH was significantly higher in participants aged over 40 years as compared with 18-29 year olds and in non-Chinese ethnic groups as compared with Chinese. These differences were observed for all PMH-I subscales, with the exception of emotional support and interpersonal skills score differences by age. In contrast, gender, marital status, and education level were significantly associated with some of the subscales, but not with total PMH.

    CONCLUSIONS: These results support the psychometric properties of the PMH-I in a multi-ethnic Asian population sample. The generalizable population-based norms support the application of the PMH-I for measuring mental health and assessing its determinants within the Singapore general population.

    Matched MeSH terms: China/ethnology
  5. Jabir RS, Ho GF, Annuar MABA, Stanslas J
    Biomarkers, 2018 Mar;23(2):142-146.
    PMID: 28554261 DOI: 10.1080/1354750X.2017.1334152
    CONTEXT: Rash and oral mucositis are major non-haematological adverse events (AEs) of docetaxel, in addition to fatigue, nausea, vomiting and diarrhoea, which restrict the use of the drug in cancer therapy. Alpha-1-acid glycoprotein (AAG) is an acute phase reactant glycoprotein and is a primary carrier of docetaxel in the blood. Docetaxel has extensive binding (>98%) to plasma proteins such as AAG, lipoproteins and albumin.

    OBJECTIVE: To study the association between plasma AAG level and non-haematological AEs of docetaxel in Malaysian breast cancer patients of three major ethnic groups (Malays, Chinese and Indians).

    MATERIALS AND METHODS: One hundred and twenty Malaysian breast cancer patients receiving docetaxel as single agent chemotherapy were investigated for AAG plasma level using enzyme-linked immunosorbent assay technique. Toxicity assessment was determined using Common Terminology Criteria of Adverse Events v4.0. The association between AAG and toxicity were then established.

    RESULTS: There was interethnic variation of plasma AAG level; it was 182 ± 85 mg/dl in Chinese, 237 ± 94 mg/dl in Malays and 240 ± 83 mg/dl in Indians. It was found that low plasma levels of AAG were significantly associated with oral mucositis and rash.

    CONCLUSIONS: This study proposes plasma AAG as a potential predictive biomarker of docetaxel non-haematological AEs namely oral mucositis and rash.

    Matched MeSH terms: China/ethnology
  6. Cheah CSL, Leung CYY, Bayram Özdemir S
    Child Dev, 2018 03;89(2):383-396.
    PMID: 28105633 DOI: 10.1111/cdev.12725
    This study examined the social-cognitive reasoning of 52 Chinese Malaysian preadolescents (9-12 years old; M = 11.02, SD = 0.94) and 68 adolescents (13-18 years old; M = 14.76, SD = 1.39) in resolving filial dilemmas within the personal and moral domain. Preadolescents deferred to parental authority, whereas adolescents endorsed filial obligation reasoning to justify compliance in the personal domain. Both appealed to filial obligation, pragmatic, or welfare and safety reasoning to justify compliance but fairness or rights reasoning to justify their noncompliance, for the moral issue. Distinctions between authoritarian and reciprocal filial piety reasoning were revealed. Findings demonstrated complex decision-making and cognitive reasoning processes among Chinese Malaysian adolescents as they negotiate their filial obligations and autonomy development.
    Matched MeSH terms: China/ethnology
  7. Heng J, Quan J, Sim LW, Sanmugam S, Broekman B, Bureau JF, et al.
    Attach Hum Dev, 2018 Feb;20(1):24-42.
    PMID: 28840781 DOI: 10.1080/14616734.2017.1365912
    Past research indicates that socioeconomic status (SES) accounts for differences in sensitivity across ethnic groups. However, comparatively little work has been conducted in Asia, with none examining whether ethnicity moderates the relation between SES and sensitivity. We assessed parenting behavior in 293 Singaporean citizen mothers of 6-month olds (153 Chinese, 108 Malay, 32 Indian) via the Maternal Behavioral Q-Sort for video interactions. When entered into the same model, SES (F(1,288) = 17.777, p 
    Matched MeSH terms: China/ethnology
  8. Gilcharan Singh HK, Lee VKM, Barua A, Mohd Ali SZ, Chee WSS
    Malays J Nutr, 2018;24(3):427-440.
    MyJurnal
    Introduction: Self-efficacy for eating predicts successful weight loss and maintenance in Type 2 Diabetes Mellitus (T2DM) individuals. The Weight Efficacy
    Lifestyle (WEL) questionnaire determines self-efficacy for controlling eating. This study aims to validate the Malay-translated version of the WEL questionnaire and
    to establish the cut-off scores to define the level of eating self-efficacy in Malaysian T2DM individuals.
    Methods: A total of 334 T2DM individuals, aged 55.0±9.0 years, were recruited from a primary healthcare clinic based on sampling ratio. Medical records were reviewed for eligibility. Inclusion criteria included BMI ≥23kg/m2, and no severe diabetes complications. The WEL questionnaire assessed eating resistance during negative emotions, food availability, social pressure, physical discomfort and positive activities, and was back translated into Malay language. Self-efficacy was rated on a 0-9 scale with higher WEL scores indicating greater self-efficacy to resist eating. Factor analysis established the factor structure of the WEL questionnaire. Inter-item and item-total correlations determined construct validity while internal consistency described the reliability of the structure.
    Results: A two-factor structure accounting for 49% of variance was obtained, and it had adequate reliability, as indicated by Cronbach’s α of 0.893 and 0.781 respectively. Item-total correlations of r>0.700, p<0.01 and inter-item correlations of r<0.500, p<0.01 demonstrated construct validity. Cut-off scores of ≥44 and ≥32, respectively for factor one and two defined high eating self-efficacies in T2DM individuals.
    Conclusion: The Malaytranslated version of the WEL questionnaire appears to be a valid and reliable tool to assess self-efficacy for controlling eating behaviour in Malaysian T2DM population.
    Keywords: Diabetes, eating self-efficacy, Malay, reliability, validity
    Matched MeSH terms: China/ethnology
  9. Lim HW
    Clin Linguist Phon, 2018;32(10):889-912.
    PMID: 29993293 DOI: 10.1080/02699206.2018.1459852
    Child multilingual phonological errors are under-explored. Cross-linguistic studies suggest monolingual children make phonological errors that are subject to effects of language universality and ambient language characteristics. Bilingual Chinese children were observed to use not only typical, but also atypical phonological errors compared to monolingual peers acquiring similar languages. Atypical errors are a result of specific bilingual pair effects. Close-language-relatedness (Cantonese-Mandarin) is claimed to be responsible for the nonexistence of atypical errors in both languages, whilst distant-language-relatedness (Cantonese-English) is observed to cause atypical errors in both languages. The present novel cross-sectional study investigated phonological acquisition in three typologically distant languages: English-Mandarin-Malay by 64 multilingual Chinese children aged 2½-4½. The present research aimed to explore if multilingual Chinese children exhibit phonological errors which commensurate to that of monolingual and bilingual Chinese children acquiring similar languages as described in the literature. The single-word phonological test results revealed that the multilinguals exhibited typical and atypical phonological patterns which largely commensurate with the monolinguals and bilinguals. Similar to bilingual children, the multilingual children showed more atypical errors in English than in Mandarin, demonstrating effects of individual language irrespective of potential interaction with additional languages. The present result did not fully support the link between closeness in typology of languages and the absence of atypical errors. Rare atypical errors were found in Mandarin and Malay, two typologically different languages, and both were also interacting with English, another typologically different language. The present findings provided useful preliminary multilingual speech norms for the use of speech therapists.
    Matched MeSH terms: China/ethnology
  10. Ikmal Hisyam Bakrin, Hasni Mahayidin, Khairul Shakir Ab Rahman, Wan Irnawati Wan Ab Rahman, Sazali Satari, Asrul Fahmi Azizan
    MyJurnal
    Lipoma arborescens is a non-neoplastic, reactive condition due to chronic synovial inflammation and irritation, characterized by frond-like or villous proliferation of mature adipose tissue covered by hyperplastic synovium. The knee is the most commonly affected site particularly the suprapatellar pouch. We report a case of lipoma arborescens affecting the right knee of an elderly Chinese gentleman associated with bilateral knee and hand osteoarthritis. He presented with progressive worsening of right knee swelling and pain. Partial synovectomy of the right knee was performed and no lesion recurrence was noted at one year post-operation. The clinical and imaging findings, pathological features, together with differential diagnoses were discussed.
    Matched MeSH terms: China/ethnology
  11. Chan, S.C., Teoh, L.C.
    MyJurnal
    The non-structural protein 1 (NS1) of the dengue viral genome has been found useful for diagnosis of acute dengue infections, being detected from one day and up to 18 days post onset of symptoms (1). Rapid Dengue NS1 antigen test was made available in commercial test kits for private clinics in Perak in 2014. This study aimed to determine the use usefulness of dengue NS1 test kits in suspected dengue cases in a general practice clinic in Perak and the period in which positive test results were obtained after the onset of symptoms. Clinic records of all suspected dengue cases seen in the ten months from October 2014 to July 2015 were traced. Patients’ demographic characteristics, presenting symptoms and the use of One Step Dengue NS1 Antigen test (Avo Diagnostics) were analyzed using SPSS version 17. Seventy one suspected dengue fever cases were seen in the study period, the highest number in July 2015 (25%). Majority were Chinese (80%), female (63%), and aged 40 years and above (51%). Most patients presented with fever (99%), body-ache (51%), gastrointestinal symptoms (51%) and headache (44%). Dengue NS1 antigen test was done in 94% of the suspected cases with 61% testing positive. The majority of the cases presenting one day to five days after onset of symptoms tested positive i.e. 59% (1 day), 90% (2 days), 54% (3-4 days) and 89% (5 days). Using dengue NS1 antigen test, positive results can be obtained as early as one day after the onset of symptoms. This test is a useful tool to aid primary care physicians detect dengue fever early.
    Matched MeSH terms: China/ethnology
  12. Hairol MI, Arif N, Mohd Shariffudin SH
    Jurnal Sains Kesihatan Malaysia, 2018;16(1):103-108.
    MyJurnal
    Patient’s appointment compliance refers to the willingness and ability of a patient to attend to their scheduled clinical appointment. Failure to do so have various consequences, especially so for a teaching clinic such as the Optometry Clinic, Universiti Kebangsaan Malaysia (UKM). The percentage of appoinment compliance at the Optometry Clinic was analysed from September to December 2015. Compliance rate was categorised based on clinic type and session, and on patient’s gender and ethnicity. Attendance compliance was around 60% for the Primary Care Clinic. It increased to 70% for patients with vision problems who where referred to specialty clinics i.e. Low Vision and Paediatric Clinics. Clinic day and session did not influence compliance significanly (p > 0.05). Patient’s gender and ethnicity did not influence compliance significantly as well but those of Indian ethnicity consistently showed the lowest appointment compliance rates. A protocol should be developed to increase the rate of patients’ appoinment compliance. This would then maximise productivity of students and clinic staff and optimise the clinic’s resources. The cost of each clinical session could be informed to the patients, even when the cost is not borne by them.
    Keywords: Appointment compliance; Optometry Clinic; appointments; clinical teaching and learning; public health
    Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: China/ethnology
  13. Leelavathi M, Teh Rohaila J, Thenmolle A, Mohamad Salehuddin MS, Barathan M, Natasha PJ, et al.
    Medicine & Health, 2018;13(2):72-82.
    MyJurnal
    Diabetes requires dedicated self-management to be able to achieve good control and outcome as this is a lifelong condition. The internet offers an amazing wealth of health information which may influence diabetes self-management. The aim of this study was to determine the prevalence of online health information seeking among people with diabetes and its associated factors. About 380 participants answered the online health information seeking questionnaire developed from literature search and expert panel review. Diabetes Self-Management was assessed using the Diabetes Self-Management Questionnaire (DSMQ). The prevalence of online health information seeking among people with diabetes was 38.4%. Common information sought included diabetes treatment (82.9%) lifestyle modification (77.4%) and diabetes prevention (67.3%). A large majority (93.1%) felt that the online information on diabetes was useful. Doctors and printed reading materials were the most common sources of information for diabetes (94.2% & 65.3%). Lower median age (59 years, IQR = 11), having a family member with diabetes, (COR = 1.188) tertiary education (COR = 6.037) and those who are employed (COR = 3.880) have higher odds of seeking online diabetes related health information. However, there was no significant association between online health information seeking and diabetes self-management. Prevalence of online health information seeking among people with diabetes was at an acceptable level. However, it was not associated with optimal diabetic self-management. Doctors and printed information remain as popular sources of information and hence should be maintained.
    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

    Matched MeSH terms: China/ethnology
  14. Whitton C, Ho JCY, Tay Z, Rebello SA, Lu Y, Ong CN, et al.
    Nutrients, 2017 Sep 25;9(10).
    PMID: 28946670 DOI: 10.3390/nu9101059
    The assessment of diets in multi-ethnic cosmopolitan settings is challenging. A semi-quantitative 163-item food frequency questionnaire (FFQ) was developed for the adult Singapore population, and this study aimed to assess its reproducibility and relative validity against 24-h dietary recalls (24 h DR) and biomarkers. The FFQ was administered twice within a six-month interval in 161 adults (59 Chinese, 46 Malay, and 56 Indian). Fasting plasma, overnight urine, and 24 h DR were collected after one month and five months. Intra-class correlation coefficients between the two FFQ were above 0.70 for most foods and nutrients. The median correlation coefficient between energy-adjusted deattenuated FFQ and 24 h DR nutrient intakes was 0.40 for FFQ1 and 0.39 for FFQ2, highest for calcium and iron, and lowest for energy and carbohydrates. Significant associations were observed between urinary isoflavones and soy protein intake (r = 0.46), serum carotenoids and fruit and vegetable intake (r = 0.34), plasma eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) and fish/seafood intake (r = 0.36), and plasma odd chain saturated fatty acids (SFA) and dairy fat intake (r = 0.25). Associations between plasma EPA + DHA and fish/seafood intake were consistent across ethnic groups (r = 0.28-0.49), while differences were observed for other associations. FFQ assessment of dietary intakes in modern cosmopolitan populations remains feasible for the purpose of ranking individuals' dietary exposures in epidemiological studies.
    Matched MeSH terms: China/ethnology
  15. Thumboo J, Wu L, Leung YY
    Int J Rheum Dis, 2017 Sep;20(9):1105-1119.
    PMID: 26990791 DOI: 10.1111/1756-185X.12843
    OBJECTIVES: Hand osteoarthritis (HOA) is common but little is known about how HOA has impact on disability and quality of life (QoL).We aim to identify important domains of concern among participants suffering from symptomatic HOA in Singapore, representing an Asian socio-cultural context.
    METHODS: A qualitative study using a focus group technique was performed. We ran focus groups stratified by gender, ethnicity and language. Two independent, trained analysts identified relevant categories and assigned codes to text segments through open coding, with discrepancies resolved through consensus. The final lists of domains and subthemes descriptive of QoL were then compared to the following commonly used HOA specific instruments: Functional Index for Hand Osteoarthritis (FIHOA), Score for Assessment and quantification of Chronic Rheumatic Affections of the Hand (SACRAH), Australian/Canadian Hand Osteoarthritis Index (AUSCAN); and Health Assessment Questionnaire (HAQ).
    RESULTS: Twenty-six patients (23 women, three men; 24 Chinese and two Malay; mean ± SD age 62.9 ± 7.5 years) with symptomatic HOA according to the American College of Rheumatology Classification Criteria participated in seven focus groups. Two and five focus groups were conducted in Chinese and English, respectively. The qualitative analysis revealed pain, stiffness and functional disability as the main domains. However, psychological consequences, aesthetic concerns, participation in leisure activities, participation in family roles were important concepts from the focus groups which were not covered by existing instruments. Impact on work productivity by HOA and the unmet health care need is revealed.
    CONCLUSION: The domains of concepts important to people with HOA in an Asian socio-cultural context are not fully represented in the most commonly used instruments. Further studies on the selection of main domains relevant to HOA patients are necessary.
    Study site: Rheumatology outpatient clinic, Singapore General Hospital
    Matched MeSH terms: China/ethnology
  16. Othman MA, Ghazali WSW, Hamid WZWA, Wong KK, Yahya NK
    Saudi Med J, 2017 Sep;38(9):934-941.
    PMID: 28889152 DOI: 10.15537/smj.2017.9.20841
    OBJECTIVES: To evaluate levels of anti-carbamylated protein (anti-CarP) antibodies in rheumatoid arthritis (RA) patients and to determine their association with serological parameters and disease activity. Methods: A cross-sectional study involving 105 multiethnic RA patients (48 rheumatoid factor [RF]-positive and 57 RF-negative patients) was conducted at Hospital Universiti Sains Malaysia, Kelantan, Malaysia, from January 2015 to February 2016. Fifty healthy controls (HCs) were included. C-reactive protein (CRP), RF, anti-cyclic citrullinated peptide (anti-CCP) and anti-CarP antibodies were measured. A health assessment questionnaire (HAQ) was administered to the study participants and 28-joint Disease Activity Score (DAS28) were obtained. Results: The level of anti-CarP antibodies was significantly increased in the RA patients compared with HCs (p=0.042). The presence of anti-CarP antibodies was significantly associated with RF (p=0.019) and the HAQ (p=0.010). A significant association between the presence of anti-CarP antibodies and the DAS28 was not found (p=0.632). Conclusion: Our study provides further evidence that the level of anti-CarP antibodies is significantly elevated in RA patients.

    Study site: Rheumatology clinic, Hospital Universiti Sains Malaysia
    Matched MeSH terms: China/ethnology
  17. Yeap SS, Nur Fazirah MFR, Nur Aisyah C, Zahari Sham SY, Samsudin IN, C Thambiah S, et al.
    Osteoporos Sarcopenia, 2017 Jun;3(2):112-116.
    PMID: 30775514 DOI: 10.1016/j.afos.2017.05.001
    Objective: Following an osteoporotic fracture, pharmacological treatment is recommended to increase bone mineral density and prevent future fractures. However, the rate of starting treatment after an osteoporotic hip fracture remains low. The objective of this study was to survey the treatment rate following a low-trauma hip fracture at a tertiary private hospital in Malaysia over a period of 5 years.

    Methods: The computerised hospital discharge records were searched using the terms "hip," "femur," "femoral," "trochanteric," "fracture," or "total hip replacement" for all patients over the age of 50, admitted between 2010 and 2014. The medical charts were obtained and manually searched for demographic data and treatment information. Hip operations done for non-low-trauma-related fracture and arthritis were excluded.

    Results: Three hundred seventy patients over the age of 50 years were admitted with a hip fracture, of which 258 (69.7%) were low trauma, presumed osteoporotic, hip fractures. The median age was 79.0 years (interquartile range [IQR], 12.0). Following a hip fracture, 36.8% (95 of 258) of the patients received treatment, but out of these, 24.2% (23 of 95) were on calcium/vitamin D only. The median duration of treatment was 1 month (IQR, 2.5). In 2010, 56.7% of the patients received treatment, significantly more than subsequent years 2011-2014, where approximately only 30% received treatment.

    Conclusions: Following a low-trauma hip fracture, approximately 72% of patients were not started on active antiosteoporosis therapy. Of those who were, the median duration of treatment was 1 month. This represents a missed opportunity for the prevention of future fractures.
    Matched MeSH terms: China/ethnology
  18. Chia YC, Ching SM, Lim HM
    J Hypertens, 2017 05;35 Suppl 1:S50-S56.
    PMID: 28350621 DOI: 10.1097/HJH.0000000000001333
    OBJECTIVES: The current study aims to determine the relationship of long-term visit-to-visit variability of SBP to cardiovascular disease (CVD) in a multiethnic primary care setting.
    METHOD: This is a retrospective study of a cohort of 807 hypertensive patients over a period of 10 years. Three-monthly clinic blood pressure readings were used to derive blood pressure variability (BPV), and CVD events were captured from patient records.
    RESULTS: Mean age at baseline was 57.2 ± 9.8 years with 63.3% being women. The BPV and mean SBP over 10 years were 14.7 ± 3.5 and 142 ± 8 mmHg, respectively. Prevalence of cardiovascular event was 13%. In multivariate logistic regression analysis, BPV was the predictor of CVD events, whereas the mean SBP was not independently associated with cardiovascular events in this population. Those with lower SBP and lower BPV had fewer cardiovascular events than those with the same low mean SBP but higher BPV (10.5 versus 12.8%). Similarly those with higher mean SBP but lower BPV also had fewer cardiovascular events than those with the same high mean and higher BPV (11.6 versus 16.7%). Other variables like being men, diabetes and Indian compared with Chinese are more likely to be associated with cardiovascular events.
    CONCLUSION: BPV is associated with an increase in CVD events even in those who have achieved lower mean SBP. Thus, we should prioritize not only control of SBP levels but also BPV to reduce CVD events further.
    Matched MeSH terms: China/ethnology
  19. Venugopal Y, Hatta SFWM, Musa N, Rahman SA, Ratnasingam J, Paramasivam SS, et al.
    Asia Pac J Clin Nutr, 2017 May;26(3):412-420.
    PMID: 28429905 DOI: 10.6133/apjcn.042016.10
    BACKGROUND AND OBJECTIVES: Vitamin D3 (cholecalciferol) dose required to maintain sufficiency in non- Caucasian women with postmenopausal osteoporosis (PMO) inthe tropics has not been well studied. Some guidelines mandate 800-1000 IU vitamin D/day but the Endocrine Society (US) advocates 1500-2000 IU/day to maintain 25-hydroxyvitamin-D (25(OH)D) concentration at >75 nmol/L. We aimed to establish oral cholecalciferol dose required to maintain 25(OH)D concentration at >75 nmol/L in PMO Chinese Malaysian women, postulating lower dose requirements amongst light-skinned subjects in the tropics.

    METHODS AND STUDY DESIGN: 90 Chinese Malaysian PMO women in Kuala Lumpur, Malaysia (2°30'N) with baseline serum 25(OH)D levels >=50 nmol/L were recruited. Prior vitamin D supplements were discontinued and subjects randomized to oral cholecalciferol 25,000 IU/4-weekly (Group-A) or 50,000 IU/4-weekly (Group- B) for 16 weeks, administered under direct observation. Serum 25(OH)D, PTH, serum/urinary calcium were measured at baseline, 8 and 16 weeks.

    RESULTS: Baseline characteristics, including osteoporosis severity, sun exposure (~3 hours/week), and serum 25(OH)D did not differ between treatment arms. After 16 weeks, 91% of women sufficient at baseline, remained sufficient on 25,000 IU/4-weekly compared with 97% on 50,000 IU/4-weekly with mean serum 25(OH)D 108.1±20.4 and 114.7±18.4 SD nmol/L respectively (p=0.273). At trial's end, 39% and 80% of insufficient women at baseline attained sufficiency in Group A and Group B (p=0.057). Neither dose was associated with hyperparathyroidism or toxicity.

    CONCLUSIONS: Despite pretrial vitamin D supplementation and adequate sun exposure, 25.6% Chinese Malaysian PMO women were vitamin D insufficient indicating sunshine alone cannot ensure sufficiency in the tropics. Both ~900 IU/day and ~1800 IU/day cholecalciferol can safely maintain vitamin D sufficiency in >90% of Chinese Malaysian PMO women. Higher doses are required with baseline concentration <75 nmol/L.
    Matched MeSH terms: China/ethnology
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