Displaying publications 21 - 40 of 245 in total

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  1. Chew ST, Gallagher JB
    Sci Rep, 2018 02 07;8(1):2553.
    PMID: 29416101 DOI: 10.1038/s41598-018-20644-2
    The canopies and roots of seagrass, mangrove, and saltmarsh protect a legacy of buried sedimentary organic carbon from resuspension and remineralisation. This legacy's value, in terms of mitigating anthropogenic emissions of CO2, is based on total organic carbon (TOC) inventories to a depth likely to be disturbed. However, failure to subtract allochthonous recalcitrant carbon overvalues the storage service. Simply put, burial of oxidation-resistant organics formed outside of the ecosystem provides no additional protection from remineralisation. Here, we assess whether black carbon (BC), an allochthonous and recalcitrant form of organic carbon, is contributing to a significant overestimation of blue carbon stocks. To test this supposition, BC and TOC contents were measured in different types of seagrass and mangrove sediment cores across tropical and temperate regimes, with different histories of air pollution and fire together with a reanalysis of published data from a subtropical system. The results suggest current carbon stock estimates are positively biased, particularly for low-organic-content sandy seagrass environs, by 18 ± 3% (±95% confidence interval) and 43 ± 21% (±95% CI) for the temperate and tropical regions respectively. The higher BC fractions appear to originate from atmospheric deposition and substantially enrich the relatively low TOC fraction within these environs.
    Matched MeSH terms: Confidence Intervals
  2. Khachatryan V, Sirunyan AM, Tumasyan A, Adam W, Asilar E, Bergauer T, et al.
    Eur Phys J C Part Fields, 2016;76(7):401.
    PMID: 28286414 DOI: 10.1140/epjc/s10052-016-4219-1
    A measurement of the W boson pair production cross section in proton-proton collisions at [Formula: see text] TeV is presented. The data collected with the CMS detector at the LHC correspond to an integrated luminosity of 19.4[Formula: see text]. The [Formula: see text] candidates are selected from events with two charged leptons, electrons or muons, and large missing transverse energy. The measured [Formula: see text] cross section is [Formula: see text], consistent with the standard model prediction. The [Formula: see text] cross sections are also measured in two different fiducial phase space regions. The normalized differential cross section is measured as a function of kinematic variables of the final-state charged leptons and compared with several perturbative QCD predictions. Limits on anomalous gauge couplings associated with dimension-six operators are also given in the framework of an effective field theory. The corresponding 95 % confidence level intervals are [Formula: see text], [Formula: see text], [Formula: see text], in the HISZ basis.
    Matched MeSH terms: Confidence Intervals
  3. Mohd Salleh NA, Richardson L, Kerr T, Shoveller J, Montaner J, Kamarulzaman A, et al.
    J Addict Med, 2018 3 10;12(4):308-314.
    PMID: 29521670 DOI: 10.1097/ADM.0000000000000403
    OBJECTIVES: Among people living with HIV (PLWH), high levels of adherence to prescribed antiretroviral therapy (ART) is required to achieve optimal treatment outcomes. However, little is known about the effects of daily pill burden on adherence amongst PLWH who use drugs. We sought to investigate the association between daily pill burden and adherence to ART among members of this key population in Vancouver, Canada.

    METHODS: We used data from the AIDS Care Cohort to Evaluate Exposure to Survival Services study, a long-running community-recruited cohort of PLWH who use illicit drugs linked to comprehensive HIV clinical records. The longitudinal relationship between daily pill burden and the odds of ≥95% adherence to ART among ART-exposed individuals was analyzed using multivariable generalized linear mixed-effects modeling, adjusting for sociodemographic, behavioural, and structural factors linked to adherence.

    RESULTS: Between December 2005 and May 2014, the study enrolled 770 ART-exposed participants, including 257 (34%) women, with a median age of 43 years. At baseline, 437 (56.7%) participants achieved ≥95% adherence in the previous 180 days. Among all interview periods, the median adherence was 100% (interquartile range 71%-100%). In a multivariable model, a greater number of pills per day was negatively associated with ≥95% adherence (adjusted odds ratio [AOR] 0.87 per pill, 95% confidence interval [CI] 0.84-0.91). Further analysis showed that once-a-day ART regimens were positively associated with optimal adherence (AOR 1.39, 95% CI 1.07-1.80).

    CONCLUSIONS: In conclusion, simpler dosing demands (ie, fewer pills and once-a-day single tablet regimens) promoted optimal adherence among PLWH who use drugs. Our findings highlight the need for simpler dosing to be encouraged explicitly for PWUD with multiple adherence barriers.

    Matched MeSH terms: Confidence Intervals
  4. Lim OW, Yong CC
    Malays J Med Sci, 2019 Sep;26(5):98-112.
    PMID: 31728122 MyJurnal DOI: 10.21315/mjms2019.26.5.9
    Background: The prevalence of known hypertension has resulted from the progression of undiagnosed hypertension. This study is targeted to examine and compare the risk factors based on the estimated odds ratios of modifiable and non-modifiable risk factors on different outcome levels of hypertension.
    Methods: A nationwide representative secondary data from the Fourth National Health of Morbidity Survey (NHMS IV) which consists of 24,632 non-institutionalised Malaysian population conducted by the Ministry of Health in 2011 has been used. Odds ratio (OR) with 95% confidence interval has been estimated using multinomial logistic regression.
    Results: Obese and overweight respondents exhibit increased likelihood of having undiagnosed and known hypertension. Physically inactive, ex-smokers and unclassified drinkers are found having higher likelihood to have known hypertension. However, current drinkers are found to have higher likelihood of having undiagnosed hypertension. Elderly, retirees, home makers and lower educated respondents are shown higher odds to have undiagnosed hypertension. Likewise, the likelihood of having known hypertension has been found to increase among the elderly and other Bumiputra.
    Conclusion: Through this research, significant predictors which consist of obese and overweight respondents, current drinkers, older respondents (above 65 years old) and primary educated respondents are having higher likelihood to have undiagnosed hypertension.
    Study name: National Health and Morbidity Survey (NHMS-2011)
    Matched MeSH terms: Confidence Intervals
  5. Naing C, Aung K, Mak JW
    J Evid Based Med, 2012 Nov;5(4):232-7.
    PMID: 23557504 DOI: 10.1111/jebm.12002
    In translating clinical research into practice, the summarization of data from randomized trials in terms of measures of effect to be readily appreciated by the point-of-care clinicians is important. In this context, the body of literature highlighted the 'number needed to treat' as a useful measure. The objectives of our study were to assess how meta-analyses described number needed to treat and corresponding 95% CI, and to explore issues related to reporting number needed to treat in the selected meta-analyses.
    Matched MeSH terms: Confidence Intervals
  6. Piros Kulandasamy Pillai C, Yoshida Y, Justin Lawrence P, Yamamoto E, Reyer JA, Hamajima1 N
    Nagoya J Med Sci, 2016 02;78(1):9-17.
    PMID: 27019524
    Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH. This study aimed to determine the demographic incidence of congenital heart diseases of patients in this program and to evaluate the outcome of the program in association with post-operative mortality rate and the beneficial factors of the program. In this study, 241 patients who participated in this program from August 2008 to September 2012 were reviewed. Fisher's exact tests were applied to calculate p-values of categorical data. Out of 241, 11 patients were rejected because of their poor health condition for flight transportation to India, leaving 230 patients for analysis. The majority of patients were 1 to 4 years of age (57.8%), Malays (61.7%), from families of monthly household income less than RM 1,500 (86.5%) and with primary school-educated parents (86.5%). Patients could apply from any government hospital in Malaysia, but 34.8% of the patients were from the state of Johor. The region (Peninsular Malaysia and East Malaysia) of patients seeking pediatric cardiac services was significantly associated with race (p<0.001), low household income (p<0.001) and low education background of parents (p=0.004). The associations between the age group and diagnosis group (p=0.010) and between duration of hospitalization and outcome of medical management (p=0.013) were significant. Post-operative mortality rate was 1.7% (95% confidence interval, 0.5-4.4). In conclusion, the patients and the government were considered to have benefited from the PCP.
    Matched MeSH terms: Confidence Intervals
  7. Ahmad N, MuhdYusoff F, Ratnasingam S, Mohamed F, Nasir NH, MohdSallehuddin S, et al.
    PMID: 26000035
    Studying trends in mental health morbidity will guide the planning of future interventions for mental and public health services. To assess the trends in mental health problems among children and adolescents aged 5 through 15 years in Malaysia from 1996 to 2011, data from the children's mental health component of three population-based surveys was analysed using a two-stage stratified sampling design. Mental health problems were assessed using the Reporting Questionnaire for Children. The prevalence of mental health problems among children and adolescents aged 5 through 15 years showed an increasing trend from 13.0% (95% Confidence Interval [CI]: 11.5-14.6) in 1996 to 19.4% (95% CI: 18.5-20.3) in 2006 and 20.0% (95% CI: 18.8-21.3) in 2011. In 2011, male children and adolescents and those who were in less affluent families were significantly associated with mental health problems. The findings indicate that even though mental health problems among children and adolescents in Malaysia are increasing, the rate of increase has decreased in the past five years. Socially and economically disadvantaged groups were most vulnerable to mental health problems.
    Matched MeSH terms: Confidence Intervals
  8. Kwan Z, Lai YN, Ch'ng CC, Tan AH, Tan LL, Robinson S, et al.
    Med J Malaysia, 2015 Apr;70(2):81-5.
    PMID: 26162382 MyJurnal
    BACKGROUND: An association of bullous pemphigoid with neurological disorders has been reported. The objectives of this study were to review the clinical characteristics of patients with bullous pemphigoid and compare the association between bullous pemphigoid and various neurological disorders and comorbidities.

    METHODS: This was a retrospective case-control study involving 43 patients with bullous pemphigoid and 43 age-, sex- and ethnicity-matched controls.

    RESULTS: There was a statistically significant association between bullous pemphigoid and neurological disorders [Odds Ratio (OR) = 3.5, 95% Confidence Interval (CI) 1.3 to 9.2, p=0.011 and adjusted OR=3.5, 95% CI 1.2-10.3, p=0.026], in particular for dementia (p=0.002). Although stroke was more common among patients with bullous pemphigoid, this association was not statistically significant with OR of 1.9 (95% CI 0.7 to 5.2) and adjusted OR of 2.1 (95% CI 0.6 to 7.2). Similarly both ischaemic stroke (OR 1.5, 95% CI 0.5 to 4.2) and haemorrhagic stroke (OR 1.5, 95% CI 0.2 to 9.7) were more common. Other neurological disorders more common among patients with bullous pemphigoid were Parkinson's disease and epilepsy. Dyslipidaemia was significantly less common among patients with bullous pemphigoid (OR 0.4, 95% CI 0.1 to 0.9, p=0.033).

    CONCLUSION: A combination of an inflammatory process, prothrombotic state and endothelial activation leads to an increased frequency of neurological disorders among patients with bullous pemphigoid. Thus, a holistic approach to patient care, including screening for dementia and control of comorbidities, should be practised as bullous pemphigoid affects more than just the skin.
    Matched MeSH terms: Confidence Intervals
  9. Mohd Suan MA, Tan WL, Soelar SA, Ismail I, Abu Hassan MR
    Epidemiol Health, 2015;37:e2015017.
    PMID: 25868638 DOI: 10.4178/epih/e2015017
    OBJECTIVES: The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma.

    METHODS: Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer.

    RESULTS: Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008).

    CONCLUSIONS: The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.

    Matched MeSH terms: Confidence Intervals
  10. Erman Shah Jaios, Suzanah Abdul Rahman, Mooi, Ching Siew, Arifah Abdul Kadir, Mohd Nasir Mohd Desa, Zainul Amirudin Zakaria
    MyJurnal
    Objectives/Research Problem:Melastoma malabathricum L., (Melastomaceae) is a medicinally important plant known as “Senduduk”. Traditionally, the leaves are used to relieve diverse pain-related ailments. Present study aims to examine the antinociceptive activity of methanolic extract of M. malabathricum (MEMM) leaves and its fractions via in vivo models of nociception.

    Materials and Method: Extracts (100, 250, 500 mg/kg) were administered orally 60 minutes prior to subjection to the respective test, n=6/group. Evaluation of MEMM antinociceptive activity; chemically (acetic acid-induced abdominal constriction; ACT, formalin-induced paw licking test; FT) and thermally (hot plate test; HT) models of nociception and elucidation of mechanisms of action involved; role of opioid, vanilloid receptors, glutamatergic system and NO/cGMP pathway were determined. Continuously, MEMM, partitioned into three fractions: petroleum ether (PEMM), ethyl acetate (EAMM), and aqueous (AQMM) extracts and determine the most potent fraction. Therefore, experiment ED50 and its 95% confidence intervals (CI) values were conducted, and ACT was used to screen. Calculation, obtained, PEMM, the most effective was further used to assess the antinociceptive properties. Phytochemical screening, HPLC and GC-MS analysis were performed.

    Results and Discussion: First stage, MEMM exhibited significant (P
    Matched MeSH terms: Confidence Intervals
  11. Muhammad J, Muhamad R, Husain NRN, Daud N
    Korean J Fam Med, 2019 Jan;40(1):45-52.
    PMID: 30613064 DOI: 10.4082/kjfm.17.0136
    BACKGROUND: Pelvic floor muscle exercise is effective for pelvic floor muscle dysfunction. Despite the high prevalence of pelvic floor muscle dysfunction in women in the community, pelvic floor muscle exercise recognition is low in Malaysian society; thus, this intervention is not frequently used . This study assessed the knowledge of, attitudes towards, and use of pelvic floor muscle exercise among antenatal women before and after educational classes. The study also determined factors associated with exercise practice.

    METHODS: An interventional study was conducted in 121 antenatal women selected through systematic random sampling between June and December 2010. Baseline knowledge of, attitude towards, and practice of pelvic floor muscle exercise were assessed using self-administered validated questionnaires at first visit and at 2 months postpartum. All participants attended two exercise education classes on their next two visits before delivery. A paired ttest and multivariate analysis were used for data evaluation.

    RESULTS: The mean pre-intervention scores for knowledge, attitudes, and practice were 24.98, 24.25, and 3.51, respectively, with statistically significant mean score increments after intervention (P<0.001). The mean differences were 4.67 (95% confidence interval [CI], 3.86-5.49), 3.77 (95% CI, 3.05-4.50) and 3.45 (95% CI, 2.90-4.00) for knowledge, attitudes, and practice, respectively. Lack of baseline information on pelvic floor muscle exercise was significantly associated with practice change following an educational class.

    CONCLUSION: Education is effective in improving knowledge of, attitude towards, and practice of pelvic floor muscle exercise. There is a need for greater effort to increase exercise awareness in our community, especially during antenatal class.

    Matched MeSH terms: Confidence Intervals
  12. Wan Mohamed WMI, Sayuti SC, Draman N
    J Taibah Univ Med Sci, 2018 Oct;13(5):432-437.
    PMID: 31435358 DOI: 10.1016/j.jtumed.2018.06.004
    Objectives: The aim of this study was to determine the incidence of hypothyroidism and its associated factors within one-year post radioactive iodine (RAI) therapy.

    Methods: A retrospective study was conducted among patients with hyperthyroidism who received RAI therapy at Nuclear Medicine Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan. Data regarding patients' demographics, gender, aetiology of hyperthyroidism, presence of autoantibodies, dose of RAI used and usage of antithyroid drug post RAI therapy were included in the analysis.

    Results: Of a total of 167 screened patients, 137 subjects were eligible for this study. The incidence of hypothyroidism within one year of RAI therapy was 32.9%. Women were found to be less likely to develop hypothyroidism post RAI therapy (adjusted odds ratio, 0.406; 95% confidence interval: 0.181-0.908; p = 0.028). The usage of antithyroid drug post RAI was significantly associated with a lower incidence of hypothyroidism post RAI therapy (adjusted odds ratio, 0.188; 95% confidence interval: 0.081-0.438; p<0.001).

    Conclusion: This study showed a high incidence of hypothyroidism within one-year post RAI therapy. Gender and usage of antithyroid drug post RAI therapy are significantly associated with the development of hypothyroidism.

    Matched MeSH terms: Confidence Intervals
  13. Muhammad J, Jamial MM, Ishak A
    Korean J Fam Med, 2019 Sep;40(5):335-343.
    PMID: 30636386 DOI: 10.4082/kjfm.18.0026
    BACKGROUND: Home blood pressure monitoring is recommended to achieve controlled blood pressure. This study evaluated home blood pressure monitoring-improvement of office blood pressure control and treatment compliance among hypertensive patients.

    METHODS: A randomized controlled trial was conducted from December 2014 to April 2015. The home blood pressure monitoring group used an automatic blood pressure device along with standard hypertension outpatient care. Patients were seen at baseline and after 2 months. Medication adherence was measured using a novel validated Medication Adherence Scale (MAS) questionnaire. Office blood pressure and MAS were recorded at both visits. The primary outcomes included evaluation of mean office blood pressure and MAS within groups and between groups at baseline and after 2 months.

    RESULTS: Mean changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) and MAS differed significantly within groups. The home blood pressure monitoring group showed greater mean changes (SBP 17.6 mm Hg, DBP 9.5 mm Hg, MAS 1.5 vs. SBP 14.3 mm Hg, DBP 6.4 mm Hg, MAS 1.3), while between group comparisons showed no significant differences across all variables. The adjusted mean difference for mean SBP was 4.74 (95% confidence interval [CI], -0.65 to 10.13 mm Hg; P=0.084), mean DBP was 1.41 (95% CI, -2.01 to 4.82 mm Hg; P=0.415), and mean MAS was 0.05 (95% CI, -0.29 to 0.40 mm Hg; P=0.768).

    CONCLUSION: Short-term home blood pressure monitoring significantly reduced office blood pressure and improved medication adherence, albeit similarly to standard care.

    Matched MeSH terms: Confidence Intervals
  14. C W Ahmad CWI, Awang Lukman K, Raja Omar RM, Jeffree MS
    Risk Manag Healthc Policy, 2021;14:803-808.
    PMID: 33658876 DOI: 10.2147/RMHP.S278786
    Background and Aim: Healthcare workers (HCWs) routinely experience occupational blood and body fluid exposure (OBBE), including percutaneous injury and splash exposure to non-intact skin. The objective of this study was to determine the prevalence of OBBE and identify associated risk factors.

    Methods: A cross-sectional study was performed on 334 HCWs at 9 workstations. Data were collected with a self-administered questionnaire that consisted of four parts: sociodemographic variables, work-related information, knowledge about needle stick and sharps injury and splash exposure, and information regarding previous OBBE incidents. The data were analyzed by SPSS version 22.0 software.

    Findings: The prevalence of OBBE was 25.1% (95% confidence interval: 20.6-30.2), mostly due to percutaneous injuries, which were not reported to authorities. The highest proportions were among nurses and those working in the medical ward. Needle recapping practices were associated with almost a four-times higher risk of OBBE compared to no-recapping practices. HCWs who did not have any infection prevention training had a three-times higher risk of OBBE.

    Conclusion: Factors associated with OBBE are unsafe work practices, inadequate infection prevention training, and lack of knowledge regarding blood-borne infection. There is a need for more training and increased awareness about the risks of OBBE to reduce unsafe practices.

    Matched MeSH terms: Confidence Intervals
  15. Teoh SL, Letchumanan V, Lee LH
    Front Psychol, 2021;12:633319.
    PMID: 33716901 DOI: 10.3389/fpsyg.2021.633319
    Objective: Mindfulness-based intervention (MBI) has been proposed to alleviate loneliness and improve social connectedness. Several randomized controlled trials (RCTs) have been conducted to evaluate the effectiveness of MBI. This study aimed to critically evaluate and determine the effectiveness and safety of MBI in alleviating the feeling of loneliness. Methods: We searched Medline, Embase, PsycInfo, Cochrane CENTRAL, and AMED for publications from inception to May 2020. We included RCTs with human subjects who were enrolled in MBI with loneliness as an outcome. The quality of evidence was assessed using Cochrane's Risk of Bias (ROB) tool and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). A random-effects model was used for meta-analysis. Results: Out of 92 articles identified, eight studies involving 815 participants were included in this study. Most (7/8) trials conducted a minimum of 8 weeks of MBI. Most of the trials (5/8) used UCLA-Loneliness Scale. A pooled analysis combining three trials and compared with wait-list showed significant improvement in loneliness score reduction using the UCLA-R scale with MD of -6.33 [95% confidence interval (CI): -9.39, -3.26]. Subgroup analysis with only two Cognitively-Based Compassion Training (CBCT) trials also showed similar MD of -6.05 (95% CI: -9.53, 2.58). The overall quality of evidence (GRADE) was low. Conclusions: Mindfulness intervention with an average length of 8-week duration significantly improved the population's loneliness level with no mental health issue. However, this evidence had a low GRADE level.
    Matched MeSH terms: Confidence Intervals
  16. Shahrin AA, Ghani SHA, Norman NH
    Korean J Orthod, 2021 Mar 25;51(2):86-94.
    PMID: 33678624 DOI: 10.4041/kjod.2021.51.2.86
    Objective: This study aimed to investigate the effect of micro-osteoperforations (MOPs) on external apical root resorption (EARR) during the initial orthodontic alignment phase of maxillary anterior crowding.

    Methods: Thirty patients (25 females, 5 males; mean age, 22.66 ± 3.27 years) who presented with moderate crowding of the upper labial segment and underwent extraction-based fixed appliance treatment were recruited. They were randomly allocated to receive adjunctive therapy with MOPs (n = 15) or treatment with fixed appliances only (control group; n = 15). EARR was measured from long-cone periapical radiographs taken at the start and the sixth month of treatment. A correction factor for the enlargement difference was used to calculate EARR. Data were analyzed with descriptive statistics and repeated-measures analysis of variance.

    Results: The mean root lengths of 168 teeth were measured and showed no statistically significant difference (p > 0.05) after six months of fixed appliance treatment in the MOP (mean difference [MD] = 0.13 mm; 95% confidence interval [CI] = -0.10-0.35) and control group (MD = 0.14 mm; 95% CI = -0.10-0.37). Most of the roots in the MOP and control groups (42.86% and 52.38%, respectively) showed only mild resorption. Less than 8% of the roots in both groups (7.14% in the MOP group and 4.76% in the control group) showed moderate resorption.

    Conclusions: Acceleration of orthodontic tooth movement with adjunctive MOPs therapy during the alignment phase does not exacerbate EARR in patients with moderate crowding of the upper labial segment in comparison with controls.

    Matched MeSH terms: Confidence Intervals
  17. Abdul Aziz FA, Abd Razak MA, Ahmad NA, Awaluddin SM, Lodz NA, Sooryanarayana R, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):73S-79S.
    PMID: 31353928 DOI: 10.1177/1010539519862161
    Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
    Study name: National Health and Morbidity Survey (NHMS-2017)
    Matched MeSH terms: Confidence Intervals
  18. Chang CT, Ang JY, Islam MA, Chan HK, Cheah WK, Gan SH
    Pharmaceuticals (Basel), 2021 Feb 25;14(3).
    PMID: 33669084 DOI: 10.3390/ph14030187
    Drug-related problems (DRPs) in the elderly include polypharmacy, potentially inappropriate medications, nonadherence, and drug-related falls. In this systematic review and meta-analysis, the prevalence of DRPs and complementary and alternative medicine (CAM) use among the Malaysian elderly was estimated. PubMed, Scopus, Web of Science, and Google Scholar databases were searched to identify studies published since their inception up to 24 August 2020. A random-effects model was used to generate the pooled prevalence of DRPs along with its corresponding 95% confidence interval (CI). The heterogeneity of the results was estimated using the I2 statistics, and Cochran's Q test and sensitivity analyses were performed to confirm the robustness of the results. We identified 526 studies, 23 of which were included in the meta-analysis. (n = 29,342). The pooled prevalence of DRPs among Malaysian elderly was as follows: (1) polypharmacy: 49.5% [95% CI: 20.5-78.6], (2) potentially inappropriate medications: 28.9% [95% CI: 25.4-32.3], (3) nonadherence to medications: 60.6% [95% CI: 50.2-70.9], and (4) medication-related falls 39.3% [95% CI: 0.0-80.8]. Approximately one in two Malaysian elderly used CAM. The prevalence of polypharmacy and potentially inappropriate medications among the Malaysian elderly population was high, calling for measures and evidence-based guidelines to ensure the safe medication use.
    Matched MeSH terms: Confidence Intervals
  19. Islam MA, Kundu S, Alam SS, Hossan T, Kamal MA, Hassan R
    PLoS One, 2021;16(4):e0249788.
    PMID: 33822812 DOI: 10.1371/journal.pone.0249788
    BACKGROUND: Coronavirus disease 2019 (COVID-19), a pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 started to spread globally since December 2019 from Wuhan, China. Fever has been observed as one of the most common clinical manifestations, although the prevalence and characteristics of fever in adult and paediatric COVID-19 patients is inconclusive. We aimed to conduct a systematic review and meta-analysis to estimate the overall pooled prevalence of fever and chills in addition to fever characteristics (low, medium, and high temperature) in both adult and paediatric COVID-19 patients.

    METHODS: The protocol of this systematic review and meta-analysis was registered with PROSPERO (CRD42020176327). PubMed, Scopus, ScienceDirect and Google Scholar databases were searched between 1st December 2019 and 3rd April 2020 without language restrictions. Both adult (≥18 years) and paediatric (<18 years) COVID-19 patients were considered eligible. We used random-effects model for the meta-analysis to obtain the pooled prevalence and risk ratio (RR) with 95% confidence intervals (CIs). Quality assessment of included studies was performed using the Joanna Briggs Institute critical appraisal tools. Heterogeneity was assessed using the I² statistic and Cochran's Q test. Robustness of the pooled estimates was checked by different subgroups and sensitivity analyses.

    RESULTS: We identified 2055 studies, of which 197 studies (n = 24266) were included in the systematic review and 167 studies with 17142 adults and 373 paediatrics were included in the meta-analysis. Overall, the pooled prevalence of fever in adult and paediatric COVID-19 patients were 79.43% [95% CI: 77.05-81.80, I2 = 95%] and 45.86% [95% CI: 35.24-56.48, I2 = 78%], respectively. Besides, 14.45% [95% CI: 10.59-18.32, I2 = 88%] of the adult COVID-19 patients were accompanied with chills. In adult COVID-19 patients, the prevalence of medium-grade fever (44.33%) was higher compared to low- (38.16%) and high-grade fever (14.71%). In addition, the risk of both low (RR: 2.34, 95% CI: 1.69-3.22, p<0.00001, I2 = 84%) and medium grade fever (RR: 2.79, 95% CI: 2.21-3.51, p<0.00001, I2 = 75%) were significantly higher compared to high-grade fever, however, there was no significant difference between low- and medium-grade fever (RR: 1.17, 95% CI: 0.94-1.44, p = 0.16, I2 = 87%). 88.8% of the included studies were of high-quality. The sensitivity analyses indicated that our findings of fever prevalence for both adult and paediatric patients are reliable and robust.

    CONCLUSIONS: The prevalence of fever in adult COVID-19 patients was high, however, 54.14% of paediatric COVID-19 patients did not exhibit fever as an initial clinical feature. Prevalence and risk of low and medium-grade fevers were higher compared to high-grade fever.

    Matched MeSH terms: Confidence Intervals
  20. Gopinath D, Kunnath Menon R, K Veettil S, George Botelho M, Johnson NW
    Cancers (Basel), 2020 Jul 14;12(7).
    PMID: 32674369 DOI: 10.3390/cancers12071893
    Whether "periodontal disease" can be considered as an independent risk factor for head and neck cancer (HNC) remains controversial. The aim of the current meta-analysis was to quantitatively assess this relationship in order to determine whether this represents a true risk factor, with implications for cancer prevention and management. PubMed, Scopus, and Embase databases were systematically searched. Selective studies were reviewed, and meta-analysis was performed to estimate the pooled odds ratio (OR) with 95% confidence intervals (CIs) on eligible studies using a random effects model. In total, 21 eligible observational studies (4 cohorts and 17 case-controls) were identified for qualitative synthesis after a review of 1051 articles. Significant heterogeneity could be identified in measures utilized for reporting of periodontal disease. Meta-analysis performed on nine studies that employed objective measures for reporting periodontal disease demonstrated a significant association between periodontal disease and HNC [OR 3.17, 95% CI, 1.78-5.64]. A diseased periodontium represents an independent risk marker, and a putative risk factor, for HNC. Prospective studies with standardized measures of periodontal disease severity and extent, integrated with microbiological and host susceptibility facets, are needed to elucidate the mechanisms of this positive association and whether treatment of the former influences the incidence and outcomes for HNC.
    Matched MeSH terms: Confidence Intervals
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