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  1. Zaharan NL, Muhamad NH, Jalaludin MY, Su TT, Mohamed Z, Mohamed MNA, et al.
    PMID: 29755414 DOI: 10.3389/fendo.2018.00209
    Background: Several non-synonymous single-nucleotide polymorphisms (nsSNPs) have been shown to be associated with obesity. Little is known about their associations and interactions with physical activity (PA) in relation to adiposity parameters among adolescents in Malaysia.

    Methods: We examined whether (a) PA and (b) selected nsSNPs are associated with adiposity parameters and whether PA interacts with these nsSNPs on these outcomes in adolescents from the Malaysian Health and Adolescents Longitudinal Research Team study (n = 1,151). Body mass indices, waist-hip ratio, and percentage body fat (% BF) were obtained. PA was assessed using Physical Activity Questionnaire for Older Children (PAQ-C). Five nsSNPs were included: beta-3 adrenergic receptor (ADRB3) rs4994, FABP2 rs1799883, GHRL rs696217, MC3R rs3827103, and vitamin D receptor rs2228570, individually and as combined genetic risk score (GRS). Associations and interactions between nsSNPs and PAQ-C scores were examined using generalized linear model.

    Results: PAQ-C scores were associated with % BF (β = -0.44 [95% confidence interval -0.72, -0.16], p = 0.002). The CC genotype of ADRB3 rs4994 (β = -0.16 [-0.28, -0.05], corrected p = 0.01) and AA genotype of MC3R rs3827103 (β = -0.06 [-0.12, -0.00], p = 0.02) were significantly associated with % BF compared to TT and GG genotypes, respectively. Significant interactions with PA were found between ADRB3 rs4994 (β = -0.05 [-0.10, -0.01], p = 0.02) and combined GRS (β = -0.03 [-0.04, -0.01], p = 0.01) for % BF.

    Conclusion: Higher PA score was associated with reduced % BF in Malaysian adolescents. Of the nsSNPs, ADRB3 rs4994 and MC3R rs3827103 were associated with % BF. Significant interactions with PA were found for ADRB3 rs4994 and combined GRS on % BF but not on measurements of weight or circumferences. Targeting body fat represent prospects for molecular studies and lifestyle intervention in this population.

    Matched MeSH terms: Humans
  2. A MH, C A R N, S M C, S R, P M, R H WS, et al.
    PLoS One, 2023;18(7):e0288325.
    PMID: 37459344 DOI: 10.1371/journal.pone.0288325
    INTRODUCTION: The current and simpler healthy eating concept 'Malaysian Healthy Plate', was introduced in 2016. This study aims to determine the prevalence of ever-never heard, understanding, and practice of this concept and also the associated factors to never-heard of Malaysian Health Plate after three years of the implementation.

    METHODOLOGY: This study utilized the data from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional survey that applied two-stage stratified cluster sampling. Questionnaires pertained to ever heard, knowledge, and practised of Malaysian Healthy Plate were asked along with another questionnaire. Complex sample analysis was applied to fit with the study design.

    RESULTS: Estimated 16.9 million (79.6%) adults in Malaysia were never heard of the Malaysian Healthy Plate Concept in 2019. Never heard of this concept was significantly associated with sex (men, aOR 0.265), ethnicity (other ethnicities, aOR 1.79), an education level (no education, aOR 9.59; primary, aOR 3.50; secondary, aOR 1.70), occupation (private, aOR 2.16; self-employed, aOR 2.31; retirees, aOR 1.69; student, aOR 2.31; unpaid workers, aOA 2.35; not working, aOR 2.86), non-diabetes aOR 1.43, and low fruit and vegetable intake person aOR 1.86. Meanwhile, another 20.4% or an estimated 4.3 million adults who were ever heard of Malaysian Healthy Plate. Among those who are ever heard, 80.8% (3.5 million) correctly interpreted or understood the concept and among those who ever heard and understood the concept, only 70.5% (2.5 million) have been practising it daily or occasionally.

    CONCLUSIONS: Four-fifth of adults never heard of the 'Malaysian Healthy Plate' and among those who ever heard, the understanding and practising of the concept were probably unsatisfactory. Multisectoral collaboration is an urge to fasten the promotion to spark awareness and educate the public to practice the concept to promote healthy eating and a healthier nation.

    Matched MeSH terms: Humans
  3. Loh UL, Tai PY, Hussein A, A Qamarruddin F
    Cureus, 2018 Dec 17;10(12):e3743.
    PMID: 30800553 DOI: 10.7759/cureus.3743
    Orbital apex syndrome (OAS) is a localized orbital cellulitis at the orbital apex that can cause vision loss from optic neuropathy and ophthalmoplegia involving multiple cranial nerves. Herein, we report a rare and rapidly progressive case of OAS secondary to fungal pansinusitis caused by Scedosporiumapiospermum in an immunocompromised patient following the extraction of abscessed teeth. A 48-year-old man with diabetes mellitus who had failed to adhere to his treatment presented with complaints of a right-sided headache and toothache for two weeks, with nausea and vomiting for two days prior to presentation. The patient was treated for septic shock secondary to the dental abscesses. Non-contrast brain computed tomography (CT) showed no significant intracranial abnormalities other than pansinusitis. Four days later, dental extraction was performed. The patient reported progressive painless blurring of the vision in his right eye following the dental extractions and was referred to the ophthalmology department. Subsequent examinations revealed decreased optic nerve function and ophthalmoplegia in his right eye and dental caries in the upper molars, with a mucopurulent discharge from the right sphenoid region. The clinical diagnosis was OAS. Pus near the orbital apex was drained surgically. Methicillin-resistant Staphylococcus aureus was isolated from the pus and a nasal swab. Tissue culture from the septal wall yielded S.apiospermum. The patient's condition deteriorated, despite intensive antibiotic and antifungal treatment and repeated surgical debridement. The disease progressed rapidly to his left eye. Sixty-seven days after the inital presentation, his visual acuity (VA) of both eyes was classified as no perception of light (NPL). The patient discharged himself from the hospital (at own risk discharge) and subsequently failed to attend a scheduled appointment in the ophthalmology clinic. If immunocompromised patients present with OAS, fungal infections should be ruled out. Prompt and aggressive treatment using a multidisciplinary approach is mandatory in cases of potentially life-threatening and vision-threatening fungal infections.
    Matched MeSH terms: Humans
  4. Hassan R, Siregar JA, A Rahman Mohd NA
    Malays J Med Sci, 2014 Mar;21(2):54-62.
    PMID: 24876808 MyJurnal
    Telemedicine in neurosurgery or teleneurosurgery has been widely used for transmission of clinical data and images throughout the country since its implementation in 2006. The impact is a reduction of patient number that need to be reviewed in the level III hospitals and an increment in the number of patients that are kept in level II hospitals for observation by the primary team. This translates to reduction of unnecessary transfer of patients and subsequently cost benefits for patients and medical providers. The main aim is to determine the amount of reduction in unnecessary transfer by the implementation of teleneurosurgery in the management of referrals to neurosurgical department in Hospital Sultanah Amninah Johor Bahru (HSAJB). Other factors associated with transfer decision are also evaluated.
    Matched MeSH terms: Humans
  5. Narayan, K.A., A Rashid, K.
    MyJurnal
    This study was conducted to study the blood pressure pattern and the prevalence of hypertension and its associated factors in a rural community in two coastal villages in rural Kedah, Mahysia. Out of the total population 504 were above 20 years of age and were eligible to participate. There were 227 males and 252 females. The mean systolic blood pressure was found to rise with age, peaking in the 6l·70 years age group, For women the mean blood pressure rose earlier from the age group of 4-l· 50 years. Mean blood pressures rose with increasing body mass index. lt also varied with occupation and education. The retired and unemployed had a higher blood pressure than those employed and there was an inverse relationship with increasing education. The prevalence of hypertension was 33.6%. More females were hypertensive (36.5%) as compared to males (3 0.4%) and this finding was the same for both systolic and diastolic hypertension. Majority (71.4%) of the hypertensives were undiagnosed. 72.5% of hypertensives who were on treatment were not under control. Hypertension was more prevalent among retirees and illiterates. Prevalence of hypertension increased correspondingly with age. Obesity was associated with hypertension. There was no association with family history of hypertension. Multiple logistic regression showed a positive association only for obesity. ln conclusion, given the high prevalence of hypertension at
    present, it appears that the prevalence will increase as each age cohort grows older. Obesity, especially among housewives is a significant assorted factor.
    Matched MeSH terms: Humans
  6. Raa H, As R, Tp G, A S
    J Neonatal Surg, 2016 04 10;5(2):19.
    PMID: 27123403
    Spontaneous gastric perforation is a rare entity in neonates. We report a case of spontaneous gastric perforation in a neonate operated for in-utero rupture of omphalocele.
    Matched MeSH terms: Humans
  7. Lim CT, R R, A S MZ
    Pak J Med Sci, 2016 Mar-Apr;32(1):27-30.
    PMID: 27022339 DOI: 10.12669/pjms.321.8214
    OBJECTIVES: The aims of this study were to determine the seroprevalence of acute dengue in Universiti Kebangsaan Malaysia (UKM) Medical Centre and its correlation with selected haematological and biochemical parameters.
    METHODS: This cross-sectional study was conducted from January to June 2015. A patient was serologically diagnosed with acute dengue if the dengue virus IgG, IgM or NS-1 antigen was reactive.
    RESULTS: Out of 1,774 patients suspected to have acute dengue, 1,153 were serologically diagnosed with the infection, resulting in a seroprevalence of 64.9%. Dengue-positive patients had a lower mean platelet count (89 × 10(9)/L) compared to the dengue-negative patients (171 × 10(9)/L) (p<0.0001). The mean total white cell count was also lower in the dengue-positive cases (4.7 × 10(9)/L vs. 7.2 × 10(9)/L; p<0.0001). The mean haematocrit was higher in patients with acute dengue (42.5% vs. 40.0%; p<0.0001). Likewise, the serum alanine transaminase level was also higher in patients with acute dengue (108 U/L vs. 54 U/L; p<0.0001).
    CONCLUSIONS: Dengue is very prevalent in UKM Medical Centre as most patients suspected to have acute dengue had serological evidence of the infection. The platelet count was the single most likely parameter to be abnormal (i.e. low) in patients with acute dengue.
    KEYWORDS: DENV; Dengue; IgG; IgM; NS1; Seroprevalence
    Matched MeSH terms: Humans
  8. B, Elamathi, R, Vijaya, V, Valliappan, A, Ramanathan
    Ann Dent, 2014;21(1):33-37.
    MyJurnal
    According to the 3rd edition of the international
    classification of headache disorders (ICHD3 2013),
    Trigeminal Neuralgia (TN) is classified into two types:
    1. Classical TN, purely paroxysmal 2. Classical TN
    with concomitant persistent facial pain. In this article,
    the authors describe a 47 year-old, male with unilateral,
    severe, recurring, electric shock-like pain involving left
    lower jaw, teeth and gingiva. Diagnosis of classical TN
    of the left 3rd division of the trigeminal nerve was made.
    The patient was treated with pharmacotherapeutic agents
    but without relief. Magnetic resonance imaging (MRI)
    of the brain showed medial vascular compression of left
    trigeminal pontine root entry zone caused by superior
    cerebellar artery. A microvascular decompression (MVD)
    surgery was done at the left trigeminal pontine root entry
    zone resulting in good relief of pain. This article highlights
    the differential diagnoses to be considered with TN and
    also emphasize the difference between the two types of
    the TN according to ICDH3 (2013). It also highlights the
    difference between classical TN purely paroxysmal with
    and without vascular compression by imaging techniques
    and their differing treatment modalities, which therefore
    should be reflected in future ICDH classification.
    Matched MeSH terms: Humans
  9. Shaila Kabir, Sadia Choudhury Shimm, M. Tanveer Hossain Parash, Mya Sanda Khaing, A. B. M. Tofazzal Hossain
    MyJurnal
    Introduction:Obesity or overweight and its consequences are important public health problems globally resulting in a significant cause of morbidity such as hypertension, Diabetes Mellitus, hypercholesterolaemia, coronary artery disease, stroke, sleep apnoea, cancers and mortality which also render distressing financial burden on everyone. It is imperative to intervene in momentous strategies for early detection to prevent the weight-related epidemic. Methods:It was a health survey conducted in June 2019 to detect the prevalence of obesity and overweight problems and the resultant detrimental health conditions among the year 1 and year 2 medical students of the University Malaysia Sa-bah. The survey was done on 145 students aged between 19-23 years. The height, weight, BMI, waist circumference, blood pressure and capillary random blood glucose were measured. Pearson correlation and Chi-square tests were done to find an association between BMI and probable factors using SPSS. Results: The prevalence of obesity was 8.2%. High blood pressure was recorded in 23.45% participants where both systolic and diastolic blood pressure was high in 18.6%, only systolic blood pressure was high in 37.2% and only diastolic blood pressure was high in 28.3% among 145 students. There was no impaired glucose tolerance among the participants. There was a positive correlation between BMI and systolic (r=0.518, p
    Matched MeSH terms: Humans
  10. Nayan NA, Ab Hamid H, Suboh MZ, Abdullah N, Jaafar R, Mhd Yusof NA, et al.
    DOI: 10.3991/ijoe.v16i07.13569
    Cardiovascular disease (CVD) is the leading cause of deaths worldwide. In 2017, CVD contributed to 13,503 deaths in Malaysia. The current approaches for CVD prediction are usually invasive and costly. Machine learning (ML) techniques allow an accurate prediction by utilizing the complex interactions among relevant risk factors. This study presents a case–control study involving 60 participants from The Malaysian Cohort, which is a prospective population-based project. Five parameters, namely, the R–R interval and root mean square of successive differences extracted from electrocardiogram (ECG), systolic and diastolic blood pressures, and total cholesterol level, were statistically significant in predicting CVD. Six ML algorithms, namely, linear discriminant analysis, linear and quadratic support vector machines, decision tree, knearest neighbor, and artificial neural network (ANN), were evaluated to determine the most accurate classifier in predicting CVD risk. ANN, which achieved 90% specificity, 90% sensitivity, and 90% accuracy, demonstrated the highest prediction performance among the six algorithms. In summary, by utilizing ML techniques, ECG data can serve as a good parameter for CVD prediction among the Malaysian multiethnic population.
    Keywords—CVD, ECG, machine learning, The Malaysian Cohort, RMSSD
    Study name: The Malaysian Cohort (TMC) project
    Matched MeSH terms: Humans
  11. Noor Aini Mohd. Yusoff, Zalina Abu Zaid, Raiza Sham, Rosita Jamaluddin, Suzana Shahar, A. Rahman A. Jamal
    MyJurnal
    Malnutrition is common among pediatric oncology patients. Factors contributing to malnutrition include physiological abnormalities, response to the tumors and side effects of the treatment. A pilot study was carried out to determine the nutritional status of 17 pediatric oncology patients aged 4 to 12 years old in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur. The
    nutritional status was assessed via anthropometric measurements and dietary intake through 3 days repeatitive 24 hours diet recall with subjects and their carers. Biochemical profiles (serum albumin and hemoglobin) were reviewed from the medical record. Through anthropometry measurements, weight and height were used to calculate Z-scores and further determine the percentile weight-for-age, height-for-age using NCHS percentile charts (WHO 1983). Frisancho’s standards (1981) were used to define malnutrition based on MUACfor- age. Underweight as determined using z scores below -2 for weight-for-age was observed in 70.6% of the subjects. Whilst, 76.5% of the subjects were classified as stunted (z score < –2) for height-for-age. Based on MUAC-for-age percentile, the sign of severe malnutrition category (<5 percentile) was observed in 35.3% of the subject and 23.6% of the subject were in the moderate malnutrition (>5 – <10 percentile). About 70.6% of the subject had low haemoglobin (< 11 g/dl) and 29.4% of the subject were hypoalbuminemia (< 35 g/dl) . Total macronutrient intake was assessed and compared with the individual requirement (Seashore 1984) for energy and protein intake were satisfactory, except for subjects in age group 10 – 12 years who achieved only 70% of the individuals requirements. As a conclusion, although food intake of the subjects was satisfactory but chronic malnutrition was prevalent. Early recognition of malnutrition is essential in order to plan for a nutritional intervention and further enhancing the quality of life.
    Key words: Nutritional status, pediatric oncology, anthropometric, dietary intake, biochemical profile.
    Matched MeSH terms: Humans
  12. Jamsiah, M., Sana Taher, A. Taufik J.
    MyJurnal
    Being a student, especially postgraduate student, could expose to stress, and being international postgraduate student would exposed to more stress to the student. This study was conducted to assess stress level among international postgraduate students and its associated factors. A cross sectional study was conducted among international postgraduate students registered at UKMMC, Cheras campus, Kuala Lumpur. Questionnaires were distributed to 119 students,. Main international student are Arabs (52.4%). The stress prevalence is 54.8%. Younger age group are more stressful with mean age 33.94 (P=0.004), while shorter duration is associated with stress, P=0.035. Relationship with neighbour and relationship with local colleagues are shown to be associated with stress with P value 0.011 and 0.005 respectively. This study reveals the presence of significant prevalence of stress among international postgraduate students. The student socio-demographic character that has shown to be associated with stress in this study was age. The poor relationships with local colleagues as well as the poor relationships with the neighbours have shown to contribute to the stress among international students.
    Matched MeSH terms: Humans
  13. Kelly AM, Keijzers G, Klim S, Graham CA, Craig S, Kuan WS, et al.
    Emerg Med Australas, 2015 Jun;27(3):187-91.
    PMID: 25940885 DOI: 10.1111/1742-6723.12397
    Shortness of breath is a common reason for ED attendance. This international study aims to describe the epidemiology of dyspnoea presenting to EDs in the South East Asia-Pacific region, to compare disease patterns across regions, to understand how conditions are investigated and treated, and to assess quality of care.
    Matched MeSH terms: Humans
  14. Kelly AM, Keijzers G, Klim S, Graham CA, Craig S, Kuan WS, et al.
    Acad Emerg Med, 2017 Mar;24(3):328-336.
    PMID: 27743490 DOI: 10.1111/acem.13118
    OBJECTIVES: The objective was to describe the epidemiology of dyspnea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome.

    METHODS: Prospective interrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong, and Malaysia of adult patients presenting to the ED with dyspnea as a main symptom. Data were collected over three 72-hour periods and included demographics, comorbidities, mode of arrival, usual medications, prehospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome, and final hospital diagnosis. The primary outcomes of interest are the epidemiology, investigation, treatment, and outcome of patients presenting to ED with dyspnea.

    RESULTS: A total of 3,044 patients were studied. Patients with dyspnea made up 5.2% (3,105/60,059, 95% confidence interval [CI] = 5.0% to 5.4%) of ED presentations, 11.4% of ward admissions (1,956/17,184, 95% CI = 10.9% to 11.9%), and 19.9% of intensive care unit (ICU) admissions (104/523, 95% CI = 16.7% to 23.5%). The most common diagnoses were lower respiratory tract infection (20.2%), heart failure (14.9%), chronic obstructive pulmonary disease (13.6%), and asthma (12.7%). Hospital ward admission was required for 64% of patients (95% CI = 62% to 66%) with 3.3% (95% CI = 2.8% to 4.1%) requiring ICU admission. In-hospital mortality was 6% (95% CI = 5.0% to 7.2%).

    CONCLUSION: Dyspnea is a common symptom in ED patients contributing substantially to ED, hospital, and ICU workload. It is also associated with significant mortality. There are a wide variety of causes however chronic disease accounts for a large proportion.

    Matched MeSH terms: Humans
  15. M Tanveer Hossain Parash, Sadia Choudhury Shimmi, ABM Tofazzal Hossain
    MyJurnal
    Introduction: The healthy, active, and receptive huge student population is potential blood donors to meet safe blood requirements. The study aimed to assess the current level of knowledge regarding blood donation of nursing students of the Faculty of Medicine & Health Sciences, UMS and to observe their attitude towards voluntary blood donation and to explore their practice as a voluntary blood donor. Methods: This cross-sectional study was con- ducted from July 2015 to June 2018 among one hundred and eight (108) nursing students who were included in this study by simple random sampling. The researchers explained the study design, objectives, and methodology to the selected subjects and obtained written consent from them. The study assessed the current level of knowledge and observed their attitude towards voluntary blood donation and explored their active involvement in donating blood through a validated questionnaire. Results: There were 89 female and 19 male participants in the study. Almost ev- ery student (96%) knew their blood group and most of them were correct about the health status of a blood donor. They had a lack of knowledge regarding the time required for blood donation and the amount of blood collected in each bag. Although most of the students were very favourable to donate blood, only 34% had previous experience of donating blood out of them; only 6% regularly donated voluntarily and on demand. Conclusion: From this finding, it can be recommended that measures for increasing knowledge regarding blood donation should be taken, and that would result in increased blood donation.
    Matched MeSH terms: Humans
  16. Campos CM, Caixeta A, Franken M, Bartorelli AL, Whitbourn RJ, Wu CJ, et al.
    Catheter Cardiovasc Interv, 2018 02 15;91(3):387-395.
    PMID: 28471086 DOI: 10.1002/ccd.27109
    OBJECTIVES: to compare the occurrence of clinical events in diabetics treated with the Absorb bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular, Santa Clara, CA) versus everolimus-eluting metal stents (EES; XIENCE V; Abbott Vascular, Santa Clara, CA) BACKGROUND: There are limited data dedicated to clinical outcomes of diabetic patients treated with bioresorbable scaffolds (BRS) at 2-year horizon.

    METHODS: The present study included 812 patients in the ABSORB EXTEND study in which a total of 215 diabetic patients were treated with Absorb BVS. In addition, 882 diabetic patients treated with EES in pooled data from the SPIRIT clinical program (SPIRIT II, SPIRIT III and SPIRIT IV trials) were used for comparison by applying propensity score matching using 29 different variables. The primary endpoint was ischemia driven major adverse cardiac events (ID-MACE), including cardiac death, myocardial infarction (MI), and ischemia driven target lesion revascularization (ID-TLR).

    RESULTS: After 2 years, the ID-MACE rate was 6.5% in the Absorb BVS vs. 8.9% in the Xience group (P = 0.40). There was no difference for MACE components or definite/probable device thrombosis (HR: 1.43 [0.24,8.58]; P = 0.69). The occurrence of MACE was not different for both diabetic status (insulin- and non-insulin-requiring diabetes) in all time points up to the 2-year follow-up for the Absorb and Xience groups.

    CONCLUSION: In this largest ever patient-level pooled comparison on the treatment of diabetic patients with BRS out to two years, individuals with diabetes treated with the Absorb BVS had a similar rate of MACE as compared with diabetics treated with the Xience EES. © 2017 Wiley Periodicals, Inc.

    Matched MeSH terms: Humans
  17. Topakian R, King A, Kwon SU, Schaafsma A, Shipley M, Markus HS, et al.
    Neurology, 2011 Aug 23;77(8):751-8.
    PMID: 21849657 DOI: 10.1212/WNL.0b013e31822b00a6
    Better methods are required to identify patients with asymptomatic carotid stenosis (ACS) at risk of future stroke. Two potential markers of high risk are echolucent plaque morphology on carotid ultrasound and embolic signals (ES) in the ipsilateral middle cerebral artery on transcranial Doppler ultrasound (TCD). We explored the predictive value of a score based on these 2 measures in the prospective, observational, international multicenter Asymptomatic Carotid Emboli Study.
    Matched MeSH terms: Humans
  18. King A, Shipley M, Markus H, ACES Investigators
    Stroke, 2011 Oct;42(10):2819-24.
    PMID: 21852607 DOI: 10.1161/STROKEAHA.111.622514
    Improved methods are required to identify patients with asymptomatic carotid stenosis at high risk for stroke. The Asymptomatic Carotid Emboli Study recently showed embolic signals (ES) detected by transcranial Doppler on 2 recordings that lasted 1-hour independently predict 2-year stroke risk. ES detection is time-consuming, and whether similar predictive information could be obtained from simpler recording protocols is unknown.
    Matched MeSH terms: Humans
  19. ACES Investigators
    Int J Stroke, 2009 Oct;4(5):398-405.
    PMID: 19765130 DOI: 10.1111/j.1747-4949.2009.00339.x
    Better methods of identifying which patients with asymptomatic carotid stenosis will develop stroke, are required to improve the risk-benefit ratio of carotid endarterectomy. A promising method is the detection of asymptomatic embolic signals using transcranial Doppler. Embolic signals predict stroke risk in symptomatic carotid stenosis, but their predictive role in asymptomatic carotid stenosis is uncertain.
    Matched MeSH terms: Humans
  20. Collister D, Mbuagbaw L, Guyatt G, Devereaux PJ, Tennankore KK, Reis G, et al.
    Contemp Clin Trials, 2021 08;107:106466.
    PMID: 34098039 DOI: 10.1016/j.cct.2021.106466
    BACKGROUND/AIMS: To examine how measuring adherence at 3 weeks by self-report and pill counts compares to measurements at 7 weeks in a pre-randomization run-in period.

    METHODS: Study within a trial of an international parallel group randomized controlled trial (RCT) that compares spironolactone to placebo. Adults receiving dialysis enter an 8-week active run-in period with spironolactone. Adherence was assessed by both self-report and pill counts in a subgroup of participants at both 3 weeks and 7 weeks.

    RESULTS: 332 participants entered the run-in period of which 166 had complete data. By self-report, 146/166 (94.0%) and 153/166 (92.2%) had at least 80% adherence at 3 and 7 weeks respectively (kappa = 0.27 (95% C.I. 0.16 to 0.38). By pill counts, the mean (SD) adherence was 96.5% (16.1%) and 92.4% (18.2%) at 3 and 7 weeks respectively (r = 0.32) with a mean (SD) difference of 3.1% (17.8%) and a 95% limit of agreement from -31.7% to +37.9%. The proportion of adherent participants by self-report and pill counts at 3 weeks agreed in 87.4% of participants (McNemar's p-value 0.58, kappa 0.11, p = 0.02) and at 7 weeks agreed in 92.2% (McNemar's p-value 0.82, kappa 0.47, p 

    Matched MeSH terms: Humans
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