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  1. Ahmad A, Yassin WM, Rahman NAA, Leman WI, Rosla L, Paul M, et al.
    Malays J Med Sci, 2021 Feb;28(1):66-74.
    PMID: 33679222 DOI: 10.21315/mjms2021.28.1.9
    Background: Nasopharyngeal carcinoma (NPC) is the fifth most common cancer among Malaysians. While several studies have reported the trend of NPC in other states in Malaysia, no studies have reported the trend of NPC in Pahang state. This study was designed to report the number and distribution of newly diagnosed NPC cases in Pahang.

    Methods: NPC cases that were diagnosed between 2012 and 2017 in two referral hospitals in Pahang were traced. The crude incidence rate (CR) and age-standardised rate (ASR) were calculated to investigate the NPC incidence.

    Results: There were 143 new cases of NPC reported from the two hospitals. The mean age at diagnosis was 52.0 ± 13.7 years old. The majority of cases involved males (74.1%) with a male to female ratio of 2.9:1. Chinese males were found to have the highest incidence with a mean ASR of 4.7 per 100,000 population. Overall, the mean ASR for Pahang was 2.4 per 100,000 population for males and 0.9 per 100,000 population for females.

    Conclusion: The total number of NPC cases reveals an increasing trend from 2012 to 2014 and then a slightly decreasing trend from 2015 to 2017. The incidence of NPC in Pahang was intermediate in males and low in females.

  2. Yong SJ, Halim A, Liu S, Halim M, Alshehri AA, Alshahrani MA, et al.
    Auton Neurosci, 2023 Dec;250:103132.
    PMID: 38000119 DOI: 10.1016/j.autneu.2023.103132
    PURPOSE: To address recent concerns of postural orthostatic tachycardia syndrome (POTS) occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination.

    METHODS: We searched PubMed, Web of Science, and Scopus as of 1st June 2023. We performed a systematic review and meta-analysis of pooled POTS rate in SARS-CoV-2-infected and COVID-19-vaccinated groups from epidemiological studies, followed by subgroup analyses by characteristic. Meta-analysis of risk ratio was conducted to compare POTS rate in infected versus uninfected groups. Meta-analysis of demographics was also performed to compare cases of post-infection and post-vaccination POTS from case reports and series.

    RESULTS: We estimated the pooled POTS rate of 107.75 (95 % CI: 9.73 to 273.52) and 3.94 (95 % CI: 0 to 16.39) cases per 10,000 (i.e., 1.08 % and 0.039 %) in infected and vaccinated individuals based on 5 and 2 studies, respectively. Meta-regression revealed age as a significant variable influencing 86.2 % variance of the pooled POTS rate in infected population (P 

  3. Tuan Abdul Aziz TA, Teh LK, Md Idris MH, Bannur Z, Ashari LS, Ismail AI, et al.
    BMC Public Health, 2016;16(1):284.
    PMID: 27009064 DOI: 10.1186/s12889-016-2848-9
    Despite the strategic development plan by the authorities for the Orang Asli, there are six subtribes of which their population numbers are small (less than 700). These minorities were not included in most of the health related studies published thus far. A comprehensive physiological and biomedical updates on these small subtribes in comparison to the larger subtribes and the urban Malay population is timely and important to help provide appropriate measures to prevent further reduction in the numbers of the Orang Asli.
  4. Umpleby AM, Shojaee-Moradie F, Fielding B, Li X, Marino A, Alsini N, et al.
    Clin Sci (Lond), 2017 Nov 01;131(21):2561-2573.
    PMID: 28923880 DOI: 10.1042/CS20171208
    Dietary sugars are linked to the development of non-alcoholic fatty liver disease (NAFLD) and dyslipidaemia, but it is unknown if NAFLD itself influences the effects of sugars on plasma lipoproteins. To study this further, men with NAFLD (n = 11) and low liver fat 'controls' (n = 14) were fed two iso-energetic diets, high or low in sugars (26% or 6% total energy) for 12 weeks, in a randomised, cross-over design. Fasting plasma lipid and lipoprotein kinetics were measured after each diet by stable isotope trace-labelling.There were significant differences in the production and catabolic rates of VLDL subclasses between men with NAFLD and controls, in response to the high and low sugar diets. Men with NAFLD had higher plasma concentrations of VLDL1-triacylglycerol (TAG) after the high (P<0.02) and low sugar (P<0.0002) diets, a lower VLDL1-TAG fractional catabolic rate after the high sugar diet (P<0.01), and a higher VLDL1-TAG production rate after the low sugar diet (P<0.01), relative to controls. An effect of the high sugar diet, was to channel hepatic TAG into a higher production of VLDL1-TAG (P<0.02) in the controls, but in contrast, a higher production of VLDL2-TAG (P<0.05) in NAFLD. These dietary effects on VLDL subclass kinetics could be explained, in part, by differences in the contribution of fatty acids from intra-hepatic stores, and de novo lipogenesis. The present study provides new evidence that liver fat accumulation leads to a differential partitioning of hepatic TAG into large and small VLDL subclasses, in response to high and low intakes of sugars.
  5. Tharumaraja T, Che-Ahmad A, Wong PF, Ahmad Hamid AH, Hasan MI, Bajuri MY, et al.
    Malays Fam Physician, 2021 Mar 25;16(1):103-113.
    PMID: 33948148 DOI: 10.51866/cpg0001
    Diabetic foot requires careful attention and coordinated management by a dedicated team. Screening, prevention, adequate assessment, and appropriate referral are crucial to prevent complications. Multimodal treatment and rehabilitation are recommended to ensure a better quality of life and reduction of amputation rate in people with diabetic foot.
  6. Manan TSBA, Kamal NLM, Beddu S, Khan T, Mohamad D, Syamsir A, et al.
    Sci Rep, 2021 06 16;11(1):12722.
    PMID: 34135374 DOI: 10.1038/s41598-021-92017-1
    The potassium (K) and sodium (Na) elements in banana are needed for hydration reaction that can enhance the strength properties of concrete. This research aims (a) to determine the material engineering properties of banana skin ash (BSA) and concrete containing BSA, (b) to measure the strength enhancement of concrete due to BSA, and (c) to identify optimal application of BSA as supplementary cement materials (SCM) in concrete. The BSA characterization were assessed through X-ray fluorescence (XRF) and Blaine's air permeability. The workability, compressive strength, and microstructures of concrete containing BSA were analysed using slump test, universal testing machine (UTM) and scanning electron microscope (SEM). A total of 15 oxides and 19 non-oxides elements were identified in BSA with K (43.1%) the highest and Na was not detected. At 20 g of mass, the BSA had a higher bulk density (198.43 ± 0.00 cm3) than ordinary Portland cement (OPC) (36.32 ± 0.00 cm3) indicating availability of large surface area for water absorption. The concrete workability was reduced with the presence of BSA (0% BSA: > 100 mm, 1% BSA: 19 ± 1.0 mm, 2%: 15 ± 0.0 mm, 3% BSA: 10 ± 0.0 mm). The compressive strength increased with the number of curing days. The concrete microstructures were improved; interfacial transition zones (ITZ) decreased with an increase of BSA. The optimal percentage of BSA obtained was at 1.25%. The established model showed significant model terms (Sum of Squares = 260.60, F value = 69.84) with probability of 0.01% for the F-value to occur due to noise. The established model is useful for application in construction industries.
  7. Lew LC, Hor YY, Yusoff NAA, Choi SB, Yusoff MSB, Roslan NS, et al.
    Clin Nutr, 2019 10;38(5):2053-2064.
    PMID: 30266270 DOI: 10.1016/j.clnu.2018.09.010
    BACKGROUND & AIMS: To investigate the effects of probiotic in alleviation of stress in stressed adults, along our focus to identify and justify strain specificity on selected health benefits with a precisely targeted population.

    METHODS: This 12-weeks randomized, double-blind and placebo-controlled study investigated the effects of a probiotic (Lactobacillus plantarum P8; 10 log CFU daily) on psychological, memory and cognition parameters in one hundred and three (P8 n = 52, placebo n = 51) stressed adults with mean age of 31.7 ± 11.1 years old. All subjects fulfilled the criteria of moderate stress upon diagnosis using the PSS-10 questionnaire.

    RESULTS: At the end of study, subjects on P8 showed reduced scores of stress (mean difference 2.94; 95% CI 0.08 to 5.73; P = 0.048), anxiety (mean difference 2.82; 95% CI 0.35 to 5.30; P = 0.031) and total score (mean difference 8.04; 95% CI 0.73 to 15.30; P = 0.041) as compared to placebo after 4-weeks, as assessed by the DASS-42 questionnaire. Although plasma cortisol levels were only marginally different between placebo and P8 (mean difference 3.28 ug/dl; 95% CI -7.09 to 0.52; P = 0.090), pro-inflammatory cytokines such as IFN-γ (mean difference 8.07 pg/ml; 95% CI -11.2 to -4.93; P 

  8. Mat Yudin Z, Ali K, Wan Ahmad WMA, Ahmad A, Khamis MF, Brian Graville Monteiro N', et al.
    Eur J Dent Educ, 2020 Feb;24(1):163-168.
    PMID: 31698535 DOI: 10.1111/eje.12480
    AIMS: To evaluate the self-perceived preparedness of final-year dental undergraduate students in dental public universities in Malaysia.

    METHODS: Final-year dental undergraduate students from six dental public universities in Malaysia were invited to participate in an online study using a validated Dental Undergraduates Preparedness Assessment Scale DU-PAS.

    RESULTS: In total, about 245 students responded to the online questionnaire yielding a response rate of 83.05%. The age range of the respondents was 23-29 years with a mean age of 24.36 (SD 0.797). The total score obtained by the respondents was ranged from 48 to 100 with a mean score of 79.56 (SD 13.495). Weaknesses were reported in several clinical skills, cognitive and behavioural attributes.

    CONCLUSIONS: The preparedness of undergraduate students at six dental institutions in Malaysia was comparable to students from developed countries. The dental undergraduate preparedness assessment scale is a useful tool, and dental institutions may be used for self-assessment as well as to obtain feedback from the supervisors.

  9. Cerci JJ, Fanti S, Lobato EE, Kunikowska J, Alonso O, Medina S, et al.
    J Nucl Med, 2022 Feb;63(2):240-247.
    PMID: 34215674 DOI: 10.2967/jnumed.120.261886
    Biochemical recurrence (BCR) is a clinical challenge in prostate cancer (PCa) patients, as recurrence localization guides subsequent therapies. The use of PET with prostate-specific membrane antigen (PSMA) provides better accuracy than conventional imaging practice. This prospective, multicenter, international study was performed to evaluate the diagnostic performance and clinical impact of PSMA PET/CT for evaluating BCR in PCa patients in a worldwide scenario. Methods: Patients were recruited from 17 centers in 15 countries. Inclusion criteria were histopathologically proven prostate adenocarcinoma, previous primary treatment, clinically established BCR, and negative conventional imaging (CT plus bone scintigraphy) and MRI results for patients with PSA levels of 4-10 ng/mL. All patients underwent PET/CT scanning with 68Ga-PSMA-11. Images and data were centrally reviewed. Multivariate logistic regression analysis was applied to identify the independent predictors of PSMA-positive results. Variables were selected for this regression model on the basis of significant associations in the univariate analysis and previous clinical knowledge: Gleason score, the PSA level at the time of the PET scan, PSA doubling time, and primary treatment strategy. All patients were monitored for a minimum of 6 mo. Results: From a total of 1,004 patients, 77.7% were treated initially with radical prostatectomy and 22.3% were treated with radiotherapy. Overall, 65.1% had positive PSMA PET/CT results. PSMA PET/CT positivity was correlated with the Gleason score, PSA level at the time of the PET scan, PSA doubling time, and radiotherapy as the primary treatment (P < 0.001). Treatment was modified on the basis of PSMA PET/CT results in 56.8% of patients. PSMA PET/CT positivity rates were consistent and not statistically different among countries with different incomes. Conclusion: This multicenter, international, prospective trial of PSMA PET/CT confirmed its capability for detecting local and metastatic recurrence in most PCa patients in the setting of BCR. PSMA PET/CT positivity was correlated with the Gleason score, PSA level at the time of the PET scan, PSA doubling time, and radiotherapy as the primary treatment. PSMA PET/CT results led to changes in therapeutic management in more than half of the cohort. The study demonstrated the reliability and worldwide feasibility of PSMA PET/CT in the workup of PCa patients with BCR.
  10. Kurniawan SB, Imron MF, Chik CENCE, Owodunni AA, Ahmad A, Alnawajha MM, et al.
    Sci Total Environ, 2022 Feb 01;806(Pt 4):150902.
    PMID: 34653447 DOI: 10.1016/j.scitotenv.2021.150902
    Biocoagulants and bioflocculants are alternative items that can be used to substitute the utilization of common-chemical coagulants and flocculants. Biocoagulants/bioflocculants can be extracted from animals, microorganisms, and plants. Moreover, biocoagulants/bioflocculants have specific characteristics that contribute to the coagulation and flocculation processes. The active compounds inside biocoagulants/bioflocculants vary and correspond to the specific working mechanisms, including charge neutralization, sweep coagulation, adsorption, bridging, and patch flocculation. This review paper summarizes the characteristics of biocoagulants/bioflocculants from different sources and its performance in treating various pollutants. Furthermore, this paper discusses the most contributing compounds and functional groups of biocoagulants/bioflocculants that can be related to their working mechanisms. Several functional groups and compounds in biocoagulants/bioflocculants are highlighted in this review article, as well as the correlation between the highlighted groups/compounds to the aforementioned coagulation-flocculation mechanisms. In addition, current knowledge gaps in the study of biocoagulants/bioflocculants and future approaches that may serve as research directions are also emphasized. This review article is expected to shed information on the characteristics of biocoagulants/bioflocculants, which may then become a focus in the optimization to obtain higher performance in future application of coagulation-flocculation processes.
  11. Ang GY, Yu CY, Subramaniam V, Abdul Khalid MI, Tuan Abdu Aziz TA, Johari James R, et al.
    PLoS One, 2016;11(10):e0164169.
    PMID: 27798644 DOI: 10.1371/journal.pone.0164169
    The human cytochrome P450 (CYP) is a superfamily of enzymes that have been a focus in research for decades due to their prominent role in drug metabolism. CYP2C is one of the major subfamilies which metabolize more than 10% of all clinically used drugs. In the context of CYP2C19, several key genetic variations that alter the enzyme's activity have been identified and catalogued in the CYP allele nomenclature database. In this study, we investigated the presence of well-established variants as well as novel polymorphisms in the CYP2C19 gene of 62 Orang Asli from the Peninsular Malaysia. A total of 449 genetic variants were detected including 70 novel polymorphisms; 417 SNPs were located in introns, 23 in upstream, 7 in exons, and 2 in downstream regions. Five alleles and seven genotypes were inferred based on the polymorphisms that were found. Null alleles that were observed include CYP2C19*3 (6.5%), *2 (5.7%) and *35 (2.4%) whereas allele with increased function *17 was detected at a frequency of 4.8%. The normal metabolizer genotype was the most predominant (66.1%), followed by intermediate metabolizer (19.4%), rapid metabolizer (9.7%) and poor metabolizer (4.8%) genotypes. Findings from this study provide further insights into the CYP2C19 genetic profile of the Orang Asli as previously unreported variant alleles were detected through the use of massively parallel sequencing technology platform. The systematic and comprehensive analysis of CYP2C19 will allow uncharacterized variants that are present in the Orang Asli to be included in the genotyping panel in the future.
  12. Chen HWJ, Marzo RR, Sapa NH, Ahmad A, Anuar H, Baobaid MF, et al.
    Healthcare (Basel), 2023 May 17;11(10).
    PMID: 37239741 DOI: 10.3390/healthcare11101455
    BACKGROUND: While social media continues to dominate, social media platforms have become powerful health communication tools for older users. However, fulfilling their social media needs can be both detrimental and beneficial to their quality of life (QoL). This study assessed social media needs as they relate to QoL among older adults in Malaysia.

    METHODS: We conducted a cross-sectional study and adopted convenience sampling to recruit participants. The participants were required to self-report their sociodemographic profile, social media use and needs, and QoL. Social media use and needs were assessed using the Social Networking Sites Uses and Needs (SNSUN) scale, and QoL was assessed using the WHOQOL-BREF questionnaire. Multiple linear regression was performed to identify the predictors of QoL.

    RESULTS: The findings revealed that the fulfilment of social integrative needs was the strongest predictor of higher QoL in all domains. However, those using social media for their affective needs demonstrated lower psychological health quality.

    CONCLUSIONS: Fulfilling social integrative needs is the key to improving the QoL among older adults. The continuous development of age-friendly applications is essential to keep up with constantly changing social media trends and bridge the gap of social media inequalities. More importantly, it would enable older adults to utilize social media to its fullest potential and enjoy a higher QoL through accessible health communication tools.

  13. Lee JK, Chee WS, Foo SH, Lee VK, Sallehuddin H, Khor HM, et al.
    Osteoporos Int, 2023 Nov;34(11):1837-1850.
    PMID: 37430004 DOI: 10.1007/s00198-023-06841-4
    PURPOSE: Vitamin D deficiency and insufficiency is common among populations globally, and in Asia and Malaysia. The purpose of this Position Paper is to propose recommendations for both clinicians and non-clinicians to promote vitamin D sufficiency in Malaysian adults. Formation of a national multisector, multidisciplinary alliance is also proposed to progress initiatives relating to safe sun exposure, adequate vitamin D intake through food fortification, and vitamin D supplementation for high-risk groups.

    METHODS: Literature reviews were undertaken to inform summaries of the following: vitamin D status globally and in Asian and Malaysian populations, vitamin D status among individuals with common medical conditions, and current recommendations to achieve vitamin D sufficiency through sun exposure, food intake and supplementation. Recommendations were based on the findings of the literature reviews, recent European guidance on vitamin D supplementation, the 2018 road map for action on vitamin D in low- and middle-income countries, and research recommendations proposed by the Malaysian Ministry of Health in 2017.

    RESULTS: Recommendations on assessment of vitamin D in the adult Malaysian population include using serum or plasma 25-hydroxyvitamin D concentration as a biomarker, widespread participation by Malaysian laboratories in the Vitamin D Standardization Program, adoption of the US Endocrine Society definitions of vitamin D deficiency and insufficiency, and development of a comprehensive nationwide vitamin D status study. Specific high-risk groups are identified for vitamin D assessment and recommendations relating to loading doses and ongoing management are also made.

    CONCLUSION: This Position Paper provides individual clinicians and national stakeholder organisations with clear recommendations to achieve vitamin D sufficiency in the adult population of Malaysia.

  14. Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, et al.
    Int J Environ Res Public Health, 2022 Sep 23;19(19).
    PMID: 36231349 DOI: 10.3390/ijerph191912051
    Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
  15. Teh LK, Subramaniam V, Tuan Abdu Aziz TA, Lee LS, Ismail MI, Yu CY, et al.
    Drug Metab. Pharmacokinet., 2016 Aug;31(4):304-13.
    PMID: 27325019 DOI: 10.1016/j.dmpk.2016.04.004
    We conducted a systematic characterization of CYP2C9 variants in 61 Orang Asli and 96 Singaporean Malays using the whole genome sequences data and compared the variants with the other 11 HapMap populations. The frequency of rs1057910 (CYP2C9*3) is the highest in the Orang Asli compared to other populations. Three alleles with clinical implication were detected in the Orang Asli while 2 were found in the Singaporean Malays. Large numbers of the Orang Asli are predicted to have reduced metabolic capacity and therefore they would require a lower dose of drugs which are metabolized by CYP2C9. They are also at increased risks of adverse effects and therapeutic failures. A large number of CYP2C9 variants in the Orang Asli were not in the Hardy Weinberg Equilibrium which could be due to small sample size or mutations that disrupt the equilibrium of allele frequencies. In conclusion, different polymorphism patterns, allele frequencies, genotype frequencies and LD blocks are observed between the Orang Asli, the Singaporean Malays and the other populations. The study provided new information on the genetic polymorphism of CYP2C9 which is important for the implementation of precision medicine for the Orang Asli.
  16. Marzo RR, Ahmad A, Islam MS, Essar MY, Heidler P, King I, et al.
    PLoS Negl Trop Dis, 2022 01;16(1):e0010103.
    PMID: 35089917 DOI: 10.1371/journal.pntd.0010103
    BACKGROUND: Mass vaccination campaigns have significantly reduced the COVID-19 burden. However, vaccine hesitancy has posed significant global concerns. The purpose of this study was to determine the characteristics that influence perceptions of COVID-19 vaccine efficacy, acceptability, hesitancy and decision making to take vaccine among general adult populations in a variety of socioeconomic and cultural contexts.

    METHODS: Using a snowball sampling approach, we conducted an online cross-sectional study in 20 countries across four continents from February to May 2021.

    RESULTS: A total of 10,477 participants were included in the analyses with a mean age of 36±14.3 years. The findings revealed the prevalence of perceptions towards COVID-19 vaccine's effectiveness (78.8%), acceptance (81.8%), hesitancy (47.2%), and drivers of vaccination decision-making (convenience [73.3%], health providers' advice [81.8%], and costs [57.0%]). The county-wise distribution included effectiveness (67.8-95.9%; 67.8% in Egypt to 95.9% in Malaysia), acceptance (64.7-96.0%; 64.7% in Australia to 96.0% in Malaysia), hesitancy (31.5-86.0%; 31.5% in Egypt to 86.0% in Vietnam), convenience (49.7-95.7%; 49.7% in Austria to 95.7% in Malaysia), advice (66.1-97.3%; 66.1% in Austria to 97.3% in Malaysia), and costs (16.0-91.3%; 16.0% in Vietnam to 91.3% in Malaysia). In multivariable regression analysis, several socio-demographic characteristics were identified as associated factors of outcome variables including, i) vaccine effectiveness: younger age, male, urban residence, higher education, and higher income; ii) acceptance: younger age, male, urban residence, higher education, married, and higher income; and iii) hesitancy: male, higher education, employed, unmarried, and lower income. Likewise, the factors associated with vaccination decision-making including i) convenience: younger age, urban residence, higher education, married, and lower income; ii) advice: younger age, urban residence, higher education, unemployed/student, married, and medium income; and iii) costs: younger age, higher education, unemployed/student, and lower income.

    CONCLUSIONS: Most participants believed that vaccination would effectively control and prevent COVID-19, and they would take vaccinations upon availability. Determinant factors found in this study are critical and should be considered as essential elements in developing COVID-19 vaccination campaigns to boost vaccination uptake in the populations.

  17. Marzo RR, Ismail Z, Nu Htay MN, Bahari R, Ismail R, Villanueva EQ, et al.
    PMID: 33619459 DOI: 10.1016/j.cegh.2021.100708
    The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.
  18. Ahmad A, Lim LL, Morieri ML, Tam CH, Cheng F, Chikowore T, et al.
    Commun Med (Lond), 2024 Jan 22;4(1):11.
    PMID: 38253823 DOI: 10.1038/s43856-023-00429-z
    BACKGROUND: Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D).

    METHODS: We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies.

    RESULTS: Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort.

    CONCLUSIONS: Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.

  19. Chew NWS, Ngiam JN, Tan BY, Tham SM, Tan CY, Jing M, et al.
    BJPsych Open, 2020 Oct 08;6(6):e116.
    PMID: 33028449 DOI: 10.1192/bjo.2020.98
    BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.

    AIMS: In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.

    METHOD: From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.

    RESULTS: A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.

    CONCLUSIONS: This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.

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