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  1. Mohidin N, Mat Yacob A, Norazman FN
    Med J Malaysia, 2020 09;75(5):538-542.
    PMID: 32918423
    BACKGROUND: Menicon Z night orthokeratology (OK) lenses was introduced in Malaysia in 2015 and to date there is no report on its effects on the cornea. The objective of this study was to examine short term changes in corneal thickness and morphology of endothelial cells in young Malay adults after wearing Menicon Z night OK lenses.

    METHODS: Corneal thickness was measured at the central and mid-peripheral locations of 20 participants aged 22.45±1.19 years using Tomey SP-3000 A-scan ultrasonography. Endothelial images of the central and peripheral locations captured using Tomey EM-3000 specular microscope were noted. Corneal thickness, endothelial cell density (ECD), coefficient of variation in cell size (CV), and hexagonality (HEX) at baseline, 24 hours, three months and six months after treatment were noted and analysed using repeated measure analysis of variance.

    RESULTS: Central corneal thickness decreased significantly over a three-month period (p=0.001) and stabilised thereafter. There were no significant changes in thickness in all peripheral areas measured (p>0.05), and in ECD, CV and HEX after the six-month period (p>0.05).

    CONCLUSIONS: The current study showed that significant thinning of central cornea and none at the mid-periphery. OK lens wear with Menicon Z night lenses had no effects on corneal morphology over the six month period.

    Matched MeSH terms: Young Adult
  2. Lim YX, Chai SC
    J Hand Ther, 2020 03 04;33(4):553-561.
    PMID: 32143983 DOI: 10.1016/j.jht.2019.09.001
    STUDY DESIGN: Cross-sectional study.

    INTRODUCTION: Adhering to test administration and standardized instructions is important for attainment of accurate and reliable results in performance-based tests.

    PURPOSE OF THE STUDY: To determine test-retest and interrater reliability of standardized translated instruction (St-TI) and spontaneously translated instruction (Sp-TI) of a hand function test.

    METHODS: Four raters and seventy-two subjects were divided into 2 groups: St-TI group, direct administration of the Hong Kong Chinese version of the Jebsen Hand Function Test to subjects by raters; and Sp-TI group, spontaneously translating the Jebsen-Taylor Hand Function Test from English into Chinese by raters. Test-retest and interrater reliability were calculated based on instruction time by the rater and performance time by the subject.

    RESULTS: Test-retest and interrater reliability of instruction time by rater for St-TI has intraclass correlation coefficient of 0.35 to 0.70 and 0.24 to 0.55, respectively, whereas that for Sp-TI was -0.50 to 0.18 and -0.09 to 0.51, respectively. Test-retest and interrater reliability of performance time by subject for St-TI was 0.56 to 0.84 and 0.33 to 0.78, respectively, whereas that for Sp-TI was 0.54 to 0.87 and 0.35 to 0.77, respectively. Sp-TI had two test-retest minimal detectable change percent values that fell within the acceptable range (subtest 3 = 21.9% and subtest 6 = 25.7%).

    CONCLUSION: Instruction time by rater for Jebsen-Taylor Hand Function Test subtests had generally poor to moderate test-retest and interrater reliability for both St-TI and Sp-TI. Performance time by subject generally had moderate to good reliability, except for St-TI with poor to good interrater reliability.

    Matched MeSH terms: Young Adult
  3. Thomas AG, Jonason PK, Blackburn JD, Kennair LEO, Lowe R, Malouff J, et al.
    J Pers, 2020 06;88(3):606-620.
    PMID: 31494937 DOI: 10.1111/jopy.12514
    OBJECTIVE: Mate choice involves trading-off several preferences. Research on this process tends to examine mate preference prioritization in homogenous samples using a small number of traits and thus provide little insight into whether prioritization patterns reflect a universal human nature. This study examined whether prioritization patterns, and their accompanying sex differences, are consistent across Eastern and Western cultures.

    METHOD: In the largest test of the mate preference priority model to date, we asked an international sample of participants (N = 2,477) to design an ideal long-term partner by allocating mate dollars to eight traits using three budgets. Unlike previous versions of the task, we included traits known to vary in importance by culture (e.g., religiosity and chastity).

    RESULTS: Under low budget conditions, Eastern and Western participants differed in their mate dollar allocation for almost every trait (average d = 0.42), indicating that culture influences prioritization. Despite these differences, traits fundamental for the reproductive success of each sex in the ancestral environment were prioritized by both Eastern and Western participants.

    CONCLUSION: The tendency to prioritize reproductively fundamental traits is present in both Eastern and Western cultures. The psychological mechanisms responsible for this process produce similar prioritization patterns despite cross-cultural variation.

    Matched MeSH terms: Young Adult
  4. Wong LP, Wong PF, Megat Hashim MMAA, Han L, Lin Y, Hu Z, et al.
    Hum Vaccin Immunother, 2020 07 02;16(7):1611-1622.
    PMID: 32429731 DOI: 10.1080/21645515.2020.1756670
    HPV vaccine hesitancy in Asia is unique compared to Western countries due to multidimensional social-cultural norms that influence beliefs regarding vaccination. Reviews on HPV vaccine hesitancy in Asia lack of in-depth discussion regarding the traditional and social-cultural norms dimensions. This paper puts forward opinions in which culture, normative beliefs, and religion influence HPV vaccine hesitancy in Asian countries. Issues surrounding HPV hesitancy among parents, young adult women, adult women, men and the sexual and gender minority people in Asian countries were highlighted. The shortage of HPV vaccine supply would soon be reduced as some Asian countries are on the way to producing the HPV vaccine which production is currently dominated by Western European countries. The culture of favoring imported Western products among many in Asia and in addition to long-existing fake vaccine crisis pose a challenge for the newly emerging HPV vaccine produced in Asia. Some recommendations, research gaps, and future research needs were discussed.
    Matched MeSH terms: Young Adult
  5. Ahmed T, Rahman NA, Alam MK
    Biomed Res Int, 2021;2021:6663683.
    PMID: 33959664 DOI: 10.1155/2021/6663683
    Objective: To compare the orthodontic bracket debonding force and assess the bracket failure pattern clinically between different teeth by a validated prototype debonding device. Materials and Method. Thirteen (13) patients at the end of comprehensive fixed orthodontic treatment, awaiting for bracket removal, were selected from the list. A total of 260 brackets from the central incisor to the second premolar in both jaws were debonded by a single clinician using a validated prototype debonding device equipped with a force sensitive resistor (FSR). Mean bracket debonding forces were specified to ten (10) groups of teeth. Following debonding, Intraoral microphotographs of the teeth were taken by the same clinician to assess the bracket failure pattern using a 4-point scale of adhesive remnant index (ARI). Statistical analysis included one-way ANOVA with post hoc Tukey HSD and independent sample t-test to compare in vivo bracket debonding force, Cohen's kappa (κ), and a nonparametric Kruskal-Wallis test for the reliability and the assessment of ARI scoring.

    Results: A significant difference (p < 0.001) of mean debonding force was found between different types of teeth in vivo. Clinically, ARI scores were not significantly different (p = 0.921) between different groups, but overall higher scores were predominant.

    Conclusion: Bracket debonding force should be measured on the same tooth from the same arch as the significant difference of mean debonding force exists between similar teeth of the upper and lower arches. The insignificant bracket failure pattern with higher ARI scores confirms less enamel damage irrespective of tooth types.

    Matched MeSH terms: Young Adult
  6. Kai Sze Chan, Yit Siew Chin
    MyJurnal
    Introduction: Recognising the limitations of present dietary assessments method, recent attention had been drawn to image-based food record (IBFR) to assess dietary intake of the population. Thus, the present study aimed to compare nutrient intake assessed using IBFR with 24-hour diet recall (24DR) among nutrition and dietetics student. Method: There were 46 nutrition and dietetic undergraduates participated in the study, and information on the socio-demo- graphic background and acceptability toward IBFR were obtained. Respondents were trained to complete one-day IBFR, and they were interviewed by researchers on the following day for their 24DR. Result: The mean age of respon- dents was 21.4±1.7 years old. The present study revealed that there were significantly higher protein and beta-caro- tene, but lower vitamin C reported by IBFR compared to 24DR. Medium to strong correlations were found between IBFR and 24DR for energy and nutrients intakes. The Bland-Altman analysis demonstrated a good level of agreement between IBFR and 24DR for energy and macronutrients (carbohydrates, protein and fat), respectively. The mean differences between IBFR and 24DR were -36 kcal for total daily energy intake, while mean differences of -12.24g, 0.79g, and 1.52g were reported for carbohydrates protein, and fat, respectively. Moderate level of agreement toward acceptability was demonstrated, and most of them (67.4%) preferred IBFR method. Conclusion: The present study re- vealed that IBFR showed a good level of agreement with 24DR in assessing nutrient intake. However, more extensive works should be considered to improve IBFR in assessing the energy and nutrients intake for the general population.
    Matched MeSH terms: Young Adult
  7. Sohn AH, Chokephaibulkit K, Lumbiganon P, Hansudewechakul R, Gani YM, Van Nguyen L, et al.
    J Adolesc Health, 2020 01;66(1):92-99.
    PMID: 31627925 DOI: 10.1016/j.jadohealth.2019.07.025
    PURPOSE: The aim of this article was to study the clinical and social outcomes of health care transition among Asian adolescents and young adults with HIV (AYHIV).

    METHODS: AYHIV who transferred from a pediatric to an adult clinic within the past year across five sites in Malaysia, Thailand, and Vietnam had clinical and laboratory evaluations and completed questionnaires about their health, socioeconomic factors, and transition experiences. Multiple logistic regression was used to assess associations with HIV viremia.

    RESULTS: Of 93 AYHIV enrolled between June 2016 and April 2017, 56% were female, 87% acquired HIV through perinatal exposure, median age was 20 years (interquartile range [IQR] 18.5-21). Two-thirds were in a formal education program, 43% were employed, 43% of females and 35% of males were sexually active. Median lifetime antiretroviral therapy duration was 6.2 years (IQR 3.3-10.7); 45% had received second-line therapy. Median CD4 was 601 cells/mm3 (IQR 477-800); 82% had HIV-RNA <40 copies/mL. Being in a relationship, a shorter posttransition duration, self-reported adherence of ≥95%, and higher CD4 were inversely associated with HIV viremia. Half felt very prepared for the transfer to adult care, and 20% frequently and 43% sometimes still met with pediatric providers. Two-thirds reported needing to keep their HIV a secret, and 23%-38% reported never or rarely having someone to discuss problems with.

    CONCLUSIONS: Asian AYHIV in our cohort were concerned about the negative social impact of having and disclosing HIV, and one-third lacked people they could trust with their personal problems, which could have negative implications for their ability to navigate adult life.

    Matched MeSH terms: Young Adult
  8. Saranya K, Ponnada SR, Cheruvathoor JJ, Jacob S, Kandukuri G, Mudigonda M, et al.
    J Forensic Odontostomatol, 2021 Apr 30;1(39):16-23.
    PMID: 34057154
    Juvenile crime or delinquency has been increasing at an alarming rate in recent times. In many countries, including India, the minimum age for criminal responsibility is 16 years. The present study aimed to estimate the probability of a south Indian adolescent either being or being older than the legally relevant age of 16 years using Demirjian's tooth formation stages. Orthopantomograms (OPG) of 640 south Indian adolescents (320 boys and 320 girls) aged between 12 and 20 years were retrospectively analyzed. In each OPG, Demirjian's formation stage of the mandibular left third molar was recorded and the data was subjected to statistical analysis. Descriptive and Pearsons correlation statistics were performed. The empirical probabilities were provided relative to the medico-legal question of predicting 16 years of age. The distribution of age throughout the 10th, 25th, 50th, 75th and 90th percentile follows a logical distribution pattern horizontally and vertically. Pearson's correlation statistics showed a strong positive correlation between the Demirjian's stages and age for both sexes. Therefore, it can be concluded that stage "F" can be used to predict the attainment of age equal to or older than 16 years with a probability of 93.9% for boys and 96.6% for girls.
    Matched MeSH terms: Young Adult
  9. Sohayla M. Attalla, Sakinah Ruhi, Che Nur Fadhlina Bt Che Mud
    MyJurnal
    Introduction: Cigarette smoking is showing an increasing prevalence among university students nowadays. Smok- ing includes the act of smoking cigarette containing tobacco and/or other ingredients or just inhaling the cigarette smoke. Smoking has many known physical side effects that include psychological or cognitive effects. Therefore, the aim of this research is to identify the effect of cigarette smoking on the academic achievement among university students. Methods: A cross-sectional study was conducted among 136 students including 113 male and 23 fe- male aged 18 to 29 years from Management and Science University with 30 non smoker students. The question- naire included items about the social demographic characteristics, smoking status, the study styles and the aca- demic achievement of the participants. A frequency statistics, descriptive statistics and chi square test were used to analyze the collected data using SPSS version 25. Results: Among the smoker students, 51.5% came to class ear- ly, 80.8% attend classes regularly, 49.3% studied on weekends and 39.7% planned sufficient time to study for exam. Mean CGPA for smoker students is 2.6. Conclusion: Smoking is proven to be associated with low academic performance among university student.
    Matched MeSH terms: Young Adult
  10. Tan RKJ, O'Hara CA, Koh WL, Le D, Tan A, Tyler A, et al.
    BMC Public Health, 2021 05 31;21(1):1026.
    PMID: 34059021 DOI: 10.1186/s12889-021-11056-5
    BACKGROUND: Young gay, bisexual, and other men who have sex with men (YMSM) are vulnerable to the risks associated with sexualized substance use. This is a novel study in Singapore that aims to classify patterns of sexualized substance use among YMSM, and investigate its association with sexual and mental health outcomes.

    METHODS: In this cross-sectional study among 570 YMSM aged 18 to 25 years old, latent class analysis (LCA) conducted to identify classes with similar patterns of sexualized substance use, across which measures of inconsistent condom use, recent STI diagnoses, past suicide ideation and depression severity were compared.

    RESULTS: LCA revealed three classes of YMSM based on types of substances ever used in sexualized contexts, which we labelled as 'substance-naive', 'substance-novice', and 'chemsex'. Substance-naive participants (n = 404) had only ever used alcohol, while substance-novice participants (n = 143) were primarily amyl nitrite users with a small proportion who reported using chemsex-related drugs. Chemsex participants (n = 23) comprised individuals who had mostly used such drugs. Those in the chemsex group were more likely to report recent unprotected anal sex with casual partners (aPR = 3.28, 95%CI [1.85, 5.79]), depression severity (aβ = 3.69, 95%CI [0.87, 6.51]) and a history of suicide ideation (aPR = 1.64, 95%CI [1.33, 2.03]).

    CONCLUSIONS: Findings of this study highlight how the use of varying substances in sexualized contexts may be classified and characterized by different sexual and mental health outcomes. Health promotion efforts should be differentiated accordingly to address the risks associated with sexualized substance use among YMSM.

    Matched MeSH terms: Young Adult
  11. Helmyati S, Kiasaty S, Amalia AW, Sholihah H, Kurnia M, Wigati M, et al.
    J Diabetes Metab Disord, 2020 Dec;19(2):749-757.
    PMID: 33553011 DOI: 10.1007/s40200-020-00555-8
    Purpose: The purpose of this study is to explore the preference and acceptance of white rice substitution with brown and black rice among young adults in Indonesia to prevent diabetes.

    Methods: This study used a qualitative design. Rice preference deeply explored using focus group discussion as a case-study. 85 informants with an average of ages 20 years old were divided into several groups. Several topics to discuss include the reasons to accept or reject brown and black rice, knowledge, attitude, motivation, and potency to substitute white rice.

    Results: Price was the main barrier to substitute white rice to brown and black rice. The participants have known brown rice from parents, mass media, and friends. Most of them were still unfamiliar with black rice. Culture also affected the preferences of the participants. To motivate people to change their white rice diet, creative packaging and segmentation of the sale were recommended.

    Conclusion: Substituting white to brown and black rice is still a challenge for young adults in Indonesia. Several barriers such as culture, accessibility, and affordability need to be considered. Further efforts are important to manage a program to increase brown and black rice consumption.

    Matched MeSH terms: Young Adult
  12. Tang ASO, Wong QY, Yeo ST, Ting IPL, Lee JTH, Fam TL, et al.
    Am J Case Rep, 2021 May 26;22:e931655.
    PMID: 34038399 DOI: 10.12659/AJCR.931655
    BACKGROUND Leprosy is an infection caused by Mycobacterium leprae. An extensive literature search did not reveal many reports of melioidosis in association with leprosy. CASE REPORT A 22-year-old woman, who was diagnosed with multibacillary leprosy, developed dapsone-induced methemoglobinemia and hemolytic anemia, complicated by melioidosis. Methemoglobinemia was treated with methylene blue and vitamin C. Two weeks of ceftazidime was initiated to treat melioidosis, and the patient was discharged on amoxicillin/clavulanic acid and doxycycline as melioidosis eradication therapy. However, she developed drug-induced hypersensitivity. Trimethoprim/sulfamethoxazole, as an alternative treatment for melioidosis eradication, was commenced and was successfully completed for 12 weeks. During the fifth month of multidrug therapy, the patient developed type II lepra reaction with erythema nodosum leprosum reaction, which was treated with prednisolone. Leprosy treatment continued with clofazimine and ofloxacin, and complete resolution of skin lesions occurred after 12 months of therapy. CONCLUSIONS Our case highlighted the challenges posed in managing a patient with multibacillary leprosy with multiple complications. Clinicians should be aware that dapsone-induced methemoglobinemia and hemolysis might complicate the treatment of leprosy. Our case also highlighted the safety and efficacy of combining ofloxacin and clofazimine as a leprosy treatment regimen in addition to gradual steroid dose titration in the presence of type II lepra reaction.
    Matched MeSH terms: Young Adult
  13. Che Hasan MK, Abdullah F, Firdaus MKZH, Jamaludin FIC
    Enferm Clin, 2021 04;31 Suppl 2:S247-S251.
    PMID: 33849174 DOI: 10.1016/j.enfcli.2020.09.010
    This study was conducted to examine the association between physical activity (PA) and body weight status among adolescents in rural and urban areas. This cross-sectional study involved 257 adolescents aged 13-19 years, randomly selected from secondary schools around Kelantan, Malaysia. Body weight and height were measured and body mass index (BMI) was calculated. The students completed the International Physical Activity Questionnaire - Short Form, to assess their physical activity. Ethical clearance was obtained from respected bodies. Adolescents in the urban area had significantly higher BMI (p-value<0.001) and lower physical activity (p-value<0.001) than adolescents in the rural area. A significant association also found between BMI and PA in both urban and rural areas. In conclusion, more physically active adolescents had lower BMI than who are less physically active. Being physically active could lower the body weight and BMI, hence improve musculoskeletal health, and could reduce co-morbidity.
    Matched MeSH terms: Young Adult
  14. Wai Heng Chew, Abdul Aziz Marwan, Ummi Nadira Daut, Rosmadi Ismail, Mona Zaria Nasaruddin, Jamalul Azizi Abdul Rahman
    MyJurnal
    Sarcomas usually frequented in the head and neck region of young adults. Trachea is a rare site, and due to scarce clinical data, its clinical outcome is unclear. We reported a case of 60-year old patient presented with progressive worsening shortness of breath, cough, and progressive worsening dysphagia. Computer tomography scan revealed extensive 2 lobulated soft tissue lesions within and surrounding the trachea at the T4 level. Rigid bronchoscopy with mass cryo-debulking was performed and ultimately synovial sarcoma was diagnosed. Shortness of breath was com- pletely relieved post-procedure.
    Matched MeSH terms: Young Adult
  15. Wong JSL, Nasruddin AB, Selveindran NM, Latif KA, Kassim F, Nair SB, et al.
    AACE Clin Case Rep, 2021 02 01;7(3):220-225.
    PMID: 34095493 DOI: 10.1016/j.aace.2021.01.008
    Objective: Primary hypophysitis refers to the isolated inflammation of the pituitary gland not associated with other secondary causes. Among its histopathologic subtypes, xanthomatous is the rarest.

    Methods: We describe a 22-year-old woman with xanthomatous hypophysitis (XH), its clinical progression over 8 years as well as the treatment effects of prednisolone and azathioprine. Our patient was first referred for severe short stature and delayed puberty at the age of 14 years.

    Results: Investigations revealed multiple pituitary deficiencies. Magnetic resonance imaging showed a pituitary mass whereby a partial resection was performed. A full resection was not feasible due to the location of the mass. The histopathologic analysis of the tissue was consistent with XH. The results of secondary workout for neoplasm, infection, autoimmune, and inflammatory disorders were negative. After surgery, a progressive enlargement of the mass was observed. Two courses of prednisolone were administered with a significant reduction in the mass size. Azathioprine was added due to the unsustained effects of prednisolone when tapered off and the concern of steroid toxicity with continued use. No further increase in the mass size was noted after 6 months on azathioprine.

    Conclusion: Glucocorticoid and immunotherapy are treatment options for XH; however, more cases are needed to better understand its pathogenesis and clinical progression.

    Matched MeSH terms: Young Adult
  16. Othman EA, Yusoff AN, Mohamad M, Abdul Manan H, Abd Hamid AI, Giampietro V
    J Magn Reson Imaging, 2020 06;51(6):1821-1828.
    PMID: 31794119 DOI: 10.1002/jmri.27016
    BACKGROUND: The auditory and prefrontal cortex supports auditory working memory processing. Many neuroimaging studies have shown hemispheric lateralization of auditory working memory brain regions in the presence of background noise, but few studies have focused on the lateralization of these regions during stochastic resonance.

    PURPOSE: To investigate the effects of stochastic resonance on lateralization of auditory working memory regions, and also to examine the brain-behavior relationship during stochastic resonance.

    STUDY TYPE: Cross-sectional.

    POPULATION/SUBJECTS: Forty healthy young adults (18-24 years old).

    FIELD STRENGTH/SEQUENCE: 3.0T, T1 , and T2 *-weighted imaging.

    ASSESSMENT: The auditory working memory performance was assessed using a backward recall task. Functional magnetic resonance imaging (fMRI) was used to measure brain activity during task performance. Functional MRI data were analyzed using SPM12 and WFU PickAtlas.

    STATISTICAL TESTS: One-way independent analyses of variance (ANOVA) were conducted on the behavioral and functional data to examine the main effect of noise level on performance (P 

    Matched MeSH terms: Young Adult
  17. Ikhlasiah M, Winarni LM, Poddar S, Bhaumik A
    Enferm Clin, 2020 06;30 Suppl 5:202-205.
    PMID: 32713569 DOI: 10.1016/j.enfcli.2019.11.054
    Based on preliminary studies, it is known that 80% of working mothers fail to make exclusive breastfeeding, on average babies are given formula milk 2-4 months old and stop breastfeeding at 6-18 months of age. Papaya leaves are one of the galactagogues that contain quercetin which can activate the hormone prolactin and help increase breastmilk. The purpose of this study was to determine the effect of giving papaya leaf juice for nursing mothers who work toward increasing levels of the hormone prolactin and infant weight in Tangerang. The research design used was a pre-experimental model with one group pretest-posttest design. Samples taken as many as 10 mothers who have babies aged 0-6 months who have difficulty in breastfeeding because the amount of breastmilk was a little. The study was conducted in several clinics in Tangerang. The intervention was giving papaya leaf juice for 7 consecutive days. The results obtained from this study are as follows: 90% of mothers aged between 20 and 35 years, 70% of mothers have a history of spontaneous labor and have no complications at the time of delivery, 40% of mother's education is junior high school (SMP), and 70% of mothers are primiparas. The average increase in the amount of prolactin after the intervention was 19.59ng/ml, while the average weight gain of the newborn after the intervention was 165g. Wilcoxon test results for increased levels of the hormone prolactin p-value of 0.047<0.05 and for an increase in body weight of newborns p-value of 0.009<0.05. CONCLUSION: There is an effect of giving papaya leaf juice for nursing mothers who work on increasing levels of the hormone prolactin and infant weight in Tangerang. Papaya leaf juice can be a galactagogue for mothers who experience problems with a small amount of breastmilk.
    Matched MeSH terms: Young Adult
  18. Zin CS, Taufek NH, Bux SH
    Front Public Health, 2020;8:551328.
    PMID: 33365294 DOI: 10.3389/fpubh.2020.551328
    Uncontrolled drug pricing in the private healthcare system in Malaysia leads to high drug prices; however, its impact on employee drug utilization and employer reimbursement coverage is unclear. This study examined patterns of drug pricing and drug utilization among employees covered by employer medical insurance. A drug price control mechanism was also devised for the employer to ensure fair benefits to all parties without compromising the quality of patient care. This retrospective study was conducted among International Islamic University Malaysia (IIUM) community members who sought outpatient treatment at the IIUM panel of health clinics serviced by general practitioners from January 2016 to September 2019. Prescription data (drug type, dose, quantity, duration, price, and manufacturer), patient characteristics (age, sex, and diagnosis) and total charges were extracted from the claims database of PMCare, the insurance company managing IIUM medical claims. Patterns of commonly prescribed drugs, drug pricing, profit margins, and total charges per clinic visit were evaluated. Descriptive statistics were used, and all analyses were performed using Stata v15.1. There were a total of 161,146 prescriptions for 10,150 patients in the IIUM community during the study period (48.85% women, mean ± standard deviation; age: 26.33 ± 17.63 years). The most commonly prescribed drug was paracetamol (25.3%), followed by chlorpheniramine (9.46%), cetirizine (7.3%), diphenhydramine (6.13%), loratadine (4.57%), and diclofenac (4.36%). Generic paracetamol (500 mg), which serves as a prime example for details on drug pricing, is commonly charged between Ringgit Malaysia (RM) 5 and 10 for 10 tablets with a profit between 2,400 and 4,900% according to the average cost price of RM 0.20 per 10 tablets. Most patients were charged within the approved coverage limit of RM 45 per clinic visit, with only 2.41% of patients being charged with costs that exceeded this limit. Uncontrolled drug pricing in the private healthcare system in Malaysia indicates that drug prices differ greatly across private healthcare providers most of the prices were charged with high profit margins. Employers may consider a multilayer capping system to prevent inappropriate drug pricing, which will inevitably benefit patients clinically and economically and provide greater patient access to better drug treatment.
    Matched MeSH terms: Young Adult
  19. Thangiah N, Chinna K, Su TT, Jalaludin MY, Al-Sadat N, Majid HA
    PMID: 32257989 DOI: 10.3389/fpubh.2020.00069
    Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time. Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages. Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13-15 year) to 19.5% (15-17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%. Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.
    Matched MeSH terms: Young Adult
  20. Teoh AN, Kaur S, Mohd Shukri NH, Shafie SR, Ahmad Bustami N, Takahashi M, et al.
    Chronobiol Int, 2021 07;38(7):959-970.
    PMID: 33779445 DOI: 10.1080/07420528.2021.1902338
    Psychological distress during pregnancy may increase the risk of adverse maternal and infant outcomes. Past studies have demonstrated the association between circadian disturbances with psychological health. However, the roles of chronotype and social jetlag on psychological state during pregnancy are yet to be identified. We aimed to examine the psychological state in pregnant women and its relations to chronotype, social jetlag (SJL), sleep quality and cortisol rhythm. The current study included a subsample of participants from an ongoing cohort study. A total of 179 primigravidas (mean age 28.4 ± 4.0 years) were recruited. Chronotype and sleep quality during the second trimester were assessed using the Morning-Eveningness Questionnaire (MEQ) and Pittsburgh Sleep Quality Index (PSQI), respectively. SJL was calculated based on the difference between mid-sleep on workdays and free days. Psychological state of participants was evaluated using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Subsamples (n = 70) provided salivary samples at 5 time points over a 24 h period during the second trimester for cortisol assay. A higher proportion of pregnant women experienced moderate to severe anxiety symptoms (n = 77, 43.0%), followed by depressive (n = 17, 9.5%) and stress (n = 14, 7.8%) symptoms. No association was observed between chronotype and psychological distress during pregnancy. There was no significant difference in cortisol rhythms in relation to psychological distress. SJL and sleep quality were significantly associated with stress symptoms among pregnant women in the second trimester. Poor sleep quality, particularly daytime dysfunction (β = 0.37, p = .006) and sleep disturbances (β = 0.23, p = .047), were significantly associated with psychological distress (depressive, anxiety and stress symptoms) during the second trimester. The findings suggest that sleep is a potential modifiable lifestyle factor that can be targeted to improve psychological health among pregnant women.
    Matched MeSH terms: Young Adult
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