Displaying publications 41 - 60 of 4452 in total

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  1. Ahamat H, Sa'ban H, Manap NA
    Health Care Anal, 2023 Dec;31(3-4):196-207.
    PMID: 37477838 DOI: 10.1007/s10728-023-00465-9
    The seriousness of the COVID-19 pandemic requires a look into the implementation of drug registration rules for COVID-19 vaccines. Amidst the surrounding exigencies, vaccines being a biological product, require comprehensive and continuing pre and post registration rules to ensure their safety and efficacy. The study focuses on Malaysia which has rules on drug registration that have been successfully applied to vaccines. The study shows that the rules have been tailor-made to emergency situations. At the moment, special rules have been introduced including to allow use of COVID-19 vaccines as unregistered product. Recognition of COVID-19 Vaccines Global Access (COVAX) facility and requirement for government sale only, are among the safety valves. The study shows that these however are temporary measures against the backdrops of possible entry of private players in the vaccination process. Therefore, regulatory responses to intellectual property (IP) related conditions underlying drug registration, and measures to ensure risk management involved in vaccine production, approval and administration are needed in the progressive rules pending further development of research in the area.
    Matched MeSH terms: Risk Assessment
  2. Yang M, Mohammad Yusoff WF, Mohamed MF, Jiao S, Dai Y
    J Environ Manage, 2024 Feb;351:119798.
    PMID: 38103426 DOI: 10.1016/j.jenvman.2023.119798
    With climate change and urbanization, flood disasters have significantly affected urban development worldwide. In this study, we developed a paradigm to assess flood economic vulnerability and risk at the urban mesoscale, focusing on urban land use. A hydrological simulation was used to evaluate flood hazards through inundation analyses, and a hazard-vulnerability matrix was applied to assess flood risk, enhancing the economic vulnerability assessment by quantifying the differing economic value and flood losses associated with different land types. The case study of Wangchengpo, Changsha, China, found average total economic losses of 126.94 USD/m2, with the highest risk in the settlement core. Residential areas had the highest flood hazard, vulnerability, and losses (61.10% of the total loss); transportation areas accounted for 27.87% of the total economic losses due to their high flooding depth. Despite low inundation, industrial land showed greater economic vulnerability due to higher overall economic value (10.52% of the total). Our findings highlight the influence of land types and industry differences on flood vulnerability and the effectiveness of land-use inclusion in urban-mesoscale analyses of spatial flood characteristics. We identify critical areas with hazard and economic vulnerability for urban land and disaster prevention management and planning, helping to offer targeted flood control strategies to enhance urban resilience.
    Matched MeSH terms: Risk Assessment
  3. Pourhassan B, Beigzadeh Z, Nasirzadeh N, Karimi A
    Biol Trace Elem Res, 2024 Mar;202(3):811-823.
    PMID: 37347403 DOI: 10.1007/s12011-023-03717-w
    Welding fumes have an important role to create the adverse health effects. So, the aim of this study was to use of multiple occupational health risk assessment models for metal fumes in welding process. This cross-sectional study was conducted among welding workers. Sampling of heavy metals such as Sn, Zn, Al, Fe, Cd, Pb, Cu, Mn, Ni, Cr, and As was provided based on the National Institute for Occupational Safety and Health (NIOSH) method 7300 and analyzed by inductively coupled plasma mass spectroscopy (ICP-MS). Risk assessment was managed by four methods including Malaysia's method, Control of Substances Hazardous to Health Essentials (COSHH model), Chinese OHRA standard (GBZ/T 298-2017), and EPA method. Also, Monte Carlo simulation was used to examine the uncertainties by using the Crystal Ball tool. To compare the models, the risk levels of each model were converted into the risk ratio and the SPSS 22.0 software was used to the statistical analysis. The consistency of the two occupational health risk assessment models was examined by Cohen's Kappa. Risk ration was the highest level for Cr (VI) fumes in all models. Also, carcinogenic risk was unacceptable for all examined fumes. Moreover, non-carcinogenic risk was the highest (HI > 1) for As fumes. Mont Carlo simulations suggested that exposure time (ET) had a significant effect on the risk. Also, there was a good consistency between Malaysia method/GBZ/T 298-2017 and COSHH model/GBZ/T 298-2017. Therefore, it is recommended that the engineering and administrative controls should be provided to reduce exposure.
    Matched MeSH terms: Risk Assessment
  4. Gad H, Kalra S, Pinzon R, Gracia RN, Yotsombut K, Coetzee A, et al.
    J Peripher Nerv Syst, 2024 Mar;29(1):28-37.
    PMID: 38268316 DOI: 10.1111/jns.12613
    Peripheral neuropathy (PN) often remains undiagnosed (~80%). Earlier diagnosis of PN may reduce morbidity and enable earlier risk factor reduction to limit disease progression. Diabetic peripheral neuropathy (DPN) is the most common PN and the 10 g monofilament is endorsed as an inexpensive and easily performed test for DPN. However, it only detects patients with advanced neuropathy at high risk of foot ulceration. There are many validated questionnaires to diagnose PN, but they can be time-consuming and have complex scoring systems. Primary care physicians (PCPs) have busy clinics and lack access to a readily available screening method to diagnose PN. They would prefer a short, simple, and accurate tool to screen for PN. Involving the patient in the screening process would not only reduce the time a physician requires to make a diagnosis but would also empower the patient. Following an expert meeting of diabetologists and neurologists from the Middle East, South East Asia and Latin America, a consensus was formulated to help improve the diagnosis of PN in primary care using a simple tool for patients to screen themselves for PN followed by a consultation with the physician to confirm the diagnosis.
    Matched MeSH terms: Risk Factors
  5. Mohamad MA, Leong Bin Abdullah MFI, Shari NI
    BMC Geriatr, 2024 Mar 14;24(1):254.
    PMID: 38486186 DOI: 10.1186/s12877-024-04753-4
    BACKGROUND: People with dementia and their caregivers are prone to suicidal behaviors due to difficulty adjusting to their initial caregiving role and due to emotional disturbances resulting from deterioration of functioning. The present systematic review (1) explored the prevalence of and risk factors for suicidal behavior and (2) assessed the similarities and differences in the prevalence and risk factors for suicidal behavior between people with dementia and their caregivers.

    METHODS: A comprehensive literature search for research articles published between 1950 and 2023 was carried out using major databases, such as Google Scholar, Web of Science, PubMed, Scopus, PsycINFO, EMBASE, the Cochrane Library, and Medline.

    RESULTS: A total of 40 research articles were selected for review. A total of 12 research articles revealed that the prevalence of suicidal behavior among caregivers ranged from 4.7% to 26%. However, the risk of suicidal behavior among people with dementia was inconsistent, as only 17 out of 28 selected studies reported the risk of suicidal behavior among people with dementia. The risk factors associated with suicidal behavior among caregivers of people with dementia could be both self-related and care receiver-related factors, whereas risk factors in people with dementia were self-related factors. Notably, greater cognitive decline, which impairs individuals' ability to carry out complex acts and planning, may lower their suicidal risk. Finally, assessment of the risk of bias indicated that 95% of the selected studies had unclear risk.

    CONCLUSION: Self-related and care receiver-related factors should be assessed among caregivers of people with dementia to evaluate the risk of suicidal behavior. In addition, we recommend evaluating suicidal risk in people with dementia in the early phase of dementia when cognitive decline is less severe. However, as the majority of the selected studies had unclear risk of bias, future studies with improved methodologies are warranted to confirm our study findings.

    Matched MeSH terms: Risk Factors
  6. Hung SK, Kou HW, Hsu KH, Wu CT, Lee CW, Leonard Goh ZN, et al.
    J Formos Med Assoc, 2021 Mar;120(3):997-1004.
    PMID: 32917483 DOI: 10.1016/j.jfma.2020.08.039
    BACKGROUND/PURPOSE: Splenic abscess is a life-threatening surgical emergency which requires early diagnosis and intervention to maximize patient outcomes. This can be achieved through accurate risk stratification in the emergency department (ED). Sarcopenia refers to an age-related loss of skeletal muscle mass and strength that is accompanied by major physiologic and clinical ramifications, and often signifies decreased physiologic reserves. It is associated with poor clinical outcomes in sepsis, acute respiratory failure, oncological surgery, and liver transplantation. This study evaluates the utility of sarcopenia as a radiological stratification tool to predict in-hospital mortality of splenic abscess patients in the ED. This will assist emergency physicians, internists and surgeons in rapid risk stratification, assessing treatment options, and communicating with family members.

    METHODS: 99 adult patients at four training and research hospitals who had undergone an abdominal contrast computed tomography scan in the ED with the final diagnosis of splenic abscess from January 2004 to November 2017 were recruited. Evaluation for sarcopenia was performed via calculating the psoas cross-sectional area at the level of the third lumbar vertebra and normalising for height, before checking it against pre-defined values. Univariate analyses were used to evaluate the differences between survivors and non-survivors. Sensitivity, specificity, and predictive values of the presence of sarcopenia in predicting in-hospital mortality were calculated. Kaplan-Meier methods, log-rank test, and Cox proportional hazards model were also performed to examine survival between groups with sarcopenia versus non-sarcopenia.

    RESULTS: Splenic abscess patients with sarcopenia were 7.56 times more at risk of in-hospital mortality than those without sarcopenia (multivariate-adjusted HR: 7.56; 95% CI: 1.55-36.93). Presence of sarcopenia was found to have 84.62% sensitivity and 96.49% negative predictive value in predicting mortality.

    CONCLUSION: Sarcopenia is associated with poor prognoses of in-hospital mortality in patients with splenic abscess presenting to the ED. We recommend its use in the ED to rapidly risk stratify and predict outcome to guide treatment strategies.

    Matched MeSH terms: Risk Factors; Risk Assessment
  7. Aftab S, Ejaz I, Waqar U, Khan HI, Hanif A, Usman A, et al.
    MyJurnal
    Background: Pneumonia is defined as the inflammation of parenchyma of the lung. It is a substantial cause of morbidity and mortality in childhood throughout the world. The incidence of pneumonia in children under the age of five years is 0.29 episodes per child-year, which equates 151.8 million cases annually in developing countries. Objective: To determine the risk factors for complicated pneumonia.

    Material and Methods: This case-control study conducted in Medical Unit III, The Children’s Hospital & Institute of Child Health Lahore. Out of total of 180 cases of pneumonia, 100 were labeled as complicated pneumonia (case) and 80 were labeled as uncomplicated pneumonia (control). Complicated pneumonia included pneumonia with associated complications. Detail history was taken in both groups and recorded on predesigned proforma. Data was analyzed by SPSS 20. Quantitative risk factors like child age, maternal age and father age were analyzed by mean and standard deviation. However qualitative risk factors like method of feeding, malnutrition, immunization, anaemia, and non-vaccination were analyzed by applying chi-square test and finding odd ratios.

    Results: Most significant risk factors associated with complicated pneumonia included younger age, maternal and father education, rural area, malnutrition, anaemia, rickets, birth problems, admission during neonatal life due to pneumonia, bottle feeding, nonvaccination, referral and delayed in presentation (p
    Matched MeSH terms: Risk Factors*
  8. Rubayah Yakob, Zulkornain Yusop, Alias Radam, Noriszura Ismail
    Sains Malaysiana, 2014;43:1439-1450.
    The objective of this study was to identify the exogenous variables of risk and investment management efficiency by using a two-stage data envelopment analysis (DEA) method. The first stage involves obtaining the efficiency scores of risk and investment management via DEA that requires only the traditional inputs and outputs. In the second stage, the Tobit regression analysis is conducted in which the efficiency score obtained from the first stage is treated as a dependent variable, while the exogenous factors are considered to be independent variables. The exogenous factors consist of operating systems, organizational form, consumer preference and size. The results showed that the mutual company as well as the takaful system demonstrate better risk management performance than their stock and conventional system counterparts. In addition, size is also a significant indicator for risk management efficiency in which the larger insurer/takaful operator exhibits better risk management performance than the smaller one. However, consumer preference is found to be insignificantly correlated with the efficiency of risk management. In contrast, with risk management, organizational form, operating system and size are not indicators of the investment management efficiency, but consumer preference is significantly and positively associated with investment management efficiency.
    Matched MeSH terms: Risk; Risk Management
  9. Goh SSL, Lai PSM, Tan ATB, Ponnampalavanar S
    Osteoporos Int, 2018 03;29(3):595-613.
    PMID: 29159533 DOI: 10.1007/s00198-017-4305-8
    A meta-analysis was conducted to evaluate the prevalence of osteopenia/osteoporosis in human immunodeficiency virus (HIV)-infected individuals. The prevalence of osteopenia/osteoporosis in HIV-infected and antiretroviral therapy (ART)-treated individuals was significantly higher than respective controls. Evidence regarding bone loss within first year of HIV infection or ART initiation was preliminary.

    PURPOSE: The aim of the study is to systematically review published literature on the prevalence of osteopenia/osteoporosis and its associated risk factors in HIV-infected individuals.

    METHODS: A literature search was conducted from 1989 to 2015 in six databases. Full text, English articles on HIV-infected individuals ≥ 18 years, which used dual X-ray absorptiometry to measure BMD, were included. Studies were excluded if the prevalence of osteopenia/osteoporosis was without a comparison group, and the BMD/T-score were not reported.

    RESULTS: Twenty-one cross sectional and eight longitudinal studies were included. The prevalence of osteopenia/osteoporosis was significantly higher in both HIV-infected [odds ratio (OR) = 2.4 (95%Cl: 2.0, 2.8) at lumbar spine, 2.6 (95%Cl: 2.2, 3.0) at hip] and ART-treated individuals [OR = 2.8 (95%Cl: 2.0, 3.8) at lumbar spine, 3.4 (95%Cl: 2.5, 4.7) at hip] when compared to controls. PI-treated individuals had an OR of 1.3 (95%Cl: 1.0, 1.7) of developing osteopenia/osteoporosis compared to controls. A higher proportion of tenofovir-treated individuals (52.6%) had lower BMD compared to controls (42.7%), but did not reach statistical significance (p = 0.248). No significant difference was found in the percent change of BMD at the lumbar spine, femoral neck, or total hip from baseline to follow-up between HIV-infected, PI-treated, tenofovir-treated, and controls. Older age, history of bone fracture, low BMI, low body weight, being Hispanic or Caucasian, low testosterone level, smoking, low CD4 cell count, lipodystrophy, low fat mass, and low lean body mass were associated with low BMD.

    CONCLUSIONS: The prevalence of osteopenia/osteoporosis in HIV-infected and antiretroviral therapy (ART)-treated individuals was two times more compared to controls. However, evidence concerning bone loss within the first year of HIV infection and ART initiation was preliminary.
    Matched MeSH terms: Risk Factors*
  10. Dhamanti I, Leggat S, Barraclough S, Liao HH, Abu Bakar N
    J Patient Saf, 2021 Jun 01;17(4):e299-e305.
    PMID: 32217924 DOI: 10.1097/PTS.0000000000000622
    OBJECTIVES: Incident reporting is one of the tools used to improve patient safety that has been widely used in health facilities in many countries. Incident reporting systems provide functionality to collect, analyze, and disseminate lessons learned to the wider community, whether at the hospital or national level. The aim of this study was to compare the patient safety incident reporting systems of Taiwan, Malaysia, and Indonesia to identify similarities, differences, and areas for improvement.

    METHODS: We searched the official Web sites and homepages of the responsible leading patient safety agencies of the three countries. We reviewed all publicly available guidelines, regulatory documents, government reports that included policies, guidelines, strategy papers, reports, evaluation programs, as well as scientific articles and gray literature related to the incident reporting system. We used the World Health Organization components of patient safety reporting system as the guidelines for comparison and analyzed the documents using descriptive comparative analysis.

    RESULTS: Taiwan had the most incidents reported, followed by Malaysia and Indonesia. Taiwan Patient Safety Reporting (TPR) and the Malaysian Reporting and Learning System had similar attributes and followed the World Health Organization components for incident reporting. We found differences between the Indonesian system and both of TPR and the Malaysian system. Indonesia did not have an external reporting deadline, analysis and learning were conducted at the national level, and there was a lack of transparency and public access to data and reports. All systems need to establish a clear and structured incident reporting evaluation framework if they are to be successful.

    CONCLUSIONS: Compared with TPR and Malaysian system, the Indonesian patient safety incident reporting system seemed to be ineffective because it failed to acquire adequate national incident reporting data and lacked transparency; these deficiencies inhibited learning at the national level. We suggest further research on the implementation at the hospital level to see how far national guidelines and policy have been implemented in each country.

    Matched MeSH terms: Risk Management*
  11. Saba AO, Ismail A, Zulkifli SZ, Halim MRA, Wahid NAA, Amal MNA
    Sci Rep, 2020 10 14;10(1):17205.
    PMID: 33057156 DOI: 10.1038/s41598-020-74168-9
    The ornamental fish trade has been considered as one of the most important routes of invasive alien fish introduction into native freshwater ecosystems. Therefore, the species composition and invasion risks of fish species from 60 freshwater fish pet stores in Klang Valley, Malaysia were studied. A checklist of taxa belonging to 18 orders, 53 families, and 251 species of alien fishes was documented. Fish Invasiveness Screening Test (FIST) showed that seven (30.43%), eight (34.78%) and eight (34.78%) species were considered to be high, medium and low invasion risks, respectively. After the calibration of the Fish Invasiveness Screening Kit (FISK) v2 using the Receiver Operating Characteristics, a threshold value of 17 for distinguishing between invasive and non-invasive fishes was identified. As a result, nine species (39.13%) were of high invasion risk. In this study, we found that non-native fishes dominated (85.66%) the freshwater ornamental trade in Klang Valley, while FISK is a more robust tool in assessing the risk of invasion, and for the most part, its outcome was commensurate with FIST. This study, for the first time, revealed the number of high-risk ornamental fish species that give an awareness of possible future invasion if unmonitored in Klang Valley, Malaysia.
    Matched MeSH terms: Risk; Risk Assessment/methods*
  12. Anstey KJ, Peters R, Zheng L, Barnes DE, Brayne C, Brodaty H, et al.
    J Alzheimers Dis, 2020;78(1):3-12.
    PMID: 32925063 DOI: 10.3233/JAD-200674
    In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographical location, representativeness, diversity, duration, mechanisms, and research on combinations of risk factors were identified. Future research to inform dementia risk reduction should fill gaps in the evidence base, take a life-course, multi-domain approach, and inform population health approaches that improve the brain-health of whole communities.
    Matched MeSH terms: Risk Factors; Risk Reduction Behavior*
  13. Joseph P, Yusuf S, Lee SF, Ibrahim Q, Teo K, Rangarajan S, et al.
    Heart, 2018 04;104(7):581-587.
    PMID: 29066611 DOI: 10.1136/heartjnl-2017-311609
    OBJECTIVE: To evaluate the performance of the non-laboratory INTERHEART risk score (NL-IHRS) to predict incident cardiovascular disease (CVD) across seven major geographic regions of the world. The secondary objective was to evaluate the performance of the fasting cholesterol-based IHRS (FC-IHRS).

    METHODS: Using measures of discrimination and calibration, we tested the performance of the NL-IHRS (n=100 475) and FC-IHRS (n=107 863) for predicting incident CVD in a community-based, prospective study across seven geographic regions: South Asia, China, Southeast Asia, Middle East, Europe/North America, South America and Africa. CVD was defined as the composite of cardiovascular death, myocardial infarction, stroke, heart failure or coronary revascularisation.

    RESULTS: Mean age of the study population was 50.53 (SD 9.79) years and mean follow-up was 4.89 (SD 2.24) years. The NL-IHRS had moderate to good discrimination for incident CVD across geographic regions (concordance statistic (C-statistic) ranging from 0.64 to 0.74), although recalibration was necessary in all regions, which improved its performance in the overall cohort (increase in C-statistic from 0.69 to 0.72, p<0.001). Regional recalibration was also necessary for the FC-IHRS, which also improved its overall discrimination (increase in C-statistic from 0.71 to 0.74, p<0.001). In 85 078 participants with complete data for both scores, discrimination was only modestly better with the FC-IHRS compared with the NL-IHRS (0.74 vs 0.73, p<0.001).

    CONCLUSIONS: External validations of the NL-IHRS and FC-IHRS suggest that regionally recalibrated versions of both can be useful for estimating CVD risk across a diverse range of community-based populations. CVD prediction using a non-laboratory score can provide similar accuracy to laboratory-based methods.

    Matched MeSH terms: Risk Factors; Risk Assessment/methods*
  14. Chia YC
    Singapore Med J, 2011 Feb;52(2):116-23.
    PMID: 21373738
    Cardiovascular Disease (CVD) is the leading cause of death in both developed and developing countries. While it is relatively easy to identify those who are obviously at high risk and those at the lowest risk for CVD, it is often the large group of individuals with what appears to be modestly abnormal risk factors who contributes most to the burden of CVD. This is where estimation of CVD risk is necessary. Many tools for risk assessment have been devised. All these risk scores have their own inherent advantages and disadvantages. Furthermore, they may also not be directly applicable to a local population. Ideally, each country should have its own risk score that takes into account other factors as well. In the interim, it is worthwhile to be familiar with one of these scores, select one that is most appropriate for your patient and discuss treatment options based on the estimated risk.
    Matched MeSH terms: Risk Factors; Risk Assessment/methods*
  15. Jihan AMN, Audey R
    Med J Malaysia, 2023 Mar;78(2):171-176.
    PMID: 36988526
    INTRODUCTION: Risk stratification tools that integrate clinical, ECG findings and cardiac biomarkers have been used to facilitate the management of chest pain patients in the emergency department (ED). We studied the feasibility of history, age, electrocardiogram and risk factors (HEAR) score as a risk stratification tool for chest pain patients presented to ED Hospital Universiti Sains Malaysia (HUSM) in comparison to modified HEART score (MHS) based on major adverse cardiac events (MACE) within 6 weeks' time.

    MATERIALS AND METHODS: We analysed retrospective data of chest pain patients presenting to ED HUSM from 1st June 2020 till 31st January 2021 based on the patient's history, ECG findings, risk factors, age and troponin level. The patients were stratified as low risk (MHS and HEAR score of 0-3), intermediate risk (MHS and HEAR score of 4-6), and high risk (MHS of 7-10 and HEAR score of 7-8). The association of the MHS and HEAR score with MACE at 6 weeks' time was evaluated using simple logistic regression.

    RESULTS: This study included 147 patients in the MHS analysis and 71 patients in HEAR score analysis. The incident rate of MACE in low, intermediate and high risk was 0%,16.3%, and 34.7%, in the MHS group, and 0%, 3.22%, and 6.66% in HEAR score group. The mean difference between MACE and non-MACE in MHS and HEAR score groups was -2.29 (CI: -3.13,1.44, p<0.001) and -2.51(CI: -5.23, 0.21, p=0.070), respectively. There was no significant association between the incidence rate of MACE with modified HEART score (MHS) and HEAR score groups (p>0.95).

    CONCLUSION: HEAR score is not feasible to be used as a risk stratification tool for chest pain patients presenting to ED HUSM in comparison to MHS. Further studies are required to validate the results.

    Matched MeSH terms: Risk Factors; Risk Assessment/methods
  16. Borges FK, Devereaux PJ, Cuerden M, Bhandari M, Guerra-Farfán E, Patel A, et al.
    BMJ Open, 2019 Sep 24;9(9):e033150.
    PMID: 31551393 DOI: 10.1136/bmjopen-2019-033150
    INTRODUCTION: Inflammation, dehydration, hypotension and bleeding may all contribute to the development of acute kidney injury (AKI). Accelerated surgery after a hip fracture can decrease the exposure time to such contributors and may reduce the risk of AKI.

    METHODS AND ANALYSIS: Hip fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) is a multicentre, international, parallel-group randomised controlled trial (RCT). Patients who suffer a hip fracture are randomly allocated to either accelerated medical assessment and surgical repair with a goal of surgery within 6 hours of diagnosis or standard care where a repair typically occurs 24 to 48 hours after diagnosis. The primary outcome of this substudy is the development of AKI within 7 days of randomisation. We anticipate at least 1998 patients will participate in this substudy.

    ETHICS AND DISSEMINATION: We obtained ethics approval for additional serum creatinine recordings in consecutive patients enrolled at 70 participating centres. All patients provide consent before randomisation. We anticipate reporting substudy results by 2021.

    TRIAL REGISTRATION NUMBER: NCT02027896; Pre-results.

    Matched MeSH terms: Risk Factors; Risk Assessment/methods
  17. Karupaiah T, Tan HK, Ong WW, Tan CH, Sundram K
    PMID: 24872121 DOI: 10.1080/19440049.2014.929183
    The extent of industrial trans fatty acids (TFA) in the food supply is unknown in Malaysia, whilst TFA disclosure on food labels is not mandatory by Malaysian food standards. Supermarket foods such as dairy products, fats and oils, meat products, snack foods, soups, and confectionery are commonly cited to be major contributors of TFA in the diet. A consumer survey (n = 622) was used to develop a food listing of these 'high risk' foods. TFA content of high-risk foods were analysed by gas chromatography. Food samples (n = 158) were analysed and their total TFA content were compared with Malaysian Food Standards. A wide variation in TFA content within food categories was indicated. Of the foods containing TFA, many food labels did not cite TFA content or the use of partially hydrogenated vegetable oils (PHVO) as an ingredient. Hypothesised estimates of TFA intake from these supermarket foods in a sample day's menu providing 2000 kcal projected a minimum intake of 0.5 g and a maximum intake of 5.2 g TFA. This study found there was no voluntary disclosure of TFA content on food labels or identifying PHVO as an ingredient. It appears that health education targeting consumers to minimise TFA consumption is required supported by mandatory PHVO disclosure on the food label.
    Matched MeSH terms: Risk Assessment*
  18. Ibrahim O, Maskon O, Darinah N, Raymond AA, Rahman MM
    Pak J Med Sci, 2013 Nov;29(6):1319-22.
    PMID: 24550945
    OBJECTIVES: To determine the prevalence of aspirin resistance and associated risk factors based on biochemical parameters using whole blood multiple electrode aggregometry.
    METHODS: The study was conducted at the outpatients cardiology clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from August 2011 to February 2012. Subjects on aspirin therapy were divided into two groups; first-ever coronary event and recurrent coronary event. Aspirin resistance was measured by a Multiplate(®) platelet analyser.
    RESULTS: A total of 74 patients (63 male, 11 female), with a mean age of 57.93 ± 74.1years were enrolled in the study. The patients were divided into two groups -first-ever coronary event group (n=52) and recurrent coronary event group (n=22). Aspirin resistance was observed in 12 out of 74 (16%) of the study patients, which consisted of 11 patients from the first-ever coronary event group and one patient from the recurrent coronary event group. There were significant correlations between aspirin resistance and age (r = -0.627; p = 0.029), total cholesterol (r = 0.608; p = 0.036) and LDL (r = 0.694; p = 0.012). LDL was the main predictor for area under the curve (AUC) for aspirin resistance. However, there was no association between aspirin resistance and cardiovascular events in both groups in this study.
    CONCLUSIONS: Aspirin resistance was observed in 16% of the study population. LDL was the major predictor of aspirin resistance. No association was found in the study between aspirin resistance with recurrent coronary events.
    KEYWORDS: Aspirin resistance; Multiplate® platelet analyser; aspirin responsiveness; first-ever coronary event; recurrent coronary event
    Matched MeSH terms: Risk Factors*
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