Displaying publications 41 - 60 of 433 in total

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  1. Springer SA, Di Paola A, Azar MM, Barbour R, Biondi BE, Desabrais M, et al.
    J Acquir Immune Defic Syndr, 2018 05 01;78(1):43-53.
    PMID: 29373393 DOI: 10.1097/QAI.0000000000001634
    OBJECTIVE: To determine whether extended-release naltrexone (XR-NTX) would improve or maintain viral suppression (VS) among prisoners or jail detainees with HIV and opioid use disorder (OUD) transitioning to the community.

    DESIGN: A 4-site, prospective randomized double-blind, placebo-controlled trial was conducted among prison and jail inmates with HIV and OUD transitioning to the community from September 2010 through March 2016.

    METHODS: Eligible participants (N = 93) were randomized 2:1 to receive 6 monthly injections of XR-NTX (n = 66) or placebo (n = 27) starting at release and observed for 6 months. The primary outcome was the proportion that maintained or improved VS (<50 copies/mL) from baseline to 6 months.

    RESULTS: Participants allocated to XR-NTX significantly improved to VS (<50 copies/mL) from baseline (37.9%) to 6 months (60.6%) (P = 0.002), whereas the placebo group did not (55.6% at baseline to 40.7% at 6 months P = 0.294). There was, however, no statistical significant difference in VS levels at 6 months between XR-NTX (60.6%) vs. placebo (40.7%) (P = 0.087). After controlling for other factors, only allocation to XR-NTX (adjusted odds ratio = 2.90; 95% confidence interval = 1.04 to 8.14, P = 0.043) was associated with the primary outcome. Trajectories in VS from baseline to 6 months differed significantly (P = 0.017) between treatment groups, and the differences in the discordant values were significantly different as well (P = 0.041): the XR-NTX group was more likely than the placebo group to improve VS (30.3% vs. 18.5%), maintain VS (30.3% vs. 27.3), and less likely to lose VS (7.6% vs. 33.3%) by 6 months.

    CONCLUSIONS: XR-NTX improves or maintains VS after release to the community for incarcerated people living with HIV with OUD.

    Matched MeSH terms: Multivariate Analysis
  2. Chun S, Choi Y, Chang Y, Cho J, Zhang Y, Rampal S, et al.
    Am Heart J, 2016 07;177:17-24.
    PMID: 27297845 DOI: 10.1016/j.ahj.2016.03.018
    BACKGROUND: Sugar-sweetened carbonated beverage consumption has been linked to obesity, metabolic syndrome, type 2 diabetes, and clinically manifest coronary heart disease, but its association with subclinical coronary heart disease remains unclear. We investigated the relationship between sugar-sweetened carbonated beverage consumption and coronary artery calcium (CAC) in a large study of asymptomatic men and women.

    METHODS: This was a cross-sectional study of 22,210 adult men and women who underwent a comprehensive health screening examination between 2011 and 2013 (median age 40 years). Sugar-sweetened carbonated beverage consumption was assessed using a validated food frequency questionnaire, and CAC was measured by cardiac computed tomography. Multivariable-adjusted CAC score ratios and 95% CIs were estimated from robust Tobit regression models for the natural logarithm (CAC score +1).

    RESULTS: The prevalence of detectable CAC (CAC score >0) was 11.7% (n = 2,604). After adjustment for age; sex; center; year of screening examination; education level; physical activity; smoking; alcohol intake; family history of cardiovascular disease; history of hypertension; history of hypercholesterolemia; and intake of total energy, fruits, vegetables, and red and processed meats, only the highest category of sugar-sweetened carbonated beverage consumption was associated with an increased CAC score compared with the lowest consumption category. The multivariable-adjusted CAC ratio comparing participants who consumed ≥5 sugar-sweetened carbonated beverages per week with nondrinkers was 1.70 (95% CI, 1.03-2.81). This association did not differ by clinical subgroup, including participants at low cardiovascular risk.

    CONCLUSION: Our findings suggest that high levels of sugar-sweetened carbonated beverage consumption are associated with a higher prevalence and degree of CAC in asymptomatic adults without a history of cardiovascular disease, cancer, or diabetes.

    Matched MeSH terms: Multivariate Analysis
  3. Skau JK, Nordin AB, Cheah JC, Ali R, Zainal R, Aris T, et al.
    Trials, 2016;17(1):215.
    PMID: 27117703 DOI: 10.1186/s13063-016-1345-x
    Over the past two decades, the population of Malaysia has grown rapidly and the prevalence of diabetes mellitus in Malaysia has dramatically increased, along with the frequency of obesity, hyperlipidaemia and hypertension. Early-life influences play an important role in the development of non-communicable diseases. Indeed, maternal lifestyle and conditions such as gestational diabetes mellitus or obesity can affect the risk of diabetes in the next generation. Lifestyle changes can help to prevent the development of type 2 diabetes mellitus. This is a protocol for an unblinded, community-based, randomised controlled trial in two arms to evaluate the efficacy of a complex behavioural change intervention, combining motivational interviewing provided by a community health promoter and access to a habit formation mobile application, among young Malaysian women and their spouses prior to pregnancy.
    Matched MeSH terms: Multivariate Analysis
  4. Guzmán Rojas RA, Kamisan Atan I, Shek KL, Dietz HP
    Ultrasound Obstet Gynecol, 2015 Sep;46(3):363-6.
    PMID: 25766889 DOI: 10.1002/uog.14845
    To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma.
    Matched MeSH terms: Multivariate Analysis
  5. Amiri M, Majid HA, Hairi F, Thangiah N, Bulgiba A, Su TT
    BMC Public Health, 2014;14 Suppl 3:S3.
    PMID: 25436515 DOI: 10.1186/1471-2458-14-S3-S3
    Objectives: The objectives are to assess the prevalence and determinants of cardiovascular disease (CVD) risk factors among the residents of Community Housing Projects in metropolitan Kuala Lumpur, Malaysia.
    Method: By using simple random sampling, we selected and surveyed 833 households which comprised of 3,722 individuals. Out of the 2,360 adults, 50.5% participated in blood sampling and anthropometric measurement sessions. Uni and bivariate data analysis and multivariate binary logistic regression were applied to identify demographic and socioeconomic determinants of the existence of having at least one CVD risk factor.
    Results: As a Result, while obesity (54.8%), hypercholesterolemia (51.5%), and hypertension (39.3%) were the most common CVD risk factors among the low-income respondents, smoking (16.3%), diabetes mellitus (7.8%) and alcohol consumption (1.4%) were the least prevalent. Finally, the results from the multivariate binary logistic model illustrated that compared to the Malays, the Indians were 41% less likely to have at least one of the CVD risk factors (OR = 0.59; 95% CI: 0.37 - 0.93).
    Conclusion: In Conclusion, the low-income individuals were at higher risk of developing CVDs. Prospective policies addressing preventive actions and increased awareness focusing on low-income communities are highly recommended and to consider age, gender, ethnic backgrounds, and occupation classes.
    Matched MeSH terms: Multivariate Analysis
  6. Manickam MA, Abdul Mutalip MH, Abdul Hamid HA, Kamaruddin RB, Sabtu MY
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):91S-9S.
    PMID: 25038196 DOI: 10.1177/1010539514542194
    Alcohol is deleterious to physical and mental health as well as social well-being. This study aims to examine the prevalence of alcohol consumption and factors associated with its use among school-going Malaysian adolescents. The Global School-Based Student Health Survey (GSHS) 2012 employed 2-stage clustering design to Malaysian secondary school respondents aged 12 to 17 years. The prevalence of current alcohol usage was 8.9% (95% confidence interval [CI]: 7.8-10.07) overall, 11.2% (95% CI: 9.80-12.80) among males, and 23.4 (95% CI: 21.40-25.50) among Chinese students. Multivariate logistic regression showed that adolescents who had used alcohol were more likely to have used substance (adjusted odds ratio [aOR] = 3.39; 95% CI: 2.33-4.99), experienced injury (aOR = 1.53; 95% CI: 1.20-1.95), and engaged in sexual behaviors (aOR = 1.42, 95% CI: 1.12-1.79), and fights (aOR = 1.23; 95% CI: 1.08-1.41). The current national policies on alcohol should be strengthened to curb alcohol consumption among adolescents.
    Study name: Global School-Based Student Health Survey (GSHS)
    Matched MeSH terms: Multivariate Analysis
  7. Sutan R, Berkat S
    PMID: 25269390 DOI: 10.1186/1471-2393-14-342
    BACKGROUND: Cultural practice have often overlooked when providing maternal and child health care services. Low birth weight is the second cause of neonatal mortality in the world but it is a major factor in a developing country such as Indonesia. The purpose of this study is to predict the neonatal mortality among low birth weight babies in Aceh Province Indonesia.
    METHODS: Unmatched case control study was conducted using data from year 2010 to 2012 in 8 selected districts of Aceh Province Indonesia. A total of 500 samples were obtained. There were 250 of the samples died in neonatal period (case group) and 250 who were alive (control group). There were 26 variables studied and were grouped into 4 factors: neonatal factor, maternal factor, maternal and child health services and neonatal care practices. The data was analysed using bivariate logistic regression and multivariate logistic regression.
    RESULTS: There were 13 out of 26 variables found as determinant factors of neonatal mortality among low birth weight babies in Aceh Province. The predictors found in this study were: boy (aOR1.80, 95% CI: 1.09-2.96), moderate low birth weight (aOR17.84, 95% CI: 6.20-51.35), preterm (aOR1.84, 95% CI: 1.07- 3.17), presence of maternal illnesses (aOR1.87, 95% CI: 1.06-3.30), too short or too long birth interval (aOR1.80, 95% CI: 1.20-2.91), inappropriate antenatal care (aOR2.29, 95% CI: 1.34-3.91), inappropriate neonatal visit (aOR7.04, 95% CI: 3.67-13.49), not practicing kangaroo mother care (aOR15.32, 95% CI: 2.85-82.56), not using warm bottle padding (aOR20.70, 95% CI: 6.32-67.80), not practicing 'didaring' (aOR4.33, 95% CI: 1.83-10.19), late initiation of breastfeeding (aOR2.03, 95% CI: 1.09-3.80), discard colostrums (aOR3.53, 95% CI: 1.93-6.43) and not practicing exclusive breastfeeding (aOR5.58, 95% CI: 2.89-10.77).
    CONCLUSIONS: Cultural practices are strongly seen among Acehnese. Inappropriate antenatal care and neonatal care, late initiation of breastfeeding, discarding colostrums and not practicing exclusive breastfeeding were related to cultural practices. Improving knowledge heat preservation to prevent hypothermia using Kangaroo mother care, warm bottle padding and 'didaring' were proven methods to reduce neonatal mortality. Strengthening of health services in screening for high risk cases and anticipate intervention tailored to cultural practices are important to decrease neonatal mortality among low birth weight.
    Matched MeSH terms: Multivariate Analysis
  8. Teh CH, Lim KK, Chan YY, Lim KH, Azahadi O, Hamizatul Akmar AH, et al.
    Public Health, 2014 May;128(5):416-23.
    PMID: 24726414 DOI: 10.1016/j.puhe.2013.10.008
    OBJECTIVES: Despite the health-enhancing benefits of physical activity, a large segment of the Malaysian population does not engage in regular physical activity at the recommended level. This study aimed to determine physical activity patterns and the associated sociodemographic correlates of physical activity.
    STUDY DESIGN: Data on physical activity were obtained from the National Health and Morbidity Survey (NHMS) 2011, a nationally representative, population-based cross-sectional study. A two-stage stratified sampling method was used to select a representative sample of Malaysian adults aged 16 years and above.
    METHODS: A total of 19,145 adults aged 16 years and above were recruited, and face-to-face interviews were conducted using the International Physical Activity Questionnaire (IPAQ), short version. The correlates for physical activity were identified using multivariate analysis.
    RESULTS: In this study, 64.3% (95%CI: 63.1-65.5) of Malaysian adults aged 16 and above were physically active, but overall physical activity levels decreased with advancing age. Men, rural residents, 'other' ethnic groups, and married women were more likely to demonstrate higher levels of physical activity.
    CONCLUSION: Approximately 65% of Malaysian adults were physically active. However, it is recommended that health promotions for active lifestyles should be targeted to the least active segments, which constitute more than a quarter of the Malaysian population.
    KEYWORDS: Correlates; IPAQ; Malaysian adults; Physical activity; Sociodemographic
    Study name: National Health and Morbidity Survey (NHMS-2011)
    Matched MeSH terms: Multivariate Analysis
  9. Chan WK, Tan AT, Vethakkan SR, Tah PC, Vijayananthan A, Goh KL
    Clin Res Hepatol Gastroenterol, 2014 Jun;38(3):284-91.
    PMID: 24736032 DOI: 10.1016/j.clinre.2014.02.009
    BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases are both common among patients with diabetes mellitus.
    OBJECTIVE: The aim of this study is to determine if ultrasonography-diagnosed NAFLD is associated with prevalent ischemic heart disease (IHD) among patients with diabetes mellitus.
    METHODS: This is a cross-sectional study on consecutive patients seen at the Diabetic Clinic, University of Malaya Medical Centre. The medical record for each patient was reviewed for documented IHD. Patients without documented IHD but had symptoms and/or electrocardiographic changes suggestive of IHD were referred for cardiac evaluation.
    RESULTS: Data for 399 patients were analyzed. Mean age was 62.8±10.5 years with 43.1% male. NAFLD and IHD were present in 49.6 and 26.6%, respectively. The prevalence of IHD among patients with and without NAFLD was 24.7 and 28.4%, respectively (P=0.414). The prevalence of IHD was highest among the Indians (34.1%) followed by the Malays (29.2%) and the Chinese (20.1%). No association was found between NAFLD and IHD when analyzed according to ethnicity. On multivariate analysis, independent factors associated with IHD were older age, lower levels of physical activity, greater waist circumference and higher serum glycated hemoglobin level.
    CONCLUSIONS: Ultrasonography-diagnosed NAFLD was not associated with prevalent IHD among patients with diabetes mellitus in a multiracial Asian hospital clinic population.

    Study site: Diabetic clinc, University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Multivariate Analysis
  10. Shaharir SS, Ghafor AH, Said MS, Kong NC
    Lupus, 2014 Apr;23(4):436-42.
    PMID: 24399814 DOI: 10.1177/0961203313518624
    INTRODUCTION: Renal involvement is the most common serious complication in patients with systemic lupus erythematosus (SLE).
    OBJECTIVE: The objective of this article is to investigate and determine the associated factors of disease damage among lupus nephritis (LN) patients.
    METHODS: Medical records of LN patients who attended regular follow-up for at least one year in the Nephrology/SLE Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), were reviewed. Their Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index scores were noted. Univariate analysis and multivariable regression analysis were performed to determine the independent factors of disease damage in LN.
    RESULTS: A total of 150 patients were included and their follow-up duration ranged from one to 20 years. Sixty (40%) LN patients had disease damage (SDI ≥1). In the univariate analysis, it was associated with age, longer disease duration, antiphospholipid syndrome (APS), higher maximum daily oral prednisolone dose (mg/day), lower mean C3 and C4, higher chronicity index and global sclerosis on renal biopsies (p < 0.05). Patients who received early (≤3 months after the SLE diagnosis) hydroxychloroquine (HCQ), optimum HCQ dose at 6.5 mg/kg/day and achieved early complete remission (CR) were less likely to have disease damage (p < 0.05). After adjustment for age, gender, disease duration and severity, multivariable regression analysis revealed that a higher maximum daily dose of oral prednisolone was independently associated with disease damage while early HCQ and CR were associated with lower disease damage.
    CONCLUSION: Higher maximum daily prednisolone dose predicted disease damage whereas treatment with early HCQ and early CR had a protective role against disease damage.
    KEYWORDS: Antiphospholipid syndrome; lupus nephritis; systemic lupus erythematosus

    Study site: Nephrology/SLE Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Multivariate Analysis
  11. Naing C, Kai YC, Yi CH, Yee NS, Yi LM, Jun LX, et al.
    Int Health, 2013 Sep;5(3):217-22.
    PMID: 24159624 DOI: 10.1093/inthealth/iht019
    BACKGROUND: This study aimed to determine knowledge of medication use, to investigate the treatment-seeking pattern and to identify factors affecting the use of public health clinics among the study population.

    METHODS: A survey was conducted in Mantin Town of Malaysia using a structured questionnaire based on a literature review. Households were recruited through a three-stage sampling technique.

    RESULTS: Of 183 respondents (mean age 44.6 [±16.9] years; 115 [62.8%] women), 157 (85.8%) did not know about the term 'generic name' and 159 (86.9%) were not sure about the difference in price between a generic medicine and a branded medicine. The majority sought healthcare from the public health clinics (102/183; 55.7%). In the multivariate analysis, higher education level of respondents (p = 0.028), good quality of services in public health clinics (p = 0.001) and short distances between their residences and the public health clinics (p<0.001) were the significant variables for predicting the use of a public health clinic.

    CONCLUSION: This study highlights that health education on the use of generic drugs needs to be scaled up. These findings are important to the health policy makers who may need to consider addressing factors such as quality of care and physical distance to the clinic in the design and implementation of health facilities and the selection of the catchment areas.
    Matched MeSH terms: Multivariate Analysis
  12. Lee YY, Wahab N, Mustaffa N, Daud N, Mohd Noor N, Shaaban J, et al.
    BMC Gastroenterol, 2013;13:84.
    PMID: 23672671 DOI: 10.1186/1471-230X-13-84
    Backgrounds: The study aimed to survey for FD in a primary care setting in a population known to have an extremely low prevalence of Helicobacter pylori (H. pylori) infection, with the hypothesis that in such a population, dyspepsia should have been relatively less common.
    Methods: The Rome III FD Diagnostic Questionnaire was translated into the Malay language and later tested for reliability. A prospective cross-sectional survey was then performed involving 160 Malay patients attending primary care clinic after informed consent. Patients positive for symptoms of FD were subjected to upper endoscopy and exclusion of H. pylori infection. Univariable and multivariable analyses were used to test for associated risk factors.
    Results: The back-translated questionnaire was similar to the original English version and was reliable (Cronbach Alpha-coefficient 0.85). Of the 160 surveyed subjects, 19 of them (11.9%) had symptoms of FD. With exclusion of erosive diseases (3/160 or 1.9%) from endoscopy, 16 subjects or 10% had FD. None of the 19 subjects were positive for H. pylori infection. Epigastric pain syndrome was present in 11/16 (68.8%) and the rest, overlap with postprandial distress syndrome. With multivariable analysis, a married status (OR = 8.1; 95% CI 1.0-36.5) and positive psychosocial alarm symptoms (OR = 3.8; 95% CI 1.0-14.0) were associated with FD. Of those married subjects, females were more likely to have FD and psychosocial symptoms than men (6.3% vs. 1.9%), P = 0.04.
    Conclusions: FD was more common than one had expected among Malays attending primary care clinic in an area with low prevalence of H. pylori.
    Keywords: Functional dyspepsia, Malays, Rome III, Females, Marriage, Psychosocial alarm
    Questionnaire: Rome III Functional Dyspepsia Diagnostic questionnaire; Red Flag Questionnaire; Psychosocial Alarm Questionnaire; Hospital Anxiety Depression Scale; HADS

    Study site: primary care clinic within the university hospital of Universiti Sains Malaysia (USM)
    Matched MeSH terms: Multivariate Analysis
  13. Ajorlo M, Abdullah RB, Yusoff MK, Halim RA, Hanif AH, Willms WD, et al.
    Environ Monit Assess, 2013 Oct;185(10):8649-58.
    PMID: 23604787 DOI: 10.1007/s10661-013-3201-8
    This study investigates the applicability of multivariate statistical techniques including cluster analysis (CA), discriminant analysis (DA), and factor analysis (FA) for the assessment of seasonal variations in the surface water quality of tropical pastures. The study was carried out in the TPU catchment, Kuala Lumpur, Malaysia. The dataset consisted of 1-year monitoring of 14 parameters at six sampling sites. The CA yielded two groups of similarity between the sampling sites, i.e., less polluted (LP) and moderately polluted (MP) at temporal scale. Fecal coliform (FC), NO3, DO, and pH were significantly related to the stream grouping in the dry season, whereas NH3, BOD, Escherichia coli, and FC were significantly related to the stream grouping in the rainy season. The best predictors for distinguishing clusters in temporal scale were FC, NH3, and E. coli, respectively. FC, E. coli, and BOD with strong positive loadings were introduced as the first varifactors in the dry season which indicates the biological source of variability. EC with a strong positive loading and DO with a strong negative loading were introduced as the first varifactors in the rainy season, which represents the physiochemical source of variability. Multivariate statistical techniques were effective analytical techniques for classification and processing of large datasets of water quality and the identification of major sources of water pollution in tropical pastures.
    Matched MeSH terms: Multivariate Analysis
  14. Keat CH, Phua G, Abdul Kassim MS, Poh WK, Sriraman M
    Asian Pac J Cancer Prev, 2013;14(1):469-73.
    PMID: 23534775
    BACKGROUND: The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) among patients receiving low emetogenic chemotherapy (LEC) with and without granisetron injection as the primary prophylaxis in addition to dexamethasone and metochlopramide.

    MATERIALS AND METHODS: This was a single-centre, prospective cohort study. A total of 96 patients receiving LEC (52 with and 42 without granisetron) were randomly selected from the full patient list generated using the e-Hospital Information System (e-His). The rates of complete control (no CINV from days 1 to 5) and complete response (no nausea or vomiting in both acute and delayed phases) were identified through patient diaries which were adapted from the MASCC Antiemesis Tool (MAT). Selected covariates including gender, age, active alcohol consumption, morning sickness and previous chemotherapy history were controlled using the multiple logistic regression analyses.

    RESULTS: Both groups showed significant difference with LEC regimens (p<0.001). No differences were found in age, gender, ethnic group and other baseline characteristics. The granisetron group indicated a higher complete response rate in acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the non-granisetron group. Both groups showed similar complete control and complete response rates for acute nausea, delayed nausea and delayed emesis.

    CONCLUSIONS: Granisetron injection used as the primary prophylaxis in LEC demonstrated limited roles in CINV control. Optimization of the guideline-recommended antiemetic regimens may serve as a less costly alternative to protect patients from uncontrolled acute emesis.

    Matched MeSH terms: Multivariate Analysis
  15. Zulkipli ZH, Abdul Rahmat AM, Mohd Faudzi SA, Paiman NF, Wong SV, Hassan A
    Accid Anal Prev, 2012 Nov;49:237-44.
    PMID: 23036400 DOI: 10.1016/j.aap.2011.12.011
    This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury.
    Matched MeSH terms: Multivariate Analysis
  16. Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al.
    BMC Public Health, 2012;12:207.
    PMID: 22429627 DOI: 10.1186/1471-2458-12-207
    BACKGROUND: Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs.
    METHODS: Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios.
    RESULTS: Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01).
    CONCLUSIONS: Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.
    Matched MeSH terms: Multivariate Analysis
  17. Sabanayagam C, Shankar A, Lee J, Wong TY, Tai ES
    J Hum Hypertens, 2013 Apr;27(4):231-6.
    PMID: 22418747 DOI: 10.1038/jhh.2011.117
    Few previous studies in Western populations have reported an association between C-reactive protein (CRP) and prehypertension. However, no previous study has examined this association in Asians. We examined individuals who were free of hypertension from two independent population-based studies in Singapore: the Singapore Prospective Study Programme (SP2, n=2843 Chinese, Malay and Indians aged 24 years) and the Singapore Malay Eye Study (SiMES, n=957 Malays, aged 40-80 years). Prehypertension was defined as systolic blood pressure (BP) 120-139 mm Hg or diastolic BP 80-89 mm Hg. CRP was analyzed as categories (<1, 1-3, >3 mg l(-1)). The prevalence of prehypertension increased with increasing categories of CRP in both cohorts (P for trend <0.05 in both cohorts). After adjusting for potential confounders including body mass index (BMI), smoking and diabetes, persons with higher levels of CRP were more likely to have prehypertension in both SP2 (compared with CRP <1 mg l(-1), odds ratio (OR) 1.23, 95% confidence interval (CI) 1.03-1.48 for CRP 1-3 and OR 1.67, 95% CI 1.32-2.10 for >3 mg l(-1)) and SiMES (OR 1.45, 95% CI 1.04-2.01 and OR 1.56, 95% CI 1.07-2.27) respectively. In conclusion, data from two population-based Asian cohorts suggest that elevated serum CRP levels are associated with prehypertension.
    Matched MeSH terms: Multivariate Analysis
  18. Picco L, Subramaniam M, Abdin E, Vaingankar JA, Chong SA
    Ann Acad Med Singap, 2012 Aug;41(8):325-34.
    PMID: 23010809
    INTRODUCTION: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.

    MATERIAL AND METHODS: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.

    RESULTS: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.

    CONCLUSION: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.

    Matched MeSH terms: Multivariate Analysis
  19. Saxena N, Hartman M, Yip CH, Bhoo-Pathy N, Khin LW, Taib NA, et al.
    PLoS One, 2012;7(9):e45809.
    PMID: 23029254 DOI: 10.1371/journal.pone.0045809
    Lymph node ratio (LNR, i.e. the ratio of the number of positive nodes to the total number of nodes excised) is reported to be superior to the absolute number of nodes involved (pN stage) in classifying patients at high versus low risk of death following breast cancer. The added prognostic value of LNR over pN in addition to other prognostic factors has never been assessed.
    Matched MeSH terms: Multivariate Analysis
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