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Fulltext Personality profile among hypertensive patient undergoing pharmacological treatment in primary care setting

Azlin Baharudin, Hatta Sidi, Norzila Zakaria, Sharifah Ezat Wan Puteh

ASEAN Journal of Psychiatry, 2007;8(2):51-63.
MyJurnal

Objective: This study aimed to determine the association between the personality traits and
social factors with compliance to anti-hypertensive pharmachotherapy. Methods: This cross
sectional study was conducted from 1st of June until 31st of December 2004, which involved
Hospital Universiti Kebangsaan Malaysia Primary Polyclinic in Bandar Tasik Selatan,
Cheras and Salak Polyclinic in Sepang, Selangor. A total of 200 patients who fulfilled all the inclusion criteria, were selected as respondents. This study used the Mini International Neuropsychiatric Interview (M.I.N.I) for the psychiatric diagnoses and personality characteristics were assessed by using Personality Assessment Schedule (PAS) Results: The prevalence rate of non-compliance was 38.5%. Paranoid personality trait (27.3%) was the most common type of personality traits that associated with non-compliance to the medications prescribed. The results of this study revealed a statistically significant difference between drug compliance and age, race, gender and the site where the study was conducted. No association was found between patients’ education level, occupation, income, marital status, family history of hypertension and personality traits and drug compliance. Conclusion: This study suggested that drug compliance among hypertensive patients was influenced by the presence of psychosocial factors. Hence, it is important for medical practitioners to understand these factors and administer treatment more individual.

Matched MeSH terms: Hypertension
Fulltext Dietary supplementation among doctors in Kelantan

Rohana Abdul Jalil, Zulkifli Ahmad

Malaysian Journal of Public Health Medicine, 2007;7(1):60-63.
MyJurnal

The aim of the study is to describe the usage of dietary supplemenu among doctors working in the hospitals in Kota Bharu, Kelantan. The method used was a postal questionaire survey of the doctors, both specialists and medical officers working in these hospitals. The results showed that
only 28.7% of the doctors are taking dietary supplements. Significantly more female doctors and doctors on long term medication, were taking these supplements. The dietary supplements commonly used were multivitamins and minerals (92.3%), garlic (26.9%), vitamin C (26.9%) and
lecithin (15.4%). The majority of the doctors who took dietary supplements (60%) felt their health status have improved. These supplements were mostly obtained from hospital pharmacies. Doctors who puchase their own supplements spend between RMIO to RMIZO per month. The main reasons given for taking these supplements were that the doctors jfelt healthier' and to ‘prevent or as a supplementary treatment’ for conditions like hypercholesterolaemia, hypertension, ischaemic heart disease and cancers. There were four doctors who regularly use traditional dietary supplements. Most doctors will generally advice their patients and children to take dietary supplements regularly, as they felt that it is important for health.

Matched MeSH terms: Hypertension
Fulltext Cigarette smoking and cardiovascular risk factor among male youth population

Raihan, K., Azmawati, M.N.

Malaysian Journal of Public Health Medicine, 2013;13(1):28-36.
MyJurnal

The leading cause of mortality in Malaysia is coronary heart disease (CHD). Several cardiovascular (CVD) risk factors contribute to this problem and smoking is one of the main modifiable risk factor. Most of the patients started smoking early during youth period. This study aimed to determine the association and to predict the cigarette smoking and cardiovascular risk factors among the male youth. A cross sectional study was conducted by self-administered data sheets, physical examinations: blood pressure measurement and body mass index calculation, blood taking procedure for blood glucose, total cholesterol and HDL-C levels. The results showed that the glycemic status was significantly associated with smoking status (p=0.048) however, there was no significant association for smokers and risk of developing diabetes mellitus compared to non smokers although smokers had higher odd ratio (OR: 4.33; 95%CI: 0.900-20.811) (p=0.068). Interestingly, for daily exposure of smoking, those who smoke 5 cigarette and less was significantly associated with high systolic blood pressure (p = 0.036) and smoking showed protective trend against systolic hypertension (OR: 0.57; 95% CI: 0.266-1.230), however, it was not significant (p=0.152). In conclusion, smoking among youth and its association with the cardiovascular risk factor should be addressed tactfully and early screening should be promptly done among the smoking youth for early prevention.

Matched MeSH terms: Hypertension
Fulltext Chemical constituents of the insecticidal active extract of Tinospora crispa

Nor Aziyah Bakhari, Siti Nur Amirah Diana Fadzillah, Norain Isa

Scientific Research Journal, 2013;10(1):0-0.
MyJurnal

Tinospora crispa Miers (Menispermaceae) is a climbing vine with stems rich in warts. The plant is called Akar Seruntum or Patawali in Malaysia and is widely used for treating skin complaints, malaria, bacterial abscess, high blood pressure and diabetes. In the present study, the stems of T. crispa were collected from the locality and succesively extracted with petroleum ether, followed by chloroform and ethanol. The insecticidal active extract (ethanol extract) was subjected to column chromatography of silica gel eluted with a gradient mobile phase containing hexane, chloroform and ethanol. Among the chemical constituents isolated are n-tetracosyl trans-ferulate and n-octacosyl alcohol, along with three known aporphine alkaloids; N-formylnornuciferine, N-acetylnornuciferine and lysicamine. All compounds were identified by comparing their spectroscopic data (UV, IR, 1H NMR, MS) with data from corresponding values in the literature. Isolation of n-tetracosyl trans-ferulate and noctacosyl alcohol is reported the first time for T. crispa.

Matched MeSH terms: Hypertension
Fulltext Adoption of the mobile health screening programme for farming communities: a study among pesticide-exposed farmers from north east of Peninsular Malaysia

Zariyantey Abdul Hamid, Zaliha Harun, Syarif Husin Lubis, Nihayah Mohamed, Ismarulyusda Ishak, Hidayatul Fathi Othman, et al.

Jurnal Sains Kesihatan Malaysia, 2014;12(2):63-70.
MyJurnal

Health awareness promotion among farming communities are important for a sustainable agriculture activities. A cross-sectional study was conducted to assess health status among farming communities in Cameron Highlands, Pahang (n = 61) and Bachok and Pasir Puteh, Kelantan (n = 143). Mobile Health Screening Programme composed of assessment of blood glucose, blood cholesterol, haemoglobin, blood pressure, pterygium, lung function and nerve conductive velocity was utilized. Our results indicate that the percentage of Cameron Highland’s farmers with hyperglycaemia, systolic hypertension, diastolic hypertension and anaemia were 8.2%, 14.8%, 11.5% and 8.2%, respectively. However, higher percentage of farmers in Bachok and Pasir Puteh, Kelantan with hyperglycaemia (32.8%), hypercholesterolaemia (83%), anaemia (24.2%) and systolic hypertension (41.9%) were observed. Pterygium was positive for 88.6% of farmers in Cameron Highlands and 94.4% in Bachok and Pasir Puteh. Lung function test shows that 61.7% and 11.4% of farmers in Cameron Highlands had restrictive and obstructive lung, respectively. In Bachok and Pasir Puteh, a total of 19.8%, 55.5% and 23.9% of farmers were found to have obstructive, restrictive and combined obstructive and restrictive lung, respectively. Current Perception Threshold (CPT) value which indicate nerve conductive velocity were significantly increased (p < 0.05) among Cameron Highland’s farmers for both median and peroneal nerve at all frequencies (5 Hz, 250 Hz and 2000 Hz). In Bachok and Pasir Puteh, the values of the CPT for median nerve was significantly increased (p < 0.05) for all frequencies (5, 250 and 2000 Hz). Meanwhile, a signifi cant increased (p < 0.05) was observed for the CPT values for peroneal nerve at the frequencies of 250 and 2000 Hz as compared to control groups. In conclusion, analysis revealed different health problem among the studied farming communities which could be influenced by the differences in farming practices. Thus, employed Mobile Health Screening Programme offers a monitoring approach that could highlight the need for suitable health services and awareness programmes for different farming communities.

Matched MeSH terms: Hypertension
Fulltext Discordance between medication adherence and blood pressure control in primary care clinics in Negeri Sembilan, Malaysia: The problem of therapeutic inertia

Chan CW, Wang J, Bouniu JJ, Singh P, Teng CL

International e-Journal of Science, Medicine & Education, 2015;9(3):27-32.
MyJurnal

Poor adherence to anti-hypertensive agents may be a major contributor for suboptimal blood pressure control among patients with hypertension. This study was conducted to assess the adherence to antihypertensive agents using Morisky Medication Adherence Scale (MMAS-8) among primary care patients, and to determine whether the blood pressure control is associated with the level of adherence.

Matched MeSH terms: Hypertension
Fulltext The prevalence of hypertension and smoking in the subdistrict of Dengkil, Selangor

Mohd Yunus, A., Sherina, M.S., Nor Afiah, M.Z., Rampal, L., Tiew, K.H.

Malaysian Journal of Public Health Medicine, 2003;3(2):5-9.
MyJurnal

Hypertension and smoking are established and independent risk factors for cardiovascular diseases. There are important inter-relationships between these two factors that may explain the aetiology of coronary heart disease. This study was conducted to determine the prevalence of hypertension and smoking in a rural community setting in Malaysia, and to identify their associated factors. A cross sectional study was conducted among residents aged 15 years and above in Mukim Dengkil, Sepang, Selangor, Malaysia from June to October 1999. Systematic random sampling was used to select the respondents. Results: Five-hundred and seventy respondents agreed to participate giving a response rate of 86.7%. The overall prevalence of hypertension was 26.8%. The prevalence was 31.7% among males, and 23.5% among females. Factors found to be significantly associated with hypertension were males and age. The overall prevalence of smoking was 21.2%. The prevalence among males was 48.7%, where as the prevalence was only 2.6% among females. The factors associated with smoking were males, ethnicity with Malays showing the highest prevalence of 27.2% and age. However, there was no significant association between hypertension and smoking. The prevalence of hypertension in this study is high. However, the prevalence of smoking in this study was slightly lower compared to the result found by the 2nd Malaysian National Health and Morbidity Survey (NHMS2).

Matched MeSH terms: Hypertension
Fulltext Medical Complications Among Type 2 Diabetes Mellitus Patients at a General Hospital in East Coast Malaysia

Noor Hasimah, M., Nurhanani, M.N., Ramli, M.

International Medical Journal Malaysia, 2010;9(1):15-19.
MyJurnal

Introduction: Diabetes Mellitus (DM) is a chronic metabolite disorder with high potential of multisystemic medical complications especially among poorly controlled patients. This study was conducted at Raja Perempuan Zainab II Hospital, Kota Bharu with objectives to explore the pattern of common diabetic mellitus type 2 complications and to compare between gender and races in relation to other risk factors during their hospitalization. Materials and Methods: This is a retrospective study based on patientsâ€™ record involving 215 patients (110 women and 105 men) who were admitted with diabetic complications in medical ward for a period of 6 months (January to June 2006) Results: Out of total 300 identifi ed subjects, 285 case notes were traceable. From 285, 84.6% (241 subjects) were diagnosed as DM type 2. 215 out of 241 subjects (89.2%) had one or more diabetic complications. In general the most common diabetic complication was diabetic nephropathy 34.9% (75 patients). When we compared between genders, diabetic foot ulcers was the most common diabetic complications among males (43.8%) and diabetic nephropathy for females (40.9%). A total of 199 patients (92.6%) had poor blood sugar control during their hospitalization and 103 patients (47.9%) had hypertension. Conclusion: Patients with DM type 2 had a high prevalence of complications. Common diabetic complications among genders were varied. Patients with diabetic complications had high prevalence of risk factors such as poor blood sugar control, concomitant hypertension and smoking habit.

Matched MeSH terms: Hypertension
Fulltext Associations between primary hypertension and genes in the renin angiotensin system: a prospective two-center study in University Kebangsaan Malaysia Medical Center and International Medical University Cardiology Clinic

Norsham Juliana, Shaiful Yahaya, Abdul Latiff Mohamed, Roslan Harun

Malaysian Journal of Medicine and Health Sciences, 2010;6(2):19-24.
MyJurnal

This study targeted two candidate genes from the best known regulator of blood pressure; the rennin angiotensin system; the ACE gene I/D polymorphism and the angiotensinogen M235T polymorphism. The study aimed to determine the genotypes trend between two different populations; the primary hypertensive patients, and the normal populations. 126 subjects were involved in this study (86 primary hypertensive patients and 40 normal individuals). All demographic factors were considered and analyzed. Insertion/deletion polymorphisms of the ACE gene were determined by an assay based on the polymerase chain reaction (PCR). Polymorphism analysis using PCR-RFLP procedure was used to identify the missense mutation M235T of the AGT gene. All significant data was collected using standardized case report form. The association of the different genotypes and the subjects’ condition was analyzed using the chi squared and odds ratio analyses. In the pooled analysis of both groups, it was shown that the polymorphisms in these genes were significantly associated with the incidence of primary hypertension, p<0.05. Results also showed that the D allele of the ACE gene may be associated with increased risk of primary hypertension (p<0.05, O.R: 3.0 [C.I: 1.25 – 5.35]). The angiotensinogen M235T polymorphism also showed a significant result; the T allele is associated with increased risk of primary hypertension (p<0.05, O.R: 2.56[C.I: 1.55 – 5.28]). This knowledge of the candidate genes of rennin angiotensin system has rendered it possible to show that gene polymorphism in symphony leads to the individual risk of primary hypertension.
Keywords: ACE, M235T, rennin, hypertension

Study site: University Kebangsaan Malaysia Medical Center and International Medical University Cardiology Clinic

Matched MeSH terms: Hypertension
Fulltext Industry and cosmetic uses of talc with their implication on health

Sinniah, Davendralingam

International e-Journal of Science, Medicine & Education, 2011;5(1):10-16.
MyJurnal

Talc’s softness, whiteness, lamellarity, inertness and affinity for organic chemicals make it valuable for industrial and domestic applications. The largest consumers are the paper and ceramic industry; only 5% is used as cosmetics. It is also used for preserving animal feed, and a carrier for drugs, insecticides, pesticides and chemicals. Talc was introduced as baby powder in 1894 and advertised aggressively worldwide. Widespread and indiscriminate use soon raised concerns about its implications for health. The IARC found that talc containing asbestiform fibres is carcinogenic to humans, but inadequate evidence to implicate talc not-containing asbestiform fibres. Pulmonary manifestations of talc inhalation include talcosis, talcosilicosis, and talcoasbestosis. Drug-users administering talc-adulterated oral medications intravenously develop pulmonary granulomas, fibrosis and irreversible pulmonary hypertension. Worldwide reports reveal talc inhalation is fatal to infants; it coats and dries mucus membranes, causes hemorrhage, edema, desquamation of bronchial epithelium, and clogs and compromises mucociliary clearance; larger quantities completely obstruct airways. Progressive diffuse pulmonary fibrosis is a recognized sequel to massive aspiration of baby powder. IARC has classified perineal use of talcum powder as a possible ovarian carcinogen, while a recent study has found that perineal talcum powder increases the risk of endometrial cancer among postmenopausal women. There is a need to raise public awareness of the serious risks associated with the use of talcum powder and for legislation to protect the health of the uninformed who represent the poorer segment of the community, and infants and young children. The dangers associated with cosmetic use of talc outweigh any possible benefits.

Matched MeSH terms: Hypertension, Pulmonary
Fulltext Hypertension and its association with Anthropometric indices among students in a public university

Cheah WL, Majorie Ensayan J, Helmy H, Chang CT

Malays Fam Physician, 2018;13(1):2-9.
PMID: 29796204 MyJurnal

Introduction: The present study aimed to determine the prevalence of hypertension and its association with nutritional status (body mass index, body fat percentage, and visceral fat) among students in a public university in Sarawak, Malaysia.
Methods: This was a cross-sectional study among undergraduate students aged 18 years old and above. Anthropometric measurements, such as weight, height, body composition, and blood pressure measurements, were collected. Hypertension was defined as equal or more than 140/90 mmHg. Statistical analyses were done using IBM SPSS version 20.
Results: A total of 354 respondents participated in the study. Mean age for the respondents was 21 years (SD 1.18 years). About 40% of the respondents were overweight or obese. Prevalence of hypertension was 8.2%. Mean systolic blood pressure was 119.1mmHg (SD14.36mmHg), and the mean diastolic blood pressure was 72.6mmHg (SD 9.73mmHg). There is a significant association between male gender (odds ratio =3.519, 95% CI is 1.886-6.566), body fat percentage (odds ratio = 1.944, 95% CI is 1.050-3.601), visceral fat (odds ratio = 2.830, 95% CI is 1.346-5.951), and family history of hypertension (odds ratio= 2.366, 95% CI is 1.334-4.194) and hypertension.
Conclusion: The prevalence of hypertension was less than 10% and is associated with male gender, body composition, and family history of hypertension.

Matched MeSH terms: Hypertension
Fulltext Neonatal clavicle fracture: a review of fourteen cases in east coast Peninsular Malaysia

Awang, M.S., Abdul Razak, A.H., Che Ahmad, A., Mohd Rus, R.

International Medical Journal Malaysia, 2017;16(2):79-83.
MyJurnal

Introduction: The purpose of this study is to identify the incidence of clavicle fractures in newborn
associated with fetal, maternal and process of deliveries in Kuantan General Hospital from June 2012 until
January 2014. This study is to determine epidemiological data of clavicle fractures, maternal and baby risk
factors associated with clavicle fractures of newborn and its’ outcome.

Methods: This is a prospective
study. 13 patients were identified to fulfill the inclusion criteria of the study. The data of
sociodemographic, associated fetal and maternal risk factors and the outcomes were recorded using
proforma. The statistical data analysis was done using SPSS 12.0.

Results: Out of 20,257 live births at our
centre during the study period, 13 infants were diagnosed to have clavicle fractures, giving an incidence of
0.64 per 1000 live births. There were 5 (38.5%) left, 7 (53.8%) right and one (7.7%) bilateral fracture. All
fractures located at the mid shaft of the clavicle and none have associated brachial plexus injuries. All
infants were delivered through vaginal delivery (61.5%); five through assisted delivery (instrumental); 2
(15.4%) forcep and 3 (23.1%) vacuum. Two of the babies developed shoulder dystocia. The average birth
weight was 3371 grams (SD 0.269) and mean gestational age was 38.7 weeks (SD 1.16). Five of the mothers
(38.5%) were primigravida and eight (61.5%) were multigravida in which,7 (53.8%)were healthy without
other co-morbidty, 5 (38.5%) having gestational diabetis and one (7.7%) hypertension. The average maternal
weight was 62.0 kg and height 1.58 metres with average BMI of 24.16 (3.29SD). All eventually had a
complete recovery at 6 weeks with clinical and radiological evident of fracture union.

Conclusions: In
conclusion, all patients with clavicle fractures were found following vaginal delivery. There were no
associations between neonatal clavicle fractures with maternal or baby risk factors. All fractures healed
without any complications.

Matched MeSH terms: Hypertension
Right ventricular dysfunction and pulmonary hypertension: a neglected presentation of thyrotoxicosis

Singarayar CS, Siew Hui F, Cheong N, Swee En G

Endocrinol Diabetes Metab Case Rep, 2018;2018.
PMID: 29785271 DOI: 10.1530/EDM-18-0012

Thyrotoxicosis is associated with cardiac dysfunction; more commonly, left ventricular dysfunction. However, in recent years, there have been more cases reported on right ventricular dysfunction, often associated with pulmonary hypertension in patients with thyrotoxicosis. Three cases of thyrotoxicosis associated with right ventricular dysfunction were presented. A total of 25 other cases of thyrotoxicosis associated with right ventricular dysfunction published from 1994 to 2017 were reviewed along with the present 3 cases. The mean age was 45 years. Most (82%) of the cases were newly diagnosed thyrotoxicosis. There was a preponderance of female gender (71%) and Graves' disease (86%) as the underlying aetiology. Common presenting features included dyspnoea, fatigue and ankle oedema. Atrial fibrillation was reported in 50% of the cases. The echocardiography for almost all cases revealed dilated right atrial and or ventricular chambers with elevated pulmonary artery pressure. The abnormal echocardiographic parameters were resolved in most cases after rendering the patients euthyroid. Right ventricular dysfunction and pulmonary hypertension are not well-recognized complications of thyrotoxicosis. They are life-threatening conditions that can be reversed with early recognition and treatment of thyrotoxicosis. Signs and symptoms of right ventricular dysfunction should be sought in all patients with newly diagnosed thyrotoxicosis, and prompt restoration of euthyroidism is warranted in affected patients before the development of overt right heart failure.
Learning points: Thyrotoxicosis is associated with right ventricular dysfunction and pulmonary hypertension apart from left ventricular dysfunction described in typical thyrotoxic cardiomyopathy.Symptoms and signs of right ventricular dysfunction and pulmonary hypertension should be sought in all patients with newly diagnosed thyrotoxicosis.Thyrotoxicosis should be considered in all cases of right ventricular dysfunction or pulmonary hypertension not readily explained by other causes.Prompt restoration of euthyroidism is warranted in patients with thyrotoxicosis complicated by right ventricular dysfunction with or without pulmonary hypertension to allow timely resolution of the abnormal cardiac parameters before development of overt right heart failure.

Matched MeSH terms: Hypertension, Pulmonary
Fulltext Evaluation of Therapeutic Effectiveness of Prescribed Medications in Patients with Type 2 Diabetes Mellitus: Findings from a Tertiary Care Hospital, Lahore, Pakistan

Rana B, Bukhsh A, Khan TM, Sarwar A, Omer MO, Jamshed SQ

J Pharm Bioallied Sci, 2017 Apr-Jun;9(2):121-125.
PMID: 28717335 DOI: 10.4103/jpbs.JPBS_29_17

AIM: The present study was aimed to highlight the current prescribing pattern of oral hypoglycemia in type 2 diabetes mellitus and to evaluate the therapeutic effectiveness of these therapeutic categories in achieving target glycemic control.

METHODS: This is a prospective, cross-sectional, observational study of 6 months' duration conducted in a tertiary care hospital of Lahore, Pakistan.

RESULTS: The current research recruited 145 patients presented in diabetes management center of a tertiary care hospital in Lahore, Pakistan. Mean age of the participants was 50.2 (± 8.5) years. Out of the 145 patients, 63% were females and 37% were males. Most patients were diagnosed to have diabetes within the past 5 years. Diabetes-induced neuropathy was the most common complication (71.7%) among the patients. A large proportion of these patients (70.3%) were also suffering from other comorbidities among which the most common one is hypertension. The average number of prescribed medications was 1.31. Metformin was prescribed to a majority of patients (64%) as monotherapy while 28.96% received combination therapy. Mean glycated hemoglobin (HBA1c) before and after 3 months of treatment was 8.5 (± 2.3) and 8.04 (± 2.1), respectively. Inferential statistics show a strong association between HBA1c and life style modifications and adherence to medication therapy (P = 0.05). However, the correlation between HBA1c and Morisky score and duration of disease was inverse and weak (P = 0.6, 0.4). The t-test values show a small difference between HBA1c values before and after 3 months (t = 0.440 and 0.466, respectively).

CONCLUSION: Optimization of medication regimen and continuous patient education regarding life style modification and adherence to medication therapy are necessitated to bring HBA1c values near to target.

Matched MeSH terms: Hypertension
Fulltext Knowledge, attitude and practices of the risk for chronic kidney disease among patients in a tertiary teaching hospital

Dariah Mohd Yusoff, Junaiti Yusof, Kueh, Yee Cheng

The Malaysian Journal of Nursing, 2016;8(2):3-11.
MyJurnal

Patients with chronic diseases such as diabetes, hypertension and cardiovascular diseases are known as
high-risk groups for developing chronic kidney disease (CKD). Adequate related knowledge among them
helps to increase their awareness towards CKD and adapt healthy attitude and practices for CKD
prevention, which will result in better health outcomes. This study aimed to identify the patients'
knowledge, attitude, and practices (KAP) towards the risks for CKD. This cross-sectional study used a selfadministered
survey questionnaire on 103 adult male and female patients at four general surgical and
medical wards in a teaching hospital using convenient sampling method. The data were computed using
STATA version 12. Data on KAP were obtained through the Chronic Kidney Disease Screening Index
questionnaire. The majority of respondents had poor knowledge (69.9%, n=72), but most of them had good
attitude (68.9%, n=71) and good practices (88.3%, n=91) towards the risk of CKD. Significant associations
were indicated between education level, occupation and monthly family income with knowledge (p-value <
0.05). Significant associations were also indicated between age, sex, marital status and occupation with
their attitude (p-value < 0.05). Meanwhile, marital status was found to be significantly associated with the
practices towards the risk for CKD (p-value=0.008).
Poor knowledge on the risk of getting CKD among hospitalized adults in this study implied the need for
improvement in the public understanding towards the risk for CKD.

Matched MeSH terms: Hypertension
Fulltext Co-morbid hypertension, diabetes mellitus or dyslipidemia among patients prescribed with second generation antipsychotic: a comparison study between aripiprazole, quetiapine and clozapine based on pharmacy prescription database

Ng CG, Chan PL, Said MA

Malaysian Journal of Psychiatry, 2015;24(2):0-0.
MyJurnal

Introduction: Second generation antipsychotic (SGA) was linked to increased risk of metabolic syndrome. The risk varies between different SGA. We aim to study this risk by examining the co-prescription of antihypertensive, antidiabetic and lipid lowering drugs in patients prescribed with either aripiprazole, quetiapine or clozapine.
Methods: This is a retrospective cohort study based on the prescription records of a teaching hospital. Prescription records between January 1, 2013 and December 31, 2014 for
psychiatric unit were extracted. Patients with at least one prescription of any antipsychotic were included. The odds of antihypertensive, antidiabetic and lipid lowering drugs co-prescription in patients with either aripiprazole, quetiapine or clozapine were calculated.
Results: Of the 1742 study subjects, 88 patients were prescribed with aripiprazole, 175 patients with clozapine and 124 patients with quetiapine. Patients prescribed with quetiapine had
higher odds of co-prescribed with antihypertensive (OR = 1.71, 95% CI = 1.11, 2.63), antidiabetic drugs (OR = 1.81, 95% CI = 1.11, 2.95) and lipid lowering drugs (OR = 1.94, 95% CI = 1.19, 3.16). There were higher odds of co-prescription of antihypertensive (OR = 1.54, 95% CI = 1.05, 2.25), antidiabetic drugs (OR = 1.69, 95% CI = 1.10, 2.59) and lipid lowering drugs
(OR = 1.90, 95% CI = 1.24, 2.91) in patients with clozapine. However, there were no increase odds of co-prescription of the three agents in patients with aripiprazole.
Conclusion: We need to monitor the risk of metabolic syndrome in patients treated with SGA. Aripiprazole has lower risk of metabolic syndrome.

Matched MeSH terms: Hypertension
Fulltext Enhanced physicochemical stability and efficacy of angiotensin I-converting enzyme (ACE) - inhibitory biopeptides by chitosan nanoparticles optimized using Box-Behnken design

Auwal SM, Zarei M, Tan CP, Basri M, Saari N

Sci Rep, 2018 Jul 10;8(1):10411.
PMID: 29991723 DOI: 10.1038/s41598-018-28659-5

Bromelain-generated biopeptides from stone fish protein exhibit strong inhibitory effect against ACE and can potentially serve as designer food (DF) with blood pressure lowering effect. Contextually, the DF refer to the biopeptides specifically produced to act as ACE-inhibitors other than their primary role in nutrition and can be used in the management of hypertension. However, the biopeptides are unstable under gastrointestinal tract (GIT) digestion and need to be stabilized for effective oral administration. In the present study, the stone fish biopeptides (SBs) were stabilized by their encapsulation in sodium tripolyphosphate (TPP) cross-linked chitosan nanoparticles produced by ionotropic gelation method. The nanoparticles formulation was then optimized via Box-Behnken experimental design to achieve smaller particle size (162.70 nm) and high encapsulation efficiency (75.36%) under the optimum condition of SBs:Chitosan mass ratio (0.35), homogenization speed (8000 rpm) and homogenization time (30 min). The SBs-loaded nanoparticles were characterized for morphology by transmission electron microscopy (TEM), physicochemical stability and efficacy. The nanoparticles were then lyophilized and analyzed using Fourier transform infra-red spectroscopy (FTIR) and X-ray diffraction (XRD). The results obtained indicated a sustained in vitro release and enhanced physicochemical stability of the SBs-loaded nanoparticles with smaller particle size and high encapsulation efficiency following long period of storage. Moreover, the efficacy study revealed improved inhibitory effect of the encapsulated SBs against ACE following simulated GIT digestion.

Matched MeSH terms: Hypertension
Fulltext Hypertension influences the exponential progression of inflammation and oxidative stress in streptozotocin-induced diabetic kidney

Muthaian R, Pakirisamy RM, Parasuraman S, Raveendran R

J Pharmacol Pharmacother, 2017 2 7;7(4):159-164.
PMID: 28163536 DOI: 10.4103/0976-500X.195898

OBJECTIVE: To investigate the association of hypertension coexisting with diabetes mellitus with oxidative stress and inflammation in the kidneys of streptozotocin (STZ)-induced diabetic rats.
MATERIALS AND METHODS: Male Wistar rats were used for the experiments. Blood glucose (BG), urea, blood pressure (BP), and heart rate (HR) were analyzed before and 48 h after STZ injection. Further, these parameters were monitored up to 3 months of diabetes induction. Subsequently, the inflammatory markers (C-reactive protein, tumor necrosis factor-alpha, and nitrate) and oxidative stress markers were estimated after 3 months of diabetes induction in the kidney homogenate. Histological analysis of renal tissue was also carried out.
RESULTS: Linear elevation of BG, urea, mean arterial pressure (MAP), and HR was observed up to 3 months of diabetes induction. In the same manner, inflammatory and oxidative stress markers were also found to be significantly increased. Notably, the histological analysis revealed the signs of nephropathy such as increased mesangial cell number, thickness of basement membrane, and renal artery. Inflammatory and oxidative stress markers positively correlated with elevated BP and BG, but the correlation was better with BP rather than BG.
CONCLUSION: Hypertension has a strong implication in the increased oxidative stress and inflammation of diabetic kidney at the very early stage of diabetes mellitus.

Matched MeSH terms: Hypertension
Fulltext Patients' blood pressure control and doctors' adherence to hypertension clinical practice guideline in managing patients at health clinics in Kuala Muda district, Kedah

Teoh SH, Razlina AR, Norwati D, Siti Suhaila MY

Med J Malaysia, 2017 02;72(1):18-25.
PMID: 28255135

BACKGROUND: blood pressure (bP) control among Malaysian is poor and doctor's adherence to clinical practice guideline (cPG) has been a well-known factor that may improve it. this study was designed to evaluate patients' bP control, doctors' adherence to the latest hypertension cPG and their association. Factors associated with bP control and cPG adherence was also examined.

METHODS: A cross-sectional study was conducted in Kuala Muda district's health clinics. 331 medical records were selected using stratified random sampling and standard proforma was used for data collection. the latest edition of the Malaysian cPG on hypertension was employed to define related variables.

RESULTS: A total of 160 patients (48.3%) had controlled bP and it was significantly associated with patients' age (adjusted Odds ratio, aOr= 1.03, 95% cI: 1.004, 1.05, p= 0.016) and systolic bP at presentation (aOr= 0.95, 95% cI: 0.93, 0.96, p< 0.001). About 60.7% of the medical records showed doctor's good level of cPG adherence. this adherence has significant association with presence of chronic kidney disease (aOr= 0.51, 95% cI: 0.31, 0.85, p= 0.007) and cardiovascular disease (aOr= 2.68, 95% cI: 1.04, 6.95, p= 0.030) in the patients and physicians' treatment intensification (aOr= 2.00, 95% cI: 1.26, 3.19, p= 0.009). However, no association was found between bP control and cPG adherence.

CONCLUSION: Hypertension control in this study was poor and the prevalence of physicians with good level of cPG adherence was slightly above average. these findings are important for relevant stakeholders to strategise an action plan to improve hypertension management outcome.

Matched MeSH terms: Hypertension
MiD49 and MiD51: New mediators of mitochondrial fission and novel targets for cardioprotection

Samangouei P, Crespo-Avilan GE, Cabrera-Fuentes H, Hernández-Reséndiz S, Ismail NI, Katwadi KB, et al.

Cond Med, 2018 Aug;1(5):239-246.
PMID: 30338314

Acute myocardial infarction (AMI) and the heart failure (HF) that often follows are among the leading causes of death and disability worldwide. As such novel therapies are needed to reduce myocardial infarct (MI) size, and preserve left ventricular (LV) systolic function in order to reduce the propensity for HF following AMI. Mitochondria are dynamic organelles that can undergo morphological changes by two opposing processes, mitochondrial fusion and fission. Changes in mitochondrial morphology and turnover are a vital part of maintaining mitochondrial health, DNA stability, energy production, calcium homeostasis, cellular division, and differentiation, and disturbances in the balance of fusion and fission can predispose to mitochondrial dysfunction and cell death. Changes in mitochondrial morphology are governed by mitochondrial fusion proteins (Mfn1, Mfn2 and OPA1) and mitochondrial fission proteins (Drp1, hFis1, and Mff). Recent experimental data suggest that mitochondria undergo fission during acute ischemia/reperfusion injury (IRI), generating fragmented dysfunctional mitochondrial and predisposing to cell death. We and others have shown that genetic and pharmacological inhibition of the mitochondrial fission protein Drp1 can protect cardiomyocytes from acute IRI and reduce MI size. Novel components of the mitochondrial fission machinery, mitochondrial dynamics proteins of 49 kDa (MiD49) and mitochondrial dynamics proteins of 51 kDa (MiD51), have been recently described, which have been shown to mediating mitochondrial fission by targeting Drp1 to the mitochondrial surface. In this review article, we provide an overview of MiD49 and MiD51, and highlight their potential as novel therapeutic targets for treating cardiovascular diseases such as AMI, anthracycline cardiomyopathy, and pulmonary arterial hypertension.

Matched MeSH terms: Hypertension, Pulmonary

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