Displaying publications 81 - 100 of 366 in total

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  1. Deurenberg-Yap M, Chew SK, Lin VF, Tan BY, van Staveren WA, Deurenberg P
    Int. J. Obes. Relat. Metab. Disord., 2001 Oct;25(10):1554-62.
    PMID: 11673781 DOI: 10.1038/sj.ijo.0801739
    OBJECTIVE: To investigate the effect of body mass index (BMI) and body fat distribution as measured by waist-to-hip ratio (WHR) on the cardiovascular risk factor profile of the three major ethnic groups in Singapore (Chinese, Malay and Indian people) and to determine if WHO recommended cut-off values for BMI and WHR are appropriate for the different sub-populations in Singapore.
    DESIGN: Cross-sectional population study.
    SUBJECTS: A total of 4723 adult subjects (64% Chinese individuals, 21% Malay individuals and 15% Indian individuals) were selected through a multi-staged sampling technique to take part in the National Health Survey in 1998.
    MEASUREMENTS: Data on socio-economic status (education level, occupation, housing type) and lifestyle habits (smoking and physical activity), body weight, body height, waist and hip circumferences and blood pressure measured using standardised protocols. Fasting venous blood samples were obtained for determination of serum total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), triglycerides (TG). Venous blood samples were taken for 2 h oral glucose tolerance test (2 h glu).
    RESULTS: Absolute and relative risks for at least one cardiovascular risk factor (elevated TC, elevated TC/HDL ratio, elevated TG, hypertension and diabetes mellitus) were determined for various categories of BMI and WHR. At low categories of BMI (BMI between 22 and 24 kg/m(2)) and WHR (WHR between 0.80 and 0.85 for women, and between 0.90 and 0.95 for men), the absolute risks are high, ranging from 41 to 81%. At these same categories the relative risks are significantly higher compared to the reference category, ranging from odds ratio of 1.97 to 4.38. These categories of BMI and WHR are all below the cut-off values of BMI and WHR recommended by WHO.
    CONCLUSIONS: The results show that, at relatively low BMI and WHR, Singaporean adults experience elevated levels of risks (absolute and relative) for cardiovascular risk factors. These findings, in addition to earlier reported high percentage body fat among Singaporeans at low levels of BMI, confirm the need to revise the WHO cut-off values for the various indices of obesity and fat distribution, viz BMI and WHR, in Singapore.
    Matched MeSH terms: Comorbidity
  2. MacDonald MR, Tay WT, Teng TK, Anand I, Ling LH, Yap J, et al.
    J Am Heart Assoc, 2020 01 07;9(1):e012199.
    PMID: 31852421 DOI: 10.1161/JAHA.119.012199
    Background Data comparing outcomes in heart failure (HF) across Asia are limited. We examined regional variation in mortality among patients with HF enrolled in the ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry with separate analyses for those with reduced ejection fraction (EF; <40%) versus preserved EF (≥50%). Methods and Results The ASIAN-HF registry is a prospective longitudinal study. Participants with symptomatic HF were recruited from 46 secondary care centers in 3 Asian regions: South Asia (India), Southeast Asia (Thailand, Malaysia, Philippines, Indonesia, Singapore), and Northeast Asia (South Korea, Japan, Taiwan, Hong Kong, China). Overall, 6480 patients aged >18 years with symptomatic HF were recruited (mean age: 61.6±13.3 years; 27% women; 81% with HF and reduced rEF). The primary outcome was 1-year all-cause mortality. Striking regional variations in baseline characteristics and outcomes were observed. Regardless of HF type, Southeast Asians had the highest burden of comorbidities, particularly diabetes mellitus and chronic kidney disease, despite being younger than Northeast Asian participants. One-year, crude, all-cause mortality for the whole population was 9.6%, higher in patients with HF and reduced EF (10.6%) than in those with HF and preserved EF (5.4%). One-year, all-cause mortality was significantly higher in Southeast Asian patients (13.0%), compared with South Asian (7.5%) and Northeast Asian patients (7.4%; P<0.001). Well-known predictors of death accounted for only 44.2% of the variation in risk of mortality. Conclusions This first multinational prospective study shows that the outcomes in Asian patients with both HF and reduced or preserved EF are poor overall and worst in Southeast Asian patients. Region-specific risk factors and gaps in guideline-directed therapy should be addressed to potentially improve outcomes. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01633398.
    Matched MeSH terms: Comorbidity
  3. Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, et al.
    Asian J Psychiatr, 2021 Apr;58:102601.
    PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601
    Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.
    Matched MeSH terms: Comorbidity
  4. Aziz CB, Omar N, Abdullah WZ, Jalil RA, Nik WS, Zakaria R
    N Am J Med Sci, 2014 Aug;6(8):377-82.
    PMID: 25210670 DOI: 10.4103/1947-2714.139286
    Obese subjects are at risk of multiple comorbidities including stroke and coronary heart disease (CHD), which is partly due to disturbances in the hemostatic system.
    Matched MeSH terms: Comorbidity
  5. Mohammed KI, Zaidan AA, Zaidan BB, Albahri OS, Alsalem MA, Albahri AS, et al.
    J Med Syst, 2019 Jun 11;43(7):223.
    PMID: 31187288 DOI: 10.1007/s10916-019-1362-x
    Remotely monitoring a patient's condition is a serious issue and must be addressed. Remote health monitoring systems (RHMS) in telemedicine refers to resources, strategies, methods and installations that enable doctors or other medical professionals to work remotely to consult, diagnose and treat patients. The goal of RHMS is to provide timely medical services at remote areas through telecommunication technologies. Through major advancements in technology, particularly in wireless networking, cloud computing and data storage, RHMS is becoming a feasible aspect of modern medicine. RHMS for the prioritisation of patients with multiple chronic diseases (MCDs) plays an important role in sustainably providing high-quality healthcare services. Further investigations are required to highlight the limitations of the prioritisation of patients with MCDs over a telemedicine environment. This study introduces a comprehensive and inclusive review on the prioritisation of patients with MCDs in telemedicine applications. Furthermore, it presents the challenges and open issues regarding patient prioritisation in telemedicine. The findings of this study are as follows: (1) The limitations and problems of existing patients' prioritisation with MCDs are presented and emphasised. (2) Based on the analysis of the academic literature, an accurate solution for remote prioritisation in a large scale of patients with MCDs was not presented. (3) There is an essential need to produce a new multiple-criteria decision-making theory to address the current problems in the prioritisation of patients with MCDs.
    Matched MeSH terms: Comorbidity*
  6. Ohno T, Thinh DH, Kato S, Devi CR, Tung NT, Thephamongkhol K, et al.
    J Radiat Res, 2013 May;54(3):467-73.
    PMID: 23192700 DOI: 10.1093/jrr/rrs115
    The purpose of this study was to evaluate the efficacy and toxicity of radiotherapy concurrently with weekly cisplatin, followed by adjuvant chemotherapy, for the treatment of N2-3 nasopharyngeal cancer (NPC) in Asian countries, especially regions of South and Southeast Asian countries where NPC is endemic. Between 2005 and 2009, 121 patients with NPC (T1-4 N2-3 M0) were registered from Vietnam, Malaysia, Indonesia, Thailand, The Philippines, China and Bangladesh. Patients were treated with 2D radiotherapy concurrently with weekly cisplatin (30 mg/m (2)), followed by adjuvant chemotherapy, consisting of cisplatin (80 mg/m(2) on Day 1) and fluorouracil (800 mg/m(2) on Days 1-5) for 3 cycles. Of the 121 patients, 56 patients (46%) required interruption of RT. The reasons for interruption of RT were acute non-hematological toxicities such as mucositis, pain and dermatitis in 35 patients, hematological toxicities in 11 patients, machine break-down in 3 patients, poor general condition in 2 patients, and others in 8 patients. Of the patients, 93% completed at least 4 cycles of weekly cisplatin during radiotherapy, and 82% completed at least 2 cycles of adjuvant chemotherapy. With a median follow-up time of 46 months for the surviving 77 patients, the 3-year locoregional control, distant metastasis-free survival and overall survival rates were 89%, 74% and 66%, respectively. No treatment-related deaths occurred. Grade 3-4 toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of the patients, respectively. In conclusion, further improvement in survival and locoregional control is necessary, although our regimen showed acceptable toxicities.
    Matched MeSH terms: Comorbidity
  7. Gijsberts CM, Groenewegen KA, Hoefer IE, Eijkemans MJ, Asselbergs FW, Anderson TJ, et al.
    PLoS One, 2015;10(7):e0132321.
    PMID: 26134404 DOI: 10.1371/journal.pone.0132321
    BACKGROUND: Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events.

    METHODS: We used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity.

    RESULTS: Ethnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites.

    CONCLUSION: The magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention.

    Matched MeSH terms: Comorbidity
  8. Jamal A, Babazono A, Li Y, Yoshida S, Fujita T, Kim SA
    Am J Med Qual, 2021 5 20;36(5):345-354.
    PMID: 34010165 DOI: 10.1097/01.JMQ.0000735484.44163.ce
    The authors examined variations in hemodialysis care and quantified the effect of these variations on all-cause mortality. Insurance claims data from April 1, 2017 to March 30, 2018 were reviewed. In total, 2895 hospital patients were identified, among whom 398 died from various causes. Controlling effects of the facility and secondary medical care areas, all-cause mortality was associated with older age, heart failure, malignancy, cerebral stroke, severe comorbidity, and the first and ninth centile of physician density. Multilevel analyses indicated a significant variation at facility level (σ22 0.27, 95% confidence interval: 0.09-0.49). Inclusion of all covariates in the final model significantly reduced facility-level variance. Physician density emerged as an important factor affecting survival outcome; thus, a review of workforce and resource allocation policies is needed. Better clinical management and standardized work processes are necessary to attenuate differences in hospital practice patterns.
    Matched MeSH terms: Comorbidity
  9. Aishvarya S, Maniam T, Karuthan C, Sidi H, Ruzyanei N, Oei TP
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S107-13.
    PMID: 24230486 DOI: 10.1016/j.comppsych.2013.06.010
    The Reasons For Living Inventory has been shown to have good psychometric properties in Western populations for the past three decades. The present study examined the psychometric properties and factor structure of English and Malay version of the Reasons For Living (RFL) Inventory in a sample of clinical outpatients in Malaysia. The RFL is designed to assess an individual's various reasons for not committing suicide. A total of 483 participants (283 with psychiatric illnesses and 200 with non-psychiatric medical illnesses) completed the RFL and other self-report instruments. Results of the EFA (exploratory factor analysis) and CFA (confirmatory factor analysis) supported the fit for the six-factor oblique model as the best-fitting model. The internal consistency of the RFL was α=.94 and it was found to be high with good concurrent, criterion and discriminative validities. Thus, the RFL is a reliable and valid instrument to measure the various reasons for not committing suicide among psychiatry and medical outpatients in Malaysia.
    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Comorbidity
  10. Suthahar A, Gurpreet K, Ambigga D, Dhachayani S, Fuad I, Maniam T, et al.
    Med J Malaysia, 2008 Dec;63(5):362-8.
    PMID: 19803291 MyJurnal
    We present the results and conclusions of an observational prospective cohort design study using self-administered questionnaires to determine correlation between psychosocial factors and cancer outcome among 80 consecutive newly diagnosed treatment naïve cancer subjects who were being referred to the Oncology Clinic, Hospital Universiti Kebangsaan Malaysia. Subjects were recruited over a period of 43 weeks from October 2000 till July 2001. Follow-up assessments were carried out at 6-months and 12 to 26 months later. The prediction of survival time was performed by the Cox Regression Analysis method with adjustments for biological and psychosocial risk factors. It was noted that depression (p = 0.001), stage 4 cancer disease (p = 0.016), neurological (p = 0.032), gastrointestinal tract (p = 0.04), head and neck (p = 0.011), gynaecological (p = 0.005) and bone and soft tissue (p = 0.030) malignancies were independent and statistically significant prognostic factor of survival during the study period. It was further shown than depressed patients were found to have almost four fold greater risk of dying than non-depressed patients and patients with stage 4 cancer illness have a five fold greater risk of dying than patients with stage 1 disease. Furthermore, based on tumour types subjects with neurological, gynaecological, head and neck, bone and soft tissue and gastro intestinal tract malignancies were found to have approximately thirty-six, twenty-five, twenty-two, sixteen and seven fold greater risk of dying respectively when compared to subjects with genitourinary cancers. This study further affirms the need for health care providers to be aware of the psychological aspects of the cancer patient and provide appropriate therapy so as to ensure that this group of individuals would have enhanced survival rates.

    Study site: Oncology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Comorbidity
  11. Ng CG, Dijkstra E, Smeets H, Boks MP, de Wit NJ
    Br J Gen Pract, 2013 Jan;63(606):e63-8.
    PMID: 23336475 DOI: 10.3399/bjgp13X660797
    It is unclear whether psychiatric disorders are specifically related to the terminal phase of cancer, or independent of the underlying disease.
    Matched MeSH terms: Comorbidity
  12. Teoh Bing Fei J, Yee A, Habil MH
    Am J Addict, 2016 Jan;25(1):49-55.
    PMID: 26692463 DOI: 10.1111/ajad.12317
    BACKGROUND AND OBJECTIVES: Co-occurring psychiatric disorders are among the difficulties faced by patients with opioid dependence on methadone maintenance therapy (MMT). This study aims to assess the prevalence of psychiatric comorbidity among patients on MMT, the factors predicting psychiatric comorbidity and to examine the association between psychiatric comorbidity and quality of life.
    METHODS: A total of 225 male patients on MMT in a tertiary hospital in Malaysia were assessed for psychiatric comorbidity and substance use disorders using the Mini-International Neuropsychiatric Interview (MINI) and Opiate Treatment Index (OTI). Their quality of life was assessed using World Health Organization Quality of Life (WHOQOL)-BREF.
    RESULTS: The prevalence of a current and lifetime non-substance use Axis I psychiatric disorder was 14.2% and 15.6% respectively, while 14.7% fulfilled the criteria for antisocial personality disorder. 80.9% had comorbid substance dependence, predominantly nicotine dependence. Factors significantly associated with a non-substance use Axis I psychiatric disorder on multivariate analysis were use of psychiatric medications, antisocial personality disorder and poorer physical health. Patients with a non-substance use Axis I psychiatric disorder had a significantly poorer quality of life in all domains namely physical health, psychological, social relationships, environment as well as combined quality of life and general health after controlling for possible confounders.
    CONCLUSION: Psychiatric comorbidity among patients on MMT negatively impacts quality of life.
    SCIENTIFIC SIGNIFICANCE: The detection of psychiatric disorders and provision of appropriate treatment is needed to improve the quality of life of patients on MMT.
    Matched MeSH terms: Comorbidity
  13. Azlin Baharudin, Lotfi Anuar, Suriati Saini, Osman Che Bakar, Rosdinom Razali, Nik Ruzyanei Nik Jaafar
    Sains Malaysiana, 2013;42(3):417-421.
    The main objectives in this study were to determine the percentage of psychiatric comorbidity among treatment seeking opioid dependents in Klang Valley. A cross sectional study of opioid dependence patients was conducted between December 2007 and May 2008 at ten community-based drug substitution therapy clinics in Klang Valley. A total of 204 opioid dependence patients participated in the study using the structured clinical interview for DSM-IV Axis I disorders
    (SCID-I) as its instruments. The percentage of psychiatric comorbidity among opioid dependents was 43.6%. Major depressive disorder had the highest prevalence at 32.6%, followed by dysthymia at 23.6% and Panic disorder at 14.6%. Psychiatric comorbidity were found to have significant differences (p<0.05) in connection with history of polysubstance abuse, previous history of court sentences (legal status) and family history of psychiatric illnesses. This study showed that the percentage of psychiatric comorbidity is high among the opioid dependents. It highlights the urgent need for the psychiatric comorbidity to be assessed and early intervention is important for this group of patients.
    Matched MeSH terms: Comorbidity
  14. Sabatino A, Regolisti G, Karupaiah T, Sahathevan S, Sadu Singh BK, Khor BH, et al.
    Clin Nutr, 2017 06;36(3):663-671.
    PMID: 27371993 DOI: 10.1016/j.clnu.2016.06.007
    BACKGROUND & AIMS: Protein-Energy Wasting (PEW) is the depletion of protein/energy stores observed in the most advanced stages of Chronic Kidney Disease (CKD). PEW is highly prevalent among patients on chronic dialysis, and is associated with adverse clinical outcomes, high morbidity/mortality rates and increased healthcare costs. This narrative review was aimed at exploring the pathophysiology of PEW in end-stage renal disease (ESRD) on hemodialysis. The main aspects of nutritional status evaluation, intervention and monitoring in this clinical setting were described, as well as the current approaches for the prevention and treatment of ESRD-related PEW.

    METHODS: An exhaustive literature search was performed, in order to identify the relevant studies describing the epidemiology, pathogenesis, nutritional intervention and outcome of PEW in ESRD on hemodialysis.

    RESULTS AND CONCLUSION: The pathogenesis of PEW is multifactorial. Loss of appetite, reduced intake of nutrients and altered lean body mass anabolism/catabolism play a key role. Nutritional approach to PEW should be based on a careful and periodic assessment of nutritional status and on timely dietary counseling. When protein and energy intakes are reduced, nutritional supplementation by means of specific oral formulations administered during the hemodialysis session may be the first-step intervention, and represents a valid nutritional approach to PEW prevention and treatment since it is easy, effective and safe. Omega-3 fatty acids and fibers, now included in commercially available preparations for renal patients, could lend relevant added value to macronutrient supplementation. When oral supplementation fails, intradialytic parenteral nutrition can be implemented in selected patients.

    Matched MeSH terms: Comorbidity
  15. Liu Y, Uemura H, Ye D, Lee JY, Chiong E, Pu YS, et al.
    Prostate Int, 2019 Sep;7(3):108-113.
    PMID: 31485435 DOI: 10.1016/j.prnil.2018.12.001
    Background: The incidence of prostate cancer (PC) in Asian countries is increasing for reasons that are not clear. Data describing how PC is diagnosed and treated are fragmented across Asia, with marked intercountry and intracountry differences in outcome and knowledge gaps in clinical diagnostic and treatment practices. To address these knowledge gaps, we have established a PC disease registry with the aim of providing a comprehensive picture of PC diagnosis, prognosis, treatment and outcome, population characteristics, and comorbidities in real-world clinical practice in Asia.

    Methods: This is a multinational, multicenter, longitudinal, and observational registry of PC patients presenting to participating tertiary-care hospitals in eight Asian countries (www.clinicaltrials.gov NCT02546908. Registry Identifier: NOPRODPCR4001). Approximately 3500-4000 eligible patients with existing or newly diagnosed high-risk localized PC (cohort 1), nonmetastatic biochemically recurrent PC (cohort 2), or metastatic PC (cohort 3) will be consecutively enrolled and followed-up for 5 years. An enrollment cap of 600 patients each will be applied to cohorts 1 and 2. Disease status is collected at enrollment, and outcome variables captured at 3-monthly intervals include diagnostic/staging, treatments including reason for change, laboratory results, comorbidities, and concomitant medications. Treatments and survival outcomes will be captured real time until study end. Patient-reported quality-of-life will be measured every 6 months, and medical resource utilization summarized at study end. Data analysis will include exploratory analyses of potential associations between multiple risk factors and socioeconomic variables with disease progression and evaluation of various treatments for PC including novel therapies on clinical outcome and health-related quality-of-life outcomes.

    Results: 3636 men with PC were enrolled until July 2018; 416 in cohort 1, 399 in cohort 2 and 2821 in cohort 3.

    Discussion: A total of 3636 patients were enrolled until July 2018. The prospective disease registry will provide comprehensive and wide-ranging real-world information on how PC is diagnosed and treated in Asia. Such information can be used to inform policy development for best practice and direct clinical study design evaluating new treatments.

    Matched MeSH terms: Comorbidity
  16. Phua CE, Bustam AZ, Yip CH, Taib NA
    Asian Pac J Cancer Prev, 2010;11(5):1205-11.
    PMID: 21198264
    BACKGROUND: Information about elderly breast cancer patients' outcome is limited. This study aimed to evaluate the treatment outcomes in women aged 70 and above with specific analysis on prognostic clinicopathological features and treatment modalities.

    MATERIALS AND METHODS: This retrospective study examined breast cancer patients between 1st January 1994 and 31st December 2004 in UMMC. Survival analysis was performed using the Kaplan-Meier method and comparisons between groups using the log-rank test. Univariate and multivariate analysis on prognostic factors were carried out using the Cox's proportionate hazard model for patient demographics, and tumour and treatment factors.

    RESULTS: One hundred and thirty six patients were identified, with a median age at diagnosis of 75 years. Most had at least one co-morbidity (61.8%). Only 75.0% had a good performance status (ECOG 0-1). Mean tumour size was 4.4 cm. Primary tumour stages (T stages) 3 and 4 were present in 8.1% and 30.1% of patients respectively, and 30.9% had stage III and 8.8% had stage IV disease based on overall AJCC staging. ER positivity was 58.1%. PR status was positive in 30.1%. Surgery was performed in 69.1% of the patients and mastectomy and axillary clearance were the commonest surgical procedures (50.7%). Some 79.4% of patients received hormonal therapy, 30.1% radiotherapy and only 3.6% chemotherapy. Non-standard treatment was given to 39.0% of patients due to a variety of reasons. The cumulative 5 years overall, relapse free and cause specific survivals were 51.9%, 79.7% and 73.3% respectively. Performance status, T3-4 tumour, presence of metastasis, tumour grade and ER status were independent prognostic factors for overall survival. For cause specific survival they were T4 tumour, presence of metastasis and ER status.

    CONCLUSION: The 5 years overall survival rate was 51.9% and 41.8% of deaths were non-breast cancer related deaths. Low survival rate was related to low life expectancy in this population. Locally advanced disease, metastatic disease and high ER negative rates play a major role in the survival of elderly breast cancer patients in Malaysia.

    Matched MeSH terms: Comorbidity
  17. Goldhaber SZ, Ageno W, Casella IB, Chee KH, Schellong S, Singer DE, et al.
    Am J Med, 2020 08;133(8):936-945.
    PMID: 32325043 DOI: 10.1016/j.amjmed.2020.03.036
    BACKGROUND: The safety and efficacy of nonvitamin K antagonist oral anticoagulants (NOACs) for the treatment of venous thromboembolism (VTE) have been established in randomized controlled trials, but limited data are available on their use in clinical practice across geographical regions.

    METHODS: In the international RE-COVERY DVT/PE observational study (enrollment January 2016 to May 2017), we sought to characterize the patient population and describe the prescribed anticoagulant. Patient characteristics and anticoagulants administered after objective diagnosis of VTE were recorded at the baseline visit and again at hospital discharge or at 14 days after the diagnosis, whichever was later.

    RESULTS: A total of 6095 patients were included, 50.2% were male, and the mean age was 61.5 years. The most common comorbidities were hypertension (35%), diabetes mellitus (11%), cancer (11%), prior VTE(11%), and trauma/surgery (7%). Overall, 77% of patients received oral anticoagulants, with 54% on NOACs and 23% on vitamin K antagonists (VKAs); 20% received parenteral anticoagulation only. NOACs comprised about 60% of anticoagulant treatment in Europe and Asia but substantially less in Latin America (29%) and the Middle East (21%). For NOAC therapies, the distribution (as a percentage of the total cohort) was rivaroxaban 25.6%, dabigatran 15.5%, apixaban 11.3%, and edoxaban 1.7%. Treatment with NOACs was less frequent in patients who had cancer, chronic renal disease, heart failure, or stroke.

    CONCLUSIONS: These findings enhance our understanding of baseline characteristics and the initial management of patients with VTE in routine practice.

    Matched MeSH terms: Comorbidity
  18. 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: Comorbidity
  19. Quek KF, Sallam AA, Ng CH, Chua CB
    J Sex Med, 2008 Jan;5(1):70-6.
    PMID: 17362280 DOI: 10.1111/j.1743-6109.2006.00423.x
    INTRODUCTION: Sexual problems are common in the general population. Studies have shown that most of these sexual problems are related to their social lives, medical illnesses, and psychological status. Among the sexual problems in men, premature ejaculation (PE) is one of the most frequent, yet it is the least well-understood of the sexual dysfunctions of men.
    AIM: To determine the prevalence of sexual problem particularly PE and erectile dysfunction (ED) among people living in urban areas and to investigate the characteristics associated with these sexual problems in a Malaysian population.
    MAIN OUTCOME MEASURE: The PE which is defined as an intravaginal ejaculation latency time less than 2 minutes was assessed in the ED and non-ED group.
    METHODS: The Hospital Anxiety and Depression scale is used as a measure of the psychological status [30]. The ED status was assessed using the International Index of Erectile Function questionnaire.
    RESULTS: The prevalence of self-reported sexual problems for ED and PE were 41.6% and 22.3%, respectively. In those subjects with ED, 33.5% reported to have PE. Of the total of 430 subjects, anxiety was present in 8.1%, while depression was 5.3%. The prevalence of PE accounted for 25% anxiety and 14.6% for depression respectively in the population. EDs were associated with diabetes and hypertension (OR [95% CI]: 5.33 [2.33, 10.16], 3.40 [1.76, 6.57], P < 0.05), respectively, while factors associated with PE were anxiety and depression (OR [95% CI]: 1.29 [0.68, 2.45], 1.39 [0.69, 2.78]), respectively.
    CONCLUSION: Prevalence of ED is associated with medical symptoms such as diabetes and hypertension and a rise in the prevalence of age while psychological distress such as anxiety and depression also contribute to a higher PE rate.
    Matched MeSH terms: Comorbidity
  20. Maria Awaluddin S, Noor Ani Ahmad, Balkish Mahadir Naidu, Muslimah Yusof, Mohamad Aznuddin Abd Razak, Mohd Kamal Ariff Abdul Ghani
    Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with adverse effects. However, NSAIDs are among the most popular pain killers and easily available over the counter. This study aimed to determine the prevalence of NSAIDs use in Malaysian adults and among those with chronic diseases such as arthritis, kidney disease, hypertension, heart disease and asthma. It also examined the factors associated with NSAIDs use. Data from the National Health Morbidity Survey (NHMS) 2011, a nation-wide survey was analysed. A total of 18231 respondents aged 18 years and above responded to this module. Multivariate logistic regression was used to investigate the association between NSAIDs use and associated factors. The overall prevalence of NSAIDs use among Malaysian adults was 14.2% (95%CI 13.3-15.1). Of the respondents, 4.2% (95%CI 3.8-4.7) took NSAIDs once daily. NSAIDs use was highly associated with those who were ever-told to have arthritis (aOR: 3.03; 95%CI 2.60-3.52) and have difficulty of performing daily activities or work (aOR: 2.06; 95%CI 1.86-2.28). Those who were ever-told to have kidney disease (aOR: 2.36; 95%CI 1.74-3.20), ever-told to have asthma (aOR: 1.36; 95%CI 1.17-1.58), ever-told to have heart disease (aOR: 1.34; 95%CI 1.08-1.65), known hypertension (aOR: 1.22; 95%CI 1.08-1.37) also were associated with NSAIDs use. By socio-demographic profiles, NSAIDs use was positively associated with those who have government benefit scheme or private health insurance (aOR: 1.44; 95%CI 1.31-1.58), higher education level (aOR: 1.35; 95%CI 1.20-1.51), higher household income (aOR: 1.26; 95%CI 1.11-1.44, aOR: 1.12; 95%CI 1.02-1.24), currently working (aOR: 1.25; 95%CI 1.13-1.39) and female (aOR: 1.17; 95%CI 1.07-1.28). NSAIDs use was less likely among those aged 60 years and above (aOR: 0.83; 95% CI 0.72-0.97), Chinese (aOR: 0.41; 95% CI 0.36-0.47) and ‘Others’ ethnicity (aOR: 0.82; 95% CI 0.67-0.99) compared to Malay ethnicity. NSAIDs use is prevalent in Malaysian adults and associated with co-morbidities and higher socio-demographic status, thus appropriate awareness should be promoted and highlighted in the community.
    Study name: National Health and Morbidity Survey (NHMS-2011)
    Matched MeSH terms: Comorbidity
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