METHODS: A systematic search of Medline via the PubMed, Science Direct, Cochrane Review and Web of Science databases was conducted for studies on the associations between diet and PA factors and cardio-metabolic risk factors among Malaysian adolescents aged 13-18 years that were published until 31 August 2017. The search results were independently screened and extracted by two reviewers.
RESULTS: From over 2,410 references retrieved, 20 full texts articles were screened as potentially relevant. Seventeen (16 cross-sectional and one intervention) met the inclusion criteria for data extraction and analysis. All 17 studies were rated as poor quality and the majority had made insufficient adjustment for confounders. As regards the effect of diet and PA on cardio-metabolic health, the intakes of energy (n = 4) and macronutrients (n = 3) and meal frequency (n = 5) were the most commonly studied dietary factors, while the PA score and level were the most commonly studied PA factors. In addition, BMI and body weight were the most common cardio-metabolic health outcomes. The studies showed that obese and overweight adolescents consume significantly more energy and macronutrients. They are also more likely to skip their daily meals compared to their normal weight peers. In most studies, the direction of the PA effect on body weight was unclear. Some studies found that higher PA is associated with a lower risk of overweight and obesity. However, the associations are often small or inconsistent, with few studies controlling for confounding factors.
CONCLUSIONS: This review identified a lack of evidence and well-conducted prospective studies on the effect of diet and PA on cardio-metabolic health of Malaysian adolescents.
METHODS: This was a cross sectional study design. A total of 347 respondents from low household income groups, including persons with disability and Orang Asli were recruited from E-kasih. A semi-guided self-administered questionnaire was used. QOL measured by EQ. 5D utility value and health status measured by visual analogue score (VAS). Descriptive statistic, bivariate Chi-square analysis and binary logistic regression were conducted to determine factors influencing low QOL and poor health status.
RESULTS: Majority of the respondents were Malay, female (61%), 63% were married, 60% were employed and 46% with total household income of less than 1 thousand Ringgit Malaysia. 70% of them were not having any chronic medical problems. Factors that associated with low QOL were male, single, low household income, and present chronic medical illness, while poor health status associated with female, lower education level and present chronic medical illness. Logistic regression analysis has showed that determinants of low QOL was present chronic illness [AOR 4.15 95%CI (2.42, 7.13)], while determinants for poor health status were; female [AOR 1.94 95%CI (1.09,3.44)], lower education [AOR 3.07 95%CI (1.28,7.34)] and present chronic illness [AOR 2.53 95%CI (1.39,4.61)].
CONCLUSION: Low socioeconomic population defined as low total household income in this study. Low QOL of this population determined by present chronic illness, while poor health status determined by gender, education level and chronic medical illness.
METHODS: Two cross-sectional studies were conducted in urban and rural areas of Yangon Region in 2013 and 2014 respectively, using the WHO STEPwise approach to surveillance of risk factors of NCDs. Through a multi-stage cluster sampling method, 1486 participants were recruited.
RESULTS: Age-standardized prevalence of the behavioral risk factors tended to be higher in the rural than urban areas for all included factors and significantly higher for alcohol drinking (19.9% vs. 13.9%; p = 0.040) and low fruit & vegetable consumption (96.7% vs. 85.1%; p = 0.001). For the metabolic risk factors, the tendency was opposite, with higher age-standardized prevalence estimates in urban than rural areas, significantly for overweight and obesity combined (40.9% vs. 31.2%; p = 0.023), obesity (12.3% vs.7.7%; p = 0.019) and diabetes (17.2% vs. 9.2%; p = 0.024). In sub-group analysis by gender, the prevalence of hypercholesterolemia and hypertriglyceridemia were significantly higher in urban than rural areas among males, 61.8% vs. 40.4%; p = 0.002 and 31.4% vs. 20.7%; p = 0.009, respectively. Mean values of age-standardized metabolic parameters showed higher values in urban than rural areas for both male and female. Based on WHO age-standardized Framingham risk scores, 33.0% (95% CI = 31.7-34.4) of urban dwellers and 27.0% (95% CI = 23.5-30.8) of rural dwellers had a moderate to high risk of developing CHD in the next 10 years.
CONCLUSION: The metabolic risk factors, as well as a moderate or high ten-year risk of CHD were more common among urban residents whereas behavioral risk factors levels were higher in among the rural people of Yangon Region. The high prevalences of NCD risk factors in both urban and rural areas call for preventive measures to reduce the future risk of NCDs in Myanmar.
METHODS: Period abridged life tables were constructed to derive the life expectancy of the Singapore population from 1965 to 2009 using data from the Department of Statistics and the Registry of Births and Deaths, Singapore.
RESULTS: All 3 of Singapore's main ethnic groups, and both genders, experienced an increase in life expectancy at birth and at 65 years from 1965 to 2009, though at substantially different rates. Although there has been a convergence in life expectancy between Indians and Chinese, the (substantial) gap between Malays and the other two ethnic groups has remained. Females continued to have a higher life expectancy at birth and at 65 years than males throughout this period, with no evidence of convergence.
CONCLUSIONS: Ethnic and gender differences in life expectancy persist in Singapore despite its rapid economic development. Targeted chronic disease prevention measures and health promotion activities focusing on people of Malay ethnicity and the male community may be needed to remedy this inequality.
METHODS: This was a cross sectional study carried out in two primary care clinics in a semi-urban locality of Ampangan, Negeri Sembilan, Malaysia. Data was collected through self-administered questionnaires assessing the demographic characteristics, medical history, lifestyle and physical activity. The Short Form 36-items health survey was used to measure HRQOL among the pre-diabetics. Data entry and analysis were performed using the SPSS version 19.
RESULTS: A total of 268 eligible pre-diabetics participated in this study. The prevalence of normal weight, overweight and obesity were 7.1%, 21.6% and 71.3% respectively. Their mean (SD) age was 52.5 (8.3) years and 64.2% were females. Among the obese pre-diabetics, 42.2% had both IFG and IGT, 47.0% had isolated IFG and 10.8% had isolated IGT, 36.2% had combination of hypertension, dyslipidemia and musculoskeletal diseases. More than 53.4% of the obese pre-diabetics had family history of diabetes, 15.7% were smokers and 60.8% were physically inactive with mean PA of <600 MET-minutes/week. After adjusted for co-variants, Physical Component Summary (PCS) was significantly associated with BMI categories [F (2,262)=11.73, p<0.001] where pre-diabetics with normal weight and overweight had significantly higher PCS than those obese; normal vs obese [Mdiff=9.84, p=0.006, 95% CIdiff=2.28, 17.40] and between overweight vs obese [Mdiff=8.14, p<0.001, 95% CIdiff=3.46, 12.80].
CONCLUSION: Pre-diabetics who were of normal weight reported higher HRQOL compared to those overweight and obese. These results suggest a potentially greater risk of poor HRQOL among pre-diabetics who were overweight and obese especially with regard to the physical health component. Promoting recommended amount of physical activity and weight control are particularly important interventions for pre-diabetics at the primary care level.
METHODS/DESIGN: Three hundred and twenty premenopausal women working in a public university in Kuala Lumpur, Malaysia will be randomized to receive either vitamin D supplement (50,000 IU weekly for 8 weeks and 50,000 IU monthly for 10 months) or placebo for 12 months. At baseline, all participants are vitamin D deficient (≤ 20 ng/ml or 50 nmol/l). Both participants and researchers will be blinded. The serum vitamin D levels of all participants collected at various time points will only be analysed at the end of the trial. Outcome measures such as 25(OH) D3, HOMA-IR, blood pressure, full lipid profiles will be taken at baseline, 6 months and 12 months. Health related quality of life will be measured at baseline and 12 months. The placebo group will be given delayed treatment for six months after the trial.
DISCUSSION: This trial will be the first study investigating the effect of vitamin D supplements on both the cardiometabolic risk and quality of life among urban premenopausal women in Malaysia. Our findings will contribute to the growing body of knowledge in the role of vitamin D supplements in the primary prevention for cardiometabolic disease.
TRIAL REGISTRATION: ACTRN12612000452897.
METHODS AND ANALYSIS: This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression.
ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.
DESIGN: Systematic review.
DATA SOURCES: EMBASE, MEDLINE, Scopus and Global Health databases.
ELIGIBILITY CRITERIA: Studies were eligible if they: (1) included Nepalese migrant workers aged 18 or older working in the GCC countries or Malaysia or returnee migrant workers from these countries; (2) were primary studies that investigated health and well-being status/issues; and (3) were published in English language before 8 May 2020.
STUDY APPRAISAL: All included studies were critically appraised using Joanna Briggs Institute study specific tools.
RESULTS: A total of 33 studies were eligible for inclusion; 12 studies were conducted in Qatar, 8 in Malaysia, 9 in Nepal, 2 in Saudi Arabia and 1 each in UAE and Kuwait. In majority of the studies, there was a lack of disaggregated data on demographic characteristics of Nepalese migrant workers. Nearly half of the studies (n=16) scored as 'high' quality and the rest (n=17) as 'moderate' quality. Five key health and well-being related issues were identified in this population: (1) occupational hazards; (2) sexual health; (3) mental health; (4) healthcare access and (5) infectious diseases.
CONCLUSION: To our knowledge, this is the most comprehensive review of the health and well-being of Nepalese migrant workers in the GCC countries and Malaysia. This review highlights an urgent need to identify and implement policies and practices across Nepal and destination countries to protect the health and well-being of migrant workers.
METHODS AND ANALYSIS: This is a cross-sectional study among 375 Malaysian medical doctors who met the inclusion criteria. A predetermined self-administered questionnaires will be used to collect information regarding the sociodemographic, health status, workplace information, work commuting information, driving behaviour, history of RCI, fatigue, sleep quality, mental health status and work engagement. The questionnaires consist of the following instruments: (1) sociodemographic, health status, workplace information, work commuting information, driving behaviour and history of RCI; (2) Checklist of Individual Strength Questionnaire; (3) Pittsburgh Sleep Quality Index; (4) 21-item Depression Anxiety and Stress Scale; and (5) Utrecht's Work Engagement Scale. The data will be analysed using SPSS program V.24. Descriptive and inferential statistics will be used to determine the prevalence and predictors of RCI.
ETHICS AND DISSEMINATION: This study protocol has received ethics approval from the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia (NMRR-18-3983-40609) and the Ethics Committee for Research Involving Human Subject, University Putra Malaysia (JKEUPM). Online written informed consent will be obtained from each study participant by the researchers. Results of the study will be disseminated through relevant journals and conferences.
TRIAL REGISTRATION NUMBER: NCT04243291.
Results: Candidal growth was found in 21.42% (n = 24) of COPD cases and 1.1% (n = 11) of control cases (p < 0.05) (95% CI 0.45, 0.59). The DMFT score was 8.26 in COPD subjects and 4.6 in controls, the SiC score was 16.42 in COPD subjects and 10.25 in controls, and the CPITN score for both COPD and control cases was score 2.
Conclusion: In conclusion, there was a higher candidal load among subjects suffering from COPD. Theophylline medication can be a risk factor for increased candidal load in COPD patients.