METHODS: From the Malaysian National Neurology Registry, we included hypertensive patients with first ischemic stroke who presented within 48 hours from ictus. Antihypertensive drugs were divided into Ang II increasers (angiotensin-I receptor blockers (ARBs), calcium channel blockers (CCBs) and diuretics) and Ang II suppressors (angiotensin-converting-enzyme inhibitors (ACEIs) and beta blockers). We evaluated stroke severity during admission with the National Institute of Health Stroke Scale (NIHSS). We performed a multivariable logistic regression with the score being dichotomized at 15. Scores of less than 15 were categorized as less severe stroke.
RESULTS: A total of 710 patients were included. ACEIs was the most commonly prescribed antihypertensive drug in patients using Ang II suppressors (74%) and CCBs, in patients prescribed with Ang II increasers at 77%. There was no significant difference in the severity of ischemic stroke between patients who were using Ang II increasers in comparison to patients with Ang II suppressors (OR: 1.32, 95%CI: 0.83-2.10, p = 0.24).
CONCLUSION: In our study, we found that use of antihypertensive drugs that increase Ang II formation was not associated with less severe ischemic stroke as compared to use of antihypertensive drugs that suppress Ang II formation.
METHODS AND FINDINGS: Stratified random sampling design was used to select adolescents from 15 urban and rural secondary schools in Selangor, Perak and Kuala Lumpur, Malaysia. Data collection was carried out from 1st April 2014 to 30th June 2014. Information regarding socio-demographic characteristics, sun exposure and sun protective behaviours, clinical data and environmental factors were collected. Blood for total vitamin D was sampled. Descriptive and multivariate logistic regressions were performed. Total 1061 participants were analyzed (62% were female; mean age 15.1 ± 0.4 years). The prevalence of vitamin D deficiency was 33%. Mean vitamin D was lower in female (53 ± 15 nmol), obese (body fat percentage (≥25%m; ≥33.8%f) (56 ± 16 nmol/L), Malays (58 ± 18 nmol/L) and Indians (58 ± 15 nmol/L). In multivariate analysis, female (OR = 5.5; 95% CI: 3.4-7.5), Malay (OR = 3.2; 95% CI: 1.3-8.0), Indian (OR = 4.3; 95% CI: 1.6-12.0) and those always wearing long sleeve (OR = 2.4; 95% CI: 1.1-5.4) were more likely to have vitamin D deficiency. For female participants, ethnicity {Malays (OR = 6.7; 95% CI: 2.0-18.5), Indian (OR = 4.5; 95% CI: 1.8-19.3)} was an important risk factors. Cloud cover, school residence, skin pigmentation, sun-exposure and sun-protective behaviours were not significant risk factors. The limitation of this study was recall bias as it relied on self-reported on the sun exposure and protective behaviours. The diet factors were not included in this analysis.
CONCLUSIONS: The prevalence of Vitamin D deficiency among Malaysian adolescents was considerable. Gender, ethnicity and clothing style were important risk factors.
METHODS AND METHODS: This retrospective population-based case-control study was conducted in Ranau district to assess sociodemographic, behavioural and medical history risk factors using a pretested questionnaire. The data were entered and analyzed using IBM SPSS version 23. Bivariate analysis was conducted using binary logistic regression whereas multivariate analysis was conducted using multivariable logistic regression. We set a statistical significance at p-value less than or equal to 0.05.
RESULTS: A total of 266 cases and 532 controls were included in the study. Male gender (AOR = 2.71; 95% CI: 1.63-4.50), spending overnight in forest (AOR = 1.92; 95% CI: 1.20-3.06), not using mosquito repellent (AOR = 2.49; 95% CI: 1.36-4.56) and history of previous malaria infection (AOR = 49.34; 95% CI: 39.09-78.32) were found to be independent predictors of P. knowlesi infection.
CONCLUSIONS: This study showed the need to strengthen the strategies in preventing and controlling P. knowlesi infection specifically in changing the practice of spending overnight in forest and increasing the usage of personal mosquito repellent.
METHODS: A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS) in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires.
RESULTS: A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9) was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity.
CONCLUSION: The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the program.