The rising incidence of inflammatory bowel disease in Asia supports the importance of environmental risk factors in disease aetiology. This prospective population-based case-control study in Asia-Pacific examined risk factors prior to patients developing IBD.
Bovine brucellosis was first reported in Peninsular Malaysia in 1950. A subsequent survey conducted in the country revealed that the disease was widespread. Current knowledge on the potential risk factors for brucellosis occurrence on cattle farms in Malaysia is lacking. Therefore, we conducted a case-control study to identify the potential herd-level risk factors for bovine brucellosis occurrence in four states in the country, namely Kelantan, Pahang, Selangor and Negeri Sembilan. Thirty-five cases and 36 controls of herds were selected where data on farm management, biosecurity, medical history and public health were collected. Multivariable logistic regression identified that Brucella seropositive herds were more likely to; have some interaction with wildlife (OR 8.9, 95% CI = 1.59-50.05); originated from farms where multiple species such as buffalo/others (OR 41.8, 95% CI = 3.94-443.19) and goat/sheep (OR 8.9, 95%Cl = 1.10-71.83) were reared, practice extensive production system (OR 13.6, 95% CI 1.31-140.24) and have had episodes of abortion in the past (OR 51.8, 95% CI = 4.54-590.90) when compared to seronegative herds. Considering the lack of information on the epidemiology of bovine brucellosis in peninsular Malaysia and absence of information on preventing the inception or spread of the disease, this report could contribute to the on-going area-wise national brucellosis eradication program.
This study aims to determine the composition and sources of particulate matter with an aerodynamic diameter of 10 μm or less (PM10) in a semi-urban area. PM10 samples were collected using a high volume sampler. Heavy metals (Fe, Zn, Pb, Mn, Cu, Cd and Ni) and cations (Na(+), K(+), Ca(2+) and Mg(2+)) were detected using inductively coupled plasma mass spectrometry, while anions (SO4 (2-), NO3 (-), Cl(-) and F(-)) were analysed using Ion Chromatography. Principle component analysis and multiple linear regressions were used to identify the source apportionment of PM10. Results showed the average concentration of PM10 was 29.5 ± 5.1 μg/m(3). The heavy metals found were dominated by Fe, followed by Zn, Pb, Cu, Mn, Cd and Ni. Na(+) was the dominant cation, followed by Ca(2+), K(+) and Mg(2+), whereas SO4 (2-) was the dominant anion, followed by NO3 (-), Cl(-) and F(-). The main sources of PM10 were the Earth's crust/road dust, followed by vehicle emissions, industrial emissions/road activity, and construction/biomass burning.
Information about the sex of individuals is important for human identification. This study was conducted to quantify classification rates of sex prediction models for Malaysians using odontometric profiles. Mesiodistal (MD) and buccolingual (BL) crown dimensions of the permanent dentition were studied in 400 young adult Malaysians, giving a total of 28 tooth size variables. The sample consisted of three major ethnic groups, the Malays, Chinese and Tamils, since the aim was to assess sex dimorphism in Malaysians as a whole. Results showed that the mesiodistal diameter of the lower canine was the most sexually dimorphic dimension in Malaysian Malays and Tamils. Univariate analyses showed that the magnitude and pattern of sex dimorphism varies between these three ethnic groups, with Malaysian Chinese and Tamils being more dimorphic than the Malaysian Malays. Stepwise discriminant functions were generated bearing in mind their application in practical forensic situations. The range of classification rates was from 70.2% to 78.5% for the composite Malaysian group, and 83.8%, 77.9%, 72.4% for Malaysian Chinese, Malays and Tamils, respectively. The 'Area Under the Receiver Operating Characteristic Curve statistics' indicated good classification rates for three prediction models obtained using a combination of all tooth size variables, mandibular teeth, and mesiodistal dimensions in the composite Malaysian group, and for all tooth size variables in each ethnic group. The present study provides strong support for the value of odontometry as an adjunct scientific method for sex prediction in human identification.
Groundwater chemistry of small tropical islands is influenced by many factors, such as recharge, weathering and seawater intrusion, among others, which interact with each other in a very complex way. In this work, multivariate statistical analysis was used to evaluate the factors controlling the groundwater chemistry of Kapas Island (Malaysia). Principal component analysis (PCA) was applied to 17 hydrochemical parameters from 108 groundwater samples obtained from 18 sampling sites. PCA extracted four PCs, namely seawater intrusion, redox reaction, anthropogenic pollution and weather factors, which collectively were responsible for more than 87% of the total variance of the island's hydrochemistry. The cluster analysis indicated that three factors (weather, redox reaction and seawater intrusion) controlled the hydrochemistry of the area, and the variables were allocated to three groups based on similarity. A Piper diagram classified the island's water types into Ca-HCO3 water type, Na-HCO3 water type, Na-SO4-Cl water type and Na-Cl water type, indicating recharge, mixed, weathering and leached from sewage and seawater intrusion, respectively. This work will provide policy makers and land managers with knowledge of the precise water quality problems affecting the island and can also serve as a guide for hydrochemistry assessments of other islands that share similar characteristics with the island in question.
This study examines the rate of decline of estimated glomerular filtration rate (eGFR) over a 10-year period and the associated risk factors in type 2 diabetes mellitus (T2DM) patients. Medical records of T2DM patients were randomly selected. The rate of fall in eGFR (simplified modification of diet in renal disease formula) was used as a measure of decline. Univariate and multivariate analysis were performed to determine the factors associated with decline of kidney function. A total of 504 patients were selected. Mean age was 57.8 ± 9 years; 65.3% were females. The mean decline rate of eGFR was 0.89 ± 2.16 mL/min/1.73 m(2)/y. Baseline proteinuria, glycosylated hemoglobin level, duration of T2DM, and Malay race were associated with faster decline in eGFR. The expected greater deterioration in kidney function in this cohort was not seen. Treatment of proteinuria and glycemia should be optimized early to retard the decline in kidney function in patients with T2DM.
Study site: Primary care clinics, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
To study the association between sleep apnea and hypertension in a younger age group than previously studied, adding upper airway sizes at endoscopy as important compounding variables not often included in the past.
Successful aging is an important and worldwide concept in gerontology. However, until recently, there has been very little known about successful aging in Malaysia. This study was designed to describe the prevalence and correlates of successful aging among older Malaysians.
Biomonitoring of multi-element atmospheric deposition using terrestrial moss is a well-established technique in Europe. Although the technique is widely known, there were very limited records of using this technique to study atmospheric air pollution in Malaysia. In this present study, the deposition of 11 trace metals surrounding the main petroleum refinery plant in Kerteh Terengganu (eastern part of peninsular Malaysia) has been evaluated using two local moss species, namely Hypnum plumaeforme and Taxithelium instratum as bioindicators. The study was also done by means of observing whether these metals are attributed to work related to oil exploration in this area. The moss samples have been collected at 30 sampling stations in the vicinity of the petrochemical industrial area covering up to 15 km to the south, north, and west in radius. The contents of heavy metal in moss samples were analyzed by energy dispersive x-ray fluorescence technique. Distribution of heavy metal content in all mosses is portrayed using Surfer software. Areas of the highest level of contaminations are highlighted. The results obtained using the principal components analysis revealed that the elements can be grouped into three different components that indirectly reflected three different sources namely anthropogenic factor, vegetation factor, and natural sources (soil dust or substrate) factor. Heavy metals deposited mostly in the distance after 9 km onward to the western part (the average direction of wind blow). V, Cr, Cu, and Hg are believed to have originated from local petrochemical-based industries operated around petroleum industrial area.
OBJECTIVE: The objective of this study is to determine the quality of life among breast cancer patients in Yemen based on socio-demographic and clinical characteristics.
METHODOLOGY: This study was designed as a cross-sectional study. The data collected from 106 female breast cancer patients who were chosen for recruitment from the outpatient in National Oncology Centre (NOC), Sana'a, Yemen from November 2008 to June 2011. Questionnaires were distributed to the patients during their visit to the outpatient clinics in the center. The instrument of this study consists of two parts: Socio-demographic and the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Regarding data analysis, means and SD of subscales were evaluated for descriptive purpose. Analysis of variance (ANOVA) was performed to compare the three groups regarding QOL subscales. Whereas, independent t-test was performed for comparing two groups regarding QOL subscales. Multiple linear regression using backward analysis was performed to obtain the final model for each domain. The final model was chosen depending on R2 and the p value of the model. A p value less than 0.05 is considered statistically significant.
RESULTS: A total number of 106 breast cancer patients were participated in this study. The majority of them were uneducated, unemployed with normal weight and had middle income (60.4%; 95.3%; 59.4%, 46.2%; respectively). As for clinical characteristics of the study participants; the majority of them had had no family history of breast cancer, have been diagnosed at least 2 years, were diagnosed at grade 3 and size of tumor greater than 2 cm (88.7%, 66.0%, 35.8%, 73.6%; respectively). The majority of them underwent mastectomy, radiotherapy, chemotherapy and tamoxifen therapy (85.8%, 63.2%, 94.3% and 62.3%; respectively). For univariate analysis, the present study has identified several factors includes family monthly income, BMI, educational status, years after diagnosis, histological grade radiotherapy and surgery that influence the QOL of breast cancer patients in Yemen. For multivariate analysis, years after diagnosis, family monthly income and radiotherapy were significantly associated with total QOL of the breast cancer patients (p=0.01, p=0.023, p=0.039; respectively).
CONCLUSION: Family monthly income, BMI, educational status, years after diagnosis, histological grade radiotherapy and surgery were significantly influence the QOL of breast cancer patients in Yemen, in univariate analysis. For multivariate analysis, years after diagnosis, family monthly income and radiotherapy were significantly associated with total QOL of the breast cancer patients.
Many studies have shown that females smile more than males do in social situations. The present study extends this research by examining a large sample of high school yearbook photographs. In addition to assessing the degree of smiling, ratings were obtained of the following traits for each photograph: hair length, hair colour, masculine-feminine appearance and physical attractiveness. Results reconfirmed earlier research showing that females smile more than males do while they are being photographed. Other findings were that smiling was positively correlated with hair length, femininity and physical attractiveness for females but not for males. When a multivariate analysis was performed, none of these traits predicted smiling in males, and only femininity was significant in predicting smiling in females. Although social learning theories of smiling can account for some of these findings, a recently proposed neurohormonal theory seems to best explain why femininity is related to smiling in females but not in males.
Age at menarche has been shown to be an important indicator for diseases such as breast cancer and ischaemic heart disease. The aim of the present study was to document secular trends in age at menarche and their association with anthropometric measures and socio-demographic factors in university students in Bangladesh. Data were collected from 995 students from Rajshahi University using a stratified sampling technique between July 2004 and May 2005. Trends in age at menarche were examined by linear regression analysis. Multiple regression analysis was used to assess the association of age at menarche with adult anthropometric measures and various socio-demographic factors. The mean and median age of menarche were 13.12+/-1.16 and 13.17 years, respectively, with an increasing tendency among birth-year cohorts from 1979 to 1986. Menarcheal age was negatively associated with BMI (p<0.01), but positively associated with height (p<0.05). Early menarche was especially pronounced among students from urban environments, Muslims and those with better educated mothers. Increasing age at menarche may be explained by improved nutritional status among Bangladeshi populations. Early menarche was associated with residence location at adolescence, religion and mother's education.
The constituents in a food emulsion interact with each other, either physically or chemically, determining the overall physico-chemical and organoleptic properties of the final product. Thus, the main objective of present study was to investigate the effect of emulsion components on beverage emulsion properties.
Multivariate analysis including correlation, multiple stepwise linear regression, and cluster analyses were applied to investigate the heavy metal concentrations (Cd, Cu, Fe, Ni, Pb, and Zn) in the different parts of bivalves and gastropods. It was also aimed to distinguish statistically the differences between the marine bivalves and the gastropods with regards to the accumulation of heavy metals in the different tissues. The different parts of four species of bivalves and four species of gastropods were obtained and analyzed for heavy metals. The multivariate analyses were then applied on the data. From the multivariate analyses conducted, there were correlations found between the soft tissues of bivalves and gastropods, but none was found between the shells and the soft tissues of most of the molluscs (except for Cerithidea obtusa and Puglina cochlidium). The significant correlations (P < 0.05) found between the soft tissues were further complemented by the multiple stepwise linear regressions where heavy metals in the total soft tissues were influenced by the accumulation in the different types of soft tissues. The present study found that the distributions of heavy metals in the different parts of molluscs were related to their feeding habits and living habitats. The statistical approaches proposed in this study are recommended for use in biomonitoring studies, since multivariate analyses can reduce the cost and time involved in identifying an effective tissue to monitor the heavy metal(s) bioavailability and contamination in tropical coastal waters.
Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.
Study site: Outpatient clinics, Hospital Universiti Sains Malaysia (HUSM)
To compare sleep habits and disturbances between Malaysian children with epilepsy and their siblings (age range 4-18 years) and to determine the factors associated with greater sleep disturbance.
OBJECTIVE: The aim of the study was to determine the prevalence of mother-infant bed sharing in Klang district, Peninsular Malaysia and to identify factors associated with bed sharing.
METHOD: This was a cross-sectional study involving 682 mother-infant pairs with infants up to 6 months attending government clinics in Klang district, Peninsular Malaysia. Data were collected by face-to-face interview using a pretested structured questionnaire for a 4-month period in 2006. Data regarding maternal, paternal, obstetric, infant, occupancy, breast-feeding characteristics, and bed-sharing practice were collected. Data on bed sharing were based on practice in the past 1-month period. Bed sharing was defined as an infant sharing a bed with mother, and infant must be within arms reach from the mother, whereas a bed was defined as either a sleeping mattress placed on a bed frame or placed on the floor. The prevalence of bed sharing was estimated. Relationship and magnitude of association between independent factors and bed sharing were examined using odds ratio and 95% confidence interval. Logistic regression analysis was used to control for confounding factors.
RESULTS: The prevalence of bed sharing among mothers with infants aged between 1 and 6 months was 73.5% (95% confidence interval: 70.0-76.7). In multivariate analysis, urban/rural differences, mothers' ethnicity, occupation, family income, husbands' support on bed sharing, number of children younger than 12 years staying in the house, and breast-feeding were associated with bed sharing.
CONCLUSIONS: These factors need to be considered in analyzing the overall risks and benefits of bed sharing, paying attention to breastfeeding practices.
A household survey was carried out in Peninsular Malaysia to determine the prevalence rate of depressive symptoms in middle-aged women and to explore its associated factors. Women aged 45 to 60 years were assessed on sociodemographic profiles, menopausal status, depressive symptoms, marital dissatisfaction, and coping strategies. A total of 3934 women participated, and the mean age was 51 years. The prevalence rate of depressive symptoms was 54.2%. Of the married women, 38.4% had poor to very severe problems in their marriage. Depressive symptoms were significantly associated with marital status (P < .001), ethnicity (P < .001), educational levels (P < .001), occupational status ( P < .001), domicile (P < .001), and menopausal status ( P < .05). Depressive symptoms were correlated with marital dissatisfaction scores. Women who consulted professionals, shared with relatives, kept problems to themselves, or consulted parents/siblings had higher mean scores on depressive symptoms compared with those who did not use these coping strategies.