Displaying publications 121 - 140 of 366 in total

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  1. Meta-analysis: the association between HIV infection and extrapulmonary tuberculosis
    Naing C, Mak JW, Maung M, Wong SF, Kassim AI
    Lung, 2013 Feb;191(1):27-34.
    PMID: 23180033 DOI: 10.1007/s00408-012-9440-6
    BACKGROUND: Extrapulmonary tuberculosis has been an AIDS-defining condition. Individual studies that highlight the association between HIV and extrapulmonary TB are available. Our objectives were to synthesis evidence on the association between extrapulmonary tuberculosis and HIV and to explore the effective preventive measures of these two diseases.

    METHODS: This is a meta-analysis of observational studies reporting effect estimates on how HIV is associated with extrapulmonary tuberculosis. We searched for the eligible studies in the electronic databases using search terms related to HIV and extrapulmonary tuberculosis. Where possible, we estimated the summary odds ratios using random effects meta-analysis. We stratified analysis by the type of study design. We assessed heterogeneity of effect estimates within each group of studies was assessed using I (2) test.

    RESULTS: Nineteen studies (7 case control studies and 12 cohort studies) were identified for the present study. The pooled analysis shows a significant association between HIV and extrapulmonary tuberculosis (summary odds ratio: 1.3; 95 % confidence interval (CI) 1.05-1.6; I (2): 0 %). In a subgroup analysis with two studies, a significant association was found between CD4+ count less than 100 and the incidence of extrapulmonary tuberculosis (summary OR: 1.31; 95 % CI 1.02-1.68; I (2): 0 %).

    CONCLUSIONS: Findings show evidence on the association between extrapulmonary tuberculosis and HIV, based on case control studies. Further studies to understand the mechanisms of interaction of the two pathogens are recommended.

    Matched MeSH terms: Comorbidity
  2. Factors associated with chronic illness among the elderly in a rural community in Malaysia
    Sherina MS, Rampal L, Mustaqim A
    Asia Pac J Public Health, 2004;16(2):109-14.
    PMID: 15624788 DOI: 10.1177/101053950401600206
    Chronic illness is one of the major causes of mortality and morbidity among the elderly. To determine the prevalence and factors associated with chronic illness among the elderly in a rural community setting. A cross sectional study design was used. Stratified proportionate cluster sampling method was used to select respondents in Mukim Sepang, Sepang, Selangor, Malaysia. Out of 263 elderly residents (6.2% of the total population), 223 agreed to participate in the study giving a response rate of 84.8%. The prevalence of chronic illness among the elderly in Mukim Sepang was 60.1%. Out of 223 respondents, 134 were diagnosed as having chronic illness such as hypertension, diabetes mellitus, ischaemic heart disease, bronchial asthma or gout. Chronic illness was found to be significantly associated with functional dependence among the elderly (chi2=6.863, df=1, p<0.05). The prevalence of chronic illness among the elderly in the rural community is very high. Problems facing this age-group should be addressed comprehensively in order to formulate appropriate programmes for the health care of the elderly.
    Matched MeSH terms: Comorbidity
  3. Socio-demographic and psychosocial correlates of erectile dysfunction among hypertensive patients
    Fadzil MA, Sidi H, Ismail Z, Hassan MR, Thuzar K, Midin M, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S23-8.
    PMID: 23453753 DOI: 10.1016/j.comppsych.2012.12.024
    OBJECTIVE:
    The main aim of the study was to estimate the prevalence of ED and the associated socio-demographic and psychological correlates among hypertensive patients from a rural multiethnic community in Malaysia.

    METHODS:
    A cross-sectional study was conducted among hypertensive patients attending rural primary care clinics. The socio-demographic, health characteristics, erectile function and levels of depression, anxiety and stress were recorded and analysed. The International Index of ErectileFunction-5 (IIEF-5) questionnaire and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess erectile function and the levels of depression, anxiety and stress, respectively.

    RESULTS:
    A total of 253 hypertensive patients comprising 178 (70.4%) Malays, 56 (22.1%) Chinese and 18 (7.5%) Indians participated. The mean age of participants was 59.8 ± 10.62 years. Overall, the prevalence rate of ED was 62%: 90 (35%) with moderate and 69 (27%) with severe ED. The prevalence rate of ED among those aged 65 years or older (83.1%) was significantly higher than those less than 65 years (51.8%), (p<0.001). Higher prevalence rates were also noted among the Chinese (78.6%) compared to Malays (59.6%) and Indians (50%) (p=0.021); lower education level (69.1%) (p=0.026), among hypertensive patients with concomitant diabetes mellitus (70.6%) (p=0.026) and WHR ≥ 0.9 (31.3%) (p=0.021). However, no significant association was found between depression, anxiety and stress scores with IIEF-5 score.

    CONCLUSION:
    The prevalence rate of ED among Malaysian hypertensive patients is high. The rate increases significantly with age, Chinese ethnicity, concomitant diabetes mellitus, lower education level, WHR and the number of pack years of smoking. ED should be properly recognized and managed in hypertensive patients.
    Matched MeSH terms: Comorbidity
  4. The risk and associated factors of methamphetamine psychosis in methamphetamine-dependent patients in Malaysia
    Sulaiman AH, Said MA, Habil MH, Rashid R, Siddiq A, Guan NC, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S89-94.
    PMID: 23433219 DOI: 10.1016/j.comppsych.2013.01.003
    The objective of this study was to determine the risk of lifetime and current methamphetamine-induced psychosis in patients with methamphetamine dependence. The association between psychiatric co-morbidity and methamphetamine-induced psychosis was also studied.
    Matched MeSH terms: Comorbidity
  5. Gambling, Drinking and Quality of Life: Evidence from Macao and Australia
    Loo JM, Shi Y, Pu X
    J Gambl Stud, 2016 Jun;32(2):391-407.
    PMID: 26337063 DOI: 10.1007/s10899-015-9569-3
    The investigation of the interface between psychological constructs, compulsive consumption of alcohol and pathological gambling is an important avenue for development of future initiatives in social marketing or prevention programs. This cross-cultural study attempts to bridge the gap in literature by providing an evaluation of the predictive ability of psychological variables such as gambling urge, gambling-related erroneous cognitions and comorbid alcohol consumption on pathological gambling behaviour and its impact on overall quality of life indicators. Participants consist of 445 Macao and Australian young adults (Mean age = 23 years). Results indicate that probable pathological gamblers as compared with non-gamblers reported significantly lower quality of life in all domains-physical health, psychological well-being, social relationships and environment. Adults who drank more alcohol and have stronger erroneous cognitions evidenced higher pathological gambling behavior. Our research model fits both cohorts and interestingly, erroneous gambling-related cognitions serve as a full mediator for the predictive relationship between gambling urge and pathological gambling in the Macao sample, but serve as a partial mediator in the Australian sample. Targeting erroneous cognitions in future social marketing or preventive campaigns should demonstrate to be an important strategy in reducing the effects of urge to gamble among at-risk individuals. Further implications for the industry, marketing and governmental strategies are discussed.
    Matched MeSH terms: Comorbidity
  6. Fulltext Social Network Strategies to Address HIV Prevention and Treatment Continuum of Care Among At-risk and HIV-infected Substance Users: A Systematic Scoping Review
    Ghosh D, Krishnan A, Gibson B, Brown SE, Latkin CA, Altice FL
    AIDS Behav, 2017 Apr;21(4):1183-1207.
    PMID: 27125244 DOI: 10.1007/s10461-016-1413-y
    Social network analysis (SNA) and social network-based interventions (SNI) are important analytical tools harnessing peer and family influences critical for HIV prevention and treatment among substance users. While SNA is an effective way to measure social network influences, SNI directly or indirectly involves network members in interventions. Even though these methods have been applied in heterogeneous ways, leading to extensive evidence-based practices, systematic reviews are however, lacking. We searched five bibliographic databases and identified 58 studies involving HIV in substance users that had utilized SNA or SNI as part of their methodology. SNA was used to measure network variables as inputs in statistical/mathematical models in 64 % of studies and only 22 % of studies used SNI. Most studies focused on HIV prevention and few addressed diagnosis (k = 4), care linkage and retention (k = 5), ART adherence (k = 2), and viral suppression (k = 1). This systematic review highlights both the advantages and disadvantages of social network approaches for HIV prevention and treatment and gaps in its use for HIV care continuum.
    Matched MeSH terms: Comorbidity
  7. Successful Treatment of Ptyalism Gravidarum With Concomitant Hyperemesis Using Hypnosis
    Beevi Z, Low WY, Hassan J
    Am J Clin Hypn, 2015 Oct;58(2):215-23.
    PMID: 26264544 DOI: 10.1080/00029157.2015.1013186
    Ptyalism gravidarum, or sialorrhea, is the excessive secretion of saliva during pregnancy. Treatment of ptyalism gravidarum is often challenging due to its unknown etiologies. This article discusses a case of ptyalism gravidarum with concomitant hyperemesis in which the condition was successfully treated with hypnosis. A 28-year-old woman presented with ptyalism 2 months into her pregnancy and hyperemesis 3 months into pregnancy with associated vomiting that occurred following every meal. Hypnosis was administered at week 16 of pregnancy to eliminate ptyalism and hyperemesis, to prepare for childbirth, and to increase overall psychological well-being. Ptyalism resolved by week 36, concurrent with the final hypnosis session.
    Matched MeSH terms: Comorbidity
  8. Fulltext Clinical manifestation and risk factors of tuberculosis infection in Malaysia: case study of a community clinic
    Shanmuganathan R, Subramaniam ID
    Glob J Health Sci, 2015;7(4):110-20.
    PMID: 25946947 DOI: 10.5539/gjhs.v7n4p110
    INTRODUCTION: The main aim of this study was to describe the clinical manifestation of tuberculosis infection cases in Malaysia and to determine the individual risk factors for their occurrence.
    METHODOLOGY: The study adopted a quantitative research approach with use of descriptive statistical approach. The study setting was a community clinic which treats walk in patients who are mainly living and working in the surrounding areas. The study was conducted for a period of one year. All tuberculosis patients who sought treatment in the clinic during the time were included in this study. The total number of cases was 40. Data was collected from the medical records of the tuberculosis patients. The risk factors selected for investigation were demographic characteristics of age and sex, personal habits such as smoking, drug use and alcohol and presence of diseases such as human immunodeficiency virus positive (HIV+), diabetes mellitus, cancer, cyanotic heart disease, renal failure and steroid use.
    RESULTS: Patients in the age group ranging from 41 to 50 years had the highest incidence of the infection. Smoking appears to be the most important risk factor for contracting followed by drug abuse, HIV+ infection and diabetes mellitus.
    CONCLUSIONS: People with diseases such as diabetes mellitus and HIV that are high risk factors for TB should be screened for TB so that early detection and intervention is possible. Educational programs should be carried out to create awareness among the at risk groups.
    Matched MeSH terms: Comorbidity
  9. Capgras syndrome in a very late onset, treatment resistant schizophrenia
    Ain MK, Rosdinom R, Raynuha M
    Int Psychogeriatr, 2015 Sep;27(9):1573-5.
    PMID: 25794136 DOI: 10.1017/S1041610215000332
    We report a Malay man, with underlying chronic medical illnesses, presenting with positive symptoms of schizophrenia, including Capgras syndrome (CS) at the age of 73. Physical examination and blood investigations were normal and brain CT scan showed age-related cerebral atrophy. Neuropsychological assessment showed probable right hemisphere lesions but relatively intact memory and intellectual functions. Several neuroleptics including depot injections were tried but ineffective. Positive symptoms including CS eventually improved with clozapine before his death from myocardial infarction. This case report highlights the uncommon occurrence of CS in treatment resistant schizophrenia (TRS) of very late onset and its treatment challenges.
    Matched MeSH terms: Comorbidity
  10. Community-acquired pneumonia in patients requiring hospitalization
    Liam CK, Lim KH, Wong CM
    Respirology, 2001 Sep;6(3):259-64.
    PMID: 11555386
    This study aimed to investigate the microbial aetiology of community-acquired pneumonia (CAP) in patients requiring hospitalization.
    Matched MeSH terms: Comorbidity
  11. Epidemiology of abdominal aortic aneurysm in an Asian population
    Yii MK
    ANZ J Surg, 2003 Jun;73(6):393-5.
    PMID: 12801335
    Abdominal aortic aneurysms (AAA) are common in the Caucasian population. Apart from reported differences in the occurrence of AAA in the black and white populations, there are few studies on the incidence of AAA in the Asian population.
    Matched MeSH terms: Comorbidity
  12. Skin prick test reactivity to common aeroallergens in asthmatic patients with and without rhinitis
    Liam CK, Loo KL, Wong CM, Lim KH, Lee TC
    Respirology, 2002 Dec;7(4):345-50.
    PMID: 12421243 DOI: 10.1046/j.1440-1843.2002.00409.x
    OBJECTIVE: The aim of this study was to investigate the prevalence of skin prick test (SPT) reactivity to common aeroallergens among Malaysian asthmatic patients with and without rhinitis.
    METHODOLOGY: An SPT using eight aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat fur, cockroach, Acacia sp., Bermuda grass, Aspergillus fumigatus and Aspergillus niger) was performed on 206 asthmatic patients.
    RESULTS: One hundred and forty patients (68%) were reactive to at least one of the aeroallergens. Among the SPT-positive patients, a positive prick test reaction to the house dust mites, D. pteronyssinus (93.6%), and D. farinae (81.4%) was most common, followed by cat fur (20.0%), cockroach (7.9%), Bermuda grass (7.9%), Acacia sp. (7.9%), A. fumigatus (0.7%) and A. niger (0.7%). A history of rhinitis was elicited in 111 (53.9%) patients and 95 (85.3%) of these patients were SPT-positive compared with only 45 (47.4%) of 95 patients with asthma symptoms alone (P < 0.001). The presence of rhinitis and a young age of onset of asthma were independent factors for positive SPT reaction to at least one of the aeroallergens.
    CONCLUSIONS: The prevalence of SPT reactivity to common aeroallergens is high among Malaysian asthmatics, particularly in those with an early age of onset and in those with coexisting rhinitis.
    Study site: Asthma Clinic, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
    Matched MeSH terms: Comorbidity
  13. Fulltext Risk Factors for 3-Year-Mortality and a Tool to Screen Patient in Dialysis Population
    Bujang MA, Kuan PX, Sapri FE, Liu WJ, Musa R
    Indian J Nephrol, 2019 8 20;29(4):235-241.
    PMID: 31423056 DOI: 10.4103/ijn.IJN_152_18
    Introduction: Clinical parameters especially co-morbidities among end stage renal disease (ESRD) patients are associated with mortality. This study aims to determine the risk factors that are associated with mortality within three years among prevalent patients with ESRD.

    Methods: This is a cohort study where prevalent ESRD patients' details were recorded between May 2012 and October 2012. Their records were matched with national death record at the end of year 2015 to identify the deceased patients within three years. Four models were formulated with two models were based on logistic regression models but with different number of predictors and two models were developed based on risk scoring technique. The preferred models were validated by using sensitivity and specificity analysis.

    Results: A total of 1332 patients were included in the study. Majority succumbed due to cardiovascular disease (48.3%) and sepsis (41.3%). The identified risk factors were mode of dialysis (P < 0.001), diabetes mellitus (P < 0.001), chronic heart disease (P < 0.001) and leg amputation (P = 0.016). The accuracy of four models was almost similar with AUC between 0.680 and 0.711. The predictive models from logistic regression model and risk scoring model were selected as the preferred models based on both accuracy and simplicity. Besides the mode of dialysis, diabetes mellitus and its complications are the important predictors for early mortality among prevalent ESRD patients.

    Conclusions: The models either based on logistic regression or risk scoring model can be used to screen high risk prevalent ESRD patients.

    Matched MeSH terms: Comorbidity
  14. Premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kelantan, Malaysia
    Ahmad Zamree MR, Shaiful Bahari I, Faridah MZ, Norhayati MN
    J Taibah Univ Med Sci, 2018 Apr;13(2):173-179.
    PMID: 31435320 DOI: 10.1016/j.jtumed.2017.10.001
    Objectives: This study aimed to determine the prevalence of premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kota Bharu, Kelantan, Malaysia.

    Methods: A cross-sectional study was conducted on 18- to 60-year-old sexually active men during at least the past 6 months. Patients with unstable psychiatric illnesses, mental retardation, and illiteracy were excluded. A questionnaire on sociodemographic factors, Malay version Premature Ejaculation Diagnostic Tool, and Malay version International Index Erectile Function-5 were distributed. Premature ejaculation was defined as a Premature Ejaculation Diagnostic Tool score of 9 and above. Descriptive analysis and simple and multiple logistic regression analyses were performed using SPSS version 22.

    Results: A total of 294 of 313 eligible men responded, with a response rate of 93.9%. The prevalence of premature ejaculation was 21.4% (n = 63). The multiple logistic regression analysis showed that mild [adj. OR (95% CI): 5.6 (1.89, 16.91); P = 0.002], mild-moderate [adj. OR (95% CI): 8.2 (2.72, 24.46); P 
    Matched MeSH terms: Comorbidity
  15. Fulltext Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARB) Are Protective Against ICU Admission and Mortality for Patients With COVID-19 Disease
    ElAbd R, AlTarrah D, AlYouha S, Bastaki H, Almazeedi S, Al-Haddad M, et al.
    Front Med (Lausanne), 2021;8:600385.
    PMID: 33748156 DOI: 10.3389/fmed.2021.600385
    Introduction: Corona Virus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. The aim of this study was to investigate the impact of being on an Angiotensin-Converting Enzyme Inhibitors (ACEI) and/or Angiotensin Receptor Blockers (ARB) on hospital admission, on the following COVID-19 outcomes: disease severity, ICU admission, and mortality. Methods: The charts of all patients consecutively diagnosed with COVID-19 from the 24th of February to the 16th of June of the year 2020 in Jaber Al-Ahmed Al-Sabah hospital in Kuwait were checked. All related patient information and clinical data was retrieved from the hospitals electronic medical record system. The primary outcome was COVID-19 disease severity defined as the need for Intensive Care Unit (ICU) admission. Secondary outcome was mortality. Results: A total of 4,019 COVID-19 patients were included, of which 325 patients (8.1%) used ACEI/ARB, users of ACEI/ARB were found to be significantly older (54.4 vs. 40.5 years). ACEI/ARB users were found to have more co-morbidities; diabetes (45.8 vs. 14.8%) and hypertension (92.9 vs. 13.0%). ACEI/ARB use was found to be significantly associated with greater risk of ICU admission in the unadjusted analysis [OR, 1.51 (95% CI: 1.04-2.19), p = 0.028]. After adjustment for age, gender, nationality, coronary artery disease, diabetes and hypertension, ICU admission was found to be inversely associated with ACEI use [OR, 0.57 (95% CI: 0.34-0.88), p = 0.01] and inversely associated with mortality [OR, 0.56 (95% CI: 0.33-0.95), p = 0.032]. Conclusion: The current evidence in the literature supports continuation of ACEI/ARB medications for patients with co-morbidities that acquire COVID-19 infection. Although, the protective effects of such medications on COVID-19 disease severity and mortality remain unclear, the findings of the present study support the use of ACEI/ARB medication.
    Matched MeSH terms: Comorbidity
  16. Fulltext Reducing the stigma of mental health disorders with a focus on low- and middle-income countries
    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
  17. Fulltext Prevalence and Factors Associated with Suicidal Ideation in Institutionalized Patients with Schizophrenia
    Chong BTW, Wahab S, Muthukrishnan A, Tan KL, Ch'ng ML, Yoong MT
    Psychol Res Behav Manag, 2020;13:949-962.
    PMID: 33204188 DOI: 10.2147/PRBM.S266976
    Purpose: The shorter life expectancy and increased risk of suicide in patients with schizophrenia have been well documented. However, study outcomes on suicidality in this special population have been few to date. This study investigated the prevalence and factors associated with suicidal ideation in a population of institutionalized patients with schizophrenia.

    Methods: Two hundred fifty-six patients with schizophrenia between the age of 18 and 65 years were randomly recruited. This cross-sectional study utilised the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS-AH). Univariate analysis was performed using an independent t-test or chi-square test, followed by binary logistic regression to determine the factors associated with increased suicidal risks.

    Results: The socio-demographic factors associated with suicidal ideation included level of education (p=0.039); secondary-level education (OR=5.76, 95% CI:1.49, 22.34, p=0.011) and tertiary-level education (OR=9.30, 95% CI: 1.80, 48.12, p=0.008) posed a greater risk. A history of attempted suicide (OR=2.09, 95% CI: 1.01, 4.36, p=0.049) and the presence of co-morbid physical illnesses (OR=2.07, 95% CI: 1.02, 4.21, p=0.044) were also found to be associated with a suicidal ideation. Other significant factors associated with suicidal thoughts were concurrent depression (OR=9.68, 95% CI: 3.74, 25.05, p<0.001) and a higher PSYRATS score in emotional characteristics of auditory hallucinations (OR=1.13, 95% CI: 1.06, 1.21, p<0.001).

    Conclusion: Suicide in schizophrenia appears to be more closely associated with certain socio-demographic factors and affective symptoms. Appropriate screening and treatment addressing these challenges must be emphasized if suicidal thoughts and actions are to be reduced.

    Matched MeSH terms: Comorbidity
  18. Endoscopic retrograde cholangiopancreatography for acute gallstone pancreatitis: Implementation of an institution safety protocol during the COVID-19 outbreak in Malaysia
    Yusoff AR, Ahmad F, Obaid KJ
    Med J Malaysia, 2020 11;75(6):764-766.
    PMID: 33219198
    Coronavirus disease 2019 (COVID-19) is a highly contagious, severe acute respiratory syndrome that poses significant health risks to healthcare providers. A delicate balance is needed between timely intervention for ill patients without apparent COVID-19 infection and the safety of healthcare personnel who provide essential treatment in the midst of the pandemic. We report our experience managing a 70-year-old man who presented with acute gallstone pancreatitis at our hospital during the COVID-19 outbreak in Malaysia. We also describe the safety protocol measures that have been implemented in our institution to protect the healthcare personnel from this disease during endoscopic retrograde cholangiopancreatography. This case illustrates the importance of meticulous planning, risk assessment, effective team communication and strict adherence to recommendations when providing treatment during an unprecedented pandemic.
    Matched MeSH terms: Comorbidity
  19. Fulltext The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population - Public Health Implications
    Rahman S, Singh K, Dhingra S, Charan J, Sharma P, Islam S, et al.
    Ther Clin Risk Manag, 2020;16:1007-1022.
    PMID: 33116550 DOI: 10.2147/TCRM.S272908
    COVID-19 pandemic is inducing acute respiratory distress syndrome, multi-organ failure, and eventual death. Respiratory failure is the leading cause of mortality in the elderly population with pre-existing medical conditions. This group is particularly vulnerable to infections due to a declined immune system, comorbidities, geriatric syndrome, and potentially inappropriate polypharmacy. These conditions make the elderly population more susceptible to the harmful effects of medications and the deleterious consequences of infections, including MERS-CoV, SARS-CoV, and SARS-CoV-2. Chronic diseases among elderlies, including respiratory diseases, hypertension, diabetes, and coronary heart diseases, present a significant challenge for healthcare professionals. To comply with the clinical guidelines, the practitioner may prescribe a complex medication regimen that adds up to the burden of pre-existing treatment, potentially inducing adverse drug reactions and leading to harmful side-effects. Consequently, the geriatric population is at increased risk of falls, frailty, and dependence that enhances their susceptibility to morbidity and mortality due to SARS-CoV-2 respiratory syndrome, particularly interstitial pneumonia. The major challenge resides in the detection of infection that may present as atypical manifestations in this age group. Healthy aging can be possible with adequate preventive measures and appropriate medication regimen and follow-up. Adherence to the guidelines and recommendations of WHO, CDC, and other national/regional/international agencies can reduce the risks of SARS-CoV-2 infection. Better training programs are needed to enhance the skill of health care professionals and patient's caregivers. This review explains the public health implications associated with polypharmacy on the geriatric population with pre-existing co-morbidities during the COVID-19 pandemic.
    Matched MeSH terms: Comorbidity
  20. Fulltext Factors associated with glycaemic control among diabetic patients at Hulu Terengganu in 2019
    Erwan Ershad Ahmad Khan, Kamilah Mohamed, Salmiah Sidek, Noriah Mahmud
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):63-63.
    MyJurnal
    Introduction:The objectives of this study were to measure the status of glycaemic control and identify factors asso-ciated with good glycaemic control among diabetic patients treated at primary health clinics. Methods: All diabetic patients registered and under follow up of Ministry of Health facilities were monitored for their glycaemic controls through HbA1c levels. Data obtained from line listing of diabetic patients that received treatment from four health clinics at Hulu Terengganu in 2019. All of patients’ data including socio demographic characteristics, latest labo-ratory investigations and treatment modalities were recorded in the line listing. In this study, 350 active patients were randomly selected systematically. Logistic regression analysis was done to predict factors associated with good glycaemic control which is defined as having HbA1c less or equal to 6.5%. Results: In this study, the proportion of patients with good glycaemic control was lower than other published studies. It is found that 99 patients (28.3%) have good glycaemic control while 251 patients (71.7%) have poor glycemic control. Factors significantly associ-ated with good glycaemic control included age (odds ratio 0.965; 95% confidence interval 0.940-0.991), presence of comorbidity (odds ratio 0.326; 95% confidence interval 0.107- 0.995) and type of treatment (odds ratio 0.302; confidence interval 0.171-0.533). Those who were not on insulin were more likely to have good glycaemic control. Older patients were also tend to have good glycaemic control. Conclusion: Multi-disciplinary approaches and great-er efforts by healthcare providers at primary health clinics are needed in order to help more patients to achieve good glycaemic control. Younger patients and those who do not have comorbidities yet should be closely monitored as they are prone to have poor glycaemic control. Extra cautions is warranted in patients with insulin in order to achieve glycaemic target thus reducing complications and making the treatment more cost-effective.
    Matched MeSH terms: Comorbidity
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