METHODS: A total of 232 women who had experienced ≥2 unexplained RPL and 141 available male partners were recruited, with 360 healthy Malay and 166 parous female controls. Prevalence of M2 carriage and RPL odds ratios were calculated in (a) control and patient groups; (b) clinically defined subgroups in categories of pregnancy loss, primary, secondary, and tertiary; and (c) timing of pregnancy loss in early, ≤15th gestation week and "late" fetal losses, and >15th gestation week subgroups.
RESULTS: Both male and female subjects had similar M2/ANXA5 allele frequencies. The carrier rate of M2/ANXA5 for the general Malay population was 42.2 and 34.9% for parous controls. These carrier rates compared to Malay RPL subjects (52% M2 carriers) resulted in elevated odds ratios (95% confidence interval) of 1.53 (1.1 to 2.1) and 1.97 (1.3 to 3.1) accordingly for early fetal losses. Moreover, exceeding copy numbers of M2/ANXA5 alleles seemed to afflict a greater chance of RPL in couples, especially when both partners were M2 carriers.
CONCLUSION: This study confirmed the proposed role of M2/ANXA5 as embryonic, genetically associated thrombophilia predisposition factor for early RPL among ethnic Malay of Malaysia.
METHODS: A population-based study was conducted on a total of 890 respondents who were representative of the adult population in Malaysia, i.e., aged ≥18 years old. Respondents were randomly selected using a stratified cluster method. The estimated glomerular filtration rate (eGFR) was estimated from calibrated serum creatinine using the CKD-EPI equation. CKD was defined as eGFR
AIMS: To systematically identify and summarize the available literature on whether the modifiable risk factors associated with prediabetes displays similar relationship in both the genders.
METHODS: A systematic search was performed on electronic databases i.e. PubMed, EBSCOhost, and Scopus using "sex", "gender", "modifiable risk factors" and "prediabetes" as keywords. Reference list from identified studies was used to augment the search strategy. Methodological quality and results from individual studies were summarized in tables.
RESULTS: Gender differences in the risk factor association were observed among reviewed studies. Overall, reported association between risk factors and prediabetes apparently stronger among men. In particular, abdominal obesity, dyslipidemia, smoking and alcohol drinking habits were risk factors that showed prominent association among men. Hypertension and poor diet quality may appear to be stronger among women. General obesity showed stringent hold, while physical activity not significantly associated with the risk of prediabetes in both the genders.
CONCLUSIONS: Evidence suggests the existence of gender differences in risk factors associated with prediabetes, demands future researchers to analyze data separately based on gender. The consideration and the implementation of gender differences in health policies and in diabetes prevention programs may improve the quality of care and reduce number of diabetes prevalence among prediabetic subjects.
SETTINGS: A validation study among people living with HIV(PLHIV) aged ≥18 years among the cohorts in the Asia-Pacific region.
METHODS: PLHIV with baseline eGFR>60 mL/min/1.73m were included for validation of the D:A:D CKD full version and the short version without cardiovascular risk factors. Those with <3 eGFR measurements from baseline or previous exposure to potentially nephrotoxic antiretrovirals were excluded. Kaplan-Meier methods were used to estimate the probability of CKD development. Area Under the Receiver Operating Characteristics (AUROC) was also used to validate the risk score.
RESULTS: We included 5,701 participants in full model(median 8.1 [IQR 4.8-10.9] years follow-up) and 9,791 in short model validation(median 4.9 [IQR 2.5-7.3] years follow-up). The crude incidence rate of CKD was 8.1 (95%CI 7.3-8.9) per 1,000 person-years(PYS) in the full model cohort and 10.5 (95%CI 9.6-11.4) per 1,000 PYS in the short model cohort. The progression rates for CKD at 10 years in the full model cohort were 2.7%, 8.9% and 26.1% for low-, medium- and high-risk groups, and 3.5%, 11.7% and 32.4% in the short model cohort. The AUROC for the full and short risk score was 0.81 (95%CI 0.79-0.83) and 0.83 (95%CI 0.81-0.85), respectively.
CONCLUSION: The D:A:D CKD full- and short-risk score performed well in predicting CKD events among Asian PLHIV. These risk prediction models may be useful to assist clinicians in identifying individuals at high risk of developing CKD.
Aim: The present research was conducted to identify site-specific pain resulting from musculoskeletal disorders (MSDs) among practicing dentists and determine its impact on their quality of life.
Setting and Design: A cross-sectional questionnaire study conducted among practicing dentists of Puducherry Taluk, Puducherry, India.
Method and Materials: A closed-ended, self-administered questionnaire was distributed to 95 practicing dentists to identify site-specific MSP from the study subjects. Data on pain due to MSDs, frequency of pain, its impact on quality of life, relieving factors, patients attended per day, working hours per day, and awareness on ergonomics were also recorded.
Statistical Analyses: The data were analyzed for descriptive statistics, and Chi-square tests was used for proportions.
Results: Almost all respondents experienced pain due to MSDs. Approximately, 11.1% "always" experienced elbow pain; 5.6% "always" experienced pain in neck and back. Approximately, 83% "sometimes" experienced pain in the back. Pain in elbow was significantly associated with gender (P = 0.036), qualification (P = 0.029), and years of practice (P = 0.032). Approximately, 36% reported having an impact on their life.
Conclusion: The magnitude of the problem is slowly shifting from "sometimes" to "always." Although small in proportion, pain due to MSDs has an impact on dental practitioners' quality of life, and elbow pain was reportedly higher in the study setting. Measures need to be implemented before MSD becomes a career limiting occupational hazard.
Method: A cross-sectional study involving a convenience sampling of 125 documented migrant workers from five selected countries was conducted. A researcher-administered questionnaire consisting of socio-demographic questions, three-day 24-hour dietary recall (3DR), and nine-item Household Food Insecurity Access Scale was used. Anthropometric measurements, including body weight, height, and waist circumference, were taken.
Findings: About 57.6% of the households studied were food insecure (24.8% mildly, 29.6% moderately, and 3.2% severely). Burmese were found to have the highest rate of household food insecurity (96%). The majority of the migrant workers were of normal weight (68.0%). No significant relationship was found between monthly household income and household food security status (p = 0.475), as well as between household food security status and weight status (p = 0.535).
Conclusion: Results imply that food security status affects certain nutrient intake among migrant workers. There were no significant associations between variables. Interventions focusing on nutritional education on food choices and implementation on health policy are recommended. Further studies should consider the accessibility, nutritional-related diseases, and dietary aspects of migrant workers, which are risk factors for food insecurity.
METHODS: A prospective case-control study was carried out among 100 GDM cases and 273 matched controls, attending regular antenatal clinic at two private hospitals of Karnataka. Data was collected by personal interviews using a standard questionnaire. Perceived stress was assessed using the Cohen 10-item Perceived Stress Scale. Score of ≥20 was identified as high stress. Statistical Package for the Social Sciences version 15 was used for analysis.
RESULTS: Exposure rates for high maternal perceived stress among cases during pregnancy were noted. The odds of GDM were 13 folds higher among those with high antenatal stress (≥20) compared to those with low (<20) (p risk factor for GDM.
Materials and methods: A cross-sectional hospital-based study was carried out on 300 participants. Blood samples were obtained. Thick and thin blood films were prepared and viewed using the standard parasitological technique of microscopy. Moreover, data on sociodemographic and environmental variables were obtained using a pre-tested standard questionnaire.
Results: Of the 300 participants examined, a total of 165 (55.0%) were found positive for Plasmodium falciparum with a mean (S.D) parasite density of 1814.70 (1829.117) parasite/μL of blood. The prevalence and parasite density of malaria infection vary significantly (P < 0.05) with age group. Children <5 years old were more likely to have malaria infection and high parasite densities than adults (p < 0.05). Similarly, in relation to gender, males significantly (P < 0.05) had a higher prevalence (60.2%) and mean (S.D) parasite density of malaria infection [2157.73 (1659.570) parasite/μL of blood] compared to females. Additionally, those without formal education had the highest prevalence (73.0%) and mean (S.D) parasite density of infection [2626.96 (2442.195) parasite/μL of blood]. The bivariate logistic regression analysis shows that age group 6-10 (Crude Odds Ratio, COR 0.066, 95% CI: 0.007-0.635), presence of streams/rivers (COR 0.225, 95% CI: 0.103-0.492), distance from streams/rivers within ≤1 km (COR 0.283, 95% CI: 0.122-0.654) and travel to rural area (COR 4.689, 95% CI: 2.430-9.049) were the significant risk factors.
Conclusions: Malaria infection is prevalent in the study area and was greatly influenced by traveling activities from the rural areas to urban centers and vice versa. Multifaceted and integrated control strategy should be adopted. Health education on mosquito prevention and chemoprophylaxis before and during travel to rural areas are essential.
OBJECTIVE: To identify the factors that are associated with rod slippage and to study the pattern of achieved length gain with a standard distraction methodology.
SUMMARY OF BACKGROUND DATA: Ability to achieve successful magnetically controlled growing rod (MCGR) distraction is crucial for gradual spine lengthening. Rod slippage has been described as a failure of internal magnet rotation leading to a slippage and an inability to distract the rod. However, its onset, significance, and risk factors are currently unknown. In addition, how this phenomenon pertains to actual distracted lengths is also unknown.
METHODS: A total of 22 patients with MCGR and at least six distraction episodes were prospectively studied. Patients with rod slippage occurring less than six distraction episodes were considered early rod slippage whereas those with more than six episodes or have yet to slip were grouped as late rod slippage. The association of parameters including body habitus, maturity status, age of implantation, total number of distractions, months of distraction from initial implantation, initial and postoperative Cobb angle, T1-T12, T1-S1, T5-T12 kyphosis, curve flexibility, instrumented length, and distance between magnets in dual rods and between the magnets and apex of the curve with early or late onset of rod slippage were studied. Differences between expected and achieved distraction lengths were assessed with reference to rod slippage episodes and rod exchanges to determine any patterns of diminishing returns.
RESULTS: Patients had mean age of 7.1 years at diagnosis with mean follow-up of 49.8 months. A mean 32.4 distractions were performed per patient. Early rod slippage occurred in 14 patients and late rod slippage occurred in eight patients. Increased height, weight, body mass index, older age, increased T1-12 and T1-S1 lengths, and less distance between magnets were significantly associated with early rod slippage. Expected distraction lengths did not translate to achieve distraction lengths and reduced gains were only observed after achieving one-third of the allowable distracted length in the MCGR. Length gains return to baseline after rod exchange.
CONCLUSION: This is the first study to specifically analyze the impact of rod slippage on distraction lengths and the risk factors associated with its onset and frequency. Increased body habitus and reduced distance between internal magnets significantly influenced rod slippage events. Diminishing returns in distracted length gains were only observed after a period of usage.
LEVEL OF EVIDENCE: 3.