MyMedR

Displaying publications 141 - 160 of 815 in total

Abstract:

Sort:

Fulltext Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: a case control study

Wee BS, Poh BK, Bulgiba A, Ismail MN, Ruzita AT, Hills AP

BMC Public Health, 2011;11:333.
PMID: 21592367 DOI: 10.1186/1471-2458-11-333

With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.

Matched MeSH terms: Risk Assessment/methods
Empirical analysis of gross vehicle weight and free flow speed and consideration on its relation with differential speed limit

Saifizul AA, Yamanaka H, Karim MR

Accid Anal Prev, 2011 May;43(3):1068-73.
PMID: 21376903 DOI: 10.1016/j.aap.2010.12.013

Most highly motorized countries in the world have implemented different speed limits for light weight and heavy weight vehicles. The heavy vehicle speed limit is usually chosen to be lower than that of passenger cars due to the difficulty for the drivers to safely maneuver the heavy vehicle at high speed and greater impact during a crash. However, in many cases, the speed limit for heavy vehicle is set by only considering the vehicle size or category, mostly due to simplicity in enforcement. In this study, traffic and vehicular data for all vehicle types were collected using a weigh-in-motion system installed at Federal Route 54 in Malaysia. The first finding from the data showed that the weight variation for each vehicle category is considerable. Therefore, the effect of gross vehicle weight (GVW) and category of heavy vehicle on free flow speed and their interaction were analyzed using statistical techniques. Empirical analysis results showed that statistically for each type of heavy vehicle, there was a significant relationship between free flow speed of a heavy vehicle and GVW. Specifically, the results suggest that the mean and variance of free flow speed decrease with an increase GVW by the amount unrelated to size and shape for all GVW range. Then, based on the 85th percentile principle, the study proposed a new concept for setting the speed limit for heavy vehicle by incorporating GVW where a different speed limit is imposed to the heavy vehicle, not only based on vehicle classification, but also according to its GVW.

Matched MeSH terms: Risk Assessment/statistics & numerical data
Male fetuses are associated with increased risk for cesarean delivery in Malaysian nulliparae

Viegas OA, Lee PS, Lim KJ, Ravichandran J

Medscape J Med, 2008;10(12):276.
PMID: 19242582

The association between fetal sex and outcome of pregnancy and labor has been well documented in western populations. However, no studies in Malaysia or other developing countries have examined the effect of fetal sex on such outcomes.The main objective of this study was to determine the influence of fetal sex on the outcome of labor at term in a cohort of Malaysian nulliparae.A retrospective observational study was designed using data from 4644 Malaysian nulliparae who gave birth consecutively to singleton male babies at Hospital Sultanah Aminah, Johor Bahru, after normal full-term pregnancies.The results of this study indicate that mothers giving birth to male infants have a greater risk of requiring cesarean delivery because male babies are heavier and have statistically significantly greater head circumference (P < .001). These findings concur with those obtained in western populations and suggest that the differences in outcome observed are biological, not dictated by race, ethnicity, or environmental conditions. Such information could help in the antenatal assessment of Malaysian patients and stimulate more comprehensive studies of the mechanisms involved in this sex-based difference in outcomes. Reasons for such differences are proposed.

Matched MeSH terms: Risk Assessment/methods*
Analysis of significant factors for dengue infection prognosis using the self organizing map

Faisal T, Ibrahim F, Taib MN

Annu Int Conf IEEE Eng Med Biol Soc, 2008;2008:5140-3.
PMID: 19163874 DOI: 10.1109/IEMBS.2008.4650371

This study presents a new approach to determine the significant prognosis factors in dengue patients utilizing the self-organizing map (SOM). SOM was used to visualize and determine the significant factors that can differentiate between the dengue patients and the healthy subjects. Bioimpedance analysis (BIA) parameters and symptoms/signs obtained from the 210 dengue patients during their hospitalization were used in this study. Database comprised of 329 sample (210 dengue patients and 119 healthy subjects) were used in the study. Accordingly, two maps were constructed. A total of 35 predictors (17 BIA parameters, 18 symptoms/signs) were investigated on the day of defervescence of fever. The first map was constructed based on BIA parameters while the second map utilized the symptoms and signs. The visualized results indicated that, the significant BIA prognosis factors for differentiating the dengue patients from the healthy subjects are reactance, intracellular water, ratio of the extracellular water and intracellular water, and ratio of the extracellular mass and body cell mass.

Matched MeSH terms: Risk Assessment/methods*
Gaining competitive advantage in personal dosimetry services through ISO 9001 certification

Noriah MA

Radiat Prot Dosimetry, 2007;125(1-4):101-4.
PMID: 17145724

This paper discusses the advantage of certification process in the quality assurance of individual dose monitoring in Malaysia. The demand by customers and the regulatory authority for a higher degree of quality service requires a switch in emphasis from a technically focused quality assurance program to a comprehensive quality management for service provision. Achieving the ISO 9001:2000 certification by an accredited third party demonstrates acceptable recognition and documents the fact that the methods used are capable of generating results that satisfy the performance criteria of the certification program. It also offers a proof of the commitment to quality and, as a benchmark, allows measurement of the progress for continual improvement of service performance.

Matched MeSH terms: Risk Assessment/standards*
Health Risk Assessment of Heavy Metal in Urban Surface Soil (Klang District, Malaysia)

Yuswir NS, Praveena SM, Aris AZ, Ismail SN, Hashim Z

Bull Environ Contam Toxicol, 2015 Jul;95(1):80-9.
PMID: 25904089 DOI: 10.1007/s00128-015-1544-2

Urban environmental quality is vital to be investigated as the majority of people live in cities. However, given the continuous urbanization and industrialization in urban areas, heavy metals are continuously emitted into the terrestrial environment and pose a great threat to human. In this study, a total of 76 urban surface soil samples were collected in the Klang district (Malaysia), and analyzed for total and bioavailable heavy metal concentrations by inductively coupled plasma-optical emission spectrometry. Results showed that the concentrations of bioavailable heavy metals declined in the order of Al, Fe, Zn, Cu, Co, Cd, Pb, and Cr, and the concentrations of total heavy metals declined in the order of Fe, Al, Cu, Zn, Pb, Cr, Co, and Cd. Principal component analysis (PCA) showed that heavy metals could be grouped into three principal components, with PC1 containing Al and Fe, PC2 comprising Cd, Co, Cr, and Cu, and PC3 with only Zn. PCA results showed that PC1 may originate from natural sources, whereas PC2 and PC3 most likely originated from anthropogenic sources. Health risk assessment indicated that heavy metal contamination in the Klang district was below the acceptable threshold for carcinogenic and non-carcinogenic risks in adults, but above the acceptable threshold for carcinogenic and non-carcinogenic risks in children.

Matched MeSH terms: Risk Assessment/methods*
Diabetes mellitus and associated cardiovascular risk factors in north-east Malaysia

Mafauzy M, Mokhtar N, Mohamad WB, Musalmah M

Asia Pac J Public Health, 1999;11(1):16-9.
PMID: 10829822 DOI: 10.1177/101053959901100104

Two thousand five hundred and eight subjects from the state of Kelantan in North-East Peninsular Malaysia were included in this study to determine the prevalence of diabetes mellitus and impaired glucose tolerance and their association with cardiovascular risk factors. The overall prevalence of diabetes mellitus was 10.5% and impaired glucose tolerance was 16.5%. There was no difference in the prevalence of diabetes mellitus between males and females but the prevalence of impaired glucose tolerance was higher in females (19.0%) than in males (11.5%). Subjects with diabetes mellitus were more obese (38.4%) than normal subjects (24.1%). They also had a higher prevalence of hypertension (12.9%) and hypercholesterolaemia (71.9%) than normal subjects. Subjects with impaired glucose tolerance also had a higher prevalence of obesity (35.5%), hypertension (9.0%) and hypercholesterolaemia (63.0%) than normal subjects. In conclusion, the prevalence of diabetes mellitus and impaired glucose tolerance was high and they were associated with a high prevalence of obesity, hypertension and hypercholesterolaemia.

Matched MeSH terms: Risk Assessment/statistics & numerical data
Assessing 10-Year Cardiovascular Disease Risk in Malaysians With Type 2 Diabetes Mellitus: Framingham Cardiovascular Versus United Kingdom Prospective Diabetes Study Equations

Yew SQ, Chia YC, Theodorakis M

Asia Pac J Public Health, 2019 10;31(7):622-632.
PMID: 31535566 DOI: 10.1177/1010539519873487

In this study, we evaluated the performance of the Framingham cardiovascular disease (CVD) and the United Kingdom Prospective Diabetes Study (UKPDS) risk equations to predict the 10-year CVD risk among type 2 diabetes mellitus (T2DM) patients in Malaysia. T2DM patients (n = 660) were randomly selected, and their 10-year CVD risk was calculated using both the Framingham CVD and UKPDS risk equations. The performance of both equations was analyzed using discrimination and calibration analyses. The Framingham CVD, UKPDS coronary heart disease (CHD), UKPDS Fatal CHD, and UKPDS Stroke equations have moderate discrimination (area under the receiver operating characteristic [aROC] curve = 0.594-0.709). The UKPDS Fatal Stroke demonstrated a good discrimination (aROC curve = 0.841). The Framingham CVD, UKPDS Stroke, and UKPDS Fatal Stroke equations showed good calibration (P = .129 to .710), while the UKPDS CHD and UKPDS Fatal CHD are poorly calibrated (P = .035; P = .036). The UKPDS is a better prediction equation of the 10-year CVD risk among T2DM patients compared with the Framingham CVD equation.

Matched MeSH terms: Risk Assessment/methods
The sources and ecological risk assessment of elemental pollution in sediment of Linggi estuary, Malaysia

Elias MS, Ibrahim S, Samuding K, Rahman SA, Hashim A

Mar Pollut Bull, 2018 Dec;137:646-655.
PMID: 30503479 DOI: 10.1016/j.marpolbul.2018.11.006

In this study, concentrations of heavy metals, rare earth elements (REEs), Uranium (U) and Thorium (Th) of the actinide group were determined from Linggi estuary sediment samples by neutron activation analysis (NAA) and inductive coupled plasma - mass spectrometry techniques. The geo-accumulation (Igeo) and ecological risk index (Ri) values were calculated to identify the quality status of Linggi estuary sediments. Results indicated Linggi estuary was polluted by arsenic (As), lead (Pb) and antimony (Sb). REEs, U and Th showed significant increase of concentration in Linggi estuary sediments. Ri of Linggi estuary was categorised as low to considerable ecological risk, which indicates no significant to moderate effect on the majority of the sediment-dwelling organisms. Correlation matrix and principal component analysis assessed pollution sources to be both natural and anthropogenic.

Matched MeSH terms: Risk Assessment*
BTEX compositions and its potential health impacts in Malaysia

Latif MT, Abd Hamid HH, Ahamad F, Khan MF, Mohd Nadzir MS, Othman M, et al.

Chemosphere, 2019 Dec;237:124451.
PMID: 31394440 DOI: 10.1016/j.chemosphere.2019.124451

This study aims to determine the composition of BTEX (benzene, toluene, ethylbenzene and xylene) and assess the risk to health at different sites in Malaysia. Continuous monitoring of BTEX in Kuala Lumpur City Centre, Kuala Terengganu, Kota Kinabalu and Fraser Hill were conducted using Online Gas Chromatograph. For comparison, BTEX at selected hotspot locations were determined by active sampling method using sorbent tubes and Thermal Desorption Gas Chromatography Mass Spectrometry. The hazard quotient (HQ) for non-carcinogenic and the life-time cancer risk (LTCR) of BTEX were calculated using the United States Environmental Protection Agency (USEPA) health risk assessment (HRA) methods. The results showed that the highest total BTEX concentrations using continuous monitoring were recorded in the Kuala Lumpur City Centre (49.56 ± 23.71 μg/m3). Toluene was the most dominant among the BTEX compounds. The average concentrations of benzene ranged from 0.69 ± 0.45 μg/m3 to 6.20 ± 3.51 μg/m3. Measurements using active sampling showed that BTEX concentrations dominated at the roadside (193.11 ± 114.57 μg/m3) in comparison to petrol station (73.08 ± 30.41 μg/m3), petrochemical industry (32.10 ± 13.13 μg/m3) and airport (25.30 ± 6.17 μg/m3). Strong correlations among BTEX compounds (p<0.01, r>0.7) at Kuala Lumpur City Centre showed that BTEX compounds originated from similar sources. The values of HQ at all stations were <1 indicating the non-carcinogenic risk are negligible and do not pose threats to human health. The LTCR value based on benzene inhalation (1.59 × 10-5) at Kuala Lumpur City Centre were between 1 × 10-4 and 1 × 10-5, representing a probable carcinogenic risk.

Matched MeSH terms: Risk Assessment*
Occurrence and distribution of endocrine-disrupting chemicals in mariculture fish and the human health implications

Ismail NAH, Aris AZ, Wee SY, Nasir HM, Razak MR, Kamarulzaman NH, et al.

Food Chem, 2021 May 30;345:128806.
PMID: 33352402 DOI: 10.1016/j.foodchem.2020.128806

The presence and distribution of endocrine-disrupting chemicals (EDCs) in the mariculture fish from Pulau Kukup, Johor of Malaysia have been studied along with the impact on human health. Six different species of mariculture fish were collected, due to their high consumption in the Asian region-especially Malaysia, to assess their levels of EDCs. The highest concentration of EDCs detected in the muscle was dexamethasone (2.37-15.84 ng/g) and (0.77-13.41 ng/g), in the liver was dexamethasone (<2.54-43.56 ng/g) and progesterone (2.23-9.78 ng/g), and in the reproductive organ are dexamethasone (<2.54-37.23 ng/g) and caffeine (0.21-18.92 ng/g). The human health risk assessment in the current study suggested that there is no potential risk to the consumer because the hazard index was below 1 (HI risk with EDCs in mariculture fish.

Matched MeSH terms: Risk Assessment*
Fulltext Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years

Eikendal AL, Groenewegen KA, Anderson TJ, Britton AR, Engström G, Evans GW, et al.

Hypertension, 2015 Apr;65(4):707-13.
PMID: 25624341 DOI: 10.1161/HYPERTENSIONAHA.114.04658

Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden.

Matched MeSH terms: Risk Assessment*
Appropriateness of deep vein thrombosis (DVT) prophylaxis use among medical inpatients: a DVT risk alert tool (DRAT) study

Diana Yap FS, Ng ZY, Wong CY, Muhamad Saifuzzaman MK, Yang LB

Med J Malaysia, 2019 02;74(1):45-50.
PMID: 30846662

INTRODUCTION: Increasing incidence of Venous Thromboembolism (VTE) has complicated treatment courses for hospitalised patients. Despite recommendation to support deep vein thrombosis (DVT) risk assessment and appropriate use of prophylaxis in medical inpatients, it is either neglected or prescribed unnecessarily by the clinicians. This study aimed to assess and compare the appropriateness of DVT prophylaxis prescribing between usual care versus a pharmacist-driven DVT Risk Alert Tool (DRAT) intervention among hospitalised medical patients.
METHODS: A prospective pre- and post-intervention study was conducted among medical inpatients in a Malaysian secondary care hospital. DVT and bleeding risks were stratified using validated Padua Risk Assessment Model (RAM) and International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) Bleeding Risk Assessment Model. Pharmacist-driven DRAT was developed and implemented post-interventional phase. DVT prophylaxis use was determined and its appropriateness was compared between pre and post study using multivariate logistic regression with IBM SPSS software version 21.0.
RESULTS: Overall, 286 patients (n=142 pre-intervention versus n=144 post-intervention) were conveniently recruited. The prevalence of DVT prophylaxis use was 10.8%. Appropriate thromboprophylaxis prescribing increased from 64.8% to 68.1% post-DRAT implementation. Of note, among high DVT risk patients, DRAT intervention was observed to be a significant predictor of appropriate thromboprophylaxis use (14.3% versus 31.3%; adjusted odds ratio=2.80; 95% CI 1.01 to 7.80; p<0.05).
CONCLUSION: The appropriateness of DVT prophylaxis use was suboptimal but doubled after implementation of DRAT intervention. Thus, an integrated risk stratification checklist is an effective approach for the improvement of rational DVT prophylaxis use.

Matched MeSH terms: Risk Assessment/methods*
Fulltext An empirical study on asymmetric jump diffusion for option and annuity pricing

Lau KJ, Goh YK, Lai AC

PLoS One, 2019;14(5):e0216529.
PMID: 31063498 DOI: 10.1371/journal.pone.0216529

In this paper, we present a method to estimate the market parameters modelled by an asymmetric jump diffusion process. The method proposed is based on Kou's jump diffusion model while the market parameters refer to the market drift, the market volatility, the jump intensity on market price, and the rate of jump occurrence in a consistent manner throughout the entire paper. The model captures the asymmetric nature of the price fluctuation during up trend markets and down trend markets. The results are compared to conventional options to observe the impact of jump effects. The results from simulation show that the asymmetric jump diffusion model can estimate the fair prices of European call options and annuity better than the Black-Scholes model and the symmetric jump diffusion model proposed by Kou and Merton.

Matched MeSH terms: Risk Assessment/methods*
Fulltext Incidence of breast cancer attributable to breast density, modifiable and non-modifiable breast cancer risk factors in Singapore

Ho PJ, Lau HSH, Ho WK, Wong FY, Yang Q, Tan KW, et al.

Sci Rep, 2020 01 16;10(1):503.
PMID: 31949192 DOI: 10.1038/s41598-019-57341-7

Incidence of breast cancer is rising rapidly in Asia. Some breast cancer risk factors are modifiable. We examined the impact of known breast cancer risk factors, including body mass index (BMI), reproductive and hormonal risk factors, and breast density on the incidence of breast cancer, in Singapore. The study population was a population-based prospective trial of screening mammography - Singapore Breast Cancer Screening Project. Population attributable risk and absolute risks of breast cancer due to various risk factors were calculated. Among 28,130 women, 474 women (1.7%) developed breast cancer. The population attributable risk was highest for ethnicity (49.4%) and lowest for family history of breast cancer (3.8%). The proportion of breast cancers that is attributable to modifiable risk factor BMI was 16.2%. The proportion of breast cancers that is attributable to reproductive risk factors were low; 9.2% for age at menarche and 4.2% for number of live births. Up to 45.9% of all breast cancers could be avoided if all women had breast density <12% and BMI <25 kg/m2. Notably, sixty percent of women with the lowest risk based on non-modifiable risk factors will never reach the risk level recommended for mammography screening. A combination of easily assessable breast cancer risk factors can help to identify women at high risk of developing breast cancer for targeted screening. A large number of high-risk women could benefit from risk-reduction and risk stratification strategies.

Matched MeSH terms: Risk Assessment/methods*
Safety of probiotics: translocation and infection

Liong MT

Nutr Rev, 2008 Apr;66(4):192-202.
PMID: 18366533 DOI: 10.1111/j.1753-4887.2008.00024.x

The long history of safety has contributed to the acceptance of probiotics as a safe food adjunct. Consequently, many probiotic products and their applications have been granted GRAS (generally regarded as safe) status. However, this classification has been frequently generalized for all probiotic strains regardless of their application. Cases of probiotics from the genera Lactobacillus, Leuconostoc, Pediococcus, Enterococcus, and Bifidobacterium have been isolated from infection sites, leading to the postulation that these probiotics can translocate. Probiotic translocation is difficult to induce in healthy humans, and even if it does occur, detrimental effects are rare. Despite this, various reports have documented health-damaging effects of probiotic translocation in immunocompromised patients. Due to probiotics' high degree of safety and their morphological confusion with other pathogenic bacteria, they are often overlooked as contaminants and are least suspected as pathogens. However, the antibiotic resistance of some strains has increased the complexity of their eradication. Probiotic translocation and infection deserve further investigation and should become a facet of safety assessment so the negative effects of probiotics do not outweigh the benefits.

Matched MeSH terms: Risk Assessment*
Fulltext Density of breast: An independent risk factor for developing breast cancer, a prospective study at two premium breast centers

Lo CH, Chai XY, Ting SSW, Ang SC, Chin X, Tan LT, et al.

Cancer Med, 2020 05;9(9):3244-3251.
PMID: 32130790 DOI: 10.1002/cam4.2821

BACKGROUND: Breast cancer is the leading cause of death among women worldwide. Studies have identified breast density as a controversial risk factor of breast cancer. Moreover, studies found that breast density reduction through Tamoxifen could reduce risk of breast cancer significantly. To date, no study on the association between breast density and breast cancer has been carried out in Malaysia. If breast density is proven to be a risk factor of breast cancer, intervention could be carried out to reduce breast cancer risk through breast density reduction.
PURPOSE: To determine if density of breast is an independent risk factor which will contribute to development of breast cancer.
MATERIALS AND METHODS: A prospective cohort study is carried out in two hospitals targeting adult female patients who presented to the Breast Clinic with symptoms suspicious of breast cancer. Participants recruited were investigated for breast cancer based on their symptoms. Breast density assessed from mammogram was correlated with tissue biopsy results and final diagnosis of benign or malignant breast disease.
RESULTS: Participants with dense breasts showed 29% increased risk of breast cancer when compared to those with almost entirely fatty breasts (odds ratio [OR] 1.29, 95% CI 0.38-4.44, P = .683). Among the postmenopausal women, those with dense breasts were 3.1 times more likely to develop breast cancer compared with those with fatty breasts (OR 3.125, 95% CI 0.72-13.64, P = .13). Moreover, the chance of developing breast cancer increases with age (OR 1.046, 95% CI 1.003-1.090, P risk of breast cancer cannot be ruled out. The study is limited by a small sample size and subjective assessment of breast density. More studies are required to reconcile the differences between studies of contrasting evidence.

Matched MeSH terms: Risk Assessment/methods*
Fulltext Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Sung JJ, Chiu PW, Chan FKL, Lau JY, Goh KL, Ho LH, et al.

Gut, 2018 10;67(10):1757-1768.
PMID: 29691276 DOI: 10.1136/gutjnl-2018-316276

Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement.

Matched MeSH terms: Risk Assessment/methods
Source apportionment and health risk assessment among specific age groups during haze and non-haze episodes in Kuala Lumpur, Malaysia

Sulong NA, Latif MT, Khan MF, Amil N, Ashfold MJ, Wahab MIA, et al.

Sci Total Environ, 2017 Dec 01;601-602:556-570.
PMID: 28575833 DOI: 10.1016/j.scitotenv.2017.05.153

This study aims to determine PM2.5concentrations and their composition during haze and non-haze episodes in Kuala Lumpur. In order to investigate the origin of the measured air masses, the Numerical Atmospheric-dispersion Modelling Environment (NAME) and Global Fire Assimilation System (GFAS) were applied. Source apportionment of PM2.5was determined using Positive Matrix Factorization (PMF). The carcinogenic and non-carcinogenic health risks were estimated using the United State Environmental Protection Agency (USEPA) method. PM2.5samples were collected from the centre of the city using a high-volume air sampler (HVS). The results showed that the mean PM2.5concentrations collected during pre-haze, haze and post-haze periods were 24.5±12.0μgm-3, 72.3±38.0μgm-3and 14.3±3.58μgm-3, respectively. The highest concentration of PM2.5during haze episode was five times higher than World Health Organisation (WHO) guidelines. Inorganic compositions of PM2.5, including trace elements and water soluble ions were determined using inductively coupled plasma-mass spectrometry (ICP-MS) and ion chromatography (IC), respectively. The major trace elements identified were K, Al, Ca, Mg and Fe which accounted for approximately 93%, 91% and 92% of the overall metals' portions recorded during pre-haze, haze and post-haze periods, respectively. For water-soluble ions, secondary inorganic aerosols (SO42-, NO3-and NH4+) contributed around 12%, 43% and 16% of the overall PM2.5mass during pre-haze, haze and post-haze periods, respectively. During haze periods, the predominant source identified using PMF was secondary inorganic aerosol (SIA) and biomass burning where the NAME simulations indicate the importance of fires in Sumatra, Indonesia. The main source during pre-haze and post-haze were mix SIA and road dust as well as mineral dust, respectively. The highest non-carcinogenic health risk during haze episode was estimated among the infant group (HI=1.06) while the highest carcinogenic health risk was estimated among the adult group (2.27×10-5).

Matched MeSH terms: Risk Assessment*
Risk assessment of pharmaceutically active compounds (PhACs) in the Klang River estuary, Malaysia

Omar TFT, Aris AZ, Yusoff FM, Mustafa S

Environ Geochem Health, 2019 Feb;41(1):211-223.
PMID: 30051257 DOI: 10.1007/s10653-018-0157-1

The concentration profile, distribution and risk assessment of pharmaceutically active compounds (PhACs) in the coastal surface water from the Klang River estuary were measured. Surface coastal water samples were extracted using offline solid phase, applying polymeric C18 cartridges as extraction sorbent and measuring with liquid chromatography mass spectrometry-mass spectrometry (LC MS-MS) technique. Extraction method was optimized for its recovery, sensitivity and linearity. Excellent recoveries were obtained from the optimized method with percentage of recoveries ranging from 73 to 126%. The optimized analytical method achieved good sensitivity with limit of detection ranging from 0.05 to 0.15 ng L-1, while linearity of targeted compounds in the LC MS-MS system was more than 0.990. The results showed that amoxicillin has the highest concentration (102.31 ng L-1) followed by diclofenac (10.80 ng L-1) and primidone (7.74 ng L-1). The percentage of contribution (% of total concentration) for the targeted PhACs is in the following order; amoxicillin (92.90%) > diclofenac (3.95%) > primidone (1.23%) > dexamethasone (0.75%) > testosterone (0.70%) > sulfamethoxazole (0.33%) > progesterone (0.14%). Environmental risk assessment calculated based on deterministic approach (the RQ method), showed no present risk from the presence of PhACs in the coastal water of Klang River estuary. Nonetheless, this baseline assessment can be used for better understanding on PhACs pollution profile and distribution in the tropical coastal and estuarine ecosystem as well as for future comparative studies.

Matched MeSH terms: Risk Assessment/methods*

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links