Displaying publications 1701 - 1720 of 2314 in total

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  1. Kader Maideen SF, Mohd Sidik S, Rampal L, Mukhtar F
    BMC Psychiatry, 2015;15:262.
    PMID: 26497745 DOI: 10.1186/s12888-015-0648-x
    Anxiety is the most common mental health disorders in the general population. This study aimed to determine the prevalence of anxiety, its associated factors and the predictors of anxiety among adults in the community of Selangor, Malaysia.
    Matched MeSH terms: China/ethnology
  2. Chia YC, Gray SY, Ching SM, Lim HM, Chinna K
    BMJ Open, 2015;5(5):e007324.
    PMID: 25991451 DOI: 10.1136/bmjopen-2014-007324
    OBJECTIVE: This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting.
    DESIGN: This is a 10-year retrospective cohort study.
    SETTING: A primary care clinic in a teaching hospital in Malaysia.
    PARTICIPANTS: 967 patients' records were randomly selected from patients who were attending follow-up in the clinic.
    MAIN OUTCOME MEASURES: Baseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted.
    RESULTS: In 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2-30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63 [c-statistic or c-index]. It also discriminates well for Malay (AUC 0.65, p=0.01), Chinese (AUC 0.60, p=0.03), and Indians (AUC 0.65, p=0.001). There was good calibration with Hosmer-Lemeshow test χ(2)=3.25, p=0.78.
    CONCLUSIONS: Taking into account that this cohort of patients were already on treatment, the Framingham General CVD Risk Prediction Score predicts fairly accurately for men and overestimates somewhat for women. In the absence of local risk prediction charts, the Framingham general CVD risk prediction chart is a reasonable alternative for use in a multiethnic group in a primary care setting.
    Study site: Primary care clinic,University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.
    Matched MeSH terms: China/ethnology
  3. Mountjoy M, Akef N, Budgett R, Greinig S, Li G, Manikavasagam J, et al.
    Br J Sports Med, 2015 Jul;49(13):887-92.
    PMID: 25833900 DOI: 10.1136/bjsports-2014-094424
    Antidoping and medical care delivery programmes are required at all large international multisport events.
    Matched MeSH terms: China/epidemiology
  4. Teng CL, Nurjahan MI, Hashim NA, Punithambigai P, Leong KC, Mihat O
    Med J Malaysia, 2003 Jun;58(2):159-66.
    PMID: 14569735 MyJurnal
    Over a 2-week period, the management of upper respiratory tract infection by 24 medical officers and medical assistants in Seremban District was studied. Each practitioner recorded clinical data and prescription for twenty consecutive patients using a structured questionnaire. The extent to which the practitioners used "predictive features" (fever, absence of cough, cervical adenopathy, enlarged tonsils and exudates on tonsils) in clinical decision-making was analysed. The mean antibiotic prescription rate was 28.7% (95% CI: 24.6%, 33.0%). The antibiotic prescription rate of medical officers and medical assistants were similar. Five features were independently associated with antibiotic prescription (phlegm, fever, cervical adenopathy, red throat and tonsillar exudates). Antibiotics were prescribed for 22.1% of patients with 0-1 predictive features. High prescribers were 5 times more likely to prescribe antibiotics in this group of patients than low prescribers. To a large extent the clinical decision-making of practitioners in this study was evidence based. However, they were unduly influenced by purulent manifestation (phlegm) and redness of throat. The antibiotic prescription rate in these government health clinics is potentially reducible by means of educational intervention.
    Matched MeSH terms: China/ethnology
  5. Kham SK, Tan PL, Tay AH, Heng CK, Yeoh AE, Quah TC
    J Pediatr Hematol Oncol, 2002 Jun-Jul;24(5):353-9.
    PMID: 12142782
    The purpose of this study was to determine the frequency of thiopurine methyltransferase (TPMT) polymorphisms in a multiracial Asian population and to assess its relevance in the management of childhood acute lymphoblastic leukemia (ALL). Six hundred unrelated cord blood samples from 200 Chinese, Malay, and Indian healthy newborns were collected at the National University Hospital, Singapore; an additional 100 children with ALL were analyzed for five of the commonly reported TPMT variant alleles using polymerase chain reaction/restriction fragment length polymorphism and allele-specific polymerase chain reaction-based assays. In the cord blood study, the TPMT*3C variant was detected in all three ethnic groups; Chinese, Malays, and Indians had allele frequencies of 3%, 2.3%, and 0.8%, respectively. The TPMT*3A variant was found only among the Indians at a low allele frequency of 0.5%. The TPMT*6 variant was found in one Malay sample. Among the children with ALL, two white and one Chinese were heterozygous for the TPMT*3A variant and showed intermediate sensitivity to 6-mercaptopurine during maintenance therapy. Three Chinese patients and one Malay patient were heterozygous for the TPMT*3C variant. Mercaptopurine sensitivity could be validated in only one out of four TPMT*3C heterozygous patients. The overall allele frequency of the TPMT variants in this multiracial population was 2.5%. The TPMT*3C was the most common variant allele; TPMT*3A and TPMT*6 were rare. These results support the feasibility of performing TPMT genotyping in all children diagnosed with acute leukemia to minimize toxicity from thiopurine chemotherapy.
    Matched MeSH terms: China/ethnology
  6. Chong HT, Kamarulzaman A, Tan CT, Goh KJ, Thayaparan T, Kunjapan SR, et al.
    Ann Neurol, 2001 Jun;49(6):810-3.
    PMID: 11409437
    Nipah virus, a newly identified paramyxovirus caused a severe outbreak of encephalitis in Malaysia with high fatalities. We report an open-label trial of ribavirin in 140 patients, with 54 patients who were managed prior to the availability of ribavirin or refused treatment as control. There were 45 deaths (32%) in the ribavirin arm; 29 deaths (54%) occurred in the control arm. This represents a 36% reduction in mortality (p = 0.011). There was no associated serious side effect. This study suggests that ribavirin is able to reduce the mortality of acute Nipah encephalitis.
    Matched MeSH terms: China/ethnology
  7. Thumboo J, Fong KY, Chan SP, Leong KH, Feng PH, Thio ST, et al.
    Lupus, 1999;8(7):514-20.
    PMID: 10483028 DOI: 10.1191/096120399678840747
    OBJECTIVE: To validate the Medical Outcomes Study Family and Marital Functioning Measures (FMM and MFM) in a multi-ethnic, urban Asian population in Singapore.
    METHODS: English speaking Chinese, Malay or Indian SLE patients (n=120) completed a self-administered questionnaire containing the FFM and MFM at baseline, after 2 weeks and after 6 months. Lupus activity, disease-related damage and quality of life were assessed using the British Isles Lupus Assessment Group (BILAG), Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index and SF-36 Health Survey respectively. Scale psychometric properties were assessed through factor analysis, Cronbach's alpha, quantifying test-retest differences and known-groups construct validity.
    RESULTS: Factor analysis of scores obtained at baseline and after 6 months identified 3 factors corresponding to the FFM (1 factor) and the MFM (2 factors). Both scales showed acceptable internal consistency, with Cronbach's alpha of 0.95 for the FFM and 0.70 for the MFM. Mean (s.d.) test-retest differences were -0.31 (3.82) points for the FFM and -0.70 (4.26) points for the MFM. Eleven out of 13 a priori hypotheses relating both the FFM and MFM to demographic, disease and quality of life variables were confirmed, supporting the construct validity of these scales.
    CONCLUSION: The FFM and MFM are valid and reliable measures of family and marital functioning in a multi-ethnic cohort of Asian SLE patients in Singapore.
    Matched MeSH terms: China/ethnology
  8. Kaushik SP, Vu C
    Aust N Z J Med, 2000 Apr;30(2):231-5.
    PMID: 10833116
    BACKGROUND: From European and North American data, it is recommended in the Asia Pacific consensus statement, that one week therapy with a proton pump inhibitor, amoxycillin and clarithromycin be used for Helicobacter pylori eradication, in areas of high metronidazole resistance. The efficacy of this regimen is unknown in Singapore.

    AIM: To assess the efficacy, safety and compliance of an H. pylori eradication regimen and examine clinical factors that potentially determine eradication.

    METHODS: Consecutive outpatients from a multicultural, south east Asian, population with H. pylori infection, with or without peptic ulcer, were treated with lansoprazole 30 mg, amoxycillin 1 gm, clarithromycin 500 mg, twice a day for seven days. Eradication was assessed by either rapid urease, histology or urea breath test. Compliance and side effects were recorded. The eradication rate and effect of ethnicity, age, sex, usage of alcohol, smoking and non-steroidal anti-inflammatory drugs, history of ulcer and endoscopic diagnosis on eradication were examined by univariate and multivariate analysis.

    RESULTS: Of 113 patients, the eradication rate by intention to treat was 98/113 (87%) (95% confidence interval [CI] 80-93%) and per protocol was 98/106 (92%) (95% CI 87-97%). Using Fisher's exact test, eradication was more successful in Chinese (intention to treat and per protocol respectively p=0.02 and p<0.001) compared to non-Chinese. By logistic regression analysis ethnicity was an independent factor associated with eradication success (p=0.0025). Side effects occurred in five (4.4%), resulting in cessation of treatment.

    CONCLUSIONS: This one week eradication regimen is safe and effective in south east Asians. Chinese ethnicity may be associated with a higher likelihood of eradication success.

    Matched MeSH terms: China/ethnology
  9. Lim PH, Li MK, Ng FC, Chia SJ, Consigliere D, Gooren L, et al.
    Int J Urol, 2002 Jun;9(6):308-15.
    PMID: 12110094 DOI: 10.1046/j.1442-2042.2002.00425.x
    Sildenafil citrate (Viagra), a selective inhibitor of cGMP-specific phosphodiesterase type-5, has been used as an oral therapeutic drug for erectile dysfunction. The present paper is a clinical study of the success rate and side-effects of the use of sildenafil in a multi-racial population in Singapore.
    Matched MeSH terms: China/ethnology
  10. Pakianathan MR, Kamarulzaman A, Ismail R, McMillan A, Scott GR
    AIDS, 1999 Sep 10;13(13):1787-8.
    PMID: 10509585
    Matched MeSH terms: China/ethnology
  11. Tan JAMA, Yap SF, Tan KL, Wong YC, Wee YC, Kok JL
    Acta Haematol., 2003;109(4):169-75.
    PMID: 12853688 DOI: 10.1159/000070965
    Molecular characterization of the compound heterozygous condition - (G)gamma((A)gammadeltabeta)(o)/beta-thalassemia - in four families showing mild beta-thalassemia intermedia was carried out using DNA amplification techniques. Using the Amplification Refractory Mutation System (ARMS) to confirm the beta-mutations and DNA amplification to detect the 100-kb Chinese-specific (G)gamma((A)gammadeltabeta)(o)-deletion, ()two families were confirmed to possess (G)gamma((A)gammadeltabeta)(o)/beta-thalassemia with the IVSII No. 654 beta(+)-allele. In the third family, the (G)gamma((A)gammadeltabeta)(o)-deletion was confirmed in the father and the mother was a beta-thalassemia carrier with the cd 41-42 beta(o)-allele. Their affected child with (G)gamma((A)gammadeltabeta)(o)/beta-thalassemia was found to be transfusion dependent. The same (G)gamma((A)gammadeltabeta)(o)-deletion and beta-thalassemia (cd 41-42) was also confirmed in a fourth family. In addition, the mother was also diagnosed with Hb H disease (genotype -alpha(3.7)/-(SEA)). Both the children were found to possess (G)gamma((A)gammadeltabeta)(o)/beta-thalassemia but they were not transfusion dependent and this could be due to co-inheritance of alpha-thalassemia-2 (genotype-alpha(3.7)/alphaalpha) in the children together with their compound heterozygous condition.
    Matched MeSH terms: China/ethnology
  12. Che Maraina CH, Kamaliah MD, Ishak M
    Asian Pac J Allergy Immunol, 2002 Dec;20(4):279-82.
    PMID: 12744629
    Anti-nuclear antibody (ANA) negative systemic lupus erythematosus (SLE) occurs in about 4-13% of SLE cases. A small group of ANA negative SLE patients with positive anti-Ro antibodies usually present with typical vasculitic skin lesions which can be associated with photosensitivity, renal disease, congenital heart block or neonatal lupus. We present a case of a persistently ANA negative patient who presented with joint pain, rashes, mouth ulcer and alopecia. Clinical diagnosis of systemic lupus erythematosus was made even though ANA was negative. She was started on steroids and went into remission. Later, she developed several episodes of convulsions associated with fever and prominent vasculitic lesions. The patient was also found to have microscopic hematuria, proteinuria, anemia and thrombocytopenia. Renal biopsy showed lupus nephritis class 1B. Due to the prominent skin lesions, we performed anti-extractable nuclear antigens (ENA) antibodies test and anti-Ro turned out to be positive. The final diagnosis was ANA negative SLE (Ro lupus) with cutaneous, renal, musculoskeletal, hematological and cerebral Involvement.
    Matched MeSH terms: China/ethnology
  13. Lim KB, Jeevan NH, Jaya P, Othman MI, Lee YH
    Forensic Sci Int, 2001 Jun 01;119(1):109-12.
    PMID: 11348801
    Allele frequencies for the nine STRs genetic loci included in the AmpFlSTR Profiler kit were obtained from samples of unrelated individuals comprising 139-156 Malays, 149-153 Chinese and 132-135 Indians, residing in Malaysia.
    Matched MeSH terms: China/ethnology
  14. Lee FN, Kong VY, Lee GP, Ho KH, Choon SC, Hoh HB
    Med J Malaysia, 1999 Dec;54(4):438-41.
    PMID: 11072460
    A total of 114 patients (48 Chinese, 34 Malay and 32 Indian) undergoing extracapsular cataract extraction (ECCE) with intraocular lens implantation, were enrolled. All were given 3 ml of local anaesthetic (combination of equal amounts of lignocaine 2% and bupivacaine 0.5%) using retrobulbar technique. Intraocular pressure (IOP) was measured at different time intervals; before, immediately after and 5 minutes after injection with Honan balloon compression. Mean IOP increased by 5.0 mmHg immediately after injection (p < 0.001) and reduced to baseline level after 5 minutes of external compression. Although there were no statistical difference in terms of IOP variation between sex and age groups, Chinese patients demonstrated the highest IOP rise following retrobulbar anaesthesia. This is the first study to demonstrate the influence of race in the IOP response with Chinese subjects having the highest IOP rise.
    Matched MeSH terms: China/ethnology
  15. Wong KS
    Stroke, 1999 Nov;30(11):2326-30.
    PMID: 10548666
    BACKGROUND AND PURPOSE: In Asia, there has been no international study to investigate the risk factors for early death in patients with ischemic stroke and intracerebral hemorrhage.

    METHODS: We conducted a prospective study of consecutive patients with acute stroke who were admitted to 36 participating hospitals in China, India, Indonesia, Korea, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. With the use of a simple identical data sheet, we recorded the demographics and cardiovascular risk factors of each patient. Early death was defined as death on discharge from the acute hospital.

    RESULTS: We enrolled 2403 patients with ischemic stroke and 783 patients with intracerebral hemorrhage. Among patients with ischemic stroke, previous use of antiplatelet drugs (adjusted odds ratio [OR] 0.53; 95% confidence interval [CI] 0. 30 to 0.95) and relatively young age group 56 to 75 years (OR 0.65; 95% CI 0.42 to 1.00) were protective factors; atrial fibrillation (OR 2.23; 95% CI 1.40 to 3.57), ischemic heart disease (OR 2.03; 95% CI 1.37 to 3.05), diabetes (OR 1.52; 95% CI 1.04 to 2.22), and ex-smoker status (OR 2.18; 95% CI 1.18 to 4.05) were risk factors for early death. Among patients with intracerebral hemorrhage, hypertension (OR 0.56; 95% CI 0.38 to 0.82) and young age group 56 to 75 years old (OR 0.55; 95% CI 0.34 to 0.87) were associated with lower death rate, whereas diabetes (OR 1.74; 95% CI 1.01 to 2.98) was a risk factor for early death.

    CONCLUSIONS: In Asian patients with stroke, previous use of antiplatelet drugs nearly halved the risk of early death in patients with ischemic stroke, whereas atrial fibrillation, ischemic heart disease, diabetes, and ex-smoker status were risk factors for early death. Among patients with intracerebral hemorrhage, diabetes was associated with early death, whereas young age group and hypertension were associated with lower death rates, though no clear explanation for the hypertension association could be discerned from the data available.

    Matched MeSH terms: China/epidemiology
  16. Tan CE, Emmanuel SC, Tan BY, Jacob E
    Diabetes Care, 1999 Feb;22(2):241-7.
    PMID: 10333940 DOI: 10.2337/diacare.22.2.241
    OBJECTIVE: The purpose of the 1992 Singapore National Health Survey was to determine the current distribution of major noncommunicable diseases and their risk factors, including the prevalence of diabetes and dyslipidemia, in Singapore.

    RESEARCH DESIGN AND METHODS: A combination of disproportionate stratified sampling and systematic sampling were used to select the sample for the survey. The final number of respondents was 3,568, giving a response rate of 72.6%. All subjects fasted for 10 h and were given a 75-g glucose load, except those known to have diabetes. Blood was taken before and 2 h after the glucose load. Diagnosis of diabetes was based on 2-h glucose alone.

    RESULTS: The age-standardized prevalence of diabetes in Singapore residents aged 18-69 years was 8.4%, with more than half (58.5%) previously undiagnosed. Prevalence of diabetes was high across all three ethnic groups. The prevalence of impaired glucose tolerance was 16.1%, that of hypertension was 6.5%, and 19.0% were regular smokers. The total cholesterol (mean +/- SD) of nondiabetic Singaporeans was 5.18 +/- 1.02 mmol/l; 47.9% had cholesterol > 5.2 mmol/l, while 15.4% had levels > 6.3 mmol/l. Mean LDL cholesterol was 3.31 +/- 0.89 mmol/l; HDL cholesterol was 1.30 +/- 0.32 mmol/l, and triglyceride was 1.23 +/- 0.82 mmol/l.

    CONCLUSIONS: Prevalence of diabetes was high across all three ethnic groups. Ethnic differences in prevalence of diabetes, insulin resistance, central obesity, hypertension, smoking, and lipid profile could explain the differential coronary heart disease rates in the three major ethnic groups in Singapore.
    Matched MeSH terms: China/ethnology
  17. Niti M, Ng TP
    J Epidemiol Community Health, 2003 Jan;57(1):17-22.
    PMID: 12490643
    STUDY OBJECTIVES: To assess avoidable hospitalisation as an indicator of quality of primary care by examining trends and gender and ethnic variations.
    DESIGN AND SETTING: Aggregated nationwide data in Singapore from 1991 to1998 were analysed for hospitalisations for chronic diseases that are avoidable by timely, appropriate, and effective primary care: asthma, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension (avoidable hospitalisations).
    MAIN RESULTS: Of a total of 1 479 494 hospitalisations, 6.7% were for ambulatory care sensitive conditions (ACSC). The annual rate of avoidable hospitalisation was 29.4 per 10 000 population. Women had lower rates of avoidable hospitalisations than men (22.4 versus 29.5 per 10 000), as well as for total hospitalisations (496.2 versus 515.5 per 10 000). Adjusted for total hospitalisation, men were 1.3 times more likely than women to be hospitalised for ACSC. With similar adjustments for baseline utilisation, Indian and Malays had 1.7 and 1.8 times higher rates of avoidable hospitalisations than Chinese. Avoidable hospitalisation decline was -9.1% overall; greater in men (-11.8%) than in women (-5.3%); greater for Chinese (-15.8%), than Malays (-1.1%) and Indians (increase of +4.3%).
    CONCLUSION: Gender and ethnic differences and declining trends in avoidable hospitalisation demonstrated in this study suggest that avoidable hospitalisation rates are a sensitive indicator for assessing quality of primary ambulatory care.
    Matched MeSH terms: China/ethnology
  18. Lim JM, Hong AG, Raman S, Shyamala N
    Ultrasound Obstet Gynecol, 2000 Feb;15(2):131-7.
    PMID: 10775996
    To determine whether racial differences affect the relationship between the fetal femur diaphysis length and the neonatal crown-heel length.
    Matched MeSH terms: China/ethnology
  19. Tang K, Ngoi SM, Gwee PC, Chua JM, Lee EJ, Chong SS, et al.
    Pharmacogenetics, 2002 Aug;12(6):437-50.
    PMID: 12172212
    The MDR1 multidrug transporter plays a key role in determining drug bioavailability, and differences in drug response exist amongst different ethnic groups. Numerous studies have identified an association between the MDR1 single nucleotide polymorphism (SNP) exon 26 3435C>T and differences in MDR1 function. We performed a haplotype analysis of the MDR1 gene in three major ethnic groups (Chinese, Malays and Indians) by examining 10 intragenic SNPs. Four were polymorphic in all three ethnic groups: one occurring in the non-coding region and three occurring in coding exons. All three coding SNPs (exon 12 1236C>T, exon 21 2677G>T/A and exon 26 3435C>T) were present in high frequency in each ethnic group, and the derived haplotype profiles exhibited distinct differences between the groups. Fewer haplotypes were observed in the Malays (n = 6) compared to the Chinese (n = 10) and Indians (n = 9). Three major haplotypes (> 10% frequency) were observed in the Malays and Chinese; of these, two were observed in the Indians. Strong linkage disequilibrium (LD) was detected between the three SNPs in all three ethnic groups. The strongest LD was present in the Chinese, followed by Indians and Malays, with the corresponding LD blocks estimated to be approximately 80 kb, 60 kb and 40 kb, respectively. These data strongly support the hypothesis that strong LD between the neutral SNP exon 26 3435C>T and a nearby unobserved causal SNP underlies the observed associations between the neutral SNP and MDR1 functional differences. Furthermore, strong LD between exon 26 3435T and different unobserved causal SNPs in different study populations may provide a plausible explanation for conflicting reports associating the same exon 26 3435T allele with different MDR1 functional changes.
    Matched MeSH terms: China/ethnology
  20. Li D, Zhang H, Hsu-Hage BH, Wahlqvist ML, Sinclair AJ
    Eur J Clin Nutr, 2001 Dec;55(12):1036-42.
    PMID: 11781668
    The aims of this study were to investigate (1) platelet phospholipid (PL) polyunsaturated fatty acid (PUFA) composition in subjects who were the Melbourne Chinese migrants, compared with those who were the Melbourne Caucasians and (2) the relationship between platelet PL PUFA and intake of fish, meat and PUFA.
    Matched MeSH terms: China/ethnology
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