Displaying publications 161 - 180 of 3389 in total

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  1. Hughes K, New AL, Lee BL, Ong CN
    Ann Acad Med Singap, 1998 Mar;27(2):149-53.
    PMID: 9663300
    The National University of Singapore Heart Study measured cardiovascular risk factors, including selected plasma vitamins, on a random sample of the general population aged 30 to 69 years. Plasma vitamins A and E were normal and similar by ethnic group. Mean plasma vitamin A levels were: Chinese (males 0.68 and females 0.52 mg/L), Malays (males 0.67 and females 0.54 mg/L), and Indians (males 0.66 and females 0.51 mg/L). Mean plasma vitamin E levels were: Chinese (males 12.6 and females 12.6 mg/L), Malays (males 13.6 and females 13.3 mg/L), and Indians (males 12.9 and females 12.8 mg/L). No person had plasma vitamin A deficiency (< 0.01 mg/L) and only 0.1% had vitamin E deficiency (< 5.0 mg/L). In contrast, plasma vitamin C was on the low side and higher in Chinese than Malays and Indians. Mean plasma vitamin C levels were: Chinese (males 6.3 and females 8.4 mg/L), Malays (males 5.1 and females 6.4 mg/L), and Indians (males 5.7 and females 6.9 mg/L). Likewise, the proportions with plasma vitamin C deficiency (< 2.0 mg/L) were lower in Chinese (males 14.4 and females 0.7%), than Malays (males 19.7 and females 7.2%), and Indians (males 17.8 and females 11.0%). Relatively low levels of plasma vitamin C may contribute to the high rates of coronary heart disease and cancer in Singapore. In particular, lower plasma vitamin C in Malays and Indians than Chinese may contribute to their higher rates of coronary heart disease. However, plasma vitamin C does not seem to be involved in the higher rates of cancer in Chinese than Malays and Indians. The findings suggest a relatively low intake of fresh fruits and a higher intake is recommended. Also, food sources of vitamin C may be destroyed by the high cooking temperatures of local cuisines, especially the Malay and Indian ones.
    Matched MeSH terms: Risk Factors
  2. Rao PV, Ahuja MM, Trivedi BB, Ramachandran M, Samal KC, Zain AZ, et al.
    J Indian Med Assoc, 1998 May;96(5):155-7.
    PMID: 9828573
    Matched MeSH terms: Risk Factors
  3. Ng TP, Seow A, Tan WC
    Eur Respir J, 1998 Jul;12(1):198-203.
    PMID: 9701437
    This study investigated the prevalence of snoring and symptoms of sleep breathing-related disorders in the multi-ethnic population of Singapore (3 million people, comprising 75% Chinese, 15% Malay and 7% Indian). A multistaged, area cluster, disproportionate stratified, random sampling of adults aged 20-74 yrs was used to obtain a sample of 2,298 subjects (65% response), with approximately equal numbers of Chinese, Malay and Indian and in each 10 yr age group. An interviewer-administered field questionnaire was used to record symptoms of snoring and breathing disturbances during sleep witnessed by a room-mate and other personal and health-related data. The weighted point estimate (and 95% confidence interval) of the whole population prevalence of snoring was 6.8% (53-83). There were pronounced ethnic differences among Chinese, 6.2% (4.4-8.1); Malay, 8.1% (6.1-10.2) and Indian, 10.9% (85-13.4). The minimum whole population prevalence by the most restricted symptom criteria for defining sleep breathing-related disorder was 0.43% (0.05-0.8%). Similar marked ethnic differences in rates were observed using various symptom criteria. The ethnic differences in sleep breathing symptoms paralleled the differences in body mass index, neck circumference and hypertension, but statistically significant differences remained after adjustment for sex, age and these known associated factors. Marked ethnic differences in snoring and sleep breathing-related disorders were observed in Chinese, Malays and Indians in Singapore, which were only partly explained by known factors of sex, age and body habitus.
    Matched MeSH terms: Risk Factors
  4. Lee WS, Puthucheary SD, Boey CC
    J Paediatr Child Health, 1998 Aug;34(4):387-90.
    PMID: 9727185
    OBJECTIVE: To study the clinical features of non-typhoid Salmonella gastroenteritis and the incidence, risk factors and outcome of invasive complications in urban Malaysian children. To describe the serotypes of Salmonella species isolated and the pattern of antibiotic susceptibility.

    METHODOLOGY: Retrospective review of a group of 131 children with non-typhoid Salmonella gastroenteritis seen at the University Hospital, Kuala Lumpur, Malaysia from January 1994 to December 1996.

    RESULTS: Sixty-seven percent were infants below one year of age. Fever and vomiting were seen in nearly half of children. Seven children (5.3%) had invasive complications: 5 bacteraemia and 2 meningitis. Age below 6 months, fever > 38.0 degrees C, and dehydration on admission were significantly associated with invasive complications. The commonest serotypes isolated were S. enteritidis, S. paratyphi B, and S. bovis-morbificans. A total of 94-100% of isolates were susceptible to commonly prescribed antibiotics.

    CONCLUSIONS: Children with Salmonella gastroenteritis below 6 months of age who are febrile and dehydrated should be treated empirically with antibiotics until the result of blood culture is available.

    Matched MeSH terms: Risk Factors
  5. Noorhassim I, Rampal KG
    Am J Otolaryngol, 1998 8 6;19(4):240-3.
    PMID: 9692632
    PURPOSE: To determine the combined effect of smoking and age on hearing impairment.

    MATERIALS AND METHODS: Pure tone audiometry test was conducted on 263 residents of a rural village who were not exposed to noise. The pack-years of smoking were computed from the subjects' smoking history. The association between pack-years and hearing impairment was assessed. The combined effect of smoking and age on hearing impairment was determined based on prevalence rate ratio.

    RESULTS: There was a statistically significant trend in the number of pack-years of smoking and age as risk factors for hearing impairment. The prevalence rates of hearing impairment for nonsmokers aged 40 years and younger, smokers aged 40 years and younger, nonsmokers older than 40 years of age, and smokers older than 40 years of age were 6.9%, 11.9%, 29.7%, and 51.3%, respectively. The prevalence rate ratio for nonsmokers aged 40 years and younger, smokers aged 40 years and younger, nonsmokers older than 40 years of age, and smokers older than 40 years of age (nonsmokers aged 40 years and younger as a reference group) was 1, 1.7, 4.3, and 7.5, respectively. The prevalence rate ratios showed a multiplicative effect of smoking and age on hearing impairment.

    CONCLUSION: Age and smoking are risk factors for hearing impairment. It is clear that smoking and age have multiplicative adverse effects on hearing impairment.

    Matched MeSH terms: Risk Factors
  6. Sivanesaratnam V
    Ann Acad Med Singap, 1998 Sep;27(5):622-6.
    PMID: 9919328
    Although the primary operative mortality following radical hysterectomy for stage IB and early stage IIA cervical carcinoma is less than 1%, survival is poor in those patients with histological evidence of "risk" features--lymph node metastases, lymphatic vascular tumour permeation and clinically undetected parametrial metastases. In the 7-year period 1983 to 1989, 239 patients with stage IB and early IIA disease had radical hysterectomy and pelvic lymphadenectomy. One hundred and eight patients (45.2%) had various poor prognostic histological features and received adjuvant chemotherapy--70 had cisplatin, vinblastine, bleomycin (PVB), 16 had mitomycin C (MMC) and 22 others received mitomycin C + 5-fluorouracil (5-FU). Although not randomised, the risk factors present in each group were identical. These patients have now been followed up for periods ranging from 8 to 14 years. All recurrences, except one, occurred within 23 months of surgery; in the remaining this occurred 8 years later. This suggests that very close long-term follow-up is needed. Recurrences were markedly higher in the group who refused adjuvant chemotherapy (31.6%). The 10-year survival in patients without risk factors was 97.2%. In those patients with risk factors refusing adjuvant therapy it was 73.7%. The adjuvant chemotherapy group had a better survival of 86.1% (P = 0.001). The 10-year survivals in patients with positive nodes were similar--66.7% in the MMC group and 71.4% in the PVB group. The 10-year survival in patients with squamous cell carcinoma was significantly better (90.3%) in the mitomycin C (and MMC + 5-FU) group compared to the PVB group (80.1%) (P = 0.005). The 10-year survival in patients with adenocarcinoma and adenosquamous carcinoma was significantly better (96.3%) in the PVB group compared to those receiving MMC (and MMC + 5-FU) (57.1%) (P = 0.01). It would, thus, appear that the adjuvant chemotherapy of choice for patients with squamous cell carcinoma would be MMC (and MMC + 5-FU) and for those with adenocarcinoma, the PVB regime.
    Matched MeSH terms: Risk Factors
  7. Goh AY, Chan PW, Lum LC, Roziah M
    Arch Dis Child, 1998 Sep;79(3):256-9.
    PMID: 9875023
    OBJECTIVES: To determine the incidence and outcome of acute respiratory distress syndrome (ARDS) in children by comparing two commonly used definitions: the lung injury score and the American-European Consensus Conference definition. The causes and risk for developing ARDS were also studied.

    METHODS: Part prospective and retrospective analysis of 8100 consecutive hospital admissions from 1 June 1995 to 1 April 1997.

    RESULTS: Twenty one patients fulfilled the criteria for ARDS. Both definitions identified the same group of patients. The incidence was 2.8/1000 hospital admissions or 4.2% of paediatric intensive care unit admissions. The main causes were sepsis and pneumonia. Mortality was 13 of 21. Factors predicting death were a high admission paediatric risk of mortality (PRISM) score (30.38 v 18.75) and the presence of multiple organ dysfunction syndrome (92% v 25%).

    CONCLUSION: Both definitions identified similar groups of patients. The incidence in this population was higher than that reported elsewhere, but mortality and cause were similar to those in developed countries. Poor outcome was associated with sepsis, a high admission PRISM score, and simultaneous occurrence of other organ dysfunction.

    Matched MeSH terms: Risk Factors
  8. Liam CK, Lim KH, Srinivas P, Poi PJ
    Int J Tuberc Lung Dis, 1998 Oct;2(10):818-23.
    PMID: 9783529
    University Hospital, Kuala Lumpur, Malaysia.
    Matched MeSH terms: Risk Factors
  9. Norhayati M, Oothuman P, Fatmah MS
    Med J Malaysia, 1998 Dec;53(4):401-7.
    PMID: 10971984
    A study on risk factors of soil-transmitted helminths was conducted in a highly endemic area. In all 205 children (95 boys and 110 girls) participated in this study. The overall prevalences of Ascaris, Trichuris and hookworm infection were 62.5%, 91.7% and 28.8% respectively. Only 22.4% of the children had a single infection either by Ascaris or Trichuris; 69.3% had mixed infection and the most prevalent of mixed infection was a combination of Ascaris and Trichuris. Logistic regression analysis confirmed that low level mother's education was a risk factor for moderate and severe infection of Ascaris and age < or = 6-year-old was a protective factor. In Trichuris infection logistic regression analysis confirmed that usage of well-water and age < or = 6-year-old were the risk factors. Logistic regression analysis on worm scores confirmed that usage of well-water and non-usage of toilets were the risk factors from getting severe worm scores and age < or = 6-year-old was a protective factor. Our finding suggest that socio-behavioural (related to mother's education), demographic (children age) and environmental-factors (usage of well-water and non-usage of toilets) are the elements to be considered in the design of long term soil-transmitted helminths (STH) control in an endemic areas.
    Matched MeSH terms: Risk Factors
  10. Norhayati M, Penggabean M, Oothuman P, Fatmah MS
    PMID: 10772555
    A study on prevalence and risk factors of Giardia duodenalis infection was conducted in rural communities of Malaysia. A total of 917 individuals between 2-70 years old (431 males and 486 females), participated in this study. The overall prevalence of G. duodenalis infection was 19.2%. The prevalence was significantly different between different age groups, but not genders. Our study indicated that age < or = 12 years old and the presence of family members infected with G. duodenalis were the risk factors of infection. Person-to-person contact within the family members was the possible mode of transmission. Health education on personal hygiene, together with the treatment of the infected people, may help in reducing and controlling this infection in these communities.
    Matched MeSH terms: Risk Factors
  11. Ong LC, Afifah I, Sofiah A, Lye MS
    Ann Trop Paediatr, 1998 Dec;18(4):301-7.
    PMID: 9924586 DOI: 10.1080/02724936.1998.11747964
    A hospital study was carried out to compare parenting stress among 87 Malaysian mothers of children with cerebral palsy and a control group (comprising 87 mothers of children without disability who attended the walk-in paediatric clinic), using the Parenting Stress Index (PSI) questionnaire. Multiple regression analysis was used to determine socio-demographic and medical factors associated with child-domain stress (CDS) and parent-domain stress (PDS). Mothers of children with cerebral palsy scored significantly higher than control subjects on all sub-scales of CDS and PDS (p < 0.01), except for the sub-scale of 'role restriction'. The presence of cerebral palsy (p < 0.001) and activities of daily living (ADL) scores (p < 0.001) were significantly associated with CDS. Factors predictive of PDS were ADL scores (p < 0.001), number of hospitalizations over the past year (p = 0.024), level of maternal education (p = 0.018) and Chinese mothers (p < 0.001). Although this study demonstrated that Malaysian mothers of children with cerebral palsy experienced higher levels of stress than controls, the impact of cerebral palsy per se on parenting stress was modified by other factors such as increased care-giving demands, low maternal education and ethnic background. Habilitation should be directed at easing the burden of daily care, minimizing hospital re-admissions and targeting appropriate psychosocial support at specific subgroups to change parental perception and expectations.
    Study site: neurology clinics or physiotherapy department or inpatients, Paediatric Institute, Kuala Lumpur, Malaysia
    Matched MeSH terms: Risk Factors
  12. Beyrer C, Vancott TC, Peng NK, Artenstein A, Duriasamy G, Nagaratnam M, et al.
    AIDS Res Hum Retroviruses, 1998 Dec 20;14(18):1687-91.
    PMID: 9870323
    We investigated the molecular epidemiology of HIV-1 subtypes in Malaysia among injecting drug users (IDUs) and sexual transmission risk groups, using serologic and genetic techniques. Frozen sera collected at a general hospital, a blood bank, several drug treatment centers, and an STD clinic in Kuala Lumpur, between 1992 and 1996, were investigated retrospectively. V3 peptide serotyping and monomeric gp120 capture serotyping were used to study 89 known HIV-1-infected subjects. The methods differentiate subtypes B, E, and C. V3 peptide and gp120 capture results were comparable. No subtype C-specific reactive sera were found; one specimen was dually reactive for subtypes C and B, using the V3 peptide ELISA; and four were durally reactive for subtypes E and C using this assay. Genotypic analysis of HIV-1 gag RNA in serum was done on a subset of subjects and confirmed serologic findings. HIV-1 subtypes differed significantly by risk category: of 53 IDUs, 29 (55%) were infected with subtype B and 19 (36%) were infected with subtype E, 3 (6%) were dually reactive, and 2 (4%) were not typable. Of 36 persons with heterosexual risks, 29 (81%) were infected with subtype E, 5 (14%) were infected with subtype B, and 2 (5%) were not typable. Persons with IDU risks were significantly more likely to be infected with subtype B than were those with sexual risks (OR 5.89; 95% CI, 1.94-18.54; p < 0.001). Subtypes B and E of HIV-1 appear to predominate in Malaysia; subtype B was more prevalent among IDUs; subtype E was more prevalent among all other groups. These results may have important HIV-1 vaccine implications.
    Matched MeSH terms: Risk Factors
  13. Wood E, Cheong I, Lee C
    Int J Clin Pract, 1998 Jan-Feb;52(1):23-6.
    PMID: 9536563
    A retrospective study of 144 adults with HIV infection was conducted to investigate the prevalence of upper and lower respiratory tract infections (URTIs and LRTIs). The patients were divided into two groups: those with acquired HIV through intravenous drug abuse (IVDA), and those who had acquired HIV through 'other' risk behaviours. LRTIs were more prevalent than URTIs overall, and LRTIs were significantly more common (p < 0.001) in IVDAs than in the other-risk group. Tuberculosis (40%) and bacterial pneumonias (33%) comprised the majority of LRTIs among IVDAs, while Pneumocystis carinii pneumonia (40%) was the commonest LRTI in the other-risk group. Analysis of CD4 T-lymphocyte counts indicated that HIV-seropositive IVDAs are at greater risk of developing chest infections at higher CD4 counts than other-risk patients. The IVDAs were also found to have a much higher rate of co-infection with hepatitis C and B, which may be a factor accelerating the progression from HIV infection to AIDS. The mean time averaged for the two groups from known seroconversion to development of respiratory tract infection is only 1.37 years, which suggests HIV-infected patients are presenting late for treatment in Malaysia.
    Matched MeSH terms: Risk Factors
  14. Krishnan R, Karim H
    World Health Forum, 1998;19(2):159-60.
    PMID: 9652215
    Matched MeSH terms: Risk Factors
  15. Khoo SP, Shanmuhasuntharam P, Mahadzir WM, Tay KK, Latif A, Nair S
    Asia Pac J Public Health, 1998;10(1):49-51.
    PMID: 10050209 DOI: 10.1177/101053959801000111
    The delay in the diagnosis of oral cancer has been variously reported as being contributed by the clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
    Matched MeSH terms: Risk Factors
  16. Ismail R
    AIDS, 1998;12 Suppl B:S33-41.
    PMID: 9679627
    Matched MeSH terms: Risk Factors
  17. Choo, C.M., Quah, B.S., Rostenberghe, H.V., Choo, K.E.
    MyJurnal
    A case control study was conducted to identify the risk factors for acute lower respiratory tract infections (ALRI) in hospitalised children in Kelantan. One hun-dred and twenty children aged one month to five years hospitalised for ALRI were matched by age with 120 children as controls. Data on demography and expo-sure to putative risk factors were collected by interview-ing parents or caretakers. Anthropometric measure-ments were also carried out to assess the nutritional sta-tus of the children. For each risk factor studied, the odds ratios for exposure and disease were calculated by using univariate analysis followed by multiple logistic regression analysis to determine those factors which remained significant.
    The presence of sibling(s) who coughed at home (OR 12.1, 95% CI 5.2-28.1), crowding in bedroom (OR 4.4, 95% CI 2.1-9.0), weight-for-age < 3rd percentile (OR 9.0, 95% CI 3.1-25.8), lack of breast feeding (OR 9.4, 95% CI 2.3-38.4) and incomplete immunisation (OR 4.5, 95% CI 1.7-12.1) were significant indepen-dent risk factors for ALRI. Other factors like poverty, maternal education level, male sex, low birth weight, history of atopy, family history of asthma and indoor air pollution were not associated with an increased risk of ALRI.
    This study showed that poor nutritional status, inap-propriate child care practices and poor living conditions, particularly those related to crowding, predispose to ALRI in Kelantanese children necessitating hospital admission. A change in these factors may reduce the morbidity and mortality of childhood ALRI in Kelantan.
    Matched MeSH terms: Risk Factors
  18. 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: Risk Factors
  19. Tan YK, Khoo KL, Low JA, Wong ZW, Theng CT, Ong TH, et al.
    Ann Acad Med Singap, 1999 Mar;28(2):214-6.
    PMID: 10497669
    We studied the relationship between different ethnic groups, obstructive sleep apnoea (OSA) and ischaemic heart disease. Four hundred and thirty-two inpatients from the medical wards were interviewed. Limited overnight sleep studies were done in 129 of those who had habitual snoring, daytime sleepiness based on an Epworth sleepiness scale of 8 or more, or a large neck size of 40 cm or more. There were 315 Chinese (72.9%), 67 Malays (15.5%), 43 Indians (10%) and 3 from other races (1.4%). The prevalence of OSA was 19.7%, 30% and 12% among the Chinese, Malays and Indians, respectively. The prevalence ratio for OSA was 1.52 in Malays using Chinese patients as the baseline (P = 0.07). The median neck circumference was 37 cm in both racial groups. The median body mass index was 22.7 kg/m2 in Chinese compared to 23.6 kg/m2 in Malays. The median apnoea-hypopnoea index was 22.7, 19.0 and 26.9 events/hour among the Chinese, Malays and Indians, respectively. OSA was independently associated with the prevalence of IHD (adjusted prevalence ratio 1.68; 95% CI: 1.15, 2.46; P = 0.009). The prevalence of ischaemic heart disease (IHD) was 31%, 24% and 28% in Chinese, Malays and Indians, respectively. The prevalence ratio for IHD in Malays compared to Chinese was 0.77. After adjusting for OSA, there was an even greater reduction in the risk of IHD (adjusted prevalence ratio 0.70). This suggests that OSA is a confounder in the relationship between race and ischaemic heart disease.
    Matched MeSH terms: Risk Factors
  20. Chye JK, Lim CT, Leong HL, Wong PK
    Ann Acad Med Singap, 1999 Mar;28(2):193-8.
    PMID: 10497665
    This study aims to determine the prevalence of and risk factors associated with retinopathy of prematurity (ROP) in very low birth weight (VLBW) infants. All premature VLBW infants, admitted into the neonatal intensive care unit of the University Hospital Kuala Lumpur, were screened from 4 weeks of life. Perinatal and neonatal data were retrieved from the infants' medical notes. Between August 1994 and July 1996, 100 infants had their eyes examined serially. Of the 15 (15%) infants with ROP, all were less than 31 weeks gestation, and only 1 infant had birth weight above 1250 g. Five (5%) infants had severe ROP; 4 infants underwent cryotherapy for stage 3 threshold disease. Infants with ROP, as compared to infants without ROP, had lower birth weight [mean (SEM) 993 (50) g versus 1205 (22) g, P < 0.001], lower gestational age [mean (SEM) 28.0 (0.4) weeks versus 30.1 (0.2) weeks, P < 0.001], higher rates of patent ductus arteriosus and chronic lung disease, greater number of radiographic examinations and episodes of late-onset suspected/confirmed sepsis, and required longer duration of supplemental oxygen, ventilation, xanthine, antibiotics and intralipid use, but were slower to establish full enteral feeds. On multivariate logistic regression analysis, birth weight < or = 1000 g [OR 2.38, 95% CI 1.25, 4.55, P = 0.009] and gestational age < or = 28 weeks [OR 2.86, 95% CI 1.47, 5.56, P = 0.002] were significant predictors of increased risk of this disease. In conclusion, ROP is strongly associated with smaller, more immature and sicker neonates. Prevention of prematurity would help reduce the incidence of this disease.
    Matched MeSH terms: Risk Factors
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