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Outcomes of Clinical Treatments Among Patients with Diabetes Mellitus in Selangor, Malaysia: A Retrospective Study

Mahmud Z, Abrahhim SA, Sulong S

Curr Diabetes Rev, 2021;17(7):e011221190236.
PMID: 33438543 DOI: 10.2174/1573399817999210112191330

BACKGROUND: It is important to assess how well patients respond to their medical treatments by observing the results that appear during the clinical treatments. As such, the clinical treatments and results must obtain information on how effective recommended treatments were for patients with diabetes.
OBJECTIVE: This study examines how patients with diabetes mellitus responded towards their clinical treatments, where the probability distribution of patients and the types of treatment received were derived from the Rasch probabilistic model.
METHODS: This is a retrospective study wherein data were collected from patients' medical records at a local public hospital in Selangor, Malaysia. Clinical and demographic information such as fasting blood glucose, hemoglobin A1c (HbA1c), family history, type of diabetes (type 1 or type 2), types of medication (oral or insulin), compliance with treatments, gender, race and age were chosen as the agents of measurement.
RESULTS: The use of Rasch analysis in the present study helped to compare the patients' responses towards the DM treatments and identify the types of treatment they received. Results from the Wright map show that a majority of the diabetes mellitus patients who were diagnosed with type 2 diabetes have no controlled readings of HbA1c during their first and second visits to the medical center. However, patients with a family history of diabetes mellitus who took oral medication have controlled readings of fasting blood glucose based on the probabilistic outcomes of the treatment received by the patients.
CONCLUSION: Controlled readings were found only in the readings of fasting blood glucose during the first and second visits, followed by family history, types of medication received, and compliance with the treatment. This study has recommended that type 2 patients with diabetes without a family history of diabetes mellitus need to exercise more control over the readings of HbA1c.
The Alkaloids of Psychotria rostrata

Lajis NH, Mahmud Z, Toia RF

Planta Med, 1993 Aug;59(4):383-4.
PMID: 17235995
Human Papilloma Virus (HPV) self-sampling: do women accept it?

Abdullah NN, Daud S, Wang SM, Mahmud Z, Mohd Kornain NK, Al-Kubaisy W

J Obstet Gynaecol, 2018 Apr;38(3):402-407.
PMID: 29385850 DOI: 10.1080/01443615.2017.1379061

This study aims to determine the acceptability of Human Papilloma Virus (HPV) self-sampling and the factors associated with willingness to buy HPV self-sampling kit in the future. A total of 164 women aged 28-60 years old from Obstetrics & Gynaecology clinics at a teaching hospital performed HPV self-sampling using the Digene HC2 DNA collection kit. After samples were taken, the participants were given self-administered questionnaires. The majority of the participants were Malay (93.9%), had attained tertiary education (65.2%) and were employed (70.1%). The acceptability was good. More than half of the participants felt that self-sampling was easy. Only 1.2% felt that the procedure was difficult to perform. Most reported no pain at all during the procedure (66.9%). The commonest concern was getting a good sample (90.1%). A number of Pap smears were found to be significantly associated with the willingness to buy the HPV self-sampling kit. HPV self-sampling has the potential to be included in the cervical cancer screening programme. Impact Statement What is already known on this subject: HPV self-sampling is acceptable in some developed and developing countries. It is acceptable because it was easy to perform with very minimal pain or discomfort. Studies on the acceptance of self-screening are needed to plan a policy on self-sampling in the future. What the results of this study add: Our study adds new findings to the body of knowledge on self-sampling in the local population. We found that more women are willing to do the self-sampling at the clinic rather than at home. Although more than 90% expressed willingness to do self-sampling in the future, only 70% of them were willing to purchase the kit. Cost is a potential barrier to women who have the interest to perform the self-sampling. Given the global economic challenges, cost is inevitably an important predictor that we have to consider. What the implications are of these findings for clinical practice and/or further research: Future research should examine women from the rural areas and those who are resilient to Pap smear screening. In clinical practice, clinicians should acknowledge that cost is a potential barrier for women who are willing to do self-sampling. Self-sampling could be an option for women with no financial constraint to buy the kit. However, clinicians should counsel women so that they can make an informed choice in determining their screening method.
Fulltext Modified matrix solid phase dispersion-HPLC method for determination of pesticide residue in vegetables and their impact on human health: A risk assessment

Mujahid M, Latif S, Ahmed M, Shehzadi W, Imran M, Ahmad M, et al.

Front Chem, 2022;10:1084350.
PMID: 36569961 DOI: 10.3389/fchem.2022.1084350

The use of pesticides is unavoidable in agricultural practices. This class of chemicals is highly toxic for the environment as well as for humans. The present work was carried out to assess the presence of some pesticides (diafenthiuron, lufenuron, azoxystrobin, difenoconazole, and chlorothalonil) residues in five of the very commonly used vegetables (eggplant, capsicum, apple gourd, cauliflower, and sponge gourd). Matrix solid phase dispersion (MSPD) technique was used to extract the pesticides and subsequently their quantification was performed through high performance liquid chromatography (HPLC) coupled to ultraviolet-visible (UV-Vis) detector. The elution was accomplished at wavelength of 254 nm by injecting 20 µL of standards or samples into chromatographic system. The mobile phase consisted of acetonitrile and water (80:20 v/v), where the flow rate was adjusted at 1.0 ml/min. The linearity was good (R 2 ≥ 0.994) over a concentration range from 20 to 100 μg/ml for the investigated pesticides. The low detection limits showed a quite appreciable potential of the method to detect (1.12-1.61 μg/L) and quantify (3.73-5.36 μg/ml) the pesticides under study. The accuracy was demonstrated in terms of percent recovery which ranged between 88.5% and 116.9% for all the pesticides under investigation. These results justify the suitability of the technique for the intended purpose. The concentration of difenoconazole in apple gourd (20.97 mg/kg), cauliflower (10.28 mg/kg), and sponge gourd (40.32 mg/kg) whereas diafenthiuron in cauliflower (0.66 mg/kg) exceeded the maximum residue level (MRLs) as defined by Food and Agriculture Organization of the United Nations and the World Health Organization (FAO/WHO). Target hazard quotient (THQ) values of difenoconazole and diafenthiuron (except for adults) were more than one which indicates the significant effect on human health on consumption of apple gourd, cauliflower, and sponge gourd.
Fulltext Genetic Testing for Cancer Risk: Is the Community Willing to Pay for It?

Aizuddin AN, Ramdzan AR, Syed Omar SA, Mahmud Z, Latiff ZA, Amat S, et al.

Int J Environ Res Public Health, 2021 Aug 19;18(16).
PMID: 34444499 DOI: 10.3390/ijerph18168752

With the increasing number of cancer cases worldwide, genetic testing for familiar cancers seems inevitable, yet little is known on population interest and the monetary value for cancer genetic risk information. The current study aimed to determine the willingness to undergo and pay for cancer genetic testing among the Malaysian population. A self-administered questionnaire was distributed to cancer patients and their family members in the oncology and daycare units in several government hospitals. Of 641 respondents (354 patients, 287 family members), 267 (41.7%) were willing to undergo cancer genetic testing. The median that respondents were willing to pay was USD 48.31 (MYR 200.00) IQR USD 96.91 (MYR 400), while 143 (22.3%) respondents were willing to pay a shared cost with the insurance company. Regression analysis identified independent positive predictors of willingness to pay as respondent's status as a family member, high education level, and willingness to undergo cancer genetic testing in general, while in patients, female gender and high level of education were identified as independent positive predictors. Generally, the population needs more information to undergo and pay for cancer genetic testing. This will increase the utilization of the services offered, and with cost-sharing practices with the provider, it can be implemented population-wide.