Displaying publications 121 - 140 of 145 in total

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  1. Impact of angiotensin-converting enzyme inhibitors administration prior to acute ischemic stroke onset on in-hospital mortality
    Hassan Y, Aziz NA, Al-Jabi SW, Looi I, Zyoud SH
    J Cardiovasc Pharmacol Ther, 2010 Sep;15(3):274-81.
    PMID: 20624923 DOI: 10.1177/1074248410373751
    Angiotensin-converting enzyme inhibitors (ACEIs) have shown promising results in decreasing the incidence and the severity of ischemic stroke in populations at risk and in improving ischemic stroke outcomes.
    Matched MeSH terms: Diabetes Complications/mortality
  2. Fulltext The impact of physical activity on cumulative cardiovascular disease risk factors among Malaysian adults
    Rasiah R, Thangiah G, Yusoff K, Manikam R, Chandrasekaran SK, Mustafa R, et al.
    BMC Public Health, 2015;15:1242.
    PMID: 26673166 DOI: 10.1186/s12889-015-2577-5
    Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups.
    Matched MeSH terms: Diabetes Complications
  3. Current status of cholesterol goal attainment after statin therapy among patients with hypercholesterolemia in Asian countries and region: the Return on Expenditure Achieved for Lipid Therapy in Asia (REALITY-Asia) study
    Kim HS, Wu Y, Lin SJ, Deerochanawong C, Zambahari R, Zhao L, et al.
    Curr Med Res Opin, 2008 Jul;24(7):1951-63.
    PMID: 18547466 DOI: 10.1185/03007990802138731
    BACKGROUND: Data on achieving National Cholesterol Education Program Adult Treatment Panel III (ATP III) goals in Asia are limited.

    OBJECTIVE: To examine treatment patterns, goal attainment, and factors influencing treatment among patients in 6 Asian countries who were taking statins.

    METHODS: A retrospective cohort study was conducted in China, Korea, Malaysia, Singapore, Taiwan, and Thailand, where 437 physicians (41% cardiologists) recruited adults with hypercholesterolemia newly initiated on statin monotherapy.

    RESULTS: Of 2622 patients meeting inclusion and exclusion criteria, approximately 66% had coronary heart disease (CHD)/diabetes mellitus, 24% had no CHD but > or =2 risk factors, and 10% had no CHD and <2 risk factors. Most patients ( approximately 90%) received statins at medium or lower equipotency doses. Across all cardiovascular risk categories, 48% of patients attained ATP III targets for low-density lipoprotein cholesterol (LDL-C), including 38% of those with CHD/diabetes (goal: <100 mg/dL), 62% of those without CHD but with > or =2 risk factors (goal: <130 mg/dL), and 81% of those without CHD and <2 risk factors (goal: <160 mg/dL). Most patients who achieved goals did so within the first 3 months. Increasing age (odds ratio (OR)=1.015 per 1-year increment; 95% confidence interval (CI)=1.005-1.206; p=0.0038) and initial statin potency (OR=2.253; 95% CI=1.364-3.722; p=0.0015) were directly associated with goal attainment, whereas increased cardiovascular risk (OR=0.085; 95% CI=0.053-0.134; p<0.0001 for CHD/diabetes mellitus at baseline compared with <2 risk factors,) and baseline LDL-C (OR=0.990; 95% CI=0.987-0.993); p<0.0001 per 1-mg/dL increment) were inversely associated with LDL-C goal achievement. Limitations of this study include potential differences in treatment settings and cardiovascular risk factors between different countries and centers. In addition, the effects on cholesterol goal achievement of concomitant changes in lifestyle were not assessed.

    CONCLUSION: LDL-C goal attainment is low in Asians, particularly those with CHD/diabetes. More effective patient monitoring, treatments, including combining regimens and dose titration, and adherence to these treatments along with therapeutic lifestyle counseling may facilitate goal attainment.

    Matched MeSH terms: Diabetes Complications
  4. Fulltext Risk factors and outcome of dysphagia after an acute ischaemic stroke
    Hamidon BB, Nabil I, Raymond AA
    Med J Malaysia, 2006 Dec;61(5):553-7.
    PMID: 17623955 MyJurnal
    Dysphagia occurs frequently after a stroke. It is a major problem as patients are at risk of malnutrition and aspiration pneumonia. We aimed to identify the risk factors for and outcome of dysphagia over the first one month after an acute ischaemic stroke. Patients with acute first-ever ischaemic stroke admitted to the medical ward of Hospital Universiti Kebangsaan Malaysia (HUKM) between July 2004 and December 2004 were prospectively examined. Observation was done using pre-defined criteria. Demographic data, risk factors, and type of stroke were recorded on admission. The assessment of dysphagia was made using standardized clinical methods. All patients were followed up for three months. One hundred and thirty four patients were recruited in the study. Fifty-five patients (41%) had dysphagia at presentation. This number was reduced to 29 (21.6%) patients at one month. Logistic regression analysis revealed that age of more than 75 years [OR 5.20 (95% CI 1.89 - 14.30)], diabetes mellitus [OR 2.91 (95% CI 1.07 - 7.91)] and MCA infarct [OR 2.48 (95% CI 1.01-6.14)] independently predicts the occurrence of dysphagia after an acute stroke. Dysphagia at presentation was found to be an independent predictor of mortality at one-month [OR 5.28 (95% CI 1.51-18.45)] post ischaemic infarct. Dysphagia occurred commonly in ischaemic stroke. Advance age, diabetes mellitus and large infarcts were independently associated with the presence of dysphagia. Early stroke mortality can be independently predicted by the presence of dysphagia.
    Matched MeSH terms: Diabetes Complications
  5. Pulmonary tuberculosis in a hospital setting: gender differences
    Nissapatorn V, Kuppusamy I, Sim BL, Fatt QK, Anuar AK
    Public Health, 2006 May;120(5):441-3.
    PMID: 16545406 DOI: 10.1016/j.puhe.2005.11.005
    Matched MeSH terms: Diabetes Complications
  6. Prevalence of peripheral artery disease in urban high-risk Malaysian patients
    Amudha K, Chee KH, Tan KS, Tan CT, Lang CC
    Int J Clin Pract, 2003 Jun;57(5):369-72.
    PMID: 12846339
    Atherosclerosis is a progressive, disseminated condition that affects all the vascular beds. Peripheral arterial disease (PAD), a manifestation of atherosclerosis, measured non-invasively in the legs by ankle-brachial index (ABI) is associated with increased cardiovascular morbidity and mortality. Though several studies in the western industrialised countries have shown that PAD is widely prevalent in the general older population at risk, not much data are available in the South East Asian developing countries. We have conducted an epidemiological survey on the prevalence of PAD in high-risk patients at an urban hospital in Malaysia. A total of 301 consecutive patients aged 32-90 years were recruited during their follow-up clinic visits for established cardiovascular disease, ischaemic stroke or diabetes mellitus > or = 5 years. All participants underwent ABI measurement and were subjected to the Edinburgh claudication questionnaire to assess leg symptoms. The prevalence of PAD in our high-risk population was 23%, of which only 27% were symptomatic with the classical intermittent claudication. All the patients with PAD were diagnosed at the time of the study. PAD was found in 33% of patients with pre-existent cardiovascular disease, 28% in patients with ischaemic stroke and 24% in diabetic patients. PAD was also highly prevalent among the younger patients. Our study has shown that PAD is highly prevalent among high-risk Malaysian patients and is not necessarily a disease of older age. Only 27% of these patients were symptomatic. All the subjects with PAD were diagnosed at the time of the study, which would suggest it is an unrecognised and underdiagnosed condition, even in patients with atherosclerotic risk factors.
    Matched MeSH terms: Diabetes Complications
  7. Fulltext Prevalence of diabetes, hypertension and renal disease amongst railway workers in Malaysia
    Khalid BA, Usha R, Ng ML, Norella Kong CT, Tariq AR
    Med J Malaysia, 1990 Mar;45(1):8-13.
    PMID: 2152075
    A survey was done to determine the prevalence of diabetes mellitus, hypertension and renal disease, as well as extent of diabetic control, amongst the workers of Malaysian Railways. The prevalence of diabetes was high at 6.6%, with 3.8% of these being insulin dependent diabetes. The highest prevalence was in Indians (16.0%) followed by Chinese (4.9%) and Malays (3.0%). Using HbA1 measurements, diabetic control was poor in 70.6% of the diabetics. Hypertension was found in 37% and proteinuria in 35%. Renal impairment was present in 30% of the diabetics. This survey shows that diabetes, hypertension and renal disease are high amongst the railway workers in Malaysia.
    Matched MeSH terms: Diabetes Complications
  8. Fulltext Hypertension and associated cardiovascular risk factors in Kelantan
    Mafauzy M, Mokhtar N, Wan Mohamad WB
    Med J Malaysia, 2003 Oct;58(4):556-64.
    PMID: 15190632
    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 hypertension and their association with cardiovascular risk factors. The overall prevalence of hypertension was 13.9%. There was no difference in the prevalence of hypertension between the males and females. The prevalence increased with age--the highest being in those above 70-years old. Subjects with hypertension also had a higher prevalence of diabetes mellitus (19.0%), obesity (39.4%) and hypercholesterolaemia (70.7%) than non-hypertensive subjects. Of the hypertensive subjects, 83.3% had 1 other risk factor for cardiovascular disease, 66.7% had 2 other risk factors and 16.7% had more than 2 risk factors. Other than age, body mass index, plasma glucose, total cholesterol and LDL-cholesterol, hypertensive subjects also had a higher mean serum urea, creatinine, uric acid and triglyceride than non-hypertensive subjects. In conclusion, hypertension is a common disease in this area and is associated with multiple risk factors for cardiovascular disease. The prevalence is likely to increase in the near future with increasing affluence and becoming a major health problem.
    Matched MeSH terms: Diabetes Complications
  9. Burkholderia cepacia: a rare cause of bacterial keratitis
    Ibrahim M, Yap JY
    BMJ Case Rep, 2018 Apr 25;2018.
    PMID: 29695396 DOI: 10.1136/bcr-2018-224552
    We describe the first clinical case of Burkholderia cepacia keratitis registered in Southeast Asia. A man in his mid-70s with underlying poorly controlled diabetes mellitus came with complaints of painful red left eye for 4 days. This was accompanied with photophobia and blurring of vision after being injured by a wooden particle while cutting grass. Slit-lamp examination showed a paracentral anterior corneal stromal infiltrates with overlying epithelial defect. Culture of the corneal smear isolated B. cepacia that was sensitive to ceftazidime, meropenem and bactrim (trimethorprim and sulfomethoxazole). Topical ceftazidime was given intensively to the patient and the infection resolved after 6 weeks of treatment.
    Matched MeSH terms: Diabetes Complications
  10. Fulltext Systemic doxycycline as an adjunct to scaling and root planing in diabetic patients with periodontitis: a systematic review and meta-analysis
    Yap KCH, Pulikkotil SJ
    BMC Oral Health, 2019 09 05;19(1):209.
    PMID: 31488125 DOI: 10.1186/s12903-019-0873-7
    BACKGROUND: To compare the effectiveness of systemic doxycycline as an adjunct to scaling and root planing (SRP) with SRP alone in improving periodontal clinical attachment level and glycemic control in diabetic patients with periodontitis.

    METHODS: Two independent reviewers (KY and SJ) screened two electronic databases, PubMed and Scopus, for randomized clinical trials on the use of systemic doxycycline as an adjunct to scaling and root planing in improving periodontal status and glycemic control in diabetic patients with periodontitis using predetermined selection criteria within a 3-month period. The reviewers independently did data screening, data selection, data extraction and risk of bias. Quality of studies involved was analysed using the revised Cochrane Risk of Bias 2.0. Weighted standard mean differences (SMD) and 95% confidence intervals were calculated using a random effects meta-analysis model. Publication bias was evaluated using funnel plot. Quality of evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

    RESULTS: Electronic searches provided 1358 records and six studies were selected. The meta-analyses indicated that there was no statistically significant difference in the improvement of periodontal status with the use of systemic doxycycline as an adjunct for scaling and root planing (SRP). SMD of clinical attachment levels (- 0.22 [- 0.52, 0.08]) and HbA1c levels (- 0.13 [- 0.41, 0.15]) were calculated. Overall risk of bias is high in 2 out of 6 studies involved.

    CONCLUSION: Systemic doxycycline when used in addition to scaling and root planing yields no significant improvement of clinical attachment levels for periodontal status and reduction of HbA1c levels in treatment of diabetic patients with periodontitis when comparing the test group to the control group.

    Matched MeSH terms: Diabetes Complications
  11. Admission Clinicopathological Factors Associated with Prolonged Hospital Stay Among Hospitalized Patients with Dengue Viral Infections
    Willeam Peter SS, Hassan SS, Khei Tan VP, Ngim CF, Azreen Adnan NA, Pong LY, et al.
    Vector Borne Zoonotic Dis, 2019 07;19(7):549-552.
    PMID: 30668248 DOI: 10.1089/vbz.2018.2379
    Background:
    There is an escalation of frequency and magnitude of dengue epidemics in Malaysia, with a concomitant increase in patient hospitalization. Prolonged hospitalization (PH) due to dengue virus (DENV) infections causes considerable socioeconomic burden. Early identification of patients needing PH could optimize resource consumption and reduce health care costs. This study aims to identify clinicopathological factors present on admission that are associated with PH among patients with DENV infections.
    Methods:
    This study was conducted in a tertiary referral hospital in Southern Malaysia. Relevant clinical and laboratory data upon admission were retrieved from medical records of 253 consecutive DENV nonstructural protein 1 (NS1) antigen and PCR-positive hospitalized patients. The DENV serotype present in each patient was determined. Patients were stratified based on duration of hospital stay (<4 vs. ≥4 days). Data were analyzed using IBM® SPSS® 25.0. Multivariate logistic regression was performed to examine the association between PH and admission parameters.
    Results:
    Of 253 DENV hospitalized patients, 95 (37.5%) had PH (≥4 days). The mean duration of hospital stay was 3.43 ± 2.085 days (median = 3 days, interquartile range = 7 days). Diabetes mellitus (adjusted odds ratio [AOR] = 6.261, 95% confidence interval [CI] = 2.130-18.406, p = 0.001), DENV-2 serotype (AOR = 2.581, 95% CI = 1.179-5.650, p = 0.018), duration of fever ≤4 days (AOR = 2.423, 95% CI = 0.872-6.734, p = 0.09), and a shorter preadmission fever duration (AOR = 0.679, 95% CI = 0.481-0.957, p = 0.027) were independently associated with PH. However, PH was not found to be associated with symptoms on admission, secondary DENV infections or platelet count, hematocrit, or liver enzyme levels on admission.
    Conclusions:
    Early identification of these factors at presentation may alert clinicians to anticipate and recognize challenges in treating such patients, leading to more focused management plans that may shorten the duration of hospitalization.
    Matched MeSH terms: Diabetes Complications
  12. Fulltext Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study
    Salman M, Khan AH, Adnan AS, Sulaiman SA, Hussain K, Shehzadi N, et al.
    Rev Assoc Med Bras (1992), 2016 Nov;62(8):742-747.
    PMID: 27992014 DOI: 10.1590/1806-9282.62.08.742
    Objective:: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy.

    Method:: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.

    Results:: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.

    Conclusion:: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

    Matched MeSH terms: Diabetes Complications
  13. Fulltext Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States
    Arnold M, Freisling H, Stolzenberg-Solomon R, Kee F, O'Doherty MG, Ordóñez-Mena JM, et al.
    Eur J Epidemiol, 2016 Sep;31(9):893-904.
    PMID: 27300353 DOI: 10.1007/s10654-016-0169-z
    Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI ≥ 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12-1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.
    Matched MeSH terms: Diabetes Complications
  14. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study
    O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al.
    Lancet, 2016 Aug 20;388(10046):761-75.
    PMID: 27431356 DOI: 10.1016/S0140-6736(16)30506-2
    BACKGROUND:Stroke is a leading cause of death and disability, especially in low-income and middle-income countries. We sought to quantify the importance of potentially modifiable risk factors for stroke in different regions of the world, and in key populations and primary pathological subtypes of stroke.
    METHODS:We completed a standardised international case-control study in 32 countries in Asia, America, Europe, Australia, the Middle East, and Africa. Cases were patients with acute first stroke (within 5 days of symptom onset and 72 h of hospital admission). Controls were hospital-based or community-based individuals with no history of stroke, and were matched with cases, recruited in a 1:1 ratio, for age and sex. All participants completed a clinical assessment and were requested to provide blood and urine samples. Odds ratios (OR) and their population attributable risks (PARs) were calculated, with 99% confidence intervals.
    FINDINGS: Between Jan 11, 2007, and Aug 8, 2015, 26 919 participants were recruited from 32 countries (13 447 cases [10 388 with ischaemic stroke and 3059 intracerebral haemorrhage] and 13 472 controls). Previous history of hypertension or blood pressure of 140/90 mm Hg or higher (OR 2·98, 99% CI 2·72-3·28; PAR 47·9%, 99% CI 45·1-50·6), regular physical activity (0·60, 0·52-0·70; 35·8%, 27·7-44·7), apolipoprotein (Apo)B/ApoA1 ratio (1·84, 1·65-2·06 for highest vs lowest tertile; 26·8%, 22·2-31·9 for top two tertiles vs lowest tertile), diet (0·60, 0·53-0·67 for highest vs lowest tertile of modified Alternative Healthy Eating Index [mAHEI]; 23·2%, 18·2-28·9 for lowest two tertiles vs highest tertile of mAHEI), waist-to-hip ratio (1·44, 1·27-1·64 for highest vs lowest tertile; 18·6%, 13·3-25·3 for top two tertiles vs lowest), psychosocial factors (2·20, 1·78-2·72; 17·4%, 13·1-22·6), current smoking (1·67, 1·49-1·87; 12·4%, 10·2-14·9), cardiac causes (3·17, 2·68-3·75; 9·1%, 8·0-10·2), alcohol consumption (2·09, 1·64-2·67 for high or heavy episodic intake vs never or former drinker; 5·8%, 3·4-9·7 for current alcohol drinker vs never or former drinker), and diabetes mellitus (1·16, 1·05-1·30; 3·9%, 1·9-7·6) were associated with all stroke. Collectively, these risk factors accounted for 90·7% of the PAR for all stroke worldwide (91·5% for ischaemic stroke, 87·1% for intracerebral haemorrhage), and were consistent across regions (ranging from 82·7% in Africa to 97·4% in southeast Asia), sex (90·6% in men and in women), and age groups (92·2% in patients aged ≤55 years, 90·0% in patients aged >55 years). We observed regional variations in the importance of individual risk factors, which were related to variations in the magnitude of ORs (rather than direction, which we observed for diet) and differences in prevalence of risk factors among regions. Hypertension was more associated with intracerebral haemorrhage than with ischaemic stroke, whereas current smoking, diabetes, apolipoproteins, and cardiac causes were more associated with ischaemic stroke (p<0·0001).
    INTERPRETATION: Ten potentially modifiable risk factors are collectively associated with about 90% of the PAR of stroke in each major region of the world, among ethnic groups, in men and women, and in all ages. However, we found important regional variations in the relative importance of most individual risk factors for stroke, which could contribute to worldwide variations in frequency and case-mix of stroke. Our findings support developing both global and region-specific programmes to prevent stroke.
    FUNDING: Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Health Research Board Ireland, Swedish Research Council, Swedish Heart and Lung Foundation, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland (Sweden), AstraZeneca, Boehringer Ingelheim (Canada), Pfizer (Canada), MSD, Chest, Heart and Stroke Scotland, and The Stroke Association, with support from The UK Stroke Research Network.
    Matched MeSH terms: Diabetes Complications/epidemiology; Diabetes Complications/prevention & control
  15. Health burden associated with visual impairment in Singapore: the Singapore epidemiology of eye disease study
    Wang X, Lamoureux E, Zheng Y, Ang M, Wong TY, Luo N
    Ophthalmology, 2014 Sep;121(9):1837-42.
    PMID: 24768238 DOI: 10.1016/j.ophtha.2014.03.017
    To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore.
    Matched MeSH terms: Diabetes Complications
  16. Fulltext Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia
    Hassan MR, Pani SP, Peng NP, Voralu K, Vijayalakshmi N, Mehanderkar R, et al.
    BMC Infect Dis, 2010;10:302.
    PMID: 20964837 DOI: 10.1186/1471-2334-10-302
    Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited.
    Matched MeSH terms: Diabetes Complications
  17. Fulltext Melioidotic septic arthritis: a case report and literature review
    Raja NS
    J Microbiol Immunol Infect, 2007 Apr;40(2):178-82.
    PMID: 17446969
    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in southeast Asia and northern Australia. In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare but well-recognized manifestation of melioidosis. Patients with underlying medical conditions, such as diabetes mellitus, renal impairment, cirrhosis, and malignancy are at greater risk. The presentations of melioidotic septic arthritis often mimic other disease processes and patients may not always be clinically septic. We present a case of septic arthritis due to B. pseudomallei in a 66-year-old male with diabetes mellitus presenting with a history of fever and ankle swelling. Follow-up ankle X-ray showed soft tissue swelling. Synovial fluid and blood samples grew B. pseudomallei. The patient improved gradually after parenteral administration of ceftazidime (2 g 8-hourly) and cotrimoxazole (1440 mg 8-hourly). He was discharged on oral cotrimoxazole (1440 mg 12-hourly), doxycycline (100 mg 12-hourly), and chloramphenicol (500 mg 6-hourly) for 6 months. This case highlights the possible occurrence of melioidotic septic arthritis, and the importance of prompt initiation of appropriate antimicrobials to achieve good outcomes.
    Study site: Emergency department, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Diabetes Complications
  18. Prevalence of diabetes and ethnic differences in cardiovascular risk factors. The 1992 Singapore National Health Survey
    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: Diabetes Complications
  19. Diabetes mellitus in peninsular Malaysia: ethnic differences in prevalence and complications
    Mustaffa BE
    Ann Acad Med Singap, 1985 Apr;14(2):272-6.
    PMID: 4037685
    Estimated prevalence of diabetes mellitus in Malaysia was about 2%. Diabetes was most common in Indians especially males and least common in Chinese. There was a slight male preponderance seen in Malays and Indians. Positive family history was obtained in 14% of cases most commonly in Malays, almost 1/3 of whom had more than one family member with diabetes. Familial association was uncommon in Chinese. Over 50% of patients were overweight. Obesity was noted in nearly 70% of female Malays and Indians while the majority of Chinese were not overweight. More than 80% of patients were non insulin requiring. Youth onset diabetes was considered rare; those 10 years and below were estimated to be only 0.4% and below 20 years of age between 2%-4% of the diabetic population. Females were twice as common than males in this type of diabetes and familial association was greater. Malnutrition-related diabetes and pancreatic calcification were not well-documented but youth-onset non insulin requiring diabetics with mild symptoms but strong family history of diabetes were observed. More than half of hospital-based patients had evidence of complications, mainly amongst Malays and Indians. Hypertension was the most frequent associated disease followed by foot ulcers and ischaemic heart disease. Hypertension usually associated with chronic renal failure was most common amongst Malays while gangrenic ulcers and heart diseases were seen mainly in Indians. The major causes of death were chronic renal failure, myocardial infarction, ketoacidosis, stroke and septicaemia related to gangrene.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Diabetes Complications
  20. Fulltext Molecular and Biochemical Pathways of Catalpol in Alleviating Diabetes Mellitus and Its Complications
    Bhattamisra SK, Koh HM, Lim SY, Choudhury H, Pandey M
    Biomolecules, 2021 02 20;11(2).
    PMID: 33672590 DOI: 10.3390/biom11020323
    Catalpol isolated from Rehmannia glutinosa is a potent antioxidant and investigated against many disorders. This review appraises the key molecular pathways of catalpol against diabetes mellitus and its complications. Multiple search engines including Google Scholar, PubMed, and Science Direct were used to retrieve publications containing the keywords "Catalpol", "Type 1 diabetes mellitus", "Type 2 diabetes mellitus", and "diabetic complications". Catalpol promotes IRS-1/PI3K/AKT/GLUT2 activity and suppresses Phosphoenolpyruvate carboxykinase (PEPCK) and Glucose 6-phosphatase (G6Pase) expression in the liver. Catalpol induces myogenesis by increasing MyoD/MyoG/MHC expression and improves mitochondria function through the AMPK/PGC-1α/PPAR-γ and TFAM signaling in skeletal muscles. Catalpol downregulates the pro-inflammatory markers and upregulates the anti-inflammatory markers in adipose tissues. Catalpol exerts antioxidant properties through increasing superoxide dismutase (sod), catalase (cat), and glutathione peroxidase (gsh-px) activity in the pancreas and liver. Catalpol has been shown to have anti-oxidative, anti-inflammatory, anti-apoptosis, and anti-fibrosis properties that in turn bring beneficial effects in diabetic complications. Its nephroprotective effect is related to the modulation of the AGE/RAGE/NF-κB and TGF-β/smad2/3 pathways. Catalpol produces a neuroprotective effect by increasing the expression of protein Kinase-C (PKC) and Cav-1. Furthermore, catalpol exhibits a cardioprotective effect through the apelin/APJ and ROS/NF-κB/Neat1 pathway. Catalpol stimulates proliferation and differentiation of osteoblast cells in high glucose condition. Lastly, catalpol shows its potential in preventing neurodegeneration in the retina with NF-κB downregulation. Overall, catalpol exhibits numerous beneficial effects on diabetes mellitus and diabetic complications.
    Matched MeSH terms: Diabetes Complications
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