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Fulltext Outbreak management during the worst flood disaster of 2006–2007 in Johore, Malaysia

Arbaiah, O., Badrul, H.A.S., Marzukhi, M.I., Mohd Yusof, Badaruddin, M., Mohd Adam

Malaysian Journal of Community Health, 2009;15(3):111-118.
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Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.
Fulltext The efficacy of over-the-counter (otc) artificial tears in treating dry eye syndrome

Mohd Adam Bin Mohd Zaed, Noor Munirah Binti Awang Abu Bakar, Mohd Zaki Awg. Isa

Journal of Optometry, Eye and Health Research, 2019;1(1):39-48.
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Introduction: Dry eye syndrome (DES) is an ocular condition characterized in decreasing of Tears Break-up Time (TBUT) leads to ocular irritation and loss of cornea integrity. Lubricants are the first-line treatment for various causes of ocular irritation, particularly dry eye. This study aimed to compare the effectiveness of Systane Hydration Lubricant (SHL) Eye Drops and Optive Fusion Lubricant (OFL) Eye Drops, the over-the-counter (OTC) artificial tears in treating DES. Materials and Methods: Ocular Surface Disease Index (OSDI) questionnaire and TBUT assessment (pre-treatment) were used to determine DES of the subject prior to their involvement in the study. The subjects then divided into two groups which were prescribed with either SHL or OFL. All subjects were instructed to instill two drops of eye drops twice a day for a duration of one week, after which the TBUT (post-treatment) was re-assessed again. Results: A total of forty (40) eyes involved in this study with the mean age was 22.65 (SD: 3.09) years old, OSDI was 29.91 (SD:19.75) and TBUT (pre-treatment) was 3.35 (SD:1.03) second and TBUT (post treatment) was 4.18 (SD0.98) second respectively. There was no significant difference in TBUT (post-treatment) between SHL and OFL Eye Drops (U = 181, p = 0.58). However, a significant difference was found between pre-treatment TBUT and post-treatment TBUT in both groups (p < 0.05). Conclusion: Systane Hydration Lubricant Eye Drops and Optive Fusion Lubricant Eye Drops are equally effective in treating DES by improving the TBUT among the subjects. Therefore, optometrists are recommended to prescribe OTC artificial tears to patients with DES.
Fulltext Determinants of uncontrolled dyslipidaemia among adult type 2 diabetes in Malaysia: the Malaysian Diabetes Registry 2009

Chew BH, Ismail M, Lee PY, Taher SW, Haniff J, Mustapha FI, et al.

Diabetes Res Clin Pract, 2012 Jun;96(3):339-47.
PMID: 22305940 DOI: 10.1016/j.diabres.2012.01.017

Numerous studies with compelling evidence had shown a clear relationship between dyslipidaemia and cardiovascular (CV) events in patients with diabetes mellitus. This was an observational study based on secondary data from the online registry database Adult Diabetes Control and Management (ADCM) looking into the determinants of uncontrolled dyslipidaemia in type 2 diabetes mellitus patients. Independent predictors were identified using multivariate logistic regression. A total of 303 centres (289 health clinics, 14 hospitals) contributed a total of 70,889 patients (1972 or 2.8% patients were from hospital). About thirty eight percent were reported to have dyslipidaemia. There were 40.7% patients on lipid-lowering agents and of those above age 40 years old, only 38.1% of them were on a statin. Malay ethnicity and younger age groups (<50 years old) were two major determinants of uncontrolled LDL-C, TG and HDL-C. Female gender and uncontrolled blood pressure were determinants of uncontrolled LDL-C, and poor glycaemic control was related independently to high TG. This study has highlighted the suboptimal management of diabetic dyslipidaemia in Malaysia. Pharmacological treatment of dyslipidaemia could be more effective. Healthcare stakeholders in this country, especially in the primary care, have to recognize these shortfalls and take immediate remedial measures.
Age ≥ 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors in patients with type 2 diabetes mellitus

Chew BH, Ghazali SS, Ismail M, Haniff J, Bujang MA

Exp Gerontol, 2013 May;48(5):485-91.
PMID: 23454736 DOI: 10.1016/j.exger.2013.02.017

Providing effective medical care for older patients with type 2 diabetes mellitus (T2D) that may contribute to their active aging has always been challenging. We examined the independent effect of age ≥ 60 years on disease control and its relationship with diabetes-related complications in patients with T2D in Malaysia. This was a cross-sectional study using secondary data from the electronic diabetes registry database Adult Diabetes Control and Management (ADCM). A total of 303 centers participated and contributed a total of 70,889 patients from May 2008 to the end of 2009. Demographic data, details on diabetes, hypertension, dyslipidemia and their treatment modalities, various risk factors and complications were updated annually. Independent associated risk factors were identified using multivariate regression analyses. Fifty-nine percent were female. Malay comprised 61.9%, Chinese 19% and Indian 18%. There were more Chinese, men, longer duration of diabetes and subjects that were leaner or had lower BMI in the older age group. Patients aged ≥ 60 years achieved glycemic and lipid targets but not the desired blood pressure. After adjusting for duration of diabetes, gender, ethnicity, body mass index, disease control and treatment, a significantly higher proportion of patients ≥ 60 years suffered from reported diabetes-related complications. Age ≥ 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors. Our findings caution against the currently recommended control of targets in older T2D patients with more longstanding diseases and complications.
Study name: Adult Diabetes Control and Management (ADCM) 2009
Simulated gastrointestinal digestion of camel and bovine casein hydrolysates: Identification and characterization of novel anti-diabetic bioactive peptides

Mudgil P, Kamal H, Priya Kilari B, Mohd Salim MAS, Gan CY, Maqsood S

Food Chem, 2021 Aug 15;353:129374.
PMID: 33740505 DOI: 10.1016/j.foodchem.2021.129374

Camel milk proteins are an important substrate for bioactive peptides generation. This study investigates in-vitro antidiabetic effect (via inhibition of α-amylase (AA), α-glucosidase (AG) and dipeptidyl peptidase IV (DPP-IV)) of bovine (BC) and camel casein (CC) hydrolysates. Further, effect of simulated gastrointestinal digestion (SGID) on inhibitory potential of generated hydrolysates was also explored. Both BC and CC hydrolysates displayed potent inhibitory properties against AA (IC50 value- 0.58 & 0.59 mg/mL), AG (IC50 value- 1.04 & 0.59 mg/mL) and DPP-IV (IC50 value- 0.62 & 0.66 mg/mL), respectively. Among different peptides identified in BC and CC hydrolysates, it was observed that FLWPEYGAL was predicted to be most potent inhibitory peptide against AA. While LPTGWLM, MFE and GPAHCLL as most active inhibitor of AG and HLPGRG, QNVLPLH and PLMLP were predicted to be active against DPP-IV. Overall, BC and CC hydrolysates can be proposed to be used in different food formulations as functional antidiabetic agents.
Fulltext Determinants of uncontrolled hypertension in adult type 2 diabetes mellitus: an analysis of the Malaysian diabetes registry 2009

Chew BH, Mastura I, Shariff-Ghazali S, Lee PY, Cheong AT, Ahmad Z, et al.

Cardiovasc Diabetol, 2012;11:54.
PMID: 22607105 DOI: 10.1186/1475-2840-11-54

BACKGROUND: Uncontrolled blood pressure (BP) is a significant contributor of morbidity and even mortality in type 2 diabetes (T2D) patients. This study was done to determine the significant determinants of uncontrolled blood pressure in T2D patients in Malaysia.
METHODS: Between 1st January 2009 to 31st December 2009, data from 70 889 patients with Type 2 diabetes was obtained from the Adult Diabetes Control and Management Registry for analysis; 303 centers participated in the study. Their demographic characteristics, the nature of their diabetes, their state of hypertension, treatment modalities, risk factors, and complications are described. Based on their most recent BP values, subjects were divided into controlled BP and uncontrolled BP and their clinical determinants compared. Independent determinants were identified using multivariate logistic regression.
RESULTS: The mean age of patients at diagnosis of diabetes was 52.3 +/- 11.1 years old. Most were women (59.0 %) and of Malay ethnicity (61.9 %). The mean duration of diabetes was 5.9 +/- 5.6 years. A total of 57.4 % were hypertensive. Of the 56 503 blood pressure (BP) measured, 13 280 (23.5 %) patients had BP <130/80 mmHg. Eighteen percent was on > two anti-hypertensive agents. Health clinics without doctor, older age (>/= 50 years old), shorter duration of diabetes (< 5 years), Malay, overweight were determinants for uncontrolled blood pressure (BP >/=130/80 mmHg). Patients who were on anti-hypertensive agent/s were 2.7 times more likely to have BP >/=130/80 mmHg. Type 2 diabetes patients who had ischaemic heart disease or nephropathy were about 20 % and 15 % more likely to have their blood pressure treated to target respectively.
CONCLUSIONS: Major independent determinants of uncontrolled BP in our group of T2D patients were Malay ethnicity, older age, recent diagnosis of diabetes, overweight and follow-up at health clinics without a doctor and possibly the improper use of anti hypertensive agent. More effort, education and resources, especially in the primary health care centres are needed to improve hypertensive care among our patients with diabetes.
Fulltext Rural-urban comparisons of dengue seroprevalence in Malaysia

Chew CH, Woon YL, Amin F, Adnan TH, Abdul Wahab AH, Ahmad ZE, et al.

BMC Public Health, 2016 08 18;16(1):824.
PMID: 27538986 DOI: 10.1186/s12889-016-3496-9

BACKGROUND: Each year an estimated 390 million dengue infections occur worldwide. In Malaysia, dengue is a growing public health concern but estimate of its disease burden remains uncertain. We compared the urban-rural difference of dengue seroprevalence and determined age-specific dengue seroprevalence in Malaysia.
METHODS: We undertook analysis on 11,821 subjects from six seroprevalence surveys conducted in Malaysia between 2001 and 2013, which composed of five urban and two rural series.
RESULTS: Prevalence of dengue increased with age in both urban and rural locations in Malaysia, which exceeded 90 % among those aged 70 years or beyond. The age-specific rates of the 5 urban surveys overlapped without clear separation among them, while prevalence was lower in younger subjects in rural series than in urban series, the trend reversed in older subjects. There were no differences in the seroprevalence by gender, ethnicity or region. Poisson regression model confirmed the prevalence have not changed in urban areas since 2001 but in rural areas, there was a significant positive time trend such that by year 2008, rural prevalence was as high as in urban areas.
CONCLUSION: Dengue seroprevalence has stabilized but persisted at a high level in urban areas since 2001, and is fast stabilizing in rural areas at the same high urban levels by 2008. The cumulative seroprevalence of dengue exceeds 90 % by the age of 70 years, which translates into 16.5 million people or 55 % of the total population in Malaysia, being infected by dengue by 2013.