Displaying all 11 publications

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  1. Ramli MI, Hamzaid NA, Engkasan JP
    J Voice, 2019 Jul 09.
    PMID: 31300185 DOI: 10.1016/j.jvoice.2019.06.006
    OBJECTIVES: The aim of this study was to investigate the performance of mechanomyography (MMG) and electromyography (EMG) in monitoring the sternocleidomastoid (SCM) as accessory respiratory muscles when breathing during singing.

    METHODS: MMG and EMG were used to record the activity of the SCM in 32 untrained singers reciting a monotonous text and a standard folk song. Their voices were recorded and their pitch, or fundamental frequency (FF), and intensity were derived using Praat software. Instants of inhale and exhales were identified during singing from their voice recordings and the corresponding SCM MMG and EMG activities were analysed.

    RESULTS: The SCM MMG, and EMG signals during breathing while singing were significantly different than breathing at rest (p < 0.001). On the other hand, MMG was relatively better correlated to voice intensity in both reading and singing than EMG. EMG was better, but not significantly, correlated with FF in both reading and singing as compared to MMG.

    CONCLUSIONS: This study established MMG and EMG as the quantitative measurement tool to monitor breathing activities during singing. This is useful for applications related to singing therapy performance measure including potentially pathologically effected population. While the MMG and EMG could not distinguish FF and intensity significantly, it is useful to serve as a proxy of inhalation and exhalation levels throughout a particular singing session. Further studies are required to determine its efficacy in a therapeutic setting.

    Matched MeSH terms: Exhalation
  2. Nurul Maizura Hashim, Zailina Hashim, Rukman Awang Hamat, Hayati Kadir
    MyJurnal
    Introduction: Water based Metalworking fluids (MWF) are commonly used in machining industries and are excellent media for microorganism growth. The study aimed at determining the relationship between the airway inflammation as indicated by fractional exhaled nitric oxide (FeNO) with the microbial contaminants of MWF in aerosol and bulk sample as well as the workers’ reported respiratory health symptoms. Methods: This cross sectional study was carried out on 138 machining workers. Their FeNO were measured using NIOX-MINO instrumentation. The microbial as- sessments of bacteria and fungus were carried out on the MWF bulk samples and the aerosol using a sampler DUO SAS SUPER 360TM. Results: Findings showed significant difference in the FeNO levels in workers from various job sections (p=0.01). Significant relationships found between high FeNO levels with their closeness to the machines (p=0.03), high number of machines in the workplaces (p=0.02), high environmental bacteria colonies (p=0.04), lon- ger employment years (p
    Matched MeSH terms: Exhalation
  3. Ng, C.G., Rusdi, A.R., Anne Yee, H.A.
    MyJurnal
    Objective: The aim of this study was to evaluate the validity and reliability of the Malay version of the Fagerstrom Test for Nicotine Dependence (FTND-M) based on a group of male staffs in the hospital. This study will also determine whether an abbreviated version of the FTND-M can be used as a screening tool for nicotine dependence. Method: 107 male staffs participated in the study. They were given the FTND-M and Malay version of Mini-International Neuropsychiatric Interview (M.I.N.I.)-L component. Their carbon monoxide level measured in their breath by using exhaled air. One week later, these participants were again given FTND-M. Results: The discriminatory ability of FTND-M was good with AUC 0.74 (P2 with the sensitivity of 70.1%, specificity of 70%, PPV of 79.7% and NPV of 58.3%. The FTND-M had moderate internal consistency with a Cronbach’s alpha of 0.67. The testretest reliability after 1 week was fair (Spearman’s rho=0.5, p)
    Matched MeSH terms: Exhalation
  4. Lim CS, Rani FA, Tan LE
    Clin Respir J, 2018 Jan;12(1):218-226.
    PMID: 27328740 DOI: 10.1111/crj.12518
    INTRODUCTION: To our knowledge, no meta-analysis has investigated the response of FeNO levels to corticosteroid treatment in ex-smokers with chronic obstructive pulmonary disease (COPD).

    OBJECTIVES: This meta-analysis assessed the potential role of fraction of exhaled nitric oxide (FeNO) as a biomarker for corticosteroid response in ex-smokers with stable COPD.

    METHODS: Medline, Cochrane, EMBASE, Google Scholar databases were searched until November 5, 2014 using the following terms: corticosteroid, chronic obstructive pulmonary disease, COPD, nitric oxide, NO, exhaled nitric oxide. Only randomized controlled trials (RCT) or two-arm prospective studies were included. The primary outcome measure was FeNO before and after treatment with inhaled corticosteroids (ICS) in ex-smokers with COPD. Sensitivity analysis was also performed.

    RESULTS: Five studies were included in the analysis with a total of 171 COPD patients. All five studies included 125 ex-smokers and two of these also included 46 current smokers. There was a significant decrease of FeNO in ex-smoking COPD patients following inhaled corticosteroid treatment (-7.51, 95% CI: -11.51 to -3.51; P =0.003); and in a population of subjects that included both smokers and ex-smokers (-1.99, 95% CI: -3.41 to -0.56; P =0.006).

    CONCLUSION: Our findings indicate that FeNO levels significantly decreased with corticosteroid treatment in ex-smokers with COPD. Additional studies are required to evaluate whether concurrent smoking has significant effect on FeNO response to ICS.
    Matched MeSH terms: Exhalation*
  5. Wee LH, West R, Mariapun J, Chan CM, Bulgiba A, Peramalah D, et al.
    Addict Behav, 2015 Aug;47:74-9.
    PMID: 25889913 DOI: 10.1016/j.addbeh.2015.03.021
    BACKGROUND: It has been proposed that the expired-air carbon monoxide (CO) threshold for confirming smoking abstinence in clinical practice be reduced below 10 ppm. Optimal thresholds may vary across regions. Data are needed to assess the impact of such a change on claimed success.
    METHODS: A total of 253 smokers who attended the Tanglin quit smoking clinic in Malaysia were followed-up 1, 3 and 6 months after the target quit date. All participants received a standard behavioural support programme and were prescribed either varenicline or nicotine replacement therapy. Expired-air CO was measured at every visit. Respondents' smoking status was assessed using a range of different CO thresholds (3, 5 and 10 ppm) and the impact on quit rates was calculated. Predictors of success as defined using the different thresholds were assessed.
    RESULTS: The 6-month abstinence rates were: 1 month - 54.9% at 10 ppm, 54.9% at 5 ppm and 48.6% at 3 ppm; 3 months - 36.0% at 10 ppm, 35.2% at 5 ppm and 30.4% at 3 ppm; 6 months - 24.1% at 10 ppm, 24.1% at 5 ppm and 20.6% at 3 ppm. Older smokers were more likely to be recorded as abstinent at 6 months regardless of the threshold used.
    CONCLUSIONS: Reducing the threshold for expired-air carbon monoxide concentrations to verify claimed smoking abstinence from 10 ppm to 5 ppm makes minimal difference to documented success rates in Malaysian smoker's clinic patients. Reducing to 3 ppm decreases success rates slightly. Predictors of success at stopping appear to be unaffected by the threshold used.
    KEYWORDS: Carbon monoxide; Predictors for abstinence; Smoking cessation; Success rates
    Matched MeSH terms: Exhalation*
  6. Singh OP, Ahmed IB, Malarvili MB
    Technol Health Care, 2018;26(5):785-794.
    PMID: 30124456 DOI: 10.3233/THC-181288
    BACKGROUND: Assessment of asthma outside of the hospital using a patient independent device is highly in demand due to the limitation of existing devices, which are manual and unreliable if patients are not cooperative.

    OBJECTIVE: The study aims to verify the use of newly developed human respiration, carbon dioxide (CO2) measurement device for the management of asthma outside of the hospital.

    METHOD: The data were collected from 60 subjects aged between 18-35 years via convenience sampling method reported in UTM Health Center using the device. Furthermore, the data were normalized and analyzed using descriptive statistics, t-test, and area (Az) under receiver operating characteristic curve (ROC).

    RESULT: Findings revealed that the normalized mean values of end-tidal carbon dioxide (EtCO2), Hjorth Activity (HA), and respiratory rate (RR) were lower in asthmatic compared with healthy subjects with minimum deviation from the mean. In addition, each parameter was found to significantly differ statistically for asthma and non-asthma with p< 0.05. Furthermore, the Az shows the strong association for the screening of asthma and non-asthma with an average of 0.71 (95% CI: 0.57-0.83), 0.77 (95% CI: 0.64-0.90), and 0.83 (95% CI: 0.73-0.94) for RR, EtCO2, and HA, respectively.

    CONCLUSIONS: This study demonstrates that the newly developed handheld human respiration CO2 measurement device may possibly be used as an effort-independent asthma management method outside of the hospital.
    Matched MeSH terms: Exhalation/physiology*
  7. Alhajj N, Zakaria Z, Naharudin I, Ahsan F, Li W, Wong TW
    Asian J Pharm Sci, 2020 May;15(3):374-384.
    PMID: 32636955 DOI: 10.1016/j.ajps.2019.02.001
    Chitosan nanoparticles are exhalation prone and agglomerative to pulmonary inhalation. Blending nanoparticles with lactose microparticles (∼5 µm) could mutually reduce their agglomeration through surface adsorption phenomenon. The chitosan nanoparticles of varying size, size distribution, zeta potential, crystallinity, shape and surface roughness were prepared by spray drying technique as a function of chitosan, surfactant and processing conditions. Lactose-polyethylene glycol 3000 (PEG3000) microparticles were similarly prepared. The chitosan nanoparticles, physically blended with fine lactose-PEG3000 microparticles, exhibited a comparable inhalation performance with the commercial dry powder inhaler products (fine particle fraction between 20% and 30%). Cascade impactor analysis indicated that the aerosolization and inhalation performance of chitosan nanoparticles was promoted by their higher zeta potential and circularity, and larger size attributes of which led to reduced inter-nanoparticulate aggregation and favored nanoparticles interacting with lactose-PEG3000 micropaticles that aided their delivery into deep and peripheral lungs.
    Matched MeSH terms: Exhalation
  8. Wong HY, Subramaniyan M, Bullen C, Amer Siddiq AN, Danaee M, Yee A
    Tob Induc Dis, 2019;17:65.
    PMID: 31582954 DOI: 10.18332/tid/111355
    INTRODUCTION: The mobile-phone-based Bedfont iCOTM Smokerlyzer® is of unknown validity and reproducibility compared to the widely-used piCO+ Smokerlyzer®. We aimed to compare the validity and reproducibility of the iCOTM Smokerlyzer® with the piCO+ Smokerlyzer® among patients reducing or quitting tobacco smoking.

    METHODS: Methadone-maintained therapy (MMT) users from three centers in Malaysia had their exhaled carbon monoxide (eCO) levels recorded via the piCO+ and iCOTM Smokerlyzers®, their nicotine dependence assessed with the Malay version of the Fagerström Test for Nicotine Dependence (FTND-M), and daily tobacco intake measured via the Opiate Treatment Index (OTI) Tobacco Q-score. Pearson partial correlations were used to compare the eCO results of both devices, as well as the corresponding FTND-M scores.

    RESULTS: Among the 146 participants (mean age 47.9 years, 92.5% male, and 73.3% Malay ethnic group) most (55.5%) were moderate smokers (6-19 cigarettes/day). Mean eCO categories were significantly correlated between both devices (r=0.861, p<0.001), and the first and second readings were significantly correlated for each device (r=0.94 for the piCO+ Smokerlyzer®, p<0.001; r=0.91 for the iCOTM Smokerlyzer®, p<0.001). Exhaled CO correlated positively with FTND-M scores for both devices. The post hoc analysis revealed a significantly lower iCOTM Smokerlyzer® reading of 0.82 (95% CI: 0.69-0.94, p<0.001) compared to that of the piCO+ Smokerlyzer®, and a significant intercept of -0.34 (95% CI: -0.61 - -0.07, p=0.016) on linear regression analysis, suggesting that there may be a calibration error in one or more of the iCOTM Smokerlyzer® devices.

    CONCLUSIONS: The iCOTM Smokerlyzer® readings are highly reproducible compared to those of the piCO+ Smokerlyzer®, but calibration guidelines are required for the mobile-phone-based device. Further research is required to assess interchangeability.

    Matched MeSH terms: Exhalation
  9. Wan Puteh SE, Mohd Ismail N, Md Isa Z, Ban AY
    PMID: 36901455 DOI: 10.3390/ijerph20054443
    Tobacco and nicotine derivatives uses are multiple in nature. These include conventional cigarettes (CCs), heated tobacco products (HTPs), and electronic cigarettes (ECs). This study aims to determine the practices, nicotine dependency profile, association with exhaled carbon monoxide (eCO) level, and pulmonary function (PF) among adult product users and non-smokers. This cross-sectional study involved smokers, nicotine users, and non-smokers from two public health facilities in Kuala Lumpur from December 2021 to April 2022. Data on socio-demography, smoking profile, nicotine dependency level, anthropometry, eCO monitor, and spirometer measurements were recorded. Out of 657 respondents, 52.1% were non-smokers, 48.3% were CC only smokers, poly-users (PUs) (27.3%), EC-only users (20.9%), and HTP-only users (3.5%). EC use was prevalent among the younger aged, tertiary educated, and females; HTP use was prevalent among those of an older age and CC users was common among lower educated males. The highest median eCO (in ppm) seen were as follows: in CC users only (13.00), PUs (7.00), EC users (2.00), HTP users (2.00), and the least was observed among non-smokers (1.00), which is significantly different across the groups (p <0.001). Comparison of practice between the different product users showed significant differences in age of product initiation (p <0.001, youngest in CC users in PUs), duration of product use (p <0.001, longest in exclusive CC users), cost per month (p <0.001, highest in exclusive HTP users) and attempt to quit product (p <0.001, CC use in PUs had the highest attempt to quit), while there is no significant difference in Fagerström score across the groups. Among EC users, 68.2% successfully switched from smoking CCs to ECs. The findings suggest that EC and HTP users are exhaling less CO. The use of these products in a targeted approach may manage nicotine addiction. Switching practice was higher among current EC users (from using CCs), hence emphasizing the need of switching encouragement and total nicotine abstinence later on. Lower eCO levels in the PU group, (as compared to CC-only users) and high quit attempt rate among in CC use in PUs may indicate attempt of PUs in reducing CC use through alternative modalities such as ECs and HTPs.
    Matched MeSH terms: Exhalation
  10. Guan NC, Ann AY
    PMID: 23082572
    We studied the use of exhaled carbon monoxide (CO) to identify nicotine dependence among adult Malaysian male smokers. We conducted a cross-sectional study among 107 male smoking staff at a university hospital. We measured their exhaled CO using a piCO+ Smokerlyzer and diagnosed nicotine dependence using a Mini-International Neuropsychiatric Interview (MINI). The optimal cut-off value for exhaled CO was determined. The correlation between exhaled CO level and the Fagerstrom Test for Nicotine Dependence (FTND) was also assessed. The mean exhaled CO level among subjects with nicotine dependence (15.78 ppm) was significantly higher than subjects without nicotine dependence (9.62 ppm). The cut-off value used to identify smokers with nicotine dependence was set at 10 ppm (specificity = 0.721, sensitivity = 0.731, positive predictive value = 0.817 and negative predictive value = 0.617). Psychometric properties were stable with various durations of smoking. Exhaled CO correlated positively with FTND scores (Pearson's rho = 0.398, p = 0.01). Our findings show exhaled CO can be used to identify nicotine dependence among adult Malaysian male smokers.
    Matched MeSH terms: Exhalation
  11. Norbäck D, Hashim JH, Hashim Z, Jalaludin J, Ismail R, Wieslander G, et al.
    J Asthma, 2024 Dec;61(12):1772-1780.
    PMID: 39066997 DOI: 10.1080/02770903.2024.2383627
    OBJECTIVE: To study associations between fractional exhaled nitric oxide (FeNO) and asthma, airway symptoms, sensitization to common allergens, outdoor pollution and home environment among 380 students in eight junior high schools in two areas in Indonesia.

    METHODS: Data on health and home were collected by a face-to face interview before measuring FeNO and performing skin prick test against common allergens. Exploratory linear mixed and logistic regression models were employed.

    RESULTS: Geometric mean of FeNO was 17.8 ppb (GSD 2.09) and 139 students (36.6%) had elevated FeNO (>20 ppb). In total, 107 students (28.2%) were sensitized to house dust mite (HDM) (Der p1 or Der f1), 4 (1.1%) to cat and 3 (0.8%) to mold (Cladosporium or Alternaria). Moreover, 20 students (5.3%) had diagnosed asthma, 38 (10.0%) had current wheeze, and 107 (28.2%) had current rhinitis. HDM sensitization, diagnosed asthma, current wheeze, and current rhinitis were associated with FeNO. In total, 281 students (73.9%) had mold or dampness, 232 (61.1%) had environmental tobacco smoke (ETS) and 43 (11.3%) had other odor at home. Indoor mold or dampness and other odor at home were associated with FeNO. ETS was negatively associated with FeNO.

    CONCLUSION: HDM sensitization and elevated FeNO can be common among children in this part of Indonesia. The high prevalence of elevated FeNO indicate that undiagnosed childhood asthma is common. Dampness, mold and odor at home can be associated with increased FeNO while ETS can be associated with decreased FeNO.

    Matched MeSH terms: Exhalation
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