Are examination findings important in screening for angina in the Malaysian patient?

Background. The objective of this study is to look at how well patient history and examination findings can be used in screening for angina. Methods. A total of 887 records were extracted from the electronic medical record system (FMR) in Selayang Hospital, Malaysia. The data was cleaned, 69 possible variables were extracted, and univariate and multivariate analyses were performed. Results. From the univariate analysis, it was found that 19 variables are significantly associated with a diagnosis of angina. However, multiple logistic regression reveals that only 11 of these 19 variables are significantly related to a diagnosis of angina. Chest pain aggravated by exertion, history of diabetes mellitus, and history of heart disease (regardless of whether on treatment or not) are significant predictors of angina. Sudden onset chest pain, pain that is persistent, pain relieved by other means, pain aggravated by inspiration, and findings of rhonchi are important predictors of a diagnosis other than angina. The degree of overall accuracy is high at 71.3. There are eight factors which are significant in the univariate analysis but are not significant in the multivariate analysis. These are marital status. pain relieved by glyceryl trinitrate (GTN), pain relieved by rest, associated nausea, pain aggravated by posture, pain aggravated by cough, history of hypertension, and history of smoking. Conclusions. These findings suggest that examination findings do not play a significant role in screening for angina. © 2004 Elsevier Inc. All rights reserved

Impairment of psychomotor responses after conscious sedation in cirrhotic patients undergoing therapeutic upper GI endoscopy

OBJECTIVES: The aim of this study was to determine whether the number connection test (NCT) times of a group of cirrhotic patients without clinically overt hepatic encephalopathy and a group of healthy patients without liver disease who were undergoing endoscopy were prolonged after sedation with short acting i.v. benzodiazepines. METHODS: All patients were administered the NCT in a standard fashion for 30 min before sedation for an upper GI endoscopy and then 2 h after sedation postprocedure. Two NCTs were carried out before and 2 h after sedation, and the mean of the tests pre- and postsedation calculated. Based on the upper limit of the 95 CI of the presedation NCT of patients without liver disease as the cut-off level for hepatic encephalopathy, the proportion of cirrhotic patients with subclinical encephalopathy before and after sedation were also deter-mined. RESULTS: A total of 61 consecutive cirrhotic patients who underwent therapeutic upper GI endoscopy completed the study. The mean presedation NCT time was 43.5 s (95 CI = 39.0-48.1 s) and the mean postsedation NCT time 60.0 s (95 CI = 50.7-69.3 s). The difference between the mean pre- and postsedation NCT times was 16.4 s (95 Cl = 9.8-23.1 s; p < 0.001). A total of 38 consecutive patients without clinical or biochemical evidence of liver disease who presented for upper GI endoscopy completed the NCT as described for the group of cirrhotic patients. The mean (+/- SD) baseline NCT time was 34.7 +/- 7.9 s (95 CI = 32.1-37.2 s), whereas the mean postsedation NCT time was 33.7 +/- 8.5 s (95 CI = 30.9-36.5 s). This difference was not statistically significant (p = 0.177). Using the upper limit of the 95 Cl of the mean (37.4 s) of the presedation time in the patients without liver disease as the cut-off between normal and encephalopathy, the number of cirrhotic patients with abnormal presedation NCT times was 33 patients (54.1), and this number rose to 46 patients (75.4) after sedation with midazolam. This increase in proportion of cirrhotic patients with prolonged NCT time was statistically significant (p < 0.001). CONCLUSIONS: Sedation with i.v. midazolam prolongs NCT times in cirrhotic patients but not in healthy individuals without liver disease. The proportion of patients with prolonged NCT times increased in patients with cirrhosis following sedation, whereas this did not occur in those without liver disease

Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen

Background and Objective: Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen. Material and Methods: A total of 2506 persons between the ages of 15 and 64 years were examined, and every permanent tooth was assessed. Missing teeth included both extracted and missing teeth. Individuals currently smoking one or more boxes of cigarettes (20 cigarettes) a day for 5 years were considered as smokers, whereas individuals with no smoking history were considered as nonsmokers. Results: Smokers had a higher mean tooth loss than nonsmokers. The difference was statistically significant at p < 0.001. Mean tooth loss was significantly higher in smokers across all age groups, except for those in the 45-54 years age group. Smokers had a significantly higher mean upper tooth loss than nonsmokers. Tooth loss decreased from the incisors to the canines and then increased, with peak loss in the first molars. Conclusion: Tooth loss among smokers is significantly higher than among nonsmokers. The central incisors, lateral incisors and first molars were the most commonly missing teeth in smokers, compared with nonsmokers

Predictors of 3-month abstinence in smokers attending stop-smoking clinics in Malaysia

Introduction: Much is known about the predictors of success in quitting smoking. In particular, nicotine dependence, but not strength of motivation to stop, appears to predict abstinence. However, to date, studies have come almost exclusively from Western countries. More data are needed on the cross-cultural generalizability of these findings. Methods: One hundred and ninety-eight smokers attending 5 stop-smoking clinics in Malaysia completed a questionnaire prior to their target quit date and were followed up 3 months after this date. Predictors included sociodemographic variables, smoking patterns, past history of quitting, characteristics of current quit attempt, and smoking motives as well as nicotine dependence (Fagerstrom Test for Nicotine Dependence FTND) and self-rated strength of motivation of stop. Results: At 3-month follow-up, 35.4% (95% CI: 28.7-42.0) of participants reported being abstinent. A backward elimination multiple logistic regression identified a number of significant predictors of success, including strength of motivation to stop (adjusted odds ratio OR: 3.05, 95% CI: 1.28-7.25). FTND did not predict success. Conclusions: Motivation and nicotine dependence may play different roles in explaining variation in ability to stop smoking in different cultures

Translating the research diagnostic criteria for temporomandibular disorders into Malay: evaluation of content and process

Journal of Orofacial Pain222131-13

Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer) - A study protocol

10.1186/1471-2458-14-611BMC Public Health14161

Breast cancer in a multi-ethnic Asian setting: Results from the Singapore-Malaysia hospital-based breast cancer registry

10.1016/j.breast.2011.01.015Breast20SUPPL. 2S75-S80BREA