Socio-demographic factors of allergy awareness among pre-university Student in Selangor

Allergic disease is a worldwide public health issues and substantially growing over the past 20 years. Due to drastically changes of environmental and dietary culture within the population, Malaysia as one of the developing country is no exception to face the same problem. This study aimed to assess the awareness of allergy diseases and its prevalence using cross-sectional survey method. This study that has been conducted to 138 students from University Teknologi Mara Cawangan Dengkil, Selangor, Malaysia. A self-administered questionnaire was used as an instrument for data collection. Based on sociodemographic data, the mean of knowledge between science and non-science students showed the significant difference. Respondents from Science course score significantly higher for part B (4.54 ± 1.654) compare with other courses. The outcome of the study also showed that, among 138 respondents, n=80 (58%) of them perceived themselves to suffer allergy diseases and it symptoms. Common food to cause food allergy in this study were identified as seafood with n=43 (31.25%) followed with dust with n=40 (29%), peanuts with n=14 (10.1%). The study also indicated the intricate situation of cross reactivity as n=21(15.2%), n=6 (4.3%) and n=1(0.7) of respondents suffered with two, three and four multi allergy reaction respectively. The factor such as family history which subjected to predisposition of genetic factor was strongly associated with occurrence of allergic among respondents. It determined from Chi Square Test (X²) that showed that, there is high significant association (P<0.001) between parental allergies with respondents allergies. As overall, it can be conclude that the knowledge of allergy term, cause and prevention were relatively low among population under study as compared to the previous study

Self-reported on food allergy among university students in Dengkil, Selangor

Prevalence of allergy is a worldwide issue. The outbreak contributes to social and economic burden of the sufferer as well as the society. In Malaysia, the condition has continued to worsen due to the misconception of certain allergy symptom. It also leads to improper clinical diagnosis which affects the accuracy of treatment and upturns the cost further. This circumstances are corresponded to the level of public awareness and knowledge about the terms, symptoms and allergy prevention. This study highlighted the allergy prevalence among young adults based on self–reported approach. This cross-sectional study involved 138 students between the age of 18 to 19 years old from the Centre of Foundation Studies, UiTM Cawangan Selangor, Kampus Dengkil. Overall, the allergy prevalence reported in this study showed higher occurrence compared to previous study of self-reported and clinical data within the same population. The data indicated that n=80 (58%) of respondents indicating seafood such as shrimp as the most common implicated food allergen at n=43 (31.25%) followed by house dust mite at n=40 (29%) and peanuts at n=14 (10.1%). Pearson correlation between respondents’ knowledge of allergy terms, causes and symptoms with allergy prevention and treatment practice shows high significant correlation with (r = 0.387, P<0.001). Chi Square Test among students with allergies who were getting consultation from health personnel showed significant association (P<0.001) in which 41 (59.4%) of students with allergies do not consult any health personnel. As a conclusion, self-reported is only useful to give surface overview on allergy prevalence, but detailed clinical diagnosis is compulsory to ensure the effectiveness of allergy prevention and treatment in the future

Parental knowledge, attitude and practice of allergy disease in Selangor

Allergy prevalence becoming a worrisome issues amongst society. It’s not just discussed as worldwide issue but also effect sufferer even in a small institution such as the family. Corresponded to the family as the simplest unit of society, parental knowledge, attitude and practice play a crucial roles in allergy prevalence, prevention and treatment strategy. Allergy known to cause social and economic burden of the sufferer as well as to the closer family member. In Malaysia, the misconception of certain allergy symptom and misused of self- perceive method for allergy diagnosis becoming another real challenges. This scenario could lead to improper clinical diagnosis thus effect the treatment accuracy and upturn the cost of the treatment. This paper highlighted the differences between paternal and maternal knowledge, attitude and practice towards allergy reaction. This study also summarized the important of having adequate knowledge self-perceiving the allergy disease as this method is useful to give surface overview on allergy prevalence. This cross-sectional study involved 117 pair of parents in Selangor with the age ranged from 18-50 years old. A self-administered questionnaire has been used to by self-perceive method to indicate respondent’s allergy status and their knowledge and practice towards allergy disease. As overall, the common symptoms of allergy among parents were allergy rhinitis, eczema and dry ant itchy rashes at skin with percentage ranged from 6.8% to 28.4% of occurrence. The data also indicated that n=17 (14.4%) of mothers and n=8 (6.8%) of fathers allergy to seafood while n=11 (9.3%) of mothers and n=15(12.7%) of fathers also allergy to house dust mites. Pearson correlation between knowledge of allergy term, cause and symptom with allergy prevention and treatment shows significant correlation with (r = 0.244, P<0.001) for maternal and (r = 0.262, P<0.001) for paternal respectively. This outcome indicated that, the decision on treatment strategy among parents strictly depends on their level of knowledge about allergy. Other test such as Chi Square Test among parents also determined the treatment strategy based on consultation of allergy symptom with an expert of health personnel. It shows that n=14 (42.5%) of mothers with allergy and n=23 (65.7%) of fathers with allergies do not consult to an expert regarding their allergy prevalence and symptom. It also shows significant association for both with (P<0.001). Parental knowledge in society represent their involvement in prevention and treatment strategy for allergy sufferer especially the offspring. Adequate knowledge and awareness at this unit of society compromised a better future to control its prevalence

Distribution of lipid-soluble vitamin intake among exclusively breastfeeding mothers and its correlation with human milk’s fatty acids

The lipid composition such as fatty acids and fat-soluble vitamins is the second-most abundant composition of human milk providing dietary energy to infants. Micronutrient dietary intake such as vitamin A, D, E, K and C by breastfeeding mothers plays an important role in regulating the quality of human milk for optimum infant health and growth. The objective of this paper is to determine the distribution and correlation of maternal micronutrient intake of lipid-soluble vitamin and vitamin C towards fatty acids composition in human milk of exclusively breastfeeding mothers. A total of N=36 nursing women were recruited from Dengkil, Selangor, and Kuantan, Pahang, using a convenience sample method. A 24-hour dietary recall (24HR) was performed to collect thorough information on all foods and beverages ingested in the previous 24 hours by the respondent. The data on micronutrients intake per mother was tabulated using Nutritionist Pro. (NP) software. Following the diet recall, the human sample was collected in the next morning and subjected to fatty acid extraction and transesterification using the Blight and Dyer method. The composition of fatty acids methyl esters was analyzed and quantified by a gas chromatography (Agilent 7890A), equipped with a flame ionization detector (FID) and Agilent Chromatography Workstation software. The highest mean of intake occurred during the fifth to sixth months with, 1067.37±629.66 μg RE/day for vitamin A, during the first two months with, 0.89±0.84 μg RE/day of vitamin D, 5.85±2.49 mg/day while during the fifth to sixth months with, 17.28±11.74 μg /day of Vitamin E and at the first two months of lactation period with, 91.60±55.26 mg per day for vitamin C. Despite the fact that there was no significant correlation between vitamin intake and the fatty acid content of human milk, the study discovered a variety of patterns of correlation. Saturated fatty acids (SFA) in human milk were only positively correlated with vitamin D and C, while monounsaturated fatty acids (MUFA) were positively correlated with vitamin A, E, and K and negatively correlated with the rest. As a result, the fatty acid composition of human milk is less dependent on micronutrient dietary intake and more dependent on De-Novo synthesis in the mammary gland

Self-perceive on food allergy prevalence among university student in Selangor

Prevalence of allergy is a worldwide issue. The outbreak contributes to social and economic burden of the sufferer as well as the society. In Malaysia, the condition has continued to worsen due to the misconception of certain allergy symptom such as food allergy versus food intolerance. It also lead to improper clinical diagnosis which effect treatment accuracy and upturn the cost of the treatment. This circumstances are corresponded to the level of public awareness and knowledge about the term, signs and symptom of allergy prevention. This study aimed to highlight the allergy prevalence among young adult based on self–perceive approach. This cross-sectional study involved 138 respondents of students with the age of 18 to 19 years old from Centre of Foundation Study, UiTM Cawangan Selangor, Kampus Dengkil. Overall, the allergy prevalence reported within the study population comparatively to another self-perceive and clinical data from previous study showed the higher occurrence. The data indicated that n=80 (58%) of respondents facing allergy problems indicating seafood such as shrimp as the most common implicated food allergen with n=43 (31.25%) followed with house dust mite with n=40 (29%)and peanuts with n=14 (10.1%). Pearson correlation between respondent’s knowledge of allergy term, cause and symptom with allergy prevention and treatment shows weak highly significant correlation with (r = 0.387, P<0.001). Chi Square Test among students with allergies who were getting consultation with health personnel shows significant association (P<0.001) in which 41 (59.4%) of students with allergies do not consult with health personnel. The study also specified the shortcoming of the self- perceive approach due to the symptom misinterpretation and the quality of the survey instrument. As a conclusion self-perceive only, is useful to give surface overview on allergy prevalence, but detail clinical diagnosis is compulsory to ensure the effectiveness of allergy prevention and treatment in future

Prevalence of cow milk protein allergy (CMPA) and soy allergy and its association with T-IgE and specific IgE composition from lactating maternal serum

Allergy is an abnormal immunological condition that cause physical and biochemical changes of individual. This undesirable immunologic reaction initiated by exposure or stimulus which tolerated by normal individual but not to the sufferer. It is affecting people at a broad spectrum of age and can be detected as early as in infancy. Maternal concern on infants relies on the genetically transmission of immunologic cell to cause this disease especially at the first six months of infant’s life. In Malaysia, cow and soy milk are known as the two common sources of food allergen to trigger allergy reaction among infants. Thus, this study aimed to determine the the prevalence status of cow and soymilk allergy through Immunoglobulin E (IgE) among 36 lactating mothers. They were chosen on convenience sampling basis surround Dengkil, Selangor and Kuantan, Pahang. Based on clinical laboratory testing using ImmunoCAP 100 with CAP RAST system, from n=36 maternal serum, Total Immunoglobulin E (T-IgE) were ranged from 82 to 233 kU/L with mean±SD of 142.27±41.49, specific IgE to cow milk (Cow Milk IgE) ranged from 0.10 to 0.48 kU/L with mean±SD of 0.251±0.09 kU/L and specific IgE to soy (Soy IgE) ranged from 0.02 to 0.22kU/L with mean±SD of 0.127±0.04. From specific allergen test to cow milk and soy n=7(19.4) of mother clinically diagnosed with cow milk allergy but none for soy allergy. The correlation between those three variables has been tested using Pearson correlation while its association has been tested using Independent T-test and ANOVA. The results showed that there was positive strong correlation with r (36) =0.691, p=0.000 between T-IgE and CM-IgE but there was no significant correlation found between T-IgE and S-IgE since r(36)=0.159, p>0.05. Independent T-test also indicated that, there was a significance difference of T-IgE for mother who positively diagnosed with cow milk allergy (M=174.00, SD=40.52) and for mother who negatively diagnosed with cow milk allergy (M=134.62 SD=38.57) conditions;t(34)=-2, p=0.022. However, there was no significance difference of S-IgE who positively diagnosed with cow milk allergy (M=0.155, SD=0.037) and for mother who negatively diagnosed with cow milk allergy (M=0.120 SD=0.138) conditions(34)=-0.6, p=0.511. As overall, to have accurate allergy diagnosis through clinical test, both concentration, the T-IgE ans specific IgE (s-IgE) have to be considered

Public Awareness and Practices Towards Self-Medication with Antibiotics Among Malaysian Population: Questionnaire Development and Pilot Testing

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Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Summary Background Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development

Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BACKGROUND The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100 000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. METHODS We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. FINDINGS 292 982 (95% UI 261 017-327 792) maternal deaths occurred in 2013, compared with 376 034 (343 483-407 574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. INTERPRETATION Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING Bill &amp; Melinda Gates Foundation

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes