Quality of care for adult Type 2 diabetes mellitus at a University Primary Care Centre in Malaysia.

Background: Type 2 Diabetes Mellitus (T2D) with its concurrent cardiovascular risk factors such as hypertension and dyslipidaemia and its complications has now accounted for the majority of national and global morbidity and mortality. Aims & Objective: The study aimed to determine the prevalence of complications appearing in diabetic patients despite therapy, addressing to an urban academic primary care centre. Methods: This was a sub-analysis of a cross-sectional study on 212 patients with Type 2 diabetes mellitus (T2D) conducted from June to September 2006. Patients aged ≥ 30 years, non-smokers and under follow-up care of senior doctors were recruited. The average of the three most recent readings of fasting plasma sugar, HbA1c, systolic and diastolic blood pressure, and lipid profiles was taken as measures of respective disease control. Results: Two thirds of the patients were female. The mean age was 62.7 (SD± 10.8) years and the duration of T2D was 11.74 (SD± 6.7) years. A total of 23.6% achieved HbA1c ≤ 7.0%, 26.2% attained LDL-C ≤ 2.6 mmol/L and 24.5% achieved target blood pressure < 130/ 80 mmHg. The most prevalent co-morbid condition was hypertension (77.3%). A total of 27.2% patients had diabetic complications, out of which 86.5% had one complication. Proteinuria < 1gm/L and coronary artery disease were the two most common complications. There were only 16% on subcutaneous insulin and this was significantly associated with fasting plasma glucose (t = 5.38, df= 204, p < 0.0001) and HbA1c (t = 4.31, df= 206, p < 0.0001). Conclusions: Many T2D patients at this centre did not achieve treatment goals. Insulin and lipid-lowering drugs use should be optimized to improve control rates. More structured care processes are urgently needed in order to achieve good glycaemic control

Readiness of Malaysian on Sustainable Development in Solar Energy Application

Solar energy is a non-vanishing renewable source of energy that is eco-friendly. However, the solar energy adoption rate in Malaysia remains low due to the low readiness level among the Malaysian. This phenomenon should be emphasized where solutions need to be figured out to encourage the adoption of solar energy in buildings. Thus, this research was conducted to explore the readiness and challenges of the Malaysians in adopting solar energy. A mixed research method was adopted where a total of 200 sets of online questionnaire surveys were distributed to the public, and a semi-structured interview was carried out to obtain the opinions from the expert in the industry. Based on the findings of the questionnaires, the top 3 challenges in solar energy adoption are (1) high setting up cost of solar panels, (2) limited public awareness of solar energy and (3) efficiency of the solar panel depends on the weather. Next, the qualitative study found that 48.9% of 139 respondents were willing to adopt solar energy in the future. The findings show that that breaking down the barriers of high investment cost and long return investment would further enhance the solar energy adoption rates at the residential scale. Since this study had explored the challenges and solution to these barriers, the outcomes of this study can be used by the policy maker as the fundamental to encourage the adoption of solar energy in the existing buildings where the current adoption rate is low

Sex, Age Group and Locality Differences in Adolescent Athletes' Beliefs, Values and Goal Orientation in Track and Field

This study used the Eccles et al. expectancy-value model of achievement choice and achievement goal theory to investigate sex, age group and locality differences in adolescent athletes' expectancy-related beliefs, subjective task values and achievement goals in track and field. A cross-sectional study was conducted on 632 (349 male, 283 female) athletes from the under 15 and 18 years age groups (mean, 15.2 ± 1.28 years) who volunteered to participate in the annual state track and field meet. The participants completed the expectancy-related beliefs, subjective task values measures, and Task and Ego Orientation in Sport Questionnaire. Results indicated a significant interaction effect between sex, age group and locality for expectancy-related beliefs, F(1, 624) = 8.02 (p < 0.05) and subjective task values, F(1, 624) = 5.98 (p < 0.05). However, no significant interaction effect between sex, age group and locality were found for task orientation, F(1, 624) = 0.68 (p > 0.05) and ego orientation, F(1, 624) = 0.04 (p > 0.05). Expectancy-related beliefs were found to be related with subjective task values (r = 0.64, p < 0.01), task orientation (r = 0.40, p < 0.01), and ego orientation (r = 0.24, p < 0.01). Subjective task values were related to task orientation (r = 0.47, p < 0.01) and weakly with ego orientation (r = 0.16, p < 0.01). Task orientation was also related to ego orientation (r = 0.29, p < 0.01)

A Neural Network Approach to Synthetic Control Chart for the Process Mean

In this project, a multivariate synthetic control chart for monitoring the process mean vector of skewed populations using weighted standard deviations has been proposed. The proposed chart incorporates the weighted standard deviation (WSD) method of Chang and Bai (2004) into the standard multivariate synthetic chart of Ghute and Shirke (2008)

Glycaemic Control after Metformin Discontinuation in Diabetic Patients with a Declining Renal Function

Metformin is contraindicated in diabetic patients with declining renal function. This study examined the glycaemic control in diabetic patients with chronic kidney disease when metformin was discontinued. This was a retrospective study. We screened 2032 diabetic patients who attended the Diabetes Clinic at a tertiary hospital between 1 September 2014 and 30 September 2015. We analyzed the data on 69 patients whom metformin was discontinued due to declining renal function and had a complete 6-month follow-up. There was no significant difference in the HbA1c and body weight at 6-month follow-up compared to baseline after metformin discontinuation. The eGFR was significantly lower at 6-month follow-up compared to baseline. Upon metformin discontinuation, the majority of patients had their diabetes medication uptitrated (in particular insulin or sulphonylurea). Patients with an improved glycaemia at 6-month follow-up had further declined in eGFR compared to patients with worsened glycaemia. 17% of the study patients experienced hypoglycaemia. Upon metformin discontinuation, glycaemic control could be optimised with uptitration but should be balanced against the risk of hypoglycaemia. Further improvement in the glycaemic control might indicate further deterioration in the renal function

Optimization for extraction on total phenolic contentand radical scavenging capacity of henna (Lawsonia inermis) stems using response surface methodology

This study aimed to optimise potential extraction conditions using response surface methodology (RSM) for yielding maximum levels of total phenolic content (TPC) and 2,2-diphenyl-1-picryhydrazyl radical (DPPH•) scavenging capacity of henna (Lawsonia inermis) stems. The ranges for selected independent variables, namely acetone concentration (20-90%, v/v), extraction time (10-90 min) and extraction temperature (25-45°C) were identified by screening tests. Optimum conditions obtained for extraction of TPC were 47.0% acetone, extraction time of 47.6 min and extraction temperature of 37.3°C. The result also showed that 75.8% acetone, extraction time of 26.2 min and extraction temperature of 41°C yielded the highest DPPH• scavenging capacity. The optimized extraction conditions have resulted in TPC and DPPH• scavenging capacity of 5232.4 mg GAE/100 g DW and 6085.7 g TE/100 g DW, respectively which similar to the predicted values. Therefore RSM has successfully optimized the extraction conditions for TPC and radical scavenging capacity of henna stems