A prevalence of elevated ARR in rural Selangor

Abstract The objective of this study was to determine the prevalence of elevated Aldosterone Renin Ratio (ARR) in Rural Selangor. Methods This was a cross sectional study involving subjects in Kuala Selangor and Tanjung Karang. The World Health Survey Kish tables were used to select eligible subjects (≥18 years old) from each household. Their social demography, past medical history, anthropometric measurement and blood pressure were recorded. Blood were withdrawn for Aldosterone (ALD), Plasma Renin Activity (PRA), Creatinine (creat) and potassium (K). Raised ARR is defined as aldosterone/renin ratio of more than 20. Results A total of 392 subjects (age 55 +/- 14.1) were enrolled. Fourty three (11%) subjects showed an ARR > 20. Out of those with raised ARR, 16 (38%) were hypertensive, 2 of which were not taking any anti-hypertensive drugs and 27 subjects (62.8%) were normotensive. Only 2 (4.7%) of them were hypokalemic, one of them being hypertensive. Conclusion The prevalence of raised ARR in Rural Selangor was 11%, and only 4.7% of them were hypokalemic

Prevalence of thyroid disorders and thyroid autoantibodies among coastal communities of Malaysia (part of nationwide study of thyroid disorders in Malaysia)

Objectives To determine the prevalence of thyroid disorders and thyroid autoantibodies in the coastal communities of Malaysia. This study is part of a nationwide study looking into the prevalence of thyroid disorders. Methods A cross sectional study was performed in two coastal districts of rural Selangor. A village from each district was chosen where a participant from each household from the village was selected using KISH tables. Sociodemographic data, medical history, anthropometric measurement and thyroid examination were performed. The presence of goiter was recorded according to the World Health Organization (WHO) goiter grading system. Blood withdrawn was tested for thyroid function and thyroid autoantibodies. Thyroid antibodies analyses were done using Immulite 2000 system. Lowest detectable limit for anti-thyroperoxidase (antiTPO) and antithyroglobulin (antiTG) are 10 IU/mL and 20 IU/mL respectively. Low, moderate and high titre is defined 40 - 100 IU/mL, 101-1000 IU/mL and >1000 IU/mL respectively. Results A total of 418 subjects were recruited with a mean age of 54.1 ± 14.2 years. Majority were Malays (86.8%), followed by Indians (11.7%) and Chinese (1.4%). Among respondents, 2.9% had Grade 1 and 8.9% had Grade 2 goitre. A mere 3.4% had clinically palpable thyroid nodules. A total of 411 blood samples were available for thyroid level assessment, with 1.9% of respondents were found to have hypothyroidism while 85.6% had TSH in the range of 0.32-2.5 mIU/L. The prevalence of overt and subclinical hypothyroidism was 0.2% and 1.7% AFES 2015 10 – 13 December 2015 respectively. On the otherhand, 3.4% of respondents were hyperthyroid (TSH < 0.32 mIU/L) with prevalence of overt and subclinical hyperthyroidism being 0.5% and 2.9% respectively. Among 417 samples which were available for antiTPO analysis, 8.9% has detectable antiTPO titre (>40.0 IU/mL), with 4.3% had moderate and 2.4% had high antiTPO titres. One respondent (10%) from among those with high antiTPO titres was found to have T3 thyrotoxicosis. Fourty percent of euthyroid respondents with high titre and 38.9% with moderate titre had high normal TSH, in the range of 2.51 – 5.00 mIU/L (p<0.001). Among 417 samples which are available for antiTG analysis, 3.4% and 5.3% had low detectable and moderate antiTG titres respectively. Only 0.5% (2 respondents) had high antiTG titre (>1000 IU/mL) and found to be hypothyroid. Among those with moderately positive titre, 9.1% were hyperthyroid and majority (63.6%), although euthyroid, had TSH levels between 0.32 – 2.50 mIU/L (p<0.001). Conclusion The low prevalence of thyroid antibodies and thyroid disorders in coastal communities could be attributed to the iodine sufficient status in those areas. Euthyroid respondents with moderate and high antiTPO titres tend to have higher TSH levels, while those with moderate and high antiTG titres had lower TSH levels

Prevalence, awareness and control of hypertension in rural areas in Selangor and Perak

Abstract The aim of this study was to describe the prevalence, awareness and control of hypertension in the rural population of Perak and Selangor. Methods This was a population based cross-sectional study involving subjects in Kuala Selangor, Tanjung Karang and Bidor. The World Health Survey Kish tables were used to select eligible subject (≥18 years old) from each selected household. A Case Report Form (CRF) was used to record their social demography, past medical history, anthropometry measurement and blood pressure (BP). Hypertension was defined as a blood pressure > 140/90 mmHg. Hypertension controlled was defined as a blood pressure of < 140/90 mmHg. Results A total of 761 people participated in this study. Of which 287 (37.8%) were males and 473 (62.2%) were females. Out of this, 271 (35.6%) were hypertensive. The study showed 36 (4.7%) subjects were not aware that they have hypertension. Only 76% of hypertensive subjects were on HPT medication. One hundred and five (51%) subjects were on monotherapy, 66 (32%) were on dual therapy, 27 (13.1%) on triple therapy, 8 (3.9%) were on more than 3 medications. 73 (26.9%) of the hypertensive subjects were not on any HPT medications having a SBP of 133.9 +/- 17 and DBP of 86.2 +/- 49.3

Emulsion breakage behaviour on chromium (VI) removal using emulsion liquid membrane containing quaternary ammonium compounds

Environmental pollution caused by heavy metals such as chromium, nickel, and lead has become a serious worldwide issue due to their threats to humans, animals and plants as well as to the stability of the overall ecosystem. Its removal from effluents such as electroplating rinse wastewater and tannery effluents is of primordial importance. In this study, the emulsion liquid membrane (ELM) technology was employed as a remediation technique that capable of removing Cr (VI) efficiently from wastewater where extraction and stripping processes are performed in a single operation. The ELM is consists of trioctylmethylammonium chloride (Alamine 336) as an extractant, palm oil as an organic diluent, sodium hydroxide (NaOH) as a stripping solution and sorbitan monooleate (Span-80) as a surfactant to stabilize the emulsion phase. The effect of operational parameters such as the agitation speed, phase contact time, extractant concentration and stripping agent concentration were studied to optimize the conditions for emulsion stability and maximum removal of chromium. The best removal efficiency was obtained at 350 rpm of agitation speed and 3 minutes of phase contact time with 0.04 M Alamine 336 as extractant and 0.1 M NaOH as stripping agent. In this condition, the maximum removal efficiency of 100% was obtained with a minimum breakage rate of 5%

Prevalence and antimicrobial susceptibilities of Acinetobacter baumannii and non-baumannii Acinetobacters from Terengganu, Malaysia and their carriage of carbapenemase genes

A total of 153 non-repeat Acinetobacter spp. clinical isolates obtained in 2015 from Hospital Sultanah Nur Zahirah (HSNZ) in Terengganu, Malaysia, were characterized. Identification of the isolates at species level was performed by ribosomal DNA restriction analysis (ARDRA) followed by sequencing of the rpoB gene. The majority of the isolates (n=128; 83.7 %) were A. baumannii while the rest were identified as A. nosocomialis (n=16), A. calcoaceticus (n=5), A. soli (n=2), A. berezeniae (n=1) and A. variabilis (n=1). Multidrug resistance (MDR) was most prevalent in A. baumannnii (66.4 %) whereas only one non-baumannii isolate (A. nosocomialis) was MDR. The blaOXA-23 gene was the predominant acquired carbapenemase gene (56.2 %) and was significantly associated (P&lt;0.001) with carbapenem resistance. However, no significant association was found for carbapenem resistance and isolates that contained the ISAba1-blaOXA-51 configuration.</p

Biocide susceptibilities and biofilm-forming capacities of Acinetobacter baumannii clinical isolates from Malaysia

Introduction. Acinetobacter baumannii is a Gram-negative nosocomial pathogen that has the capacity to develop resistance to all classes of antimicrobial compounds. However, very little is known regarding its susceptibility to biocides (antiseptics and disinfectants) and capacity to form biofilms, particularly for Malaysian isolates.Aim. To determine the susceptibility of A. baumannii isolates to commonly-used biocides, investigate their biofilm-forming capacities and the prevalence of biocide resistance and biofilm-associated genes.Methodology. The minimum inhibitory concentration (MIC) values of 100 A. baumannii hospital isolates from Terengganu, Malaysia, towards the biocides benzalkonium chloride (BZK), benzethonium chloride (BZT) and chlorhexidine digluconate (CLX), were determined by broth microdilution. The isolates were also examined for their ability to form biofilms in 96-well microplates. The prevalence of biocide resistance genes qacA, qacE and qacDE1 and the biofilm-associated genes bap and abaI were determined by polymerase chain reaction (PCR).Results. Majority of the A. baumannii isolates (43%) showed higher MIC values (&gt; 50 µg/mL) for CLX than for BZK (5% for MIC &gt; 50 µg/mL) and BZT (9% for MIC &gt; 50 µg/mL). The qacDE1 gene was predominant (63%) followed by qacE (28%) whereas no isolate was found harbouring qacA. All isolates were positive for the bap and abaI genes although the biofilm-forming capacity varied among the isolates.Conclusion. The Terengganu A. baumannii isolates showed higher prevalence of qacDE1 compared to qacE although no correlation was found with the biocides’ MIC values. No correlation was also observed between the isolates’ biofilm-forming capacity and the MIC values for the biocides

Prevalence of elevated aldosterone renin ratio in three main states of Peninsular Malaysia

Objective: The objective of this study was to determine the prevalence of increased Aldosterone Renin Ratio (ARR) in parts of Selangor, Perak and Pahang. Methods: This was a cross sectional study involving subjects in Selangor, Perak and Pahang. The World Health Survey Kish tables were used to select eligible subjects (≥18 years old) from each household. Their social demography, past medical history, anthropometric measurement and blood pressure were recorded. Blood were withdrawn for Aldosterone (ALD), Plasma Renin Activity (PRA), Creatinine (creat) and potassium (K). Raised ARR is defined as aldosterone/renin ratio of more than 20. Results: A total of 1073 subjects (age 50 +/- 16.4). One hundred and nineteen (11.1%) subjects showed an ARR =/> 20. Forty nine (41.2%) out of the elevated ARR =/> 20 were hypertensive, 11 of which were not taking any anti-hypertensive drugs and 54 subjects (45.4%) were normotensive. Only 7 (5.9%) of them were hypokalemic, one of them being hypertensive. The main clinical characteristics of subjects with raised ARR are shown in Table 1. Conclusion: The prevalence of raised ARR in Rural Selangor was 11.1%, and only 5.9% of them were hypokalemic