Determination of factors associated with physical activity levels among adolescents attending school in Kuantan, Malaysia.

Introduction: Findings from the National Health and Morbidity Survey III (MOH, 2008) indicate a 43.7% prevalence of physical inactivity among Malaysian adults. This sedentary lifestyle can also be observed among children and adolescents. Methodology: A cross-sectional study was conducted to determine factors associated with physical activity levels of four hundred, 13 year-old adolescents in Kuantan, Pahang. Data on socio-demographic, health-related, and psychosocial factors were collected using a self-administered questionnaire while physical activity level was assessed using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: About one-third of the respondents were in the low physical activity level category, 61.5% were in the moderate category and only 3.0% of the adolescents were in the high physical activity level category. Males were more physically active than females (χ 2=23.667, p=0.0001) with female adolescents (45.1%) twice as likely as male adolescents (22.1%) to be in the low physical activity level category. The associations between physical activity level with socio-demographic and health-related factors, perception of weight status and body parts satisfaction were not significant. However, physical activity was found to be positively correlated with physical activity self-efficacy (r=0.496, p=0.0001), peer influence (r=0.468, p=0.0001), family influence (r=0.298, p=0.0001) and beliefs in physical activity outcomes (r=0.207, p=0.0001). Negative relationships were found between physical activity with depression (r=-0.116, p=0.021) and body size discrepancy (r=-0.143, p<0.01). Respondents who had a better perception of their current health status were more physically active (χ 2=21.062, p=0.0001). Multivariate analyses for the prediction of physical activity showed that physical activity self-efficacy, sex and peer influence were the most significant contributors in explaining physical activity among adolescents. Conclusion: Physical activity interventions should include psychosocial components as mediator variables in interventions designed to promote regular physical activity in adolescence

ST Elevation in a Patient With COVID-19 Infection-Associated Fever: A Case of Brugada Pattern.

Coronavirus disease 2019 (COVID-19) is a global pandemic presenting with various cardiovascular manifestations. Although Brugada pattern ST-segment elevation (STE) is well described in patients admitted with febrile illness, the implication of recognizing this abnormality in patients with COVID-19 is critical in providing appropriate care for the patient and also reducing the exposure of healthcare professionals to the risk of infection. We report a patient with COVID-19 infection presenting with STE due to fever-related unmasking of Brugada pattern, who was managed conservatively

Disordered eating behaviors, depression, anxiety and stress among Malaysian University students.

The aim of this study was to examine the relationships between depression, anxiety and stress with disordered eating among university students. The Eating Attitudes Test-26 (EAT-26) and Depression, Anxiety and Stress Scale-21 (DASS-21) were administered on 584 Malaysian university students (59.4% females and 40.6% males). About one in five participants (18.2%) were at risk of eating disorders. Females had significantly higher proportion of at risk of eating disorders (21.3%) compared to males (13.5%). There was no sex difference in mean EAT-26 scores. The prevalence of depression, anxiety and stress of moderate severity or above were 29.3%, 55.0% and 21.6% respectively. No sex differences in depression and anxiety scores were found but females had significantly higher stress score compared to males. There was significant relationship between EAT-26 and DASS-21 subscales. Further, no significant interaction effect was found for sex and ethnicity with EAT-26 and DASS-21 subscales. The prevalence of at risk of eating disorders, depression, anxiety and stress among university students were high. There were positive correlations between depression, nxiety, and stress with disordered eating. Further studies on their associated risks are warranted

Differences in eating behaviors, dietary intake and body weight status between male and fermale Malaysian University students.

University students are potentially important targets for the promotion of healthy lifestyles as this may reduce the risks of lifestyle-related disorders later in life. This cross-sectional study examined differences in eating behaviours, dietary intake, weight status, and body composition between male and female university students. A total of 584 students (59.4% females and 40.6% males) aged 20.6 +/- 1.4 years from four Malaysian universities in the Klang Valley participated in this study. Participants completed the Eating Behaviours Questionnaire and two-day 24-hour dietary recall. Body weight, height, waist circumference and percentage of body fat were measured. About 14.3% of males and 22.4% of females were underweight, while 14.0% of males and 12.3% of females were overweight and obese. A majority of the participants (73.8% males and 74.6% females) skipped at least one meal daily in the past seven days. Breakfast was the most frequently skipped meal. Both males and females frequently snacked during morning tea time. Fruits and biscuits were the most frequently consumed snack items. More than half of the participants did not meet the Malaysian Recommended Nutrient Intake (RNI) for energy, vitamin C, thiamine, riboflavin, niacin, iron (females only), and calcium. Significantly more males than females achieved the RNI levels for energy, protein and iron intakes. This study highlights the presence of unhealthy eating behaviours, inadequate nutrient intake, and a high prevalence of underweight among university students. Energy and nutrient intakes differed between the sexes. Therefore, promoting healthy eating among young adults is crucial to achieve a healthy nutritional status

Demographic determinants and effect of pre-operative angiotensin converting enzyme inhibitors and angiotensin receptor blockers on the occurrence of atrial fibrillation after CABG surgery

<p>Abstract</p> <p>Background</p> <p>Atrial fibrillation (AF) occurs in about 27% to 40% of post cardiac surgery patients. AF following coronary artery bypass graft surgery (CABG) is associated with a two-fold increase in morbidity and mortality. Various demographic risk factors and medications have been studied to predict the occurrence of this arrhythmia. The role of angiotensin related medications on the occurrence of AF in CABG patients is not determined.</p> <p>Methods</p> <p>Retrospective clinical and statistical analysis was made of all the patients who had undergone CABG surgery at Lehigh Valley Hospital during the years 2005 and 2006. Patients with chronic AF and those undergoing valvular surgery with CABG were excluded. Statistic analysis included chi-square test for categorical and student t-test for continuous variables.</p> <p>Results</p> <p>757 patients (560 males and 197 females) were studied. AF occurred in 19% of the patients. Age (70.5 vs. 65.1, p < 0.005. OR per year of age: 1.02, 95%CI: 1.018-1.023) and presence of hypertension (OR: 1.92, 95%CI: 1.086-3.140, p = 0.025) were significantly associated with occurrence of AF. Neither ARBs (OR: 0.78, 95%CI: 0.431-1.410, p = 0.41) nor ACE inhibitors (OR: 1.01, 95%CI: 0.753-1.608, p = 0.63) reduced the occurrence of post operative AF. Patients with post operative AF had a significantly longer hospital stay (9.5 +/- 5.4 days vs. 6.9 +/- 4.3 days, p = 0.001).</p> <p>Conclusions</p> <p>Advanced age and presence of hypertension were independent predictors of post-CABG AF. Patients with post operative AF had significantly longer hospital stay. Neither ARBs nor ACE inhibitors were associated with reduction of post-surgical AF. Further studies are needed to better delineate the role of angiotensin related medications on reduction of post-surgical AF.</p

Dietary patterns as a predictive factor for overweight and obesity among secondary school children in Mashhad, Iran

This cross-sectional study was carried out to determine the prevalence of overweight and obesity among secondary school children in the city of Mashhad, Iran and its association with dietary patterns. A total of 1189 secondary school children (579 males and 610 females) aged 12- 14 years old were selected through a stratified multistage random sampling. All adolescents were measured for weight and height. Household socio-demographic information were self-reported by parents. Adolescents were classified as overweight or obese based on BMI-for age Z-score. Dietary patterns were assessed using a validated Iranian food frequency questionnaire (FFQ) included 121 food items. The principal component factor analysis (PCA) was applied to derive dietary patterns, and Logistic Regression (LR) was applied to examine the association between dietary pattern and adolescents BMI. The overall prevalence of overweight and obesity among the study population was 17.2% and 11.9%, respectively. The PCA analysis revealed the presence of two dietary patterns that were labeled as ‘Healthy dietary pattern’ (HP), and ‘Unhealthy dietary pattern’ (UP). LR analysis showed that HP was significantly associated with BMI (OR: 1.28, 95% CI: 1.124-1.47). Similarly, UP was significantly associated with BMI (OR: 0.861, 95% CI: .725-.968). In Iran, nutritional transition has taken place in the context of urbanization and has changed lifestyle, and dietary patterns. Policies must be formulated and circulated in the society to reach every family in the form of healthy dietary pattern

Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students : a mediation analysis of psychological distress.

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18–24 years old (M = 20.6, SD = 1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial

Development and preliminary validation of socio-cultural influences on body image scale for Malaysian female adolescents

The present study aimed to develop and validate comprehensive multi-dimensional sociocultural (parental, peers, media) influence on body image scale for Malaysian female adolescents. A total of 328 female adolescents from a secondary school in Kuantan district, Pahang, Malaysiacompleted a self-administered questionnaire, which encompassed a multiple measure of sociocultural influence, Body Dissatisfaction and Body Importance subscales of Body Image Questionnaire (McCabe & Ricciardelli, 2001), and Body Change Inventory (Ricciardelli & McCabe, 2002). Through factor analysis, the three major components (parental, peers, media) of the sociocultural influence scale were found to consist of multi-dimensional constructs. Particularly, five dimensions were identified for the parental influence subscale: 1) parental teasing on weight, 2) parental encouragement on increasing muscle and weight, 3) parental social support, 4) parental preoccupation with thinness and dieting behaviour, and 5) parental feedback on body change behaviour; the peer influence subscale comprised four dimensions including 1) peer social support, 2) peer preoccupation with thinness and dieting behaviour, 3) peer teasing on weight, and 4) peer encouragement on increasing muscle and weight; and three dimensions were identified in the media influence subscale, which included 1) media encouragement on reducing weight, 2) media modeling on weight reducing behaviour, and 3) media encouragement on increasing muscle and weight. As for construct validity, there were positive correlations between the composite score of the subscales and body dissatisfaction, body importance, strategies to decrease body size and strategies to increase body size and muscle size. In short, the present study has developed a sociocultural (parental, peer, media) influences on body image scale with construct validity and good internal consistency for Malaysian female adolescents. The scale can be used to assess the various dimensions of socio-cultural influences and will be useful to determine the etiology, prevention and treatment of negative body image and its related problems for Malaysian female adolescents

Household food insecurity among urban welfare recipient households in Hulu Langat, Selangor

Food insecurity is defined as a condition whenever people are not able to access enough food at all time for an active and healthy life, as well as the availability of adequate and safe food acquired by socially acceptable ways. This study utilized the Malaysian Coping Strategy Instrument (MCSI) to determine the percentage and the risk factors of food insecurity among the urban welfare recipient households in Hulu Langat, Selangor. A total of one hundred and three women (aged 20-55 years old) from selected welfare recipient households were involved in this study. Questionnaires were used to collect demographic and socio-economic information, as well as food security status of the participating households. The results indicated that 26.3% of the households faced food security, while 39.8% experienced moderate food insecurity, and 34.0% were subjected to severe food insecurity. The risk factors of food insecurity included the presence of children below 7 years old (F=3.690; p≤0.05), school-going children (F=2.599; p≤ 0.5), disabled members in the households (F=3.690; p<0.028), income reliance on financial assistance and per capita income (F=4.349; p≤0.05). In conclusion, food insecurity is a major public health problem among the urban welfare recipient households. Meanwhile, diverse risk factors were identified to have contributed to food insecurity in this study. Therefore, welfare recipient households with these circumstances ought to give priority to intervention programmes that address food insecurity by policy makers and programme implementers. In addition, the intervention programmes should be designed to address this issue and other risk factors influencing food acquisition