Meal skipping among patients with type 2 diabetes mellitus (T2DM) and its associations with glycaemic control, eating out of home and binge eating

Meal skipping is a common way to restrict diet, but its practice by patients with type 2 diabetes mellitus (T2DM) remains undetermined due to the scarcity of the research. The main aim of this study was to assess how common patients with T2DM skipped meals. Its associations with sociodemographic and clinical characteristics, HbA1c, eating out of home and binge eating were examined too. This cross-sectional study was conducted in 2015 among 203 patients at a public healthcare clinic in Kuala Lumpur. A self-administered questionnaire including the Malay-version Binge Eating Scale was used. The proportions of participants who frequently skipped meals and ate out of home were 41.4% and 61.6%, respectively. Only 2% of them had binge eating disorder. Multiple logistic regression showed only Chinese was significantly associated with frequent meal skipping compared to Malay (adjusted odds ratio: 0.36; 95% confidence interval: 0.16-0.77; p value= 0.009) after controlling for age, employment status, educational status, HbA1c, presence of complication, type of treatment, eating out of home and binge eating. In conclusion, meal skipping was a frequently practised eating behaviour. Eating out of home was common too, but binge eating was rare. Meal skipping was not influenced by both eating practices and it had insignificant associations with glycaemic control. Cultural and religious factors may play an important role in defining their eating practice. Further studies are needed to assess the safety and acceptability of this practice, but clinically, its effects must be individually examined to prevent unwanted consequences on their health

MRSA Infection in Vascular Surgical Patients: The HKL Experience

ABSTRAK Jangkitan Methicillin-resistant Staphylococcus aureus (MRSA) kerap berlaku di kalangan pesakit yang menjalani pembedahan vaskular. Ianya boleh mengakibatkan kehilangan anggota atau kematian. Kami melaksanakan analisa retrospektif terhadap nota pesakit pembedahan vaskular di Hospital Kuala Lumpur untuk tempoh 2 tahun mulai Januari 2005 hingga Disember 2007. Ianya bertujuan mengamati corak jangkitan dan faktor-faktor yang mengakibatkan jangkitan ini. Seramai 999 pesakit menjalani pembedahan vaskular dalam rangkuman jangkamasa kajian ini. Dari jumlah ini, seramai 24 pesakit (2.4%) dikesan terjangkit oleh MRSA. Jangkitan ini didapati terjurus kepada pesakit yang merokok, pesakit diabetes melitus dan mereka yang terdahulunya pernah menjalani pembedahan vaskular. Kebanyakan jangkitan bercorak kemusnahan terhadap luka pembedahan dan berlaku dalam kategori pembedahan kecemasan. Sebanyak 54% dari kes jangkitan berakhir dengan kehilangan anggota atau pengeluaran graf vaskular atau kematian. Jangkitan MRSA mengakibatkan kesan klinikal yang buruk terhadap pesakit yang menjalani pembedahan vaskular. Langkah pencegahan yang intensif diperlukan bagi mengelakkan kesan buruk yang tidak diingini ini. Kata kunci: jangkitan MRSA, pembedahan vaskular ABSTRACT Methicillin-resistant Staphylococcus aureus (MRSA) infection is important among vascular surgical patients. Its effect can be devastating resulting in limb amputation and mortality. We performed a retrospective patients record analysis to determine the pattern of MRSA infection among vascular surgical patients in Hospital Kuala Lumpur from January 2005 to December 2007. We also attempted to identify the factors associated with poor clinical outcome after such infection. There were 999 patients who underwent vascular surgeries in HKL within the analysis period. Of these 24 patients (2.4%) were detected to have MRSA surgical site infection. The infection was commoner among cigarette smokers, patients with diabetes melitus and those who & Health 2008; 3(2): 294-299 had previous vascular surgery. Most infections occurred in the emergency surgery category and manifested as wound breakdown. Fifty-four percent of the infected patients ended with graft removal, amputations or death. MRSA infection complicating vascular surgery resulted in poor clinical outcome. This serious threat requires intensified preventive measures

Methylsulfonylmethane Suppresses Breast Cancer Growth by Down-Regulating STAT3 and STAT5b Pathways

Breast cancer is the most aggressive form of all cancers, with high incidence and mortality rates. The purpose of the present study was to investigate the molecular mechanism by which methylsulfonylmethane (MSM) inhibits breast cancer growth in mice xenografts. MSM is an organic sulfur-containing natural compound without any toxicity. In this study, we demonstrated that MSM substantially decreased the viability of human breast cancer cells in a dose-dependent manner. MSM also suppressed the phosphorylation of STAT3, STAT5b, expression of IGF-1R, HIF-1α, VEGF, BrK, and p-IGF-1R and inhibited triple-negative receptor expression in receptor-positive cell lines. Moreover, MSM decreased the DNA-binding activities of STAT5b and STAT3, to the target gene promoters in MDA-MB 231 or co-transfected COS-7 cells. We confirmed that MSM significantly decreased the relative luciferase activities indicating crosstalk between STAT5b/IGF-1R, STAT5b/HSP90α, and STAT3/VEGF. To confirm these findings in vivo, xenografts were established in Balb/c athymic nude mice with MDA-MB 231 cells and MSM was administered for 30 days. Concurring to our in vitro analysis, these xenografts showed decreased expression of STAT3, STAT5b, IGF-1R and VEGF. Through in vitro and in vivo analysis, we confirmed that MSM can effectively regulate multiple targets including STAT3/VEGF and STAT5b/IGF-1R. These are the major molecules involved in tumor development, progression, and metastasis. Thus, we strongly recommend the use of MSM as a trial drug for treating all types of breast cancers including triple-negative cancers

Elemental hydrochemistry assessment on its variation and quality status in Langat River, Western Peninsular Malaysia.

This paper discusses the hydrochemistry variation and its quality status in Langat River, based on the chemistry of major ions, metal concentrations and suitability for drinking purposes. Water samples were collected from 30 different stations to assess their hydrochemical characteristics. The physico-chemical parameters selected were temperature, electrical conductivity, total dissolved solids (TDS), salinity, dissolved oxygen , pH, redox potential, HCO3, Cl, SO4, NO3, Ca, Na, K, Mg, 27Al, 138Ba, 9Be, 111Cd, 59Co, 63Cu, 52Cr, 57Fe, 55Mn, 60Ni, 208Pb, 80Se and 66Zn to investigate the variation of the constituents in the river water. Most of the parameters comply with the Drinking Water Quality Standard of the World Health Organization and the Malaysian National Standard for Drinking Water Quality by the Malaysia Ministry of Health except for EC, TDS, Cl, HCO3, SO4, Na, Mg, Al, Fe and Se. The results show that the Langat River is unsuitable for drinking purposes directly without treatment

Derivation and validation of a risk-factor model for detection of oral potentially malignant disorders in populations with high prevalence

Background:Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is needed. We aimed to validate a model for screening so that only high-risk individuals receive the clinical examination.Methods:A community-based case-control study (n1029) in rural Sri Lanka assessed risk factors and markers for oral potentially malignant disorders (OPMD) by administering a questionnaire followed by an oral examination. We then developed a model based on age, socioeconomic status and habits of betel-quid chewing, alcohol drinking and tobacco smoking, with weightings based on odds ratios from the multiple logistic regression. A total, single score was calculated per individual. Standard receiver-operator characteristic curves were plotted for the total score and presence of OPMD. The model was validated on a new sample of 410 subjects in a different community.Results:A score of 12.0 produced optimal sensitivity (95.5%), specificity (75.9%), false-positive rate (24.0%), false-negative rate (4.5%), positive predictive value (35.9%) and negative predictive value (99.2%).Conclusion:This model is suitable for detection of OPMD and oral cancer in high-risk communities, for example, in Asia, the Pacific and the global diaspora therefrom. A combined risk-factor score of 12.0 was optimal for participation in oral cancer/OPMD screening in Sri Lanka. The model, or local adaptations, should have wide applicability

The prevalence of hyperuricemia in China: a meta-analysis

<p>Abstract</p> <p>Background</p> <p>The prevalence of hyperuricemia varied in different populations and it appeared to be increasing in the past decades. Recent studies suggest that hyperuricemia is an independent risk factor for cardiovascular disease. However, there has not yet been a systematic analysis of the prevalence of hyperuricemia in China.</p> <p>Methods</p> <p>Epidemiological investigations on hyperuricemia in China published in journals were identified manually and on-line by using CBMDISC, Chongqing VIP database and CNKI database. Those Reported in English journals were identified using MEDLINE database. Selected studies had to describe an original study defined by strict screening and diagnostic criteria. The fixed effects model or random effects model was employed according to statistical test for homogeneity.</p> <p>Results</p> <p>Fifty-nine studies were selected, the statistical information of which was collected for systematic analysis. The results showed that the pooled prevalence of hyperuricemia in male was 21.6% (95%CI: 18.9%-24.6%), but it was only 8.6% (95%CI: 8.2%-10.2%) in female. It was found that thirty years was the risk point age in male and it was fifty years in female.</p> <p>Conclusions</p> <p>The prevalence of hyperuricemia is different as the period of age and it increases after 30 years in male and 50 in female. Interventions are necessary to change the risk factors before the key age which is 30 years in male and 50 in female.</p

Multivariable regression analysis in Schistosoma mansoni-infected individuals in the Sudan reveals unique immunoepidemiological profiles in uninfected, egg+ and non-egg+ infected individuals

Background: In the Sudan, Schistosoma mansoni infections are a major cause of morbidity in schoolaged children and infection rates are associated with available clean water sources. During infection, immune responses pass through a Th1 followed by Th2 and Treg phases and patterns can relate to different stages of infection or immunity. Methodology: This retrospective study evaluated immunoepidemiological aspects in 234 individuals(range 4–85 years old) from Kassala and Khartoum states in 2011. Systemic immune profiles(cytokines and immunoglobulins) and epidemiological parameters were surveyed in n = 110 persons presenting patent S. mansoni infections (egg+), n = 63 individuals positive for S. mansoni via PCR in sera but egg negative (SmPCR+) and n = 61 people who were infection-free (Sm uninf). Immunoepidemiological findings were further investigated using two binary multivariable regression analysis. Principal Findings: Nearly all egg+ individuals had no access to latrines and over 90% obtained water via the canal stemming from the Atbara River. With regards to age, infection and an egg+ status was linked to young and adolescent groups. In terms of immunology, S. mansoni infection per se was strongly associated with increased SEA-specific IgG4 but not IgE levels. IL-6, IL-13 and IL-10 were significantly elevated in patently-infected individuals and positively correlated with egg load. In contrast, IL-2 and IL-1β were significantly lower in SmPCR+ individuals when compared to Sm uninf and egg+ groups which was further confirmed during multivariate regression analysis. Conclusions/Significance: Schistosomiasis remains an important public health problem in the Sudan with a high number of patent individuals. In addition, SmPCR diagnostics revealed another cohort of infected individuals with a unique immunological profile and provides an avenue for future studies on non-patent infection states. Future studies should investigate the downstream signalling pathways/mechanisms of IL-2 and IL-1β as potential diagnostic markers in order to distinguish patent from non-patent individuals

Biosurfactants produced by Bacillus subtilis A1 and Pseudomonas stutzeri NA3 reduce longevity and fecundity of Anopheles stephensi and show high toxicity against young instars

Anopheles stephensi acts as vector of Plasmodium parasites, which are responsible for malaria in tropical and subtropical areas worldwide. Currently, malaria management is a big challenge due to the presence of insecticide-resistant strains as well as to the development of Plasmodium species highly resistant to major antimalarial drugs. Therefore, the present study focused on biosurfactant produced by two bacteria Bacillus subtilis A1 and Pseudomonas stutzeri NA3, evaluating them for insecticidal applications against malaria mosquitoes. The produced biosurfactants were characterized using FT-IR spectroscopy and gas chromatography-mass spectrometry (GC-MS), which confirmed that biosurfactants had a lipopeptidic nature. Both biosurfactants were tested against larvae and pupae of A. stephensi. LC50 values were 3.58 (larva I), 4.92 (II), 5.73 (III), 7.10 (IV), and 7.99 (pupae) and 2.61 (I), 3.68 (II), 4.48 (III), 5.55 (IV), and 6.99 (pupa) for biosurfactants produced by B. subtilis A1 and P. stutzeri NA3, respectively. Treatments with bacterial surfactants led to various physiological changes including longer pupal duration, shorter adult oviposition period, and reduced longevity and fecundity. To the best of our knowledge, there are really limited reports on the mosquitocidal and physiological effects due to biosurfactant produced by bacterial strains. Overall, the toxic activity of these biosurfactant on all young instars of A. stephensi, as well as their major impact on adult longevity and fecundity, allows their further consideration for the development of insecticides in the fight against malaria mosquitoes