Hematram Yadav

Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia

Aliment Pharmacol Ther 31, 1141–1151

Risk factors associated with dyspepsia in a rural Asian population and its impact on quality of life.

OBJECTIVES:The epidemiology and impact of dyspepsia in rural Asia remains uncertain. We aimed to determine the prevalence epidemiology and impact of dyspepsia in a rural Malaysian community.METHODS:A door-to-door survey was conducted in a representative rural population in Malaysia. Dyspepsia was defined according to the Rome II criteria, and health-related quality of life (HRQOL) was assessed using the Euroqol (EQ-5D) instrument.RESULTS:Of 2,260 adults, 2,000 (88.5%) completed the survey. The mean age of respondents was 40.4±15.3 years, 62.7% were women, 79.0% were ethnic Malays, 8.4% had been educated up to the tertiary level, 49.7% were unemployed, and 63.4% resided in village-type housing with 49.1% having >8 residents per household. Dyspepsia was prevalent in 292 (14.6%) adults, and they had lower mean EQ-5D utility scores compared with healthy controls (0.91±0.17 vs. 0.97±0.08, P<0.0001). Dyspepsia was found to be associated with female gender (15.8 vs. 12.7% males, P=0.058), Chinese ethnicity (19.7 vs. 14.2% non-Chinese), higher education levels, medium-range incomes (19.1% medium range vs. 13.3% low range), non-village-type housing (16.3 vs. 13.5% village-type house, P=0.08), nonsmokers (18.7 vs. 13.7%, P=0.015), non-tea drinkers (19.5 vs. 12.3%, P<0.0001), regular analgesia intake (27 vs. 12.7%, P<0.0001), and adults with chronic illness (26.6 vs. 11.1%, P<0.0001). Logistic regression analysis showed that higher levels of education, i.e., secondary (odds ratio (OR) 2.13, 95% confidence interval (CI)=1.15–3.93) and tertiary (2.70, 95% CI=1.30–5.62) education, non-village housing (OR 1.36, 95% CI=1.02–1.80), regular analgesia (OR 2.22, 95% CI=1.60–3.09), and chronic illness (OR 2.83, 95% CI=2.12–3.77) were independent risk factors for dyspepsia. Conversely, regular tea drinking (OR 0.59) seemed to have an inverse relationship.CONCLUSIONS:Dyspepsia in rural Malaysians is associated with a lower HRQOL. Epidemiological risk factors include a higher socioeconomic status, regular analgesic consumption, and chronic illness.

Economic impact of dyspepsia in rural and urban Malaysia: a population-based study

Background/Aims The economic impact of dyspepsia in regions with a diverse healthcare system remains uncertain. This study aimed to estimate the costs of dyspepsia in a rural and urban population in Malaysia. Methods Economic evaluation was performed based on the cost-of-illness method. Resource utilization and quality of life data over a specific time frame, were collected to determine direct, indirect and intangible costs related to dyspepsia. Results The prevalences of dyspepsia in the rural (n = 2,000) and urban (n = 2,039) populations were 14.6% and 24.3% respectively. Differences in socioeconomic status and healthcare utilisation between both populations were considerable. The cost of dyspepsia per 1,000 population per year was estimated at USD14,816.10 and USD59,282.20 in the rural and urban populations respectively. The cost per quality adjusted life year for dyspepsia in rural and urban adults was USD16.30 and USD69.75, respectively. Conclusions The economic impact of dyspepsia is greater in an urban compared to a rural setting. Differences in socioeconomic status and healthcare utilisation between populations are thought to contribute to this difference.

Adverse Health Effects and Unhealthy Behaviors among Medical Students Using Facebook

Little is known about the relationships between adverse health effects and unhealthy behaviors among medical students using Facebook. The aim of this study was to determine the associations between adverse health effects and unhealthy behaviors with Facebook use. A cross-sectional study was conducted in a private university in Malaysia among 316 medical students. A self-administered questionnaire was used. It included questions on sociodemographics, pattern of Facebook use, social relationship, unhealthy behaviors, and health effects. Mean age was 20.5 (±2.7) years. All students had a Facebook account. The average daily Facebook surfing hours were 2.5 (±1.7). Significant associations were found between average hours of Facebook surfing and the following factors: isolation from family members and community, refusing to answer calls, musculoskeletal pain, headache, and eye irritation (P < 0.005). The average hours spent on Facebook were significantly associated with holding urination and defecation while online, surfing Facebook until midnight, and postponing, forgetting, or skipping meals (P < 0.005). The average hours spent on Facebook were associated with adverse health effects and unhealthy behaviors among medical students, as well as social isolation from the family and community.

Depression among the urban poor in Peninsular Malaysia: A community based cross-sectional study

This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.

Factors influencing macrosomia in pregnant women in a tertiary care hospital in Malaysia

To identify the risk factors influencing the development of macrosomia among pregnant women and to develop a regression model to predict macrosomia.

Pre-hospital delays in ischemic stroke patients in a Malaysian tertiary hospital

Dear editor, Stroke is the third largest cause of death in Malaysia and it is considered to be the single most common cause of severe disability. Early arrival to hospital and, consequently, initiation of thrombolytic treatment of ischemic stroke are critical in improving patient outcomes. Although, several studies were conducted in the developed countries, there is lack of data on pre-hospital delay in Malaysia. In this study, we investigated delays in presentation of stroke patients and explored factors associated with such delays in a tertiary health center of Malaysia. We conducted a cross-sectional study from 24 March to 25 June 2014 in the outpatient neurology clinic in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). We recruited 142 subjects who had ischemic stroke or transient ischemic attack in the last two years. Univariate analysis was conducted by using Chi-square test. Multiple logistic regression analysis was used to identify predictors of pre-hospital delay in variables selected from the univariate analyses with a significance level 0 05 The mean (SD) age was 63.5 (12.3) years. The median time from symptom onset to hospital arrival was 2 h with 68.4% of the patients arriving before 4.5 h. In previous studies, the median pre-hospital delay time was found to be from 2 to 15 h and the percentage of stroke patient who received thrombolytic therapy was 2.1% and 8.5%.Multiple logistic regression analysis showed that those who were conscious were more likely to be delayed compared to those who were unconscious (p1⁄4 0.035). Those who had stroke before midnight were more likely to be delayed compared to those who had stroke in the morning (p1⁄4 0.035 and 0.021, respectively) (Table 1). Previous studies showed similar findings. In conclusion, our study found that pre-hospital delay is associated with the consciousness status and the time of occurrence of stroke symptoms. Public education programs on stroke are recommended.

Factors Influencing Acute Exacerbation of Bronchial Asthma Among Children in Malaysia

The aim of this study was to determine the factors influencing acute exacerbation of bronchial asthma among children in Malaysia. A cross-sectional study was done to identify the factors influencing acute exacerbation of asthma in the University Malaya Medical Centre. In this study 103 known asthmatic children between the ages of 2 to 12 years were analysed. Among the children, 60% had a family history of asthma, 39% allergic rhinitis and only 17% eczema. The main complaints were coryza (84%) and shortness of breath (88%). Majority of the patients were treated as out-patient (58%) and only two were admitted in Intensive Care Unit. The factors that were significantly associated with mild exacerbation compared to a moderate to severe exacerbation was well-controlled asthmatic, good compliance to medications and those who had regular follow up.