1.Home-Based Physical Activity in Patients With Type 2 Diabetes Mellitus: A Scoping Review
Amirah MUSTAPA ; Maria JUSTINE ; Aliff Abdul LATIR ; Haidzir MANAF
Annals of Rehabilitation Medicine 2021;45(5):345-358
To promote optimal healthcare delivery in type 2 diabetes mellitus (T2DM) following the outbreak of coronavirus disease 2019, adopting home-based physical activity (PA) is being seriously considered. Therefore, this study aims to outline the characteristics of exercise protocols for home-based PA and the challenges and limitations in implementing home-based PA in patients with T2DM. This scoping review was carried out by identifying eligible studies in six different databases (Scopus, Cochrane Library, SpringerLink, ProQuest, Science Direct, and Google Scholar). The keywords used in the search strategies were: home-based physical activity, home-based exercise therapy, home-based physical exercise, home-based exercise, home-based exercise training, diabetes mellitus, and T2DM. Two reviewers independently screened all full-text articles to find articles that met the eligibility requirements. A total of 443 articles were identified in the search. Approximately 342 articles were excluded by screening titles and abstracts, which led to the selection of 44 articles relevant to the current study. Further screening of the full-text led to the subsequent removal of 34 other articles, leading to 10 studies that were eligible for data extraction. This review suggested that the exercise protocols for home-based PA include resistance exercise using free weight and own body weight with a frequency of two to three sessions per week at moderate intensity, along with aerobic exercise (particularly walking) with a frequency of three to five times per week at moderate intensity. A combination of resistance and aerobic exercise showed more significant benefits of PA in patients with T2DM. More studies regarding home-based PA in T2DM patients with metabolic disorders are warranted.
2.Barriers to Physical Activity and Exercise Amongst Persons With Physical Disability in a Government-funded Teaching Hospital, Kuala Lumpur
Haidzir Manaf ; Aishah Shaid ; Maria Justine ; Hafifi Hisham ; Nazirah Hasnan ; Ummi Mohlisi Mohd Asmawi ; Amirah Mustapa
Malaysian Journal of Medicine and Health Sciences 2021;17(No.2):34-39
Introduction: Physical inactivity is common among persons with disabilities (PWDs), thereby leading to harmful
secondary complications. Therefore, this cross-sectional study aimed to identify the barriers to physical activity and
exercise amongst PWDs in Malaysia. Methods: A total of 102 adults (age 15–65 years) with physical disabilities were
recruited from a government-funded hospital. The participants completed the ‘Barriers to Physical Exercise and Disability’ questionnaire via interview by telephone calls or a one-to-one approach. Results: Most participants (90.2%)
were interested in engaging in exercise programs. However, the mean concern index score was 2.83 ± 1.35. The
majority of the respondents identified five major barriers. These barriers include health concerns (36.3%), transport
barriers (36.3%), lack of energy and motivation (36.3%, 31.4%), and exercise program costs (23.54%). Conclusion:
Many participants were interested in beginning an exercise program despite the barriers. This observation shows
that if the barrier is eliminated, then, this community would be able to participate in an exercise program regularly.
Results from the study can inspire health care providers to devise strategies for the promotion of physical activity
participation and long-term adherence between PWDs.
3.C-reactive Protein, Albumin, Urea, CRP/Albumin Ratio, and Urea/Albumin Ratio: A Retrospective Evaluation in COVID-19 Patients
Nor Amirah Mohammad Nazri ; Wan Norlina Wan Azman ; Norsyuhadah Musa ; Tuan Salwani Tuan Ismail ; Azian Harun ; Najib Majdi Yaacob ; Sarina Sulong ; Sirajudeen K.N.S ; Mahaya Che Mat ; Hani Ajrina Zulkeflee ; Siti Sarah Mustapa
Malaysian Journal of Medicine and Health Sciences 2023;19(No.6):164-170
Introduction: C-reactive protein (CRP), urea, albumin, CRP/albumin ratio (CAR) and urea/albumin ratio (UAR) could
be valuable biomarkers for determining the severity of illness in patients with COVID-19. This study aimed to determine the association between these markers and disease severity in COVID-19 patients on admission and days five to
seven after admission. Methods: This retrospective study includes 153 adult COVID-19 patients admitted to Hospital
Raja Perempuan Zainab II and Hospital Ampang from January 2021 to December 2021. Patients’ serum CRP, urea,
albumin and creatinine levels were recorded on admission and on days five to seven after admission. The patients
were categorised based on the Annex 2e guidelines published by the Ministry of Health, Malaysia and further classified as mild to moderate disease (stages 1-3) and severe to critical illness (stages 4-5). Results: On admission, urea,
creatinine, CRP, UAR and CAR were significantly higher in the severe to critical group (p<0.001). The optimal cut-off
value for the UAR was 0.16; the area under the curve (AUC) was 0.760, and sensitivity and specificity were 63.6%
and 85.7%, respectively. The AUC of the CAR was 0.752, with 54.2% sensitivity and 91.4% specificity at an optimal
cut-off value of 1.63. In severe to critical COVID-19 patients, albumin levels decreased significantly on days five to
seven after admission, while urea levels remained significantly higher in this group (p<0.001, p<0.05, respectively).
Conclusion: CRP, urea, albumin, CAR and UAR are promising biomarkers for predicting the severity of disease in
COVID-19 patients.