Cardiovascular disease is the leading cause of mortality in patients with chronic kidney disease (CKD) and dyslipidaemia is an important contributor. The use of statins in this subgroup of patients appears to be beneficial in lowering the cardiovascular (CV) risk from the body of evidence available, although there are some important considerations that need to be taken into account. These include the dose and choice of statin, depending on the stage of the CKD and risk profile of the patient. This review looks at some of the important studies that support the clinical use of statins in patients with CKD and summarises some of the key points that the practising clinician should consider.

Introduction: Evidence has shown an increase in paediatric hypertension globally and this could give rise to increase prevalence of adult hypertension. The purpose of this paper was to determine the prevalence of hypertension among adolescents in Malaysia as well as the association between hypertension and lifestyle factors selected based on published literature. Methods: Adolescents aged 13-17 years old were selected randomly from two secondary schools to have their blood pressure measured. Their lifestyle information was obtained through completed bilingual questionnaires based on validated instruments, as well as anthropometry measurements. The relationship between hypertension and lifestyle factors was determined through statistical analysis. Results: A total of 273 students were included in the study with 120 (44%) males and 153 (56%) females. The prevalence of hypertension was 24.5% among the respondents with the highest being recorded among Malays (28.7%). Generally, hypertension was associated with an increased Body Mass Index (BMI) (AOR=4.053, 95%CI=1.677-9.795, p=0.002) and waist circumference (WC) (AOR=2.918, 95%CI=1.171-7.269, p=0.021) in all respondents. Similar associations were noted in females (BMI: AOR=7.707, 95%CI=2.043-29.072, p=0.003; WC: AOR=3.690, 95%CI=1.011-13.464, p=0.048) but not in males. Conclusion: Hypertension recorded high prevalence among Malaysian adolescents in our study. The strong association between elevated body weight, BMI and WC with hypertension may require further study to evaluate the need for screening.

Publications ; Ethics

Evidence-Based Medicine ; Primary Health Care

Peripheral Intravenous Catheters (PIC) are widely used. Nurses are required to possess appropriate knowledge and practice. The present study aimed to determine nurses' knowledge and practice towards care of PIC. A cross-sectional descriptive study was conducted and 84 respondents participated in the study. A 26-item questionnaire comprising 11 items on knowledge and 15 items related to nursing practice was adapted and modified. The findings reported higher mean score from specialty unit respondents, with knowledge (M = 49.19, SD = 3.44) and practice (M = 66.38, SD = 5.15), compared to medical surgical wards with knowledge (M = 46.25, SD = 4.68) and practice (M = 63.17, SD = 4.63) towards the care of PIC, which was significant (p value = 0.010 and p value = 0.009, respectively). The study indicated a higher mean score of charge nurse respondents as compared with registered nurse with knowledge (M = 49.68, SD = 3.23); (M = 46.20, SD = 4.62) and practice (M = 67.11, SD = 4.84); (M = 63.06, SD = 4.61), which was significant (p value = 0.003 and p value = 0.001, respectively). There were no significant differences between respondents’ education qualification towards care of PIC with p > 0.05. However, the findings reported that respondents who possessed Bachelor of Nursing were deemed to score slightly higher in their knowledge and practice towards the care of PIC. In conclusion, the specialty unit and charge nurse respondents were deemed to possess better knowledge and practice towards the care of PIC in the hospital.
Phlebitis

The Coronavirus disease (COVID-19) pandemic (caused by the virus SARS-CoV-2) is the greatest threat not only to global health but also has far reaching socio economic impact on nearly all the countries in the world. The first 4 cases of COVID-19 was first reported on the 29th December 2019, all linked to Huanan (Southern China) seafood wholesale market. 1,2 On the 31st December 2019, the World Health Organization (WHO) China Country Office was informed of a pneumonia of unknown cause, detected in the city of Wuhan in the Hubei province, China

Fibrin sheath formation around long-term haemodialysis catheter is a common cause of failed dialysis access. Treatment options include pharmacological and mechanical methods. This paper reports a case of failed dialysis access due to fibrin sheath encasement. Pharmacologic thrombolysis, mechanical disruption using guide wire and catheter exchange had failed to address the issue. Eventually, fibrin sheath stripping using the loop snare technique was able to successfully restore the catheter function.