1.Colorectal Cancer Screening Using Immunochemical Fecal Occult Blood Test
Mun Chieng Tan ; Ooi Chuan Ng ; Ray Yee Paul Yap ; Yan Pan ; Jin Yu Chieng
Malaysian Journal of Public Health Medicine 2017;17(1):33-37
Fecal occult blood test (FOBT) screening has been shown to decrease the incidence and mortality of colorectal cancer
(CRC). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the
immunochemical fecal occult blood test (i-FOBT) in diagnosing CRC were assessed among the patients in a tertiary
referral hospital in Malaysia. A total sample of 814 patients aged 16 to 85 years old who performed i-FOBT and
endoscopic screenings was obtained. The patients were recruited for a retrospective investigation. Sensitivity,
specificity, PPV, and NPV were derived for the CRC screenees. Out of the 814 patients screened using i-FOBT, half of
them were above 59 years old (49.6%), and 36% had positive i-FOBT. Gender distribution was almost equal, where 53.4%
of the patients were female, and 46.6% were male. Majority of the patients were Malays (56.6%), followed by Chinese
(24.0%), Indians (16.5%), and others (2.9%). Among the 71 patients referred for colonoscopy, 57.7% and 42.3%
corresponded to positive and negative i-FOBT cases, respectively. Polyps were found to be most common among the
patients (25.6%), 7.0% were found positive for invasive CRC, and 35.2% had normal colonoscopic findings. There was a
significant association between colonoscopic finding and positive i-FOBT (p=0.001). The sensitivity, specificity, PPV, and
NPV for CRC detection were 66.7%, 43.0%, 9.8%, and 93.3%, respectively. The results indicate that i-FOBT is a useful tool
in the detection of abnormalities in the lower gastrointestinal tract and therefore serves as a cornerstone for potential
large-scale screening programmes.
2.Practice Of Self-Monitoring Blood Glucose Among Insulin-treated Diabetic Patients In Hospital Serdang
Siti Yazmin Zahari Sham ; Subashini C. Thambiah ; Intan Nureslyna Samsudin ; Ng Ooi Chuan ; Yong Shao Wei ; Nur Izzati Razmin
Malaysian Journal of Medicine and Health Sciences 2016;12(2):38-44
Background: Diabetes Mellitus (DM), characterised by chronic
hyperglycaemia, exposes patients to acute and chronic
complications, such as hypoglycaemia and vascular
complications, respectively. The latter is associated with the
degree of glycaemic control. Glycated haemoglobin (HbA1c)
indicates long-term glycaemic control of the preceding 2-3
months. The practice of self-monitoring blood glucose (SMBG)
is essential for insulin-treated diabetic patients to achieve
optimum glycaemic control and prevent hypoglycaemia. Aim:
The study aimed to determine the SMBG practice and frequency
and its association with HbA1c and factors in insulin-treated
diabetic patients. Methods: This was a cross-sectional study of
insulin-treated diabetic patients attending follow-up at the
diabetic clinic of Hospital Serdang from April 2015 to August
2015. Consented eligible patients completed validated selfadministered
questionnaires. Patients’ HbA1c results were
obtained from the hospital information system. Results: Ninetyone
of 137 (66%) patients practiced SMBG and 46 (34%) did
not. Although 82% had seen diabetic nurses, 54% of patients did
not alter their treatment accordingly. Neither the practice nor the
frequency of SMBG was significantly associated with
differences in HbA1c levels (p=0.334 and p=0.116 respectively).
Ethnicity and household income significantly affected SMBG
practice. The presence and frequency of hypoglycaemia
significantly increased the likelihood of SMBG practice
(p<0.001) and frequency (p<0.001). Conclusions: The
prevalence of SMBG practice in diabetic patients on insulin was
66%. However, SMBG was not followed by proper treatment
alteration in 54% of patients. There was no association between
SMBG practice and frequency with good glycaemic control.
Hypoglycaemia significantly affected the practice and frequency
of SMBG.
Insulin
3.Dietary Compliance, Dietary Supplementation and Traditional Remedy Usage of Type 2 Diabetic Patients With and Without Cardiovascular Disease.
Mun Chieng TAN ; Ooi Chuan NG ; Teck Wee WONG ; Anthony JOSEPH ; Abdul Rahman HEJAR ; Abdul Aziz RUSHDAN
Clinical Nutrition Research 2015;4(1):18-31
This analytical cross-sectional study examined the nutrient intakes, dietary compliance, dietary supplementation and traditional remedy usage in type 2 diabetes mellitus (T2DM) patients from selected tertiary hospitals in multi-racial Malaysia. We compared the different characteristics of T2DM patients with and without cardiovascular disease (CVD). Socio-demographic status, dietary intakes, dietary supplementation, traditional remedy use, medical history, anthropometric measurements and clinical characteristics were obtained from face-to-face interviews. A total of 313 patients who were treated for T2DM participated in this study, in which 36.1% of them had CVD. The mean age of study subjects was 55.7 +/- 9.2 years; mean diabetes duration was 10.1 +/- 8.1 years; 52.1% were females; and 47.0% were Malays. The mean total energy intake of the subjects was 1674 +/- 694 kcal/day, and patients with CVD consumed higher total calories (p = 0.001). Likewise, the mean carbohydrate, protein and total fat intake of CVD patients were significantly higher than non-CVD patients (p < 0.05), while mean intakes of cholesterol, fibre, minerals and all vitamins were comparable between CVD and non-CVD patients. Regardless of CVD status, a notably high proportion of the subjects did not meet the recommendations of the Medical Nutrition Therapy Guidelines for Type 2 Diabetes for total energy, carbohydrate, protein, total fat, and fibre intakes. Meanwhile, 52.4% used at least one dietary supplement and 12.1% took single traditional remedy or in various combinations. Traditional remedies and supplement intake did not differ between CVD and non-CVD subjects. It is suggested that T2DM patients should be educated based on their personalized dietary intake, dietary supplementation and traditional remedy usage. The recommendations for T2DM patients shall be met to achieve the optimal metabolic goals and minimize the potential diabetic complications.
Cardiovascular Diseases*
;
Cholesterol
;
Compliance*
;
Cross-Sectional Studies
;
Diabetes Complications
;
Diabetes Mellitus, Type 2
;
Dietary Supplements*
;
Energy Intake
;
Female
;
Humans
;
Malaysia
;
Minerals
;
Nutrition Therapy
;
Tertiary Care Centers
;
Vitamins
4.The association of cardiovascular disease with impaired health-related quality of life among patients with type 2 diabetes mellitus.
Mun Chieng TAN ; Ooi Chuan NG ; Teck Wee WONG ; Abdul Rahman HEJAR ; Joseph ANTHONY ; Harri SINTONEN
Singapore medical journal 2014;55(4):209-216
INTRODUCTIONThe aim of this study was to evaluate the health-related quality of life (HRQoL) of Malaysian patients with type 2 diabetes mellitus (T2DM) who have cardiovascular disease (CVD), as well as identify the determinants of HRQoL among this cohort of patients.
METHODSThis study was an analytical cross-sectional study involving 313 patients aged 30-78 years (150 men, 163 women; mean age 55.7 ± 9.2 years) who were diagnosed with T2DM (mean duration of T2DM 10.1 ± 8.1 years) at two tertiary Malaysian government hospitals. The patients' sociodemographic, lifestyle, clinical and laboratory data were collected prospectively from medical records and via face-to-face interviews. HRQoL was assessed using the 15D instrument - a generic, 15-dimensional and standardised measure of HRQoL that can be used as both a profile and a single index score measure.
RESULTST2DM patients with CVD were found to have significantly lower 15D HRQoL scores than their nonCVD counterparts (p < 0.001). The HRQoL of T2DM patients with CVD was significantly lower than those without CVD (p < 0.05) in all of the 15 dimensions of the 15D instrument. Multinomial logistic regression analysis using backward stepwise method revealed a significant association between CVD and impaired HRQoL (odds ratio [OR] 11.746, 95% confidence interval [CI] 4.898-28.167). Age (OR 1.095, 95% CI 1.054-1.137), duration of T2DM (OR 1.085, 95% CI 1.032-1.140), ethnicity (OR 0.411, 95% CI 0.187-0.903), body mass index (OR 1.074, 95% CI 1.006-1.148), and physical activity level (OR 3.506, 95% CI 1.415-8.689) were also significant predictors of HRQoL.
CONCLUSIONIn T2DM patients, the presence of CVD was significantly associated with a lower HRQoL. Therefore, the importance of tertiary prevention to minimise the potential deterioration of the HRQoL of T2DM patients with CVD should be highly emphasised.
Adult ; Aged ; Cardiovascular Diseases ; complications ; psychology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; complications ; psychology ; Female ; Humans ; Malaysia ; Male ; Middle Aged ; Quality of Life ; Social Class ; Surveys and Questionnaires ; Tertiary Care Centers