1.A clinical appraisal of adult psoriasis patients in Serdang Hospital
Shalini Devi P ; Quek SL ; Siti Farah M ; Tan YJ ; Norashikin S ; Norhafizah M
Malaysian Journal of Dermatology 2011;27(-):26-26
Objectives
To determine the socio-demographic profile, clinical characteristics and quality of life of adult psoriasis patients as well as the association between the first two variables with the latter.
Methods
A cross-sectional study of 30 adult psoriasis patients was conducted in the Dermatology Clinic, Serdang Hospital from 9th to 23rd May 2011. A questionnaire regarding clinical data containing multilingual Dermatology Life Quality Index (DLQI) was used in a face-to-face interview.
Results
Male-to-female ratio was 1:1.5. Psoriasis was more common in Malays (76.7%) compared to Chinese (10%) and Indians
(10%), however this ethnic distribution was proportionate to that of the clinic attendance. The onset of psoriasis was during the second to third decade of life in most patients (53.3%) with a mean of 31 years (range 7 - 62). Nine (30%) patients had positive family history of psoriasis. The main aggravating factors were stress and sunlight. Hyperlipidemia was the commonest associated co-morbidity. Plaque psoriasis was the commonest clinical type (66.7%) and majority (66.7%) had <10% body surface area affected. Nail changes were present in 15 (50%) patients and psoriatic arthropathy
occurred in 11 (36.7%), with mono/oligoarticular type being as common as symmetrical polyarthropathy. All patients were treated with topical therapy, six were on systemic medication and only one underwent phototherapy. The mean DLQI score was 10.77 ± 6.22. The duration of disease and the age group were negatively correlated with the DLQI scores (r= -0.45 and -0.42 respectively, p < 0.05).
Conclusion
The clinical findings are similar to previous local studies and are valuable to improve patient care.
2.Synergistic impact of pre-diabetes and immunosuppressants on the risk of diabetes mellitus during treatment of glomerulonephritis and renal vasculitis
Cynthia Ciwei LIM ; Daphne GARDNER ; Rui Zhi NG ; Yok Mooi CHIN ; Hui Zhuan TAN ; Irene YJ MOK ; Jason CJ CHOO
Kidney Research and Clinical Practice 2020;39(2):172-179
Background:
Glomerulonephritis is often treated with kidney-saving, but potentially diabetogenic immunosuppressants such as glucocorticosteroids and calcineurin inhibitors. Unfortunately, there are little data on dysglycemia before and after diagnosis and during treatment of glomerulonephritis. We aimed to evaluate the occurrence and risk factors for pre-diabetes and incident diabetes among non-diabetic patients with glomerular disease with or without treatment with immunosuppressants.
Methods:
A single-center, retrospective cohort study was performed on 229 non-diabetic immunosuppressantnaïve adults diagnosed with glomerulonephritis and renal vasculitis. Patients with known diabetes and prior immunosuppressant treatment were excluded. Outcomes of new-onset pre-diabetes and new-onset diabetes were defined according to American Diabetic Association criteria.
Results:
Pre-diabetes was present pre-biopsy in 74 of the 229 patients (32.3%). During the median follow-up of 34.0 (23.3-47.5) months, 29 patients (12.7%) developed new-onset diabetes and 58 (25.3%) had new-onset prediabetes. Immunosuppressive therapy in patients with pre-existing pre-diabetes was associated with increased odds of new-onset diabetes compared to those without either risk factor (26.0% versus 5.0%; odds ratio, 6.67; 95% confidence interval [CI], 1.41 to 31.64), P = 0.02).
Conclusion
New-onset diabetes after immunosuppressant treatment occurred in one-quarter of patients with glomerulonephritis and pre-existing pre-diabetes. Physicians should screen for pre-diabetes when planning treatment with immunosuppressants, as its presence significantly increases the risk of diabetes mellitus.
3.Impact of Knowledge and Attitudes on Lifestyle Practices in Preventing Type 2 Diabetes Mellitus.
Benson Wg ANG ; Mui Yee TAN ; Cheryl My GOH ; Sylwan RAHARDJA ; Beatrice Y LIM ; Wenqi CHIEW ; Thurston Yj HENG ; Kuang Ian TAN ; Jenies Hx FOO ; Sarah Zl THAM ; Jason Ks CHNG ; Wei Jie SEOW ; Nan LUO
Annals of the Academy of Medicine, Singapore 2019;48(8):247-263
INTRODUCTION:
Diabetes mellitus is a major public health issue in Singapore. To shape healthcare policies for the primary prevention of diabetes, it is crucial to understand Singaporeans' knowledge, attitudes and practices related to diabetes and its prevention. This study aimed to assess the knowledge, attitudes and lifestyles of individuals without diabetes.
MATERIALS AND METHODS:
A cross-sectional household survey was performed between 31 January to 3 February 2019 to examine knowledge, attitudes and practices related to diabetes. Inclusion criteria of the participants included: 1) Singaporeans/permanent residents, 2) between 30 to 64 years old, and 3) who did not have a diagnosis of diabetes. Logistic and linear regression models were used to analyse the association of knowledge and attitudes with physical activity and diet habits, respectively.
RESULTS:
Among 806 participants, 72.2% did not meet the Health Promotion Board's physical activity recommendation. Physical activity was associated with better diabetes knowledge (odds ratio [OR] 5.38, 95% confidence interval [CI] = 1.65-17.53, = 0.049), stronger beliefs in diabetes prevention (OR 3.36, 95% CI = 1.02-11.12, = 0.047) and lower levels of worry about diabetes (OR 0.41, 95% CI 0.17-1.00, = 0.049). Neither knowledge nor beliefs or worries about diabetes was associated with diet.
CONCLUSION
There is a need to reinforce the importance of physical activity and healthy diet in preventing diabetes. Although improving the knowledge level of diabetes may increase physical activity of the population, it is unlikely to improve dietary choices without effective behavior change interventions.
4.Epidemiology and Factors Affecting Functional Outcome of Distal Radial Fracture in an Urban Tertiary Medical Centre in Malaysia
Chao WQ ; Azman MZ ; Rosdi SA ; Tuan-Mustafa TAW ; Tan YJ ; Abdullah S ; Aizuddin AN
Malaysian Orthopaedic Journal 2021;15(No.3):84-90
Introduction: Distal radial fracture is a commonly
encountered fracture. This study aims to study the
epidemiology of distal radial fracture and factors affecting
the patients’ functional outcome one to two years after the
injury.
Materials and methods: This is a retrospective cohort
study. The records of patients, fulfilling the radiographical
diagnosis of distal radial fracture, and aged 18 and above,
who presented to our Emergency Department from 1st
January 2018 to 31st December 2018 were retrieved.
According to AO classification, we grouped our patients into
A (extra-articular), B (partial articular) and C (complete
articular). Patients with congenital abnormalities were
excluded. Epidemiological data and relevant medical history
were obtained and tabulated. A Malaysian language
translation of Disability of the Arm, Shoulder and Hand
(DASH) questionnaire was used to assess the functional
outcome.
Results: Out of 168 patients’ data retrieved, only 110
patients’ data were found complete for purposes of this study.
The mean DASH score was 13.7 ± 7.87 approximately one
to two years post-injury regardless of treatment method.
Increasing age was associated with higher DASH score with
r=0.407(p<0.001). Several variables had significantly better
functional outcome: male gender (p=0.01), Type A fracture
configuration (p=0.007) and non-operational treatment
(p=0.03). There was no significant difference between
treatment modalities in Type A fracture (p=0.094), but
Type B (p=0.043) and Type C (p=0.007) had better outcome
without surgery. There was no significant difference between
different ethnic groups, open or closed fracture and
mechanism of injury.
Conclusion: Better functional outcome after sustaining
distal radial fracture was associated with young age, male
gender, type A fracture and treated non-operatively.
Interestingly, more complex fracture pattern had better
functionality were observed without surgery.