NORLAILA MUSTAFA
@ukm.edu.my
Consultant Endocrinologist
universiti kebangsaan malaysia
RESEARCH INTERESTS
Diabetes and Obesity
Diabetes in Pregnancy
Reproductive Endocrinology
Scopus Publications
Scopus Publications
Michelle Hwee Pheng Tan, Siew Chin Ong, Nurul Ain Mohd Tahir, Adliah Mhd Ali, and Norlaila Mustafa
Public Library of Science (PLoS)
Introduction Health state utility values (HSUV) for Type 2 diabetes mellitus (T2DM) complications are useful in economic evaluations to determine cost effectiveness of an intervention. However, there is a lack of reference ranges for different severity and stages of individual complications. This study aimed to provide an overview of HSUV decrement ranges for common T2DM complications focusing on different severity and stages of complications. Method A systematic search was conducted in MEDLINE, SCOPUS, WEB OF SCIENCE. (Jan 2000 to April 2022). Included studies for HSUV estimates were from outpatient setting, regardless of treatment types, complication stages, regions and HRQoL instruments. Health Related Quality of Life (HRQoL) outcomes was to be presented as HSUV decrement values, adjusted according to social demographics and comorbidities. Adjusted HSUV decrements were extracted and compiled according to individual complications. After which, subsequently grouped into mild or severe category for comparison. Results Searches identified 35 studies. The size of the study population ranged from 160 to 14,826. The HSUV decrement range was widest for cerebrovascular disease (stroke): -0.0060 to -0.0780 for mild stroke and -0.035 to -0.266 for severe stroke; retinopathy: mild (-0.005 to -0.0862), moderate (-0.0030 to -0.1845) and severe retinopathy (-0.023 to -0.2434); amputation: (-0.1050 to -0.2880). Different nature of complication severity defined in studies could be categorized into: those with acute nature, chronic with lasting effects, those with symptoms at early stage or those with repetitive frequency or episodes. Discussion Overview of HSUV decrement ranges across different stages of each T2DM diabetes-related complications shows that chronic complications with lasting impact such as amputation, severe stroke with sequelae and severe retinopathy with blindness were generally associated with larger HSUV decrement range. Considerable heterogeneities exist across the studies. Promoting standardized complication definitions and identifying the most influential health state stages on HSUV decrements may assist researchers for future cost-effectiveness studies.
Lee-Ling Lim, Zanariah Hussein, Nurain Md Noor, Anis S. Abd Raof, Norlaila Mustafa, Mohamed B. Long Bidin, Rohana Abdul Ghani, Syahrizan Samsuddin, Sy-Liang Yong, Siew-Hui Foo,et al.
Public Library of Science (PLoS)
Aim Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who were managed at publicly-funded hospitals between December 2021 and June 2022. Methods Patients aged ≥18 years with T2D from eight publicly-funded hospitals in the Greater Kuala Lumpur region, who had ≥2 outpatient visits within the preceding year and irrespective of treatment regimen, were eligible. The primary outcome was ≥2 treatment target attainment (defined as either HbA1c <7.0%, blood pressure [BP] <130/80 mmHg, or low-density lipoprotein cholesterol [LDL-C] <1.8 mmol/L). The secondary outcomes were the individual treatment target, a combination of all three treatment targets, and patterns of GDMT use. To assess for potential heterogeneity of study findings, all outcomes were stratified according to prespecified baseline characteristics namely 1) history of atherosclerotic cardiovascular disease (ASCVD; yes/no) and 2) clinic type (Diabetes specialist versus General medicine). Results Among 5094 patients (mean±SD age 59.0±13.2 years; T2D duration 14.8±9.2 years; HbA1c 8.2±1.9% (66±21 mmol/mol); BMI 29.6±6.2 kg/m2; 45.6% men), 99% were at high/very high cardiorenal risk. Attainment of ≥2 treatment targets was at 18%, being higher in General medicine than in Diabetes specialist clinics (20.8% versus 17.5%; p = 0.039). The overall statin coverage was 90%. More patients with prior ASCVD attained LDL-C <1.4 mmol/L than those without (13.5% versus 8.4%; p<0.001). Use of sodium-glucose cotransporter-2 (SGLT2) inhibitors (13.2% versus 43.2%), glucagon-like peptide-1 receptor agonists (GLP1-RAs) (1.0% versus 6.2%), and insulin (27.7% versus 58.1%) were lower in General medicine than in Diabetes specialist clinics. Conclusions Among high-risk patients with T2D, treatment target attainment and use of GDMT were suboptimal.
Michelle Hwee Pheng Tan, Siew Chin Ong, Mohamad Adam Bujang, Shamsul Azhar Shah, and Norlaila Mustafa
Springer Science and Business Media LLC
Ooi Ting Kee, Harmiza Harun, Norlaila Mustafa, Nor Azian Abdul Murad, Siok Fong Chin, Rosmina Jaafar, and Noraidatulakma Abdullah
Springer Science and Business Media LLC
AbstractPrediction model has been the focus of studies since the last century in the diagnosis and prognosis of various diseases. With the advancement in computational technology, machine learning (ML) has become the widely used tool to develop a prediction model. This review is to investigate the current development of prediction model for the risk of cardiovascular disease (CVD) among type 2 diabetes (T2DM) patients using machine learning. A systematic search on Scopus and Web of Science (WoS) was conducted to look for relevant articles based on the research question. The risk of bias (ROB) for all articles were assessed based on the Prediction model Risk of Bias Assessment Tool (PROBAST) statement. Neural network with 76.6% precision, 88.06% sensitivity, and area under the curve (AUC) of 0.91 was found to be the most reliable algorithm in developing prediction model for cardiovascular disease among type 2 diabetes patients. The overall concern of applicability of all included studies is low. While two out of 10 studies were shown to have high ROB, another studies ROB are unknown due to the lack of information. The adherence to reporting standards was conducted based on the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) standard where the overall score is 53.75%. It is highly recommended that future model development should adhere to the PROBAST and TRIPOD assessment to reduce the risk of bias and ensure its applicability in clinical settings. Potential lipid peroxidation marker is also recommended in future cardiovascular disease prediction model to improve overall model applicability.
, Bin Zhou, Kate E. Sheffer, James E. Bennett, Edward W. Gregg, Goodarz Danaei, Rosie K. Singleton, Jonathan E. Shaw, Anu Mishra, Victor P. F. Lhoste,et al.
Springer Science and Business Media LLC
AbstractFasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.
Jennifer L. Carter, Noraidatulakma Abdullah, Fiona Bragg, Nor Azian Abdul Murad, Hannah Taylor, Chin Siok Fong, Benjamin Lacey, Paul Sherliker, Fredrik Karpe, Norlaila Mustafa,et al.
Springer Science and Business Media LLC
Abstract Background No large-scale studies have compared associations between body composition and cardiovascular risk factors across multi-ethnic populations. Methods Population-based surveys included 30,721 Malay, 10,865 Indian and 25,296 Chinese adults from The Malaysian Cohort, and 413,737 White adults from UK Biobank. Sex-specific linear regression models estimated associations of anthropometry and body composition (body mass index [BMI], waist circumference [WC], fat mass, appendicular lean mass) with systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), triglycerides and HbA1c. Results Compared to Malay and Indian participants, Chinese adults had lower BMI and fat mass while White participants were taller with more appendicular lean mass. For BMI and fat mass, positive associations with SBP and HbA1c were strongest among the Chinese and Malay and weaker in White participants. Associations with triglycerides were considerably weaker in those of Indian ethnicity (eg 0.09 [0.02] mmol/L per 5 kg/m2 BMI in men, vs 0.38 [0.02] in Chinese). For appendicular lean mass, there were weak associations among men; but stronger positive associations with SBP, triglycerides, and HbA1c, and inverse associations with LDL-C, among Malay and Indian women. Associations between WC and risk factors were generally strongest in Chinese and weakest in Indian ethnicities, although this pattern was reversed for HbA1c. Conclusion There were distinct patterns of adiposity and body composition and cardiovascular risk factors across ethnic groups. We need to better understand the mechanisms relating body composition with cardiovascular risk to attenuate the increasing global burden of obesity-related disease.
Michelle Hwee Pheng Tan, Siew Chin Ong, Annushiah Vasan Thakumar, and Norlaila Mustafa
Springer Science and Business Media LLC
F D Zahedi, S Husain, A K Wan Hamizan, G J Tuang, H S Gendeh, T J Oui, N Mustafa, and H T Kok
Cambridge University Press (CUP)
AbstractBackgroundOlfactory impairment may be present among patients with coronavirus disease 2019 self-perceived as asymptomatic. This study aimed to assess olfactory function among these individuals.MethodsA cross-sectional study involving patients with coronavirus disease 2019 self-perceived as asymptomatic was conducted. Assessments included the subjective Malaysian Smell and Taste Questionnaire and the culturally adapted Malaysian version of the objective Sniffin’ Sticks Identification smell test.ResultsIn 81 participants (mean age of 31.59 ± 12.04 years), with mean time from diagnosis to smell test of 7.47 ± 3.79 days, subjective assessment showed that 80.2 per cent were asymptomatic (questionnaire score of 6) and 19 per cent had mild symptoms (questionnaire score of 7 and 8). The mean objective smell test score was 10.89 ± 2.11. The prevalence of olfactory impairment was 76.6 per cent among patients with coronavirus disease 2019 self-perceived as asymptomatic. There was no association between the questionnaire and the smell test scores (p = 0.25). There was a correlation between the smell test score and the duration from diagnosis to smell test (p = 0.04).ConclusionThe objective assessment demonstrated that coronavirus disease 2019 patients who perceived themselves as asymptomatic showed olfactory impairment.
Ooi Ting Kee, Harmiza Harun, Norlaila Mustafa, Nor Azian Abdul Murad, Siok Fong Chin, Rosmina Jaafar, Hamat Hamdi Che Hassan, Mohd Zubir Suboh, and Noraidatulakma Abdullah
IEEE
Type 2 diabetes mellitus patients have a relatively higher risk of developing cardiovascular disease compared to non-diabetic individuals due to other microvascular complications. A prediction model is necessary to reduce the risk of cardiovascular disease development and the economic burden due to the treatment costs. This study has developed a cardiovascular disease risk prediction model with participants recruited from Endocrine and Cardiology Clinic in Hospital Canselor Tuanku Muhriz (HCTM). After ranking the 24 features using ANDVA, several classifiers were trained with 80:20 data split and to-fold cross validation using the organized data. A neural networks model with 97.5% accuracy, 97.22% F1 score, and AUC of 0.9979 was selected. A graphical user interface was also developed to provide a user-friendly platform to run the prediction model. The prediction model developed in this study has a high accuracy and precision even though it is trained with a relatively small data size. Prediction models using machine learning should be introduced to the medical settings to assist in the development of cardiovascular complications among diabetes patients.
Kazi Majidur Rahaman, Rabani Remli, Hui Jan Tan, Norlaila Mustafa, Mohd Rizal Abdul Manaf, and Chen Fei Ng
ASEAN Neurological Association
Background & Objective: Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes mellitus (DM). Vitamin D deficiency has been shown to be prevalent among patients with type 2 DM, particularly in those with DPN. This study aimed to look at the association of serum vitamin D level with peripheral neuropathy in patients with type 2 DM. Methods: This was a comparative cross- sectional study conducted in a tertiary hospital in Malaysia. Fifty diabetic patients with DPN and fifty diabetic patients without DPN were recruited. Serum vitamin D level was determined by measuring 25-hydroxyvitamin D [25(OH)D] level. The patients were clinically assessed and screened with Diabetic Neuropathy Symptoms score. Nerve conduction study was performed for patients with DPN. Results: The serum 25(OH)D level was significantly lower in patients with DPN (11.81 [9.09-18.06] vs 18.63 [11.25-22.63] ng/ml; p=0.006). Multiple logistic regression analysis showed that DPN was significantly associated with higher BMI, longer duration of DM, insulin usage and serum 25(OH)D level. The usage of fibrates had negative association with DPN. Subgroup analysis of the DPN group showed that patients with painful DPN had significant lower serum 25(OH)D level (p<0.001) and the clinical severity of DPN negatively correlated with serum 25(OH)D level (p=0.015). Conclusion: Vitamin D deficiency is associated with DPN in patients with type 2 DM. In addition, patients with painful DPN tend to have significantly lower serum 25(OH)D level.
Jamie Hong Im Teoh, , Norlaila Mustafa, and Norasyikin Wahab
Journal of the ASEAN Federation of Endocrine Societies (JAFES)
Autoimmunity associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been well-described as the mechanism of development of thyroid dysfunction following Coronavirus Disease 19 (COVID-19) infection and SARS-CoV-2 vaccination. However, the occurrence of thyroid eye disease (TED) after SARS-CoV-2 vaccination is scarcely described. The postulated mechanisms include immune reactivation, molecular mimicry and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). We report a case of new-onset TED after receiving the SARS-CoV-2 vaccine.
Cheng Jun Chong, Mohd Makmor Bakry, Ernieda Hatah, Nor Asyikin Mohd Tahir, and Norlaila Mustafa
SAGE Publications
Introduction The prevalence of non-adherence to antidiabetic treatment remains high despite various efforts. Thus, the positive effects of the antidiabetic treatment cannot be optimised and the disease progresses to complications. This present systematic review and meta-analysis aimed to evaluate the effects of mobile applications (apps) intervention on medication adherence and type 2 diabetes mellitus (T2DM) control. Methods This research was conducted following the PRISMA guidelines. The databases that had been searched included Web of Science, PubMed, Scopus, Cochrane Library and Ovid from 2017 to 2022. Study characteristics were retrieved and study outcomes such as adherence status and diabetes control were extracted and quantitatively analysed through meta-analysis. Results Eight studies met the final inclusion criteria and were included in the analysis, contributing to a total of 884 subjects. The methodological quality of the included studies was variable. Three studies reported statistically significant improvement in medication adherence through mobile apps intervention. Additionally, the mobile apps intervention proved effective in reducing glycaemic outcomes. As compared to non-mobile apps users, glycated haemoglobin (HbA1c) significantly decreased by 0.36% (95% CI −0.47% to −0.25%), whereas fasting plasma glucose (FPG) significantly decreased by 16.75 mg/dL (95% CI −17.60 mg/dL to −15.80 mg/dL). Conclusion Mobile apps intervention had beneficial impacts on medication adherence and glycaemic parameters. Future research should explore the best practical approach for real-world settings.
Aznida Firzah Abdul Aziz, Tuti Ningseh Mohd-Dom, Norlaila Mustafa, Abdul Hadi Said, Rasidah Ayob, Salbiah Mohamed Isa, Ernieda Hatah, Sharifa Ezat Wan Puteh, and Mohd Farez Fitri Mohd Alwi
Springer Science and Business Media LLC
Abstract Background The practice of referring diabetic patients for dental intervention has been poor despite awareness and knowledge of the oral health effects of diabetes. Likewise, dentists treating patients receiving diabetes treatment are rarely updated on the glycaemic status and as a result, the opportunity for shared management of these patients is missed. This study aimed to provide a standardised care pathway which will initiate screening for diabetes from dental clinics and link patients with primary care for them to receive optimised care for glycaemic control. Method A Modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices to screen for diabetes among patients attending dental clinics for periodontitis. Expert panel members were recruited using snowball technique where the experts comprised Family Medicine Specialists (5), Periodontists (6), Endocrinologists (3) and Clinical Pharmacists (4) who are involved in management of patients with diabetes at public and private healthcare facilities. Care algorithms were designed based on existing public healthcare services. Results The CODAPT© panel recommends referral to primary care for further evaluation of glycaemic status if patients diagnosed with periodontitis record fasting capillary blood glucose levels ≥ 5.6 mmol/L. Intervention treatment options for prediabetes are listed, and emphasis on feedback to the dental healthcare team is outlined specifically. Conclusion The CODAPT© care pathway has the potential to link dental clinics with primary care for diagnosis and/or optimised treatment of prediabetes/diabetes among patients receiving periodontitis treatment.
Syarifah Nafisah Al-Yahya, Muhammad Haffiz Haslam Mohamed Akram, Kasturi Vijaya Kumar, Siti Nor Asyrah Mat Amin, Noor Alifah Abdul Malik, Nor Ain Mohd Zawawi, Nik Ritza Kosai Nik Mahmood, Norlaila Mustafa, Mawaddah Azman, and Marina Mat Baki
Elsevier BV
OBJECTIVE
Maximum phonation time (MPT) is a test to measure glottic efficiency for laryngeal pathology screening and treatment monitoring. The normative value of MPT for South East Asia population has yet to be reported. It is postulated that MPT may be affected by body mass index (BMI) despite the paucity of evidence. Therefore, this study was designed to establish the normative value of MPT for a South East Asia population and investigate its relation to BMI.
DESIGN & SETTING
This cross-sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center between May and September 2017.
PARTICIPANTS AND METHODS
Three hundred males and females with mean age of 30.23 (±11.04) years were recruited in equal number for each gender (n = 150) and divided into 3 groups of 50 according to their BMI (n = 50). The three groups are non-obese (BMI≤22.9kg/m2); obese (BMI between 23 and 34.9 kg/m2); and morbidly obese (BMI >35kg/m2). BMI and Voice Handicap Index-10 (VHI-10) were obtained. The average of three readings of MPT was measured using a stopwatch while the participants phonate /a/, /i/ and /u/. Unpaired t-test and ANOVA were used to compare means between and across groups. Spearman correlation assessed the correlation between MPT and BMI.
MAIN OUTCOME MEASURES
The normative values of MPT of both genders and correlation with BMI were analyzed.
RESULTS
The MPT normative values for males and females in the non-obese group were of 21.41 (±6.85) seconds and 18.05 (±5.06)seconds respectively for /a/. The MPT for all vowels were significantly higher in males across the BMI groups (P ≤ 0.05). There was low negative correlation between MPT and BMI in both genders.
CONCLUSIONS
This pioneering study documented the normative values of MPT among Malaysians showed that males had longer MPT than females across the BMI groups. Obesity affects the MPT in that as BMI increases, the MPT decreases.
Essam Ali Al-Sanaani, Aniza Ismail, Mohd Rizal Abdul Manaf, Leny Suzana Suddin, Norlaila Mustafa, Norlela Sukor, Alabed Ali A. Alabed, Ahmed Abdelmajed Alkhodary, and Syed Mohamed Aljunid
Public Library of Science (PLoS)
Introduction Even in a country with a tax-based healthcare financing system, health insurance can play an important role, especially in the management of chronic diseases with high disease and economic burden such as Type 2 Diabetes Mellitus (T2DM). The insurance coverage among T2DM patients in Malaysia is currently unclear. The aim of this study was to determine the insurance status of T2DM patients in public and private healthcare facilities in Malaysia, and the association between this status and patients’ sociodemographic and economic factors. Methods A cross-sectional study among T2DM patients seeking inpatient or outpatient treatment at a public tertiary hospital (Hospital Canselor Tuanku Muhriz) and a private tertiary hospital (Universiti Kebangsaan Malaysia Specialist Centre) in Kuala Lumpur between August 2019 and March 2020. Patients were identified via convenience sampling using a self-administered questionnaire. Data collection focused on identifying insurance status as the dependent factor while the independent factors were the patients’ sociodemographic characteristics and economic factors. Results Of 400 T2DM patients, 313 responded (response rate, 78.3%) and 76.0% were uninsured. About 69.6% of the respondents had low monthly incomes of <RM5000. Two-thirds of participants (59.1%) spent RM100–500 for outpatient visits whilst 58.5% spent <RM100 on medicines per month (RM1 = USD0.244). Patients who visited a private facility had five times more likely to have insurance than patients who visited a public facility. Participants aged 18–49 years with higher education levels were 4.8 times more likely to be insured than participants aged ≥50 years with low education levels (2 times). Conclusions The majority of T2DM patients were uninsured. The main factors determining health insurance status were public facilities, age of ≥ 50 years, low education level, unemployment, and monthly expenditure on medicines.
Atiqah Salleh, Norlaila Mustafa, Yeit Haan Teow, Mohd Nor Fatimah, Fauzul Azim Khairudin, Ishak Ahmad, and Mh Busra Fauzi
MDPI AG
Tissue engineering products have grown rapidly as an alternative solution available for chronic wound and burn treatment. However, some drawbacks include additional procedures and a lack of antibacterial properties that can impair wound healing, which are issues that need to be tackled effectively for better wound recovery. This study aimed to develop a functionalized dual-layered hybrid biomatrix composed of collagen sponge (bottom layer) to facilitate cell proliferation and adhesion and gelatin/cellulose hydrogel (outer layer) incorporated with graphene oxide and silver nanoparticles (GC-GO/AgNP) to prevent possible external infections post-implantation. The bilayer hybrid scaffold was crosslinked with 0.1% (w/v) genipin for 6 h followed by advanced freeze-drying technology. Various characterisation parameters were employed to investigate the microstructure, biodegradability, surface wettability, nanoparticles antibacterial activity, mechanical strength, and biocompatibility of the bilayer bioscaffold towards human skin cells. The bilayer bioscaffold exhibited favourable results for wound healing applications as it demonstrated good water uptake (1702.12 ± 161.11%), slow rate of biodegradation (0.13 ± 0.12 mg/h), and reasonable water vapour transmission rate (800.00 ± 65.85 gm−2 h−1) due to its porosity (84.83 ± 4.48%). The biomatrix was also found to possess hydrophobic properties (48.97 ± 3.68°), ideal for cell attachment and high mechanical strength. Moreover, the hybrid GO-AgNP promoted antibacterial properties via the disk diffusion method. Finally, biomatrix unravelled good cellular compatibility with human dermal fibroblasts (>90%). Therefore, the fabricated bilayer scaffold could be a potential candidate for skin wound healing application.
Norefrina Shafinaz Md Nor, Chee Wai Yip, Nazlina Ibrahim, Mohd Hasni Jaafar, Zetti Zainol Rashid, Norlaila Mustafa, Haris Hafizal Abd Hamid, Kuhan Chandru, Mohd Talib Latif, Phei Er Saw,et al.
Springer Science and Business Media LLC
AbstractThe rapid spread of the SARS-CoV-2 in the COVID-19 pandemic had raised questions on the route of transmission of this disease. Initial understanding was that transmission originated from respiratory droplets from an infected host to a susceptible host. However, indirect contact transmission of viable virus by fomites and through aerosols has also been suggested. Herein, we report the involvement of fine indoor air particulates with a diameter of ≤ 2.5 µm (PM2.5) as the virus’s transport agent. PM2.5 was collected over four weeks during 48-h measurement intervals in four separate hospital wards containing different infected clusters in a teaching hospital in Kuala Lumpur, Malaysia. Our results indicated the highest SARS-CoV-2 RNA on PM2.5 in the ward with number of occupants. We suggest a link between the virus-laden PM2.5 and the ward’s design. Patients’ symptoms and numbers influence the number of airborne SARS-CoV-2 RNA with PM2.5 in an enclosed environment.
Bin Zhou, Rodrigo M Carrillo-Larco, Goodarz Danaei, Leanne M Riley, Christopher J Paciorek, Gretchen A Stevens, Edward W Gregg, James E Bennett, Bethlehem Solomon, Rosie K Singleton,et al.
Elsevier BV
BACKGROUND
Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories.
METHODS
We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.
FINDINGS
The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.
INTERPRETATION
Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.
FUNDING
WHO.
Katrul Nadia Basri, Nur Azera Tuhaime, Mohd Hafizulfika Hisham, Muhammad Hafiz Laili, Zalhan Md Yusof, Fatin Suraini Mazni, Abdul Rauf Yusof, Norlaila Mustafa, and Hyzan Mohd Yusof
IEEE
Diabetes is one of the non-communicable disease that has high prevalence trends. The use of finger pricking to monitor the glucose level is painful thus non-invasive alternative is needed. Non-invasive finger touch blood glucose NIR spectrosensor was utilized for the in-vivo glucose monitoring on patients at Hospital Universiti Kebangsaan Malaysia (HUKM). The development of predictive model for the glucose monitoring was based on partial least square (PLS) algorithm. Different type of preprocesses were selected to check the performance of the model with different method of signal preprocessing. The optimum number of variable when performing variable selection is 744. The R2C and R2p acquired were 0.2492 and 0.1734 respectively. The RMSEC and RMSEP for the model were 3.0324 and 2.9901 for the combination of preprocessing of generalized least square (Gls) weighting and autoscale (As). Interval PLS (iPLS) was implemented for the wavelength extraction to enhance the predictive model. R2p for 500 variables (wavelength points) shown the best result with a value of 0.2390. RMSEP also has decreased by to 2.8221 from the previous model 2.9956.
Alvin Oliver Payus, Ann Chee Chai, and Norlaila Mustafa
Wiley
Abstract Sinus bradycardia is a rare but important side effect of high‐dose hydrocortisone. It is a self‐limiting condition that recovered spontaneously upon stopping the medication and did not recur with other types of corticosteroids.
Atif Usman, Norlaila Mustafa, Saleem Perwaiz Iqbal, Md Zobaer Hasan, Mohd Farooq Shaikh, Juman Abdulelah Dujaili, and Siew Hua Gan
Wiley
BACKGROUND
Incidence of hypokalemia during management of diabetic ketoacidosis (DKA) is high despite detailed potassium replacement guidelines in its treatment.
AIMS
We aimed to find the role of pHK in development of hypokalemia, and their mutual impact on patient outcomes during DKA management.
METHODOLOGY
Adult DKA patient's admission-data of preceding three years (2015-2017) was retrospectively clerked. Outcomes of interest were time to develop hypokalemia and to terminate emergency department (ED) care (in hours), severity of hypokalemia, and hospitalization length (days). Linear regression was used to determine significant associations/predictors.
RESULTS
The study was concluded on 85 patients. Hypokalemia was observed in nearly three-fourths of all admissions and occurred by the time of ED care termination. Each one mmol/L increase in pHK significantly 1) reduced degree of hypokalemia by 0.07 mmol/L, 2) delayed time to develop hypokalemia by 4.58 hours, 3) and reduced the ED care time by 1.28 hours. Arterial pH was the other factor significantly delaying time to develop hypokalemia (36.25 hours) and facilitating early discharge from ED (13.86 hours). Moreover, each one mmol/L reduction in degree of hypokalemia increased hospitalization length by 1.86 days. Though significant, acute kidney injury negligibly increased hospitalization length by 0.01 days.
CONCLUSION
pH-adjusted potassium (pHK ) shall be used as a marker for hypokalemia and to initiate potassium replacement instead of measure serum potassium in DKA. Utilizing pHK will help to avoid hypokalemia, reduce its severity, and shorten ED care which will subsequently reduce hospitalization length. We expect pHK to improve pharmacoeconomics in future.
Cheow Peng Ooi, Abdul Hanif Khan Yusof Khan, Rosliza Abdul Manaf, Norlaila Mustafa, Norlela Sukor, Paula R Williamson, and Nor Azmi Kamaruddin
BMJ
AbstractIntroductionThyroid dysfunctions (TD) are common medical conditions affecting all global populations. Improved healthcare leading to increasing survival rates and delayed diagnosis rendered significant burden of the disease in the increasing number of patients with TD with comorbid illnesses. Therefore, reducing the burden of TD and improving the quality of care are crucial. Existing poor-quality data that guide evidence-based decisions only provide a fragmented picture of clinical care. The different outcomes across studies assessing the effectiveness of treatments impede our ability to synthesise results for determining the most efficient treatments. This project aims to produce a core outcome set (COS), which embeds the multiple complex dimensions of routine clinical care for the effectiveness studies and clinical care of adult patients with TD.Methods and analysisThis mixed-method project has two phases. In phase 1, we will identify a list of patient-reported and clinical outcomes through qualitative research and systematic reviews. In phase 2, we will categorise the identified outcomes using the Core Outcome Measures in Effectiveness Trials taxonomy of core domains and the International Classification of Functioning, Disability and Health. We will develop questionnaires from the list of outcomes identified from each domain for the two-round online Delphi exercise, aiming to reach a consensus on the COS. The Delphi process will include patients, carers, researchers and healthcare participants. We will hold an online consensus meeting involving representatives of all key stakeholders to establish the final COS.Ethics and disseminationThe study has been reviewed and approved by the Ethics Committee for Research Involving Human Subjects, Universiti Putra Malaysia and the Research Ethics Committee, National University of Malaysia. This proposed COS in TD will improve the value of data, facilitate high-quality evidence synthesis and evidence-based decision-making. Furthermore, we will present the results to participants, in peer-reviewed academic journals and conferences.Registration detailsCore Outcome Measures in Effectiveness Trials (COMET) Initiative database registration: http://www.comet-initiative.org/studies/details/1371
Nor Azian Abdul Murad, , Noraidatulakma Abdullah, Mohd Arman Kamaruddin, Nazihah Abd Jalal, Norliza Ismail, Nurul Ain Mhd Yusof, Norlaila Mustafa, and Rahman Jalal
Journal of the ASEAN Federation of Endocrine Societies (JAFES)
Alvin Oliver Payus, Sat Lin Liew, Nee Tiong, and Norlaila Mustafa
BMJ
Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism is an uncommon clinical phenomenon characterised by lower limb paralysis secondary to hypokalaemia in the background of subclinical hyperthyroidism. In this article, we report a patient who presented with progressive lower limb muscle weakness secondary to hypokalaemia that was refractory to potassium replacement therapy. He has no diarrhoea, no reduced appetite and was not taking any medication that can cause potassium wasting. Although he was clinically euthyroid, his thyroid function test revealed subclinical hyperthyroidism. His 24-hour urine potassium level was normal, which makes a rapid transcellular shift of potassium secondary to subclinical hyperthyroidism as the possible cause. He was successfully treated with potassium supplements, non-selective beta-blockers and anti-thyroid medication. This case report aimed to share an uncommon case of hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism, which to our knowledge, only a few has been reported in the literature.
, Maria LC Iurilli, Bin Zhou, James E Bennett, Rodrigo M Carrillo-Larco, Marisa K Sophiea, Andrea Rodriguez-Martinez, Honor Bixby, Bethlehem D Solomon, Cristina Taddei,et al.
eLife Sciences Publications, Ltd
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.