Prevalence In Asia Research Articles

Disease burden of Parkinson's disease in Asia and its 34 countries and territories from 1990 to 2021: findings from the Global Burden of Disease Study 2021.

The increasing global population and aging have made Parkinson's disease (PD) a significant public health concern. Comprehensive evaluations of PD burden trends in Asian subregions and countries are lacking. This study investigated PD burden in Asia from 1990 to 2021, categorized by age, sex, and region. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed to assess the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across five Asian subregions and 34 countries/territories, using join-point regression, decomposition analysis, frontier analysis, and Bayesian models to examine changes, influencing factors, and predict future trends. In 2021, the age-standardized PD incidence and prevalence in Asia were higher than the global average, particularly in East Asia (24.16 and 243.46/100,000, respectively). From 1990 to 2021, the incidence of PD in Asia rose by 198.01%, its prevalence rose by 284.35%, mortality rose by 111.27%, and DALY rose by 144.45%. Males consistently presented a greater PD burden than females did, with a growing sex gap over time. PD burden increased with age, especially among those aged 65 years and older. Population aging was the primary driver of new PD cases, and increasing etiological factors led to more patients. Inequalities in the PD burden have increased between high- and low-income areas, with low-income regions being more affected. By 2036, PD incidence is projected to increase in all subregions except the High-income Asia-Pacific region, with males experiencing a higher rate of increase. The PD burden in Asia has significantly increased over the past three decades, particularly in middle-aged and elderly males, middle- and low-SDI countries, and individuals already suffering from PD. The increasing incidence and aging population necessitate the reallocation of medical resources, improved chronic disease management systems, stronger public health interventions, and sustainable development efforts. Research into etiological factors, pathogenesis, early diagnosis, preventive interventions, and regional management is critical.

Emerging trends in cognitive impairment and dementia among older populations in Asia: A systematic review.

Dementia and cognitive impairment rates in Asia have significant policy implications. Contrary to the existing literature, which primarily focused on the Western region, in this study, we provide novel insights into previously unexplored geographical contexts. We aimed to evaluate the prevalence of cognitive impairment and dementia in Asia. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched six bibliographic databases: Web of Science, Medline, Science Direct, Ovid, Google Scholar, and PubMed. We targeted cross-sectional studies on dementia and cognitive impairment in Asia, published between 2019-23. Our extensive search yielded 2593 original articles, of which 39 met eligibility criteria. This selection unveiled a significant rise in dementia and cognitive impairment prevalence in Asia, aligning now with trends observed in Western countries - a novel finding that challenges previous assumptions about regional prevalence disparities. The studies predominantly conducted in East Asia (n = 29), along with limited research from Southeast (n = 2), South (n = 7), and Central Asia (n = 1), underscore the geographical gaps in current research. This shift in prevalence patterns is potentially linked to demographic changes, urbanisation, environmental factors, ethnic diversity, and neuroimaging advancements. Identifying modifiable risk factors associated with dementia in these regions presents new avenues for prevention and intervention strategies. Current dementia research in Asia is concentrated in East Asia, with limited data from Southeast, South, and Central Asia. Comprehensive studies across all parts of Asia are crucial to establishing robust data collection methods and identifying modifiable risk factors. This can help manage and mitigate the growing burden of dementia in these societies.

Parental Awareness, Understanding, and Factors of Stunting among Preschool Children

Undernutrition, including stunting, is a global issue, with significant prevalence in Asia, including Malaysia. Stunting, characterized by low height-for-age in children under five, is a critical health concern. This study focused on parents in Puncak Alam, Selangor, to assess their awareness and understanding of stunting factors. Using a cross-sectional quantitative approach with 137 participants, the study found that most parents had a good awareness and understanding of stunting. Parental education emerged as a key factor influencing understanding. These findings can guide policymakers and health professionals in reducing stunting and improving children's health in Malaysia.

Prevalence and impact of sleep-related breathing disorder in multiple system atrophy patients: a cross-sectional study and meta-analysis.

Sleep-related breathing disorder (SRBD) is a prevalent non-motor symptom in multiple system atrophy (MSA). However, the reported prevalence of SRBD in MSA from different studies has shown inconsistency. Additionally, only one study has examined the impact of SRBD on both motor and non-motor symptoms in MSA. Cross-sectional study of 66 patients with probable MSA from China. SRBD was ascertained with polysomnography (PSG). All the MSA individuals were assessed using the Epworth Sleepiness Scale (ESS), Unified Multiple-System Atrophy Rating Scale (UMSARS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), the Mini-mental State Examination (MMSE), Non-Motor Symptoms Scale (NMSS), and Pittsburgh Sleep Quality Index (PSQI). Moreover, a meta-analysis was conducted by searching studies related to MSA and SRBD in PubMed, Web of Science, Embase, and Cochrane databases. Data were pooled as necessary to calculate prevalence of SBRD with 95% confidence intervals (CI). Our study included 66 patients with MSA, 52 of whom had a diagnosis of SRBD (78.8%). There were no significant differences between the MSA with SRBD and without SRBD groups on the age, sex, disease onset, disease duration, UMSARS I, II, and IV, the NMSS, the HAMA, HAMD, the ESS the FSS, the MMSE, and the PSQI scales. However, MSA patients with SRBD having a significant higher obstructive apnea index and percentage of snoring during sleep than MSA patients without SRBD [10.0 (4.1-10.6) vs. 0.1 (0-0.3), and 8.3 (5.1-12.2) vs. 4.2 (0-7.5)]. Also, between the two groups, the mean and minimum oxygen concentrations during sleep were lower in MSA patients with SRBD than in those without SRBD [93.7 (93-95) vs. 95.5 (95.8-97), p = 0.001] and [83.9 (81.2-89.0) vs. 90.3 (89.8-93.3), p = 0.000]. The primary search strategy identified 701 articles, with 10 meeting the inclusion criteria. The overall prevalence of SRBD in a combined sample of 295 MSA patients was found to be 60.5% (95% CI, 43.2-76.5%). Further analysis revealed that the prevalence of SRBD in MSA patients in Asia was 79.2% (95% CI, 54.7-96.3%), which was higher than that in Europe (41.6, 95% CI, 32-51.5%). The study found a prevalence of 78.8% of SRBD in MSA patients, with a notably higher prevalence in Asia compared to Europe. The majority of SRBD cases in MSA were attributed to obstructive apnea. Furthermore, the presence of SRBD did not show a significant impact on the motor and non-motor symptoms of MSA patients.

Comprehensive assessment of lumpy skin disease prevalence across Asia and African countries: A systematic review and meta-analysis

Lumpy Skin Disease (LSD) stands out as one of the economically significant ailments affecting both small-scale farmers and the broader livestock industry. To gauge its prevalence across Asia and Africa, this study employs a rigorous methodology combining systematic review, and meta-analysis, accounting for heterogeneity. Adhering to the guidelines set forth by the cochrane collaboration’s preferred reporting items for systematic reviews and meta-analysis, present initial search sifted through approximately 6,000 articles spanning from 1990 to 2022, using carefully crafted combinations of keywords; Boolean operators, asterisks, and quotation marks. After meticulous assessment for quality bias, employing inclusion and exclusion criteria, 52 publications were included in present study for analysis. The methodology involved in current study utilizing scientometric tools to determine LSD prevalence, with a median sample size of 293 across various studies, predominantly focusing on cattle and buffaloes. Meta-analysis outcomes were dissected based on parameters such as study period, sample size, tests employed, continents, and species, with samples stratified into two to three categories based on medians for heterogeneity assessment. Meta-analysis unveiled a pooled prevalence rate of 14% in Asia and Africa. The subgroup analysis found an 11% prevalence in Asia and Africa constituted 21%. Clinical observation showed a 19% prevalence followed by other tests and PCR with 12 and 13%, respectively. The results underscore the necessity for effective strategies to control and prevent LSD spread, mitigating its economic impact on the livestock industry. This collaborative and comprehensive assessment is crucial in combating the widespread dissemination of LSD and offers valuable insights for policymakers, veterinarians, and stakeholders in the livestock sector.

The Prevalence and Vaccination Coverage Rates of COVID-19 in Asia: A Cross-sectional Study after Four Years

Asia is the largest and most populous continent and is divided into five regions: Eastern Asia, South-eastern Asia, Central Asia, Southern Asia, and Western Asia. Understanding the pattern of the coronavirus disease 2019 (COVID-19) prevalence in Asia could help researchers and decision-makers learn how to respond to public health emergencies more effectively. By the end of 2023, it would have been nearly four years since the first cases of COVID-19 were detected. In this article, COVID-19 data, including the vaccination coverage rate, were used to examine the COVID-19 prevalence across Asia by the end of 2023 based on income and geographic division. Data on COVID-19, including the vaccination coverage rates, for various Asian countries were collected from reliable, publicly available websites. Then, COVID-19 data were analyzed based on income and geographic division. An analysis of variance (ANOVA) test and an Independent Samples t-test were also performed to assess the variation of the means of COVID-19 data across the continent. As of January 1, 2024, COVID-19 data across Asia's five regions were inconsistent. West Asia was most affected, with the highest cases and deaths per million and most tests performed per population. Eastern Asia had the lowest deaths per million, tests per population, and case-fatality rates (CFRs). The COVID-19 vaccination rates range between 2.39% and 105.7%, while the booster vaccination rates varied from 0% in Kyrgyzstan and Laos to 141.7% in Japan. The ANOVA test showed significant variance in the mean, median age, mean vaccination coverage rates, and mean booster vaccination rates, where Eastern Asia had higher averages than the other parts. The independent t-test revealed significant differences in COVID-19 data means, except for CFRs, where low- and lower-middle-income countries had lower averages than upper-middle and high-income countries. Inconsistent COVID-19 data, including vaccination coverage, across Asia highlights the need for uniform standards in case identification and diagnosis, ensuring equitable vaccine distribution, and providing essential diagnostic resources to all countries for future emergencies.

Huntington's disease prevalence in Asia: a systematic review and meta-analysis.

The epidemiological studies on Huntington's disease (HD) in the Asian population suggest that prevalence rates are significantly lower than in the Western population. We conducted a systematic review of epidemiological studies of HD in Asia to compare the level of impact of the disease on the Asian population. Original articles and reviews about HD prevalence in the Asian population were found through databases such as Embase, Medline, and PsychInfo. Relevant articles were analysed by scrutinising of references, including specific key words. A meta-analysis was performed on prevalence rates to find the degree of similarities with I2. Point Prevalence was measured as the number of people affected by HD in a 100,000 population and expressed as Point Prevalence (PP)= Number of people affected/100,000 with 95% Confidence Intervals (CI95). Results from the random-effect meta-analysis show the highest point prevalence of HD in the Middle East with PP=4.0 (CI95=2.90-5.30). The lowest point prevalence was found in the Chinese population with PP=0.25 (CI95=0.16-0.36). Europe remains at a high prevalence compared to Asian countries with PP=1.00 (CI95=0.82-1.19). The overall prevalence in Asia is PP=0.70 (CI95=0.44-1.0). Our study reveals that HD disease affects the population of Asia to a lesser extent than in Europe. The plausible explanation for differences in prevalence is that in some countries, the affected individuals will not self-refer to HD screening for fear of social stigma, negative influence in marriage, and lack of genetic and neurological testing. Another explanation is that studies that used genetic testing exclusively were able to identify the CAG repeats, subgroups of CAG repeat A1 & A2, and haplogroup C, which has less predisposition to high HD prevalence in Asians compared to the Caucasian population.

AKTIVITAS ANTIJAMUR EKSTRAK ETANOL DAUN KRATOM (Mitragyna speciosa) TERHADAP JAMUR Microsporum canis

The world population experiencing dermatophytosis has reached 20%. Dermatophytosis is an infection caused by dermatophyte fungi. The prevalence in Asia reaches 35.6%. One of the fungi that causes dermatophytosis is Microsporum canis. Microsporum canis is known to be resistant to antifungal drugs. Kratom (Mitragyna speciosa) is a plant originating from Southeast Asia and in Indonesia it is often found in the Kapuas Hulu area, West Kalimantan. Kratom leaves are widely used as herbal medicine and have secondary metabolite compounds that have the potential to be used as antifungals. This study aims to determine the antifungal activity of ethanol extract of kratom leaves (Mitragyna speciosa) on the growth of Microsporum canis. Phytochemical screening was carried out using the Thin Layer Chromatography (TLC) scanner method and spray testing to determine the secondary metabolite compounds of the extract being tested. The test extract was made in concentrations of 5%, 10%, 15%, 20%, 25%, 50%, 75%, and 90% (w/v) with ethanol as a solvent. 8 µg itraconazole discs were used as a positive control and 10% DMSO was used as a negative control. Antifungal activity testing was carried out using the disc diffusion method by measuring the fungal growth inhibition zone. The ethanol extract of kratom leaves contains secondary metabolite compounds, namely alkaloids, terpenoids, steroids, flavonoids and tannins with the most dominant groups of alkaloid and tannin compounds. The results showed that there was no growth inhibition zone for Microsporum canis at all extract concentrations tested. The ethanol extract of kratom leaves does not have antifungal activity against the growth of Microsporum canis.

Seroprevalence of Hepatitis B virus and Associated factors among adult Chronic liver disease patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Background: Hepatitis B virus infection is a global health problem with the highest prevalence in Asia and Sub-Saharan countries. It causes both acute and chronic hepatitis, with complications including cirrhosis and hepatocellular carcinoma. Hence, this study aimed to determine the seroprevalence of hepatitis B virus and associated factors among chronic liver disease patients at University of Gondar Comprehensive Specialized Hospital. Methods: An institutional-based cross-sectional study was conducted at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, from May to September 2021. Data was collected by face-to-face interview using structured questionnaire from the patients’ medical record, and a laboratory test was done on a blood sample for HBsAg and hepatitis C virus antibody. Data was entered using Epi-data 4.6 and exported to SPSS version 26 for analysis. Descriptive analysis was done for the sociodemographic characteristics of the participants. Bivariate and multivariate logistic regression analysis were employed, and the odds ratio using a confidence interval of 95% was retrieved. P-value <0.05 was taken as significant. Results: A total of 227 chronic liver disease patients were enrolled. The mean age of participants was 44.04 (±12.4). Most (84.6%) of them were males, and females account 15.4%. The prevalence of hepatitis B virus infection was 34.8% (95% CI፡ 28.8-41) among chronic liver disease patients. An increased proportion of hepatitis B virus were detected in males (AOR=4.0;95% CI=1.21,13.23). Contact to jaundiced patients (P=0.01), having multiple sexual partners (P=0.001), and hepatitis C virus coinfection (P=0.008) were significantly associated with Hepatitis B virus infection among Chronic liver disease patients. Conclusions: The prevalence of hepatitis B virus infection among Chronic liver disease patients at University of Gondar Comprehensive Specialized Hospital was high. Male gender, having multiple sexual partners, contact to jaundiced patients, and hepatitis C virus co-infection were predominant factors for hepatitis B virus infection among chronic liver disease patients. Therefore, Proper health education and media campaign should be conducted with the general population to inform them about the risk factors of HBV infection and its routes of transmission. Further multicenter studies of high-risk behavior could also be encouraged

A five-year study of Kikuchi Fujimoto Disease in Dr. Cipto Mangunkusumo National Central General Hospital

Link of Video Abstract: https://youtu.be/4GFvBGh4sdI Background: Kikuchi Fujimoto Disease (KFD) is a disease characterized by regional lymphadenopathy and fever. KFD is often misdiagnosed as tuberculosis because of the symptom’s similarities. Several studies have shown KFD prevalence in Asia, however, not much is known about KFD characteristics in Indonesia. This study aimed to determine KFD clinicopathological characteristics in an Indonesian National Central General Hospital and to determine the association between clinical characteristics and KFD histopathological features. Methods: Samples were taken from the medical records of patients with KFD in the span of 2016–2020. The data collected includes age, gender, lymphadenopathy location, clinical diagnosis, clinical symptoms, lymph node size, number of lymph nodes involved, histopathology, and immunohistochemical examination. Data were analyzed using Chi-square and Fisher exact test. Result: It was found that KFD mainly occurred in young women, mean age 25 years old, located in cervical lymphadenopathy, ≤ 2 cm size, and solitary. The main histopathological appearance is phagocytic subtype and necrotic phase, with < 50% coagulative necrosis area. It also appeared KFD with < 50% coagulative necrosis area was found significantly in ≤ 2 cm lymph nodes (p = 0.008). Conclusion: Clinical characteristics and complete histopathological features are important to be assessed in KFD to achieve accurate diagnosis.

Complete mesogastric excision for gastric cancer: is it the future of gastric cancer surgery?

Gastric cancer remains undoubtedly one of the most common and deadly cancers worldwide. The global incidence shows wide geographic variation with a high prevalence in Asia. Besides that, there are evident differences in epidemiology, histopathology, tumor location, diagnosisand treatment strategy between east and west countries. Gastric cancer represents an aggressive disease, with many factors influencing its development and also recurrence after surgical resection. New knowledge of disease spread and new routes of metastases are now emerging and the 'novel' concept of complete mesogastric excision for gastric cancer is under consideration and debate. This article aims to analyze and highlight this new concept after a careful literature review, offering also a view toward the future.

Hubungan Lama Menstruasi, Gaya Hidup, dan Pola Makan dengan Kejadian Anemia pada Remaja Putri di SMK Negeri 1 Lempuing Jaya Kabupaten Ogan Komering Ilir Tahun 2021

Adolescence is a transitional period characterized by physical, emotional and psychic changes. Adolescence, namely the period between 10-19 years, is a period of maturation of the human reproductive organs which is often called puberty, in puberty there are problems that are often faced by adolescents during menstruation. According to the World Health Organization (WHO) 2018 women aged 15–49 years who suffer from anemia in six countries namely Africa, America, Asia, Europe, Eastern Mediterranean, and the Western Pacific region amounted to 409 – 595 million people. The prevalence in Asia, anemia in women aged 15–45 years reaches 191 million people and Indonesia ranks 8th out of 11 countries in Asia after Sri Lanka with a prevalence of anemia of 7.5 million people at the age of 10–19 years. This study aims to find out the relationship between menstruation, lifestyle, and diet with the incidence of anemia in young women at SMK Negeri 1 Lempuing Jaya, Ogan Komering Ilir Regency in 2021. The method in this study used an analytical survey with a cross-secsional design approach so that the total sample was 81 respondents. Data collection is carried out with a questionnaire. The data were analyzed by the Chi-square test formula. Univariate analysis was obtained by students who experienced anemia as many as 35 respondents (43.2%). Normal mentruation duration 50 respondents (61.7%), unhealthy lifestyle 50 respondents (61.7%), irregular diet 44 resonden (54.3%). From the results of the Chi-square static test, the p-Value = 0.005 was obtained, this shows that there is a meaningful relationship between the duration of menstruation and anemia, p-Value = 0.018 which states that there is a lifestyle relationship with anemia in young women, p value Value = 0.013 means that there is a relationship between diet and anemia in young women. The conclusion in this study is that there is a relationship between the duration of menstruation, lifestyle, diet and anemia, in young women. It is hoped that midwives will further improve services and education to young women about reproductive health in adolescents, especially the impact of anemia on young women.

Global prevalence of Neospora caninum in rodents: A systematic review and meta-analysis.

Neosporosis has been considered a cause of abortion in dairy and beef cattle worldwide. Rodents are reservoir hosts for several infectious diseases. It is necessary to determine the prevalence of Neospora caninum in rodents to improve the current understanding of the transmission dynamics of Neospora as well as its life cycle and risk of transmission to livestock. Therefore, the objective of the present study was to estimate the pooled global prevalence of N. caninum in different rodent species. Published studies on the prevalence of N. caninum in different rodent species were searched in the MEDLINE/PubMed, ScienceDirect, Web of Science, Scopus and Google Scholar and the reference lists of the retrieved articles until July 30, 2022. The eligible studies were selected using inclusion and exclusion criteria. The extracted data were verified and analysed using the random-effect meta-analysis. For this meta-analysis, a total of 4372 rodents from 26 eligible studies were included. The global prevalence of N. caninum in rodents was estimated at 5% (95% CI 2%-9%), with the highest prevalence in Asia (12%; 95% CI 6%-24%) and lowest prevalence in America (3%; 95% CI 1%-14%) and Europe (3%; 95% CI 1%-6%). N. caninum was more prevalent in females (4%; 95% CI 2%-9%) than in males (3%; 95% CI 1%-11%). The most common diagnostic test was polymerase chain reaction (PCR) (21 studies). The pooled prevalence of N. caninum in rodents based on the diagnostic method was as follows: immunohistochemistry: 11% (95% CI 6%-20%), NAT: 5% (95% CI 4%-7%), IFAT: 5% (95% CI 2%-13%) and PCR: 3% (95% CI 1%-9%). The results of this study showed a relatively low but widespread prevalence of N. caninum infection in rodents.

Expert Consensus Recommendations on Biomarker Testing in Metastatic and Nonmetastatic NSCLC in Asia.

Most published guidelines for genomic biomarker testing in NSCLC reflect the disease epidemiology and treatments readily available in Europe and North America. Nevertheless, 60% of annual global NSCLC cases occur in Asia, where patient characteristics, tumor molecular profiles, and treatments vary greatly from the Western world. For example, mutations in the EGFR occur at a higher prevalence in Asia than in other world regions. Although medical associations such as the International Association for the Study of Lung Cancer, European Society for Medical Oncology, and American Society of Clinical Oncology have described principles for tumor genomic biomarker testing in NSCLC, there is a need for recommendations specific for Asia. This report provides consensus recommendations for NSCLC biomarker testing from Asian lung cancer experts for clinicians working in Asia to improve patient care. Biomarker testing approaches for actionable genetic alterations inEGFR,ALK,ROS1, and others are discussed. These recommendations are divided into nonmetastatic and metastatic forms of adenocarcinoma and squamous cell carcinoma. Owing to the higher prevalence of EGFR mutations in Asia, the experts emphasized the need for EGFR testing to include not just common mutations (exon 19 deletions and L858R substitutions) but also other uncommon EGFR mutations. In addition to the assessment of biomarkers in the tumor tissue, the role of assessing tumor biomarkers by liquid biopsy is discussed. This consensus provides practical recommendations for biomarker testing in nonmetastatic and metastatic Asian NSCLC patients.

Application of Aptamer-based Biosensors in Early Diagnosis of Gastric Cancer: A Promising Method for Early Detection

Personalized medicine is a relatively new approach that addresses differences between patients based on unique features such as genetic make-up, environment, and physiology. Aptamers are synthetic sequences of single-stranded DNA or RNA with a particular three-dimensional conformation that binds to a target. Aptamer-based biosensors are promising tools to detect disease markers, especially in cancer. Gastric cancer is the third most common cause of cancer-related deaths worldwide and has very high prevalence in Asia. Currently, there is a lack of effective screening tools for the early detection of gastric cancer. Thus, identifying new methods to detect markers of gastric cancer is crucial. In this study, the role of aptamer-based biomarkers in early diagnosis of gastric cancer is reviewed.

Description of Polypharmacy and Interactions that can Reduce the Effectiveness of Dyspepsia Drugs in patient BPJS with Dyspepsia at the Porsea Regional General Hospital based on Prescriptions Period November-January 2020

Dyspepsia is a collection of symptoms of pain, persistent or recurring discomfort in the upper abdomen, feeling full when eating, feeling full quickly, bloating, belching, decreased appetite, nausea, vomiting. Dyspepsia ranks 5th out of the top 10 diseases in hospitalized patients and 6th for outpatients. The prevalence of dyspepsia varies between 7-45%, depending on the definition used in geographic location. The prevalence in Asia is around 8-30%. It is estimated that 30% of patients who come to the gastroenterologist's practice are 60% with complaints of dyspepsia, around 20-40% of adults experience dyspepsia, whereas in general clinics it is only 2-5%. This study aims to Description of Polypharmacy and Interactions that can Reduce the Effectiveness of Dyspepsia Drugs in patient BPJS with Dyspepsia at the Porsea Regional General Hospital based on Prescriptions Period November-January 2020. The research design was descriptive with a retrospective time approach carried out at Porsea Hospital, Toba Regency, based on prescriptions for the period November-Januari 2020, data were collected in February 2020 with a sample of 118 cases using the Simple random sampling technique (November: 41 cases, December: 38 cases, January 39 cases). The instrument used to collect data in this study is the data collection format. The results showed polypharmacy in outpatient BPJS patients with dyspepsia at the Porsea Regional General Hospital for the period November-January 2020, namely 71 (60.17%) cases with major polypharmacy (5-11) and 47 (39.83%) cases with minor polypharmacy. For future researchers to examine the effects of the use of polypharmacy on reducing the effectiveness of dyspepsia drugs with guide books or other references.

Scalp psoriasis and Dermatology Life Quality Index: A retrospective study based on 12-year data from the Malaysian Psoriasis Registry.

Psoriasis affects approximately 2-3% of the population worldwide, although the overall prevalence in Asia is <0.5%. Scalp psoriasis is a common initial presentation of psoriasis, which affects almost 80% of patients with psoriasis. This retrospective descriptive study investigated 1,671 patients with psoriasis with scalp involvement registered with the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. A total of 21,859 patients with psoriasis were registered with the MPR during the study period; among them, scalp involvement was seen in 7.6% (n= 1,671). Female sex preponderance (61%) was observed in the majority of Malay patients (58.5%), followed by the Chinese (16.9%), Indian (17.1%) and other ethnic patients (7.5%). A positive family history of psoriasis was identified in 22.7% (n=380). Approximately 34.8% (n=581) and 11% (n=172) of the patients had nail changes and psoriatic arthropathy, respectively. The mainstay treatment modality was topical treatment (93.6%), followed by systemic therapy (10%) and phototherapy (0.5%). The comorbidities found among the patients with scalp psoriasis included hypertension (27.9%), obesity (26%), dyslipidaemia (21%), diabetes mellitus (18.4%), ischaemic heart disease (5.4%) and cerebrovascular disease (1.3%). Approximately 23% reported a Dermatology Life Quality Index (DLQI) of >10, which indicated moderate-to-severe impairment. The proportion of patients with psoriasis with scalp involvement in our study (7.6%) is much lower than previous reports. Scalp psoriasis markedly negatively impacts the DLQI.

Allergic rhinitis in Chinese young adults from the Singapore/Malaysia cross-sectional genetics epidemiology study (SMCGES) cohort: Prevalence, patterns, and epidemiology of allergic rhinitis

BackgroundAllergic rhinitis (AR) is characterized by the occurrence of at least 2 symptoms of nasal itching, nasal blockage, rhinorrhea, and sneezing, when not afflicted with a cold or flu, with defined atopic sensitization demonstrated by skin prick test or specific IgE responses. Besides the detriment to standard of living and economic burden of AR, both multicentre and single-cohort studies have observed an increase in AR prevalence in Asia over time. MethodsIn total, 12 872 individuals, with mean age 22.1 years (SD = 4.8), were recruited from universities in Singapore and Malaysia. Each participant provided epidemiological data based on an investigator-administered questionnaire adapted from the validated International Study of Allergies and Asthma in Childhood (ISAAC) protocol, and atopy status was determined using a skin prick test (SPT) performed by qualified staff. AR was diagnosed according to Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines and a positive SPT result. ResultsSensitization (determined by SPT) to either Blomia tropicalis or Dermatophagoides pteronyssinus was prevalent in 66.5% of the cohort. Current rhinitis (manifesting ≥2 rhinitis symptoms, within the past 12 months) was observed in 48.9% of our population, while AR, which included atopy status, was estimated at 39.4%. Sneezing and rhinorrhea were the most common symptoms among AR cases. AR prevalence decreased with increasing age (OR: 0.979; 95% CI: 0.969–0.989), while male gender (OR: 2.053; 95% CI: 1.839–2.294), and a parental history of allergic diseases (OR: 2.750; 95% CI: 2.284–3.316) were significant risk factors for AR. Upon adjustment for age, gender, and parental history, housing type (OR: 0.632; 95% CI: 0.543–0.736) and income level (>$6000 vs <$2000; OR: 2.461; 95% CI: 2.058–2.947) remained as significant risk factors for AR, while ever having kept a pet (OR: 1.167; 95% CI: 1.025–1.328) emerged as a risk factor. Conflicting results were obtained for indicators of sedentary lifestyle: frequent physical activity (OR: 1.394; 95% CI: 1.150–1.694) and increased duration spent using the TV/computer (OR: 1.224; 95% CI: 1.006–1.489) both increased the risk of AR. Lastly, we used the Quality of Diet based on Glycaemic Index Score (QDGIS) to assess the Glycaemic Index (GI) level of overall diet. We identified lower GI level of overall diet as a protective factor against AR manifestation (OR: 0.682; 95% CI: 0.577–0.807). ConclusionWhile the previously established non-modifiable risk factors for AR were present in our study population, the identification of modifiable risk factors, such as TV/computer usage, and dietary habits, opens a new area for research, both in the areas of gene-environment interaction, and management of AR.

Review article: the epidemiologic burden of non-alcoholic fatty liver disease across the world.

The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing in parallel with obesity and type 2 diabetes. To review the global epidemiology of NAFLD METHODS: We retrieved articles from PubMed using search terms of NAFLD, epidemiology, prevalence, incidence, and comorbidities. Over 250 articles were reviewed. In 2016, the global NAFLD prevalence was 25%; this increased to >30% in 2019. Prevalence in Asia, Latin America and Middle East-North Africa (MENA) was 30.8%, 34.5% and 42.6%, respectively. Prevalence increased with age. Although prevalence was higher in men, prevalence in post-menopausal women was similar. NAFLD prevalence was higher in certain subpopulations, especially among the obese and those with metabolic syndrome (MS). However, the prevalence of lean NAFLD was 11.2%. The global prevalence of non-alcoholic steatohepatitis (NASH) is estimated between 2% and 6% in the general population. Approximately 7% of patients with NAFLD have advanced fibrosis; rates were between 21% and 50% among patients with NASH. Overall mortality related to NAFLD was 15-20 per 1000 person-years, and increased substantially in patients with NASH, especially in those with components of MS. Recent data suggest mortality/morbidity from NAFLD is increasing globally but NAFLD awareness remains low among patients and healthcare providers. NAFLD poses a global public health problem with a very high disease burden in Asia, MENA and Latin America. Research is needed to better quantify the full impact of NAFLD and to develop strategies to improve awareness and risk stratification.

PREVALENCE OF ANTIMICROBIAL-RESISTANT ENTEROCOCCUS FAECIUM IN COMMERCIAL CATTLE: A SYSTEMATIC REVIEW AND META-ANALYSIS

The use of antimicrobials in animals is broader compared to humans, which can influence the increase in microbial resistance. This study was a systematic review which determined the prevalence of resistant Enterococcus faecium in commercial cattle. Eighteen studies were included, mainly carried out in European countries (n= 9) and in the production (n= 11) and retail (n= 7) environments. The main material used in the detection of the microorganism was milk. The mean prevalence of resistant E. faecium in cattle was 4.3% (95% CI= 2.8–5.0%), but the prevalence in Asia was higher [25.4% (95% CI= 20.5-30.6%)]. There was a higher prevalence in samples from retail (13.7%; 95% CI= 11.5-16.1%) and collected mainly from equipment surfaces (12.5%; 95% CI= 5.5-26.1%) than in the others tested samples. Antibiotics frequently tested were vancomycin, tetracycline, ciprofloxacin, and erythromycin, with resistance percentages of 50%, 59%, 79%, and 94%, respectively. These results reinforce the need to plan interventions to reduce antimicrobials in food-producing animals.