40 research outputs found
Evaluation of patients with remission following radioactive iodine treatment: a retrospective analysis
No full textIntroduction:
Prompt and appropriate management of thyrotoxicosis is important to prevent premature cardiovascular morbidity and mortality. In this respect, our experience with radioactive iodine therapy (RAI) has been very favourable with 85% achieving remission after six months. Nevertheless, the use of antithyroid drugs post-RAI has been suggested to be associated with hypothyroidism at one year. However, we do not use antithyroid drugs postRAI in our centre. We evaluated the characteristics of our patients who have remission after RAI.
Methodology:
Participants were identified from the list of patients who underwent RAI therapy for thyrotoxicosis in our institution from January 2013 to April 2018. All the patients were referred for RAI following the failure of conventional antithyroid therapy to induce lifelong remission. Patients’ characteristics, clinical outcomes and laboratory results were analyzed from the medical and laboratory records. Descriptive statistics were used to describe the data. Relationships were explored with appropriate statistics with significant findings established at p<0.05.
Results:
A total of 168 patients were identified. Out of 142 (85%) patients who had remission, 58 (34.5%) were euthyroid while 84 (50%) have hypothyroidism within one-year postRAI. There is no association between RAI dose, age, gender, aetiology or day of administration of RAI.
Conclusion:
Despite not using antithyroid post-RAI, remission rate remained high. Since remission is associated with significant hypothyroidism, determining the optimal time for initiating thyroxine replacement treatment is an important area for research
Fertilization the Omission One Test as Determination Limiting Factors for Maize Biomass (Zea Mays L.)
No full textIntroduction: The research was aimed to obtain information on the impact of omission one test fertilization as a determination limiting factors for the growth and biomass of maize in variety Bonanza F1.
Materials and Methods: The research was located in the experimental field, Faculty of Agriculture and Animal Husbandry, Universitas Tjut Nyak Dhien, Medan from December 2020 until February 2021. The research was applied by Randomized Block Design in non-factorial through fertilization of omission one test that has been converted (urea : SP-36 : KCl = 0.75 : 0.50 : 0.125 g polybag-1). The treatment of this research include P0 = non-fertilization; P1= N+P+K; P2= P+K; P3= N+K; P4= N+P using three replications. The parameters include plant height, leaf growth, total fresh weight, total dry weight, and the percentage of relative yield then processed using ANOVA and continued with DMRT at 5% ± standard error with SPSS v.20 software.
Results: Informed that the omission one test technique significantly improved all the characteristics of maize in the variety Bonanza F1. The highest increase in plant height was found in the N+P of 83.65%, meanwhile, the highest leaf and biomass growth characters were found in N+P+K, ranged of 50.00 to 177.81% and 487.60 to 507.37%, respectively. It was obtained that the limiting factor for the maize growth in variety Bonanza F1 was found in the un-fertilization of nitrogen
Species composition and DNA barcoding of hemipteran assemblages throughout paddy growing seasons
No full textHemipterans are the diverse, abundant, and important pests in the paddy ecosystem due to their piercing and sucking mouthparts that feed on the crop causing significant losses in rice yields. Despite their important roles in the paddy ecosystem, the information on DNA barcode, diversity, and species richness has been occasionally discussed. This study aimed to measure its abundance, species richness, and barcode hemipteran species from the paddy ecosystem. Active sampling was used with two different sampling arrangements in the paddy ecosystem in Sabak Bernam, Selangor, for two different seasons. Hemipterans were collected and identified up to species level morphologically prior to DNA barcoding. The richness and the abundance of species were measured along with the paddy growth phases (vegetative, reproductive, and mature). A total of 2,167 individuals of seven hemipteran species (Cyrtorhinus lividipennis, Leptocorisa oratorius, Nephotettix virescens, Cofana spectra, Sogatella furcifera, Scotinophara coarctata, and Graptostethus sp.) were successfully collected with Shannon-Diversity Index (H’ = 0.4572), Margalef richness index (D = 0.7811), and Evenness Index (E = 0.2257). There was no significant difference (p > 0.05) for species diversity in both seasons. The highest abundance of hemipteran was during the maturity stage (1,543 individuals), followed by the reproductive (591 individuals) and vegetative stages (33 individuals). This study observed a significant difference between the paddy growth for both seasons (p < 0.05). Five hemipteran species namely C. lividipennis, L. oratorius, N. virescens, C. spectra, and S. furcifera, were successfully barcoded with Leptocorisa, the dominant genus. Outcomes from this study suggested that different hemipteran management approaches must be developed to cater to different hemipteran species at different paddy growth stages for a successful and sustainable paddy growing practice in Malaysia
Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial
No full textAim: Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing. However, the effect of multi-strain probiotics in people with type 2 diabetes remains unclear. This study investigated the effect of multi-strain microbial cell preparation—also refers to multi-strain probiotics—on glycemic control and other diabetes-related outcomes in people with type 2 diabetes. Design: A randomized, double-blind, parallel-group, controlled clinical trial. Setting: Diabetes clinic of a teaching hospital in Kuala Lumpur, Malaysia. Participants: A total of 136 participants with type 2 diabetes, aged 30–70 years, were recruited and randomly assigned to receive either probiotics (n = 68) or placebo (n = 68) for 12 weeks. Outcomes: Primary outcomes were glycemic control-related parameters, and secondary outcomes were anthropomorphic variables, lipid profile, blood pressure and high-sensitivity C-reactive protein. The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract. Statistical analysis: Intention-to-treat (ITT) analysis was performed on all participants, while per-protocol (PP) analysis was performed on those participants who had successfully completed the trial with good compliance rate. Results: With respect to primary outcomes, glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis (p < 0.05, small effect size of 0.050), while these changes were not significant in ITT analysis. Fasting insulin increased by 1.8 µU/mL in placebo group and decreased by 2.9 µU/mL in probiotics group in PP analysis. These changes were significant between groups at both analyses (p < 0.05, medium effect size of 0.062 in PP analysis and small effect size of 0.033 in ITT analysis). Secondary outcomes did not change significantly. Probiotics successfully passed through the gastrointestinal tract. Conclusion: Probiotics modestly improved HbA1c and fasting insulin in people with type 2 diabetes
Assessment of factors associated with post-dialysis hyperglycemic spike and glycemic variability in patients undergoing maintenance haemodialysis
No full textIntroduction: Chronic hyperglycemia and post-excursion hyperglycemia had been established as independent risk factors for diabetic complications. Recently, the concept of glycemic triumvirate, which encompasses chronic hyperglycemia, hypoglycemia and glycemic variability (GV) being favored as the main pathophysiology in diabetic outcome mainly cardiovascular complications. In Malaysia, cardiovascular disease attributed to one-third of all death in diabetic hemodialysis patients with a 3-fold increase in mortality as compared to non-diabetic patients. Objective: This study is performed to determine magnitude of post-dialysis rebound hyperglycemia, GV and their contributing factors. Methodology: 150 patients on haemodialysis were recruited, 93 patients had end-stage-diabetic-renal disease (DM-ESRD) and 57 patients had end-stage-non-diabetic renal disease (NDM-ESRD). Post-dialysis rebound hyperglycemia and GV indices (standard deviation [SD] and %co-variant [%CoV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles during hemodialysis day (HD) and non-hemodialysis day (NHD). GV were analysed between HD vs. NHD in DM-ESRD patients as well as those with NDM-ESRD. Results: Mean blood glucose during dialysis-day was 9.33 [SD 2.7, %CoV 30.6%] mmol/L in DM-ESRD compared to 6.07 [SD 0.85, %CoV 21.3%] mmol/L in NDM-ESRD (p =<0.01). Post-dialysis rebound hyperglycaemia occurred in 71% of patients (n=105. This spike was pronounced in DM-ESRD compared to NDM-ESRD (83.5% vs. 53.6%; OR 4.39 [95% CI 2.05 – 9.42]). Significantly higher GV indices were observed in DM-ESRD compared to NDM-ESRD during HD and NHD day especially in group with HbA1c 8-10% (p= <0.01). Furthermore, GV indices tended to be higher on HD compared to NHD (p= <0.01). Asymptomatic hypoglycemia was observed in 18% of patients (n=21), mostly during first-hour of hemodialysis. Higher HbA1c levels and older age were the main factors contributing to higher post-dialysis rebound hyperglycemia and GV and in this study (p<0.05). Correlation between HbA1c and mean blood glucose in this population is moderate with r2 = 0.58. Conclusion: Diabetic patients on haemodialysis are at increased risk of post-dialysis rebound hyperglycemia and fluctuations in blood glucose on hemodialysis-days with high HbA1c level and old age being two significant contributing factors. Since this group of patients are vulnerable to CVD mortality urgent attention is needed to rectify it
Medical nutrition therapy administered by a dietitian yields favourable diabetes outcomes in individual with type 2 diabetes mellitus
No full textThis prospective, single-group, pre-post design trial was conducted to evaluate the effect of individualised Medical Nutrition Therapy intervention administered by a dietitian in individuals with type 2 diabetes mellitus on glycaemic control, metabolic parameters and dietary intake. Subjects (n=104; age=56.4 ±9.9 years; 37% male; years of diagnosis = 6.3 ±4.9 years) treated with diet and on a stabile dose of oral anti-diabetic agents were given dietary advice by a dietitian for a 12 week period. Individualised dietary advice was based on Malaysian Medical Nutrition Therapy for adults with type 2 diabetes mellitus. The primary outcome measure was glycaemic control (fructosamine and HbA1c level) and the secondary outcome included measures of anthropometry, blood pressure, lipid profile, insulin levels dietary intake and knowledge on nutrition.
At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-Medical Nutrition Therapy results showed a significant reduction of fructosamine (311.5 ±50 to 297 ±44 umol/L; P9.3% at baseline. Waist circumference (90.7 ±10.2 to 89.1 ±9.8 cm, p<0.05), HDL-cholesterol (1.1 ±0.3 to 1.2 ±0.3 mmol/L, p<0.05), dietary intake and nutrition knowledge score (42 ±19 vs. 75 ±17%; p< 0.001) were significantly improved from the baseline. Individualised Medical Nutrition Therapy administered by a dietitian resulted in favourable diabetes outcomes, which were more apparent for individuals with higher than optimal HbA1c levels at the start of the study
Improvement of dietary quality with the aid of a low glycemic index diet in Asian patients with type 2 diabetes mellitus.
No full textThis randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM).
Asian patients with T2DM (N = 104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record.
At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ = -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ = -0.1 ± 0.2%).
These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM
Profiles and factors associated with poor glycemic control among inpatients with diabetes mellitus type 2 as a primary diagnosis in a teaching hospital
No full textContext: Diabetes mellitus is a growing health problem in most countries. In Malaysia, there was an increase in prevalence over the years. This makes diabetes also a growing concern in Malaysia, which warrants strengthening of the prevention and control programme. Aims: This paper aims to describe the profiles of diabetes mellitus type 2 in tertiary setting and to identify the risk factors for high level of HbA1c among the study population. The findings will give a glimpse on current status of diabetes in our country and may reflect the achievement of the country in combating this disease. Settings and Design: A cross-sectional study was conducted in UKM Medical Centre. Methods and Material: Medical records of patient with E11 ICD-10 code were collected using Case Report Form. Statistical Analysis Used: Descriptive analysis done of mean and median while test of association were done using Spearman correlation and logistic regression. Results: The results showed that majority of inpatients of DMT2 showed mean age of 58.8 + 12.6 years and most were males (56.7%) with secondary level of education (41.7%). Median duration of disease was 12.0 + 11.0 years with median HbA1c level of 8.9 ± 4.4%. Only small proportion of patients achieved the desired level of HbA1c <6.5% (21.3%) and significant association was found with tertiary level of education [AOR=0.10, 95%CI=0.01-0.96] and with type of anti-diabetic therapy [AOR=15.90, 95%CI=2.03-124.30]. Conclusions: In conclusion, diabetes mellitus type 2 inpatients still showed unsatisfactory glycemic control and holistic approach using health education should be advocated continuously in the future in view of education being one of the predictors for the good HbA1c outcome
Development of a spark plug fuel injector for direct injection of natural ags in spark ignition engine
No full textIn the name of God, The Most Gracious, The Most Merciful. By His will, this thesis has
been completed as another episode of knowledge seeking and contribution.
The author wishes to express a greatest gratitude to the academic supervisor for this project,
Dr. Matthew Harrison and Professor Douglas Greenhalgh for their warmth, continuous
guidance and support, priceless knowledge and expertise, and kindly understanding.
Secondly, author's deepest appreciation to Dr. Mark Jermy, the initial supervisor for this
project, for his ideas, understanding, support, availability and generosity for providing
assistance both in author's academic and private life.
To my mother and father whose supplications and encouragements have given me strength
to complete this work. To my family whose support during this course of studies has given
me comfort. To my parents in-law and siblings in-law, thank you for your support.
My dearest gratitude to the beloved wife, Ira for standing by my side and giving me
continuous support throughout this course of study and the hardship of life due to it. Your
sacrifice is priceless. To my children, Balgis, Naufal, Nadiyah and Safiyah, you are my source
of inspirations.
A special thank to Dr. Glenn Sherwood, Tim Lee, Brian Scully, Richard Kennewell, Alan
Hutching, and all others for providing technical supports during the experiment works.
To Andreas, Eudoxios, Anni, Edouard, Fatiha, Alessio, Andy and Adam, I thank you all for
the friendship and helps during my studies
