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Kuala Lumpur, Malaysia

Amplavanar N.T.,Institute of Respiratory Medicine
The Medical journal of Malaysia | Year: 2010

This study describes the prevalence of selected cardiovascular disease (CVD) risk factors screened in patients 30 years and above attending a health centre in Cheras, Selangor. The study involved 3772 patients screened from March 2002 to June 2008. Risk factors screened included blood pressure, height, weight, serum total cholesterol, random blood sugar levels and smoking status. Majority of respondents were between 40 and 49 years of age (58.1%), males (64.7%) and ethnic Malays (74.4%). About two thirds (62.6%) were found to be overweight or obese, two fifths (40.2%) had hypercholesterolemia, a third (34.2%) had hypertension and 31.6% were smokers at some time. Overall 87% and 60% had at least one and two CVD risk factors respectively. Prevalence of four of the five risk factors screened was highest among the Malay middle aged men and lowest among the Chinese. Thus a substantial proportion of middle aged men were at high risk of CVD. Our findings show the need for ongoing monitoring of CVD risk factors and implementation of effective preventive strategies. Source

Cho S.-H.,Seoul National University | Lin H.-C.,Chang Gung Memorial Hospital | Ghoshal A.G.,National Allergy Asthma Bronchitis Institute | Abdul Muttalif A.R.B.,Institute of Respiratory Medicine | And 7 more authors.
Allergy and Asthma Proceedings | Year: 2016

Background: Respiratory diseases represent a significant impact on health care. A cross-sectional, multicountry (India, Korea, Malaysia, Singapore, Taiwan, and Thailand) observational study was conducted to investigate the proportion of adult patients who received care for a primary diagnosis of asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), or rhinosinusitis. Objective: To determine the proportion of patients who received care for asthma, AR, COPD, and rhinosinusitis, and the frequency and main symptoms reported. Methods: Patients ages ≥18 years, who presented to a physician with symptoms that met the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Patients and physicians completed a survey that contained questions related to demographics and respiratory symptoms. Results: A total of 13,902 patients with a respiratory disorder were screened, of whom 7030 were eligible and 5250 enrolled. The highest percentage of patients who received care had a primary diagnosis of AR (14.0% [95% confidence interval {CI}, 13.4-14.6%]), followed by asthma (13.5% [95% CI, 12.9-14.1%]), rhinosinusitis (5.4% [95% CI, 4.6-5.3%]), and COPD (4.9% [95% CI, 5.0-5.7%]). Patients with a primary diagnosis of COPD (73%), followed by asthma (61%), rhinosinusitis (59%), and AR (47%) most frequently reported cough as a symptom. Cough was the main reason for seeking medical care among patients with a primary diagnosis of COPD (43%), asthma (33%), rhinosinusitis (13%), and AR (11%). Conclusion: Asthma, AR, COPD, and rhinosinusitis represent a significant proportion of respiratory disorders in patients who presented to health care professionals in the Asia-Pacific region, many with concomitant disease. Cough was a prominent symptom and the major reason for patients with respiratory diseases to seek medical care. Copyright © 2016, OceanSide Publications, Inc. Source

Cao B.,CAS Institute of Microbiology | Huang G.-H.,Chinese National Institute for Viral Disease Control and Prevention | Huang G.-H.,Xinjiang Medical University | Pu Z.-H.,Yantai Yu Huang Ding Hospital | And 16 more authors.
Chest | Year: 2014

Background: Since 2008, severe cases of emerging human adenovirus (HAdV) type 55 (HAdV-55) were reported sporadically in China. But no comparative studies had been conducted to discern the differences in epidemiologic and clinical abnormalities between HAdV-55 and other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). Methods: A multicenter surveillance study for adult and adolescent community-acquired pneumonia (CAP) was conducted prospectively in Beijing and Yan Tai between November 2010 and April 2012. A standardized data form was used to record clinical information. The viral DNA extracted from the clinical samples or adenovirus viral isolates was sequenced. Results: Among 969 cases, 48 (5%) were identified as adenovirus pneumonia. Six branches were clustered: HAdV-55 in 21, HAdV-7 in 11, HAdV-3 in nine, HAdV-14 in four, HAdV-50 in two, and HAdV-C in one. Most HAdV-55 cases were identified during February and March. All the hypervariable regions of the hexon genes of the 21 HAdV-55 strains were completely identical. Patients who had HAdV-55 were about 10 years older (P 5 .027) and had higher pneumonia severity index scores (P 5 .030) compared with those with other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). Systemic BP was also higher among patients in the HAdV-55 group (P 5 .006). Unilateral or bilateral consolidations were the most common radiologic findings in both patients with HAdV-55 and those with other types (57.9% vs 36%). More than one-half of the patients were admitted to hospital; oxygen therapy was given to 29.2% of the 48 patients, and two needed mechanical ventilation. Conclusions: HAdV-55 has established itself as a major pneumonia pathogen in the Chinese population, and further surveillance and monitoring of this agent as a cause of CAP is warranted. © 2014 American College of Chest Physicians. Source

Noor N.Mohd.,University of Technology Malaysia | Rijal O.Mohd.,University of Malaya | Yunus A.,Institute of Respiratory Medicine | Abu-Bakar S.A.R.,University of Technology Malaysia
Computerized Medical Imaging and Graphics | Year: 2010

This paper presents a statistical method for the detection of lobar pneumonia when using digitized chest X-ray films. Each region of interest was represented by a vector of wavelet texture measures which is then multiplied by the orthogonal matrix Q2. The first two elements of the transformed vectors were shown to have a bivariate normal distribution. Misclassification probabilities were estimated using probability ellipsoids and discriminant functions. The result of this study recommends the detection of pneumonia by constructing probability ellipsoids or discriminant function using maximum energy and maximum column sum energy texture measures where misclassification probabilities were less than 0.15. © 2009 Elsevier Ltd. All rights reserved. Source

Sun B.,Capital Medical University | He H.,Capital Medical University | Wang Z.,Capital Medical University | Qu J.,Capital Medical University | And 7 more authors.
Critical Care | Year: 2014

Introduction: Since 2008, severe cases of emerging human adenovirus type 55 (HAdV-55) in immunocompetent adults have been reported sporadically in China. The clinical features and outcomes of the most critically ill patients with severe acute respiratory distress syndrome (ARDS) caused by HAdV-55 requiring invasive mechanical ventilation (IMV) and/or extracorporeal membrane oxygenation (ECMO) are lacking. Methods: We conducted a prospective, single-center observational study of pneumonia with ARDS in immunocompetent adults admitted to our respiratory ICU. We prospectively collected and analyzed clinical, laboratory, radiological characteristics, sequential tests of viral load in respiratory tract and blood, treatments and outcomes. Results: The results for a total of five consecutive patients with severe ARDS with confirmed HAdV-55 infection were included. All five patients were immunocompetent young men with a median age of 32 years. The mean time from onset to dyspnea was 5 days. Arterial blood gas analysis at ICU admission revealed profound hypoxia. Mean partial oxygen pressure/fraction of inspired oxygen was 58.1. Mean durations from onset to a single-lobe consolidation shown on chest X-rays (CXRs) and, from the first positive CXR to bilateral multilobar lung infiltrates, were 2 days and 4.8 days, respectively. The viral load was higher than 1 × 108 copies in three patients and was 1 × 104 in one patient. It was negative in the only patient who survived. The mean duration for noninvasive positive pressure ventilation (NPPV) failure and IMV failure were 30.8 hours and 6.2 days, respectively. Four patients received venovenous ECMO. Four (80%) of the five patients died despite receiving appropriate respiratory support. Conclusions: HAdV-55 may cause severe ARDS in immunocompetent young men. Persistent high fever, dyspnea and rapid progression to respiratory failure within 2 weeks, together with bilateral consolidations and infiltrates, are the most frequent clinical manifestations of HAdV-55-induced severe ARDS. Viral load monitoring may help predict disease severity and outcome. The NPPV and IMV failure rates were very high, but ECMO may still be the respiratory support therapy of choice. Trial registration: Clinicaltrials.gov NCT01585922. Registered 20 April 2012. © 2014 Sun et al., licensee BioMed Central Ltd. Source

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