Pattern of macronutrients intake among type-2 diabetes mellitus (T2DM) patients in Malaysia

BACKGROUND

The incidence of type 2 diabetes mellitus (T2DM) is rising rapidly in Malaysia. Modifying dietary intake is key to both the prevention and treatment of T2DM. This study aims to investigate the pattern of macronutrient intake among T2DM patients in Malaysia.

METHODS

This study was carried out on adults aged between 35 and 70 years, residing in urban and rural Malaysian communities. A series of standardised questionnaires was used to assess the sociodemographic information, dietary intake and physical activity level of 15,353 respondents who provided informed consent to participate in this study. Blood sampling (finger prick test) and physical examination were performed to obtain blood glucose and anthropometric data, respectively. The Chi-square test was used to assess differences in the trends of macronutrient intake among T2DM patients.

RESULTS

The total number of participants diagnosed with T2DM in this study was 2254. Of these, 453 (20.1%) were newly diagnosed, 1156 (51.3%) were diagnosed for ≤5 years and 645 (28.6%) were diagnosed for > 5 years. Male patients show that there were significant differences among the three groups of T2DM according to the following variables: age, BMI, residency, participant comorbidity of hypertension, family history of T2DM and hypertension, and active smoker. Meanwhile, female patients show significant differences among the three groups of T2DM according to the following variables: age, BMI, marital status, education level, residency, participant comorbidity of hypertension and family history of T2DM. Most of the male patients consumed appropriate proportions of carbohydrate (458, 60.7%) and protein (618, 81.9%). However, female patients did not show any significant differences of the macronutrients intake among the three groups of T2DM patients.

CONCLUSIONS

The pattern of dietary intake among T2DM patients in this study showed consumption of carbohydrate and protein within the range of Malaysian RNI, coupled with high fat intake. Compliance with the Recommended Nutrient Intake (RNI) was satisfactory for both carbohydrate and protein but not for fat. The pattern indicated a preference for fat rather than protein when carbohydrate intake was restricted.

Assessment of dust exposure in a steel plant in the eastern coast of peninsular Malaysia

BACKGROUND

Steel manufacturing produces dust, fumes, and pollutant gases that may give adverse health effects to the respiratory function of workers. Improper occupational hygiene practice in the workplace will affect both workers wellbeing and productivity.

OBJECTIVE

To assess the level of particulate matter [(PM2.5, PM10, and Total Particulate Matter (TPM)], and trace metal dust concentrations in different sections of a steel plant and compare with the occupational exposure values.

METHODS

The work environmental parameters of the particulate matters were evaluated using Indoor Air Quality, while metal dust concentrations were measured using portable personal air sampler. A total of 184 personal samples were randomly collected from workers in three major sections; steel making plant, direct reduced plant, and support group. Trace metal dust concentrations were subjected to wet mineral acid mixture digestion and analysed by atomic absorption spectrophotometer (AAS).

RESULTS

The overall average PM2.5 concentration observed was varied according to the section: steel making plant was 0.18 mg/m3, direct reduced iron plant was 0.05 mg/m3, and support plant was 0.05 mg/m3. Average PM 10 concentration in steel making shop (SMS) plant, direct reduced (DR) plant, and support plant were 0.70 mg/m3, 0.84 mg/m3, and 0.58 mg/m3, respectively. The average TWA8 of trace metal dusts (cobalt and chromium) in all the sections exceeded 1 to 3 times the ACGIH prescribed values, OSHA PELs, NIOSH RELs as well as USECHH OSHA, whereas TWA8 concentration of nickel for each section did not exceed the occupational exposure values.

CONCLUSIONS

The average PM2.5, PM10 and TPM did not exceed the prescribed values, while average trace metal dust concentration TWA8 for cobalt and chromium in all plants exceeded occupational exposure prescribed values. However, the nickel found did not exceed the prescribed values in all the plants except for NIOSH RELs.

Sources of Stress and Coping Strategies among Iranian Physicians

BACKGROUND: Physicians are at risk of having high levels of stress which affect their performance. Finding the stressors and the coping skills to manage stress could be used to develop program to decrease stressful situation. No study has been done on Physicians' stress and coping in Iran. The main objective of this study is to find out the main stressors and coping strategies among Iranian Physicians working in hospital in Tehran-Iran.METHODS: A cross-sectional study was performed on 780 Physicians,using a questionnaire consisted of two sections ;The first section were the stressors which included 67 questions and The second section were The Brief COPE with 28-items for assessing a broad range of coping behaviors among respondents.RESULTS: A total of 1100 questionnaires were distributed to all the available Physicians in the hospitals selected. 780 Physicians returned complete questionnaires with observed response rate of 75%. The majority of respondents (56.9%) were women. The first 3 sources of stress in workplace (Job stressors) are physical environment problem (75%), too much volume of work and poorly paid. The main sources of stress outside the work place (non-job stressors) ranked by Physicians were; financial problem (9.09), not enough time to spend with family (8.87), conflicts with household tasks (7.36).The top five coping strategies used by Iranian Physicians were Behavioral Disengagement, Planning, Instrumental support, Acceptance, and turning to religion.CONCLUSIONS: This study revealed that both workplace and non-job sources of stress can affect the Physicians performance and there is an association between gender and coping skills.

Implication of the prevalence of needlestick injuries in a general hospital in Malaysia and its risk in clinical practice

OBJECTIVES

To determine the prevalence of cases and episodes of needlestick injury among three groups of health care workers in the past one-year, the level of knowledge on blood-borne diseases and universal precautions and the practice of universal precautions. Other factors associated with the occurrence of needlestick injuries and the reporting of needlestick injuries were also analysed.

METHODS

A cross-sectional study was conducted in May 2003 to study the needlestick injuries among 285 health care workers (doctors, nurses, medical students) in a public teaching hospital in Negeri Sembilan, Malaysia.

RESULTS

The prevalence of needlestick injuries among the respondents was 24.6% involving 71 cases i.e. 48.0% among doctors, 22.4% among medical students, and 18.7% among nurses and the difference was statistically significant (p<0.001). There were a total of 174 episodes of needlestick injury. Prevalence of episode of needlestick injuries was highest among doctors (146%), followed by nurses (50.7%) and medical students (29.4%). Cases of needlestick injuries attained lower scores on practice of universal precautions compared to non-cases (p<0.001). About 59% of cases of needlestick injury did not report their injuries.

CONCLUSIONS

The study showed that needlestick injuries pose a high risk to health care workers and it is underreported most of the time. Many needlestick injuries can be prevented by strictly following the practice of universal precautions.

A study on compliance to hearing conservation programme among industries in Negeri Sembilan, Malaysia

Noise is one of the hazards faced by workers. A cross-sectional study was conducted among industries in Negeri Sembilan with the objective to assess their compliance to Hearing Conservation Programme (HCP). The other objectives of this study were to determine the factors influencing it and to show the industries' compliance to each element of the programme. It was also to identify the association between compliance to HCP and the prevalence of hearing impairment and standard threshold shift. Data for this study were collected using questionnaires sent by mail and also the results of the latest audiometric tests. A total of 167 industries were analysed for this study. It was found that 41.3% of these industries fully complied to the programme. It was also found that the industries preferred to provide hearing protection device (92.8%) and least complied to noise control (61.1%). There were significant associations (p<0.05) between compliance and number of employees, status of ownership and the presence of officer in charge of hearing conservation programme. Having at least 150 employees actually raised the compliance to HCP in two folds (beta = 0.717, OR = 2.048, C.I 95% = 1.063 to 3.944). The prevalences of hearing impairment and standard threshold shift were 23.9% and 5.2% respectively. There was no significant association between the prevalence for hearing impairment and compliance to HCP. The prevalence for standard threshold shift was inversely related to compliance. This study showed that compliance percentage need to be improved as an effort to prevent the hearing problems among workers exposed to noise.

Study on incidence of needle stick injury and factors associated with this problem among medical students

Medical students face the threat of needle stick injury with the consequent risk of acquiring blood-borne infection by pathogens such as HIV, Hepatitis B and Hepatitis C while performing their clinical activities in the hospitals. A cross-sectional study was conducted among 417 final year medical students from Universiti Kebangsaan Malaysia (UKM), University Malaya (UM) and Universiti Putra Malaysia (UPM). The aims of the study were to determine the incidence of cases and episodes of needle stick injury among them in the past year. This study was also done to find out the factors that might be associated with the occurrence of this problem. The factors were sociodemographic factors, duration of exposure, level of knowledge of blood-borne diseases and Universal Precaution, perception of risk of blood-borne diseases and level of practice of Universal Precaution. The incidence of needle stick injury among medical students was 14.1% (59 cases). The total number of episodes of needle stick injury was 87 and the incidence of episodes among respondents was high i.e. 20.9%. The highest incidence of episodes of needle stick injury occurred in Obstetric & Gynaecology postings, followed by Medicine and Surgery. For clinical procedures, venepuncture had the highest incidence followed by setting up drips and giving parenteral injections. The results showed the students who had needle stick injury (cases) had lower scores in the practice of Universal Precautions than non-cases (p<0.05). There was a significant association between the level of practice of Universal Precautions and the number of episodes of needle stick injury, i.e. the higher the score for the practice of Universal Precautions, the lower the number of episodes (beta=-2.03 x 10(-2), p<0.05). This study showed that medical students are at risk of needle stick injury and blood-borne infections during their clinical activities while performing procedures on patients especially for those who were poor at practising Universal Precautions. Therefore some preventive measures should be taken by the management of the universities and medical students to avoid the occurrence of these problems.