Investigating factors associated with the prevalence of IHD among uncontrolled diabetic patients

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): Monash University Malaysia

Background

Ischaemic Heart Disease (IHD) is the leading cause of death in Malaysia (1), and there is an increasing trend in mortality due to IHD from 15.2% in 2019 to 17.2% in 2020 (2). IHD is one of the NCDs, estimated to have an RM100.79 billion burden of disease cost (health burden resulting from disability and loss of healthy life years), equivalent to 7% of GDP (3). Diabetes mellitus (DM) is known to be one of the risk factors for IHD.

Purpose

This study aimed to investigate the risk factors associated with the prevalence of IHD in uncontrolled diabetic patients. Besides, these characteristics were also compared among the duration of uncontrolled DM (<10 years vs. ≥10 years)

Materials and Methods

A single-center, cross-sectional study was conducted in a cardio referral center using Electronic Medical Record from 1 January 2020 to 31 December 2020. Adult patients aged ≥ 18 years old with uncontrolled type 2 diabetes mellitus (defined as HbA1c ≥7%) had their medical records examined for IHD upon first contact with the Diabetes Mellitus Therapy Adherence Clinic (DMTAC) pharmacist.

Results

A total of 495 participants with uncontrolled diabetes were included in the final analysis. The mean age and HbA1c in the overall cohort were 52.2 (10.9) years and 10.5%, respectively, with 59.4% (n=294) of them having <10 years of underlying diabetes. The majority were obese (64.8%) and had underlying hypertension (78.4%) and hyperlipidemia (78.4%). The prevalence of ischemic heart disease (IHD) among the overall cohort was 19.0% (n=94). Patients with longer underlying diabetes (≥10 years) were significantly older [mean age 56.8 (8.4) vs. 49.0 (11.4), p=<0.001], drinks alcohol [12.0% vs. 6.0%; p=0.022], had underlying hypertension [86.6 vs. 72.8; p=<0.001] and more comorbidities [mean 1.7 (0.55) vs. 1.5 (0.65); p=<0.001] compared to those with <10 years respectively. Independent predictors of IHD events were age 40-49 [OR 5.1 (95% CI 1.1-23.3); p=0.038], 50-59 [OR 5.36 (1.2-23.7); p=0.027] and ≥60 [OR 7.1 (1.6-32.3); p=0.011], alcohol use [OR 2.4 (1.1-5.1); p=0.023], ≥10 years of uncontrolled diabetes [OR 2.0 (1.2-3.3); P=0.007], and underlying hypertension [OR 2.6 (1.2-5.8); p=0.016].

Conclusion

IHD has an indirect impact on social and economic development due to the high burden of the disease cost. In our study, older age, alcohol use, prolonged uncontrolled diabetes, and underlying hypertension seem to be associated with the prevalence of IHD complications. With the understanding of the recent outlook on diabetes, health education for the targeted population may negate this complication.

Effect of dual-functional coating of chicken fillet with pectin-curcumin-lemongrass oil emulsion on the shelf-life stability and fat uptake during frying

This study aims to formulate the optimal pectin-curcumin-lemongrass oil emulsion (PE) for coating of chicken fillet at 50:50%, 70:30%, and 90:10%, based on microbial growth inhibition, freshness consistency, and fat absorption during frying. Throughout the 7 days of storage, chicken fillet coated with 70:30% PE showed significant (P < 0.05) suppressive activity against psychrophilic bacteria (8.09 ± 0.00 log10 CFU g−1) compared to non-coated sample (8.27 ± 0.06 log10 CFU g−1). In contrast, 90:10% PE coating inhibited the growth of yeasts or moulds on chicken fillet at 8.24 ± 0.28 log10 CFU g−1, compared to non-coated sample (9.16 ± 0.14 log10 CFU g−1). The 70:30% PE coating showed a better fillet's toughness (18.30 ± 1.32 N mm−1 s−1) and firmness (1.49 ± 0.22 N mm−1) when compared to fillet without coating. After 7 days of storage, coated and uncoated samples showed the same total colour difference (E value) indicating PE coating preserved the texture of fillet and colour. Both coated samples (70:30% and 90:10%) reduced fat uptake during frying by 13.70%–14.25%. The application of PE coating at 90:10% was effectively functioned as an excellent coating to preserve the quality and safety of fillet.

External beam for the Heavy Ion Accelerator Facility

Radiotherapy using protons and heavier ions is emerging as an alternative to traditional photon radiotherapy for cancer treatment. Ions have a depth-dose profile that results in high energy deposition at the end of the particle’s path, with a relatively low dosage elsewhere. However, the specifics of ion interactions with cellular biology are not yet fully understood. To study the induced biological effects of the ions on cell cultures, an external beam is required as biological specimens cannot be placed in vacuum. The Heavy Ion Accelerator Facility (HIAF) at the Australian National University hosts accelerators for a wide variety of ion-beam research applications. However, HIAF does not currently have an external beam capability. Here, we present an initial design for a radiobiological research capability at HIAF. A systems engineering approach was used to develop the architecture of the apparatus and determine the feasibility of adapting the current facilities to external beam applications. This effort included ion optics calculations, coupled to a Geant4 simulation, to characterise ion beam transitions through a thin window into the air. The beam spread, intensity distributions, and energy of proton and carbon ions were studied as a function of distance travelled from the window, as well as the effects of alternative window materials and thicknesses. It was determined that the proposed line at the HIAF would be suitable for the desired applications. Overall, this feasibility study lays the foundations of an external beam design, a simulation test framework, and the basis for a grant application for an external beam at the HIAF.