exudates and Alcoholism

Chronic pancreatitis is a difficult disease to treat. Worldwide, alcohol is the most common aetiology but based on recent studies it is clear that genetic susceptibility plays an important role in determining disease. Several important genetic mutations have been identified. The prevalence of chronic pancreatitis appears to be lower in Asia although very high rates have been reported in parts of India. Severe intractable pain is the predominant presenting complaint of patients. The natural history of the disease and the onset of exocrine and endocrine insufficiency depend on the classification of disease as early onset, late-onset or alcohol associated. Complications of chronic pancreatitis are important and include pseudocyst formation, bile duct and duodenal strictures.

Topics: Alcoholism; Chronic Disease; Disease Susceptibility; Humans; Malaysia; Mutation; Pancreatitis; Prevalence

In this study, we aimed to determine the prevalence and risk factors of alcohol use among a cohort of population in Sabah.. This is a prospective, cohort study involving rural community residents.. Rural community resident at Bingkor, Keningau, Sabah.. 363 individuals aged 13 years old and above.. Community-based participatory research to determine the prevalence and risk factors associated with alcohol use.. Measurement of alcohol use using Alcohol Use Disorders Identification Test (AUDIT) and assessment of psychiatric morbidity using Mini International Neuropsychiatric Interview (MINI) questionnaires.. Most alcohol drinkers aged between 36-45 years old, followed by 26-35 years old and 46-55 years old. Interestingly, there are almost similar female to male ratio. Most were Kadazan-Dusun ethnic, non-Muslims, and married. Although only less than a third of the participants received tertiary education, the majority were working. Based on the findings, being a male, non-Muslim and having an obsessive-compulsive disorder (OCD) (current) posed a significantly higher risk of alcohol consumption.. A worryingly high prevalence of hazardous alcohol consumption among the locals is reported. There is a need for population-wide intervention towards preventive measures based on the identified risk factors for hazardous alcohol use.

Topics: Adolescent; Adult; Alcohol Drinking; Alcoholism; Borneo; Community-Based Participatory Research; Female; Humans; Indigenous Peoples; Malaysia; Male; Middle Aged; Prevalence; Prospective Studies; Risk Factors; Young Adult

Three single nucleotide polymorphisms (SNPs) in alcohol-metabolizing genes - ADH1B (Arg47His), ADH1C (Ile350Val) and ALDH2 (Glu504Lys) have been extensively associated with flush reaction and alcoholism. Therefore, we investigated the association of these three SNPs with alcohol-induced reactions (AIRs), alcoholism risk, personality and anthropometric traits among Malaysian university students. AIRs, Self-Rating of the Effects of Alcohol (SRE) and Ten-Item Personality were surveyed, anthropometric measurements and DNA samples were taken. Among 264 valid drinkers (111 males, 153 females; 229 ethnic Chinese, 35 ethnic Indians), the minor allele frequencies for ADH1B, ADH1C, ALDH2 among Chinese/Indians were .45/.07, .33/.40, .32/.41, respectively; distribution of ADH1B alleles significantly different between ethnicities. Current/former experiences of flushing, hives, heart palpitations after alcohol consumption; and sleepiness, headache reactions, early and overall SRE were significantly different between ethnicities and genders, respectively. Overall SRE score was associated with ADH1C and ALDH2 alleles. 'Openness to Experiences' was associated with ALDH2 genotypes and alleles; Glu/Glu or Glu carriers showed significantly higher means. ADH1B Arg/Arg and Arg carriers showed significantly higher total body and subcutaneous fats but association was abolished after controlling for ethnicity. In conclusion, gender and ethnicity, but not alcohol-metabolizing gene variants, play a role in influencing the manifestation of AIRs.

Topics: Adipose Tissue; Adult; Alcohol Dehydrogenase; Alcohol Drinking in College; Alcoholism; Aldehyde Dehydrogenase; Aldehyde Dehydrogenase, Mitochondrial; Female; Humans; Malaysia; Male; Personality; Polymorphism, Single Nucleotide; Risk Factors; Students; Universities; Young Adult

Alcohol is the number three contributor to the burden of disease worldwide so must remain a priority health promotion issue internationally. Malaysia is a Muslim country and alcohol-related harm was not seen as a priority until recently, because it only affects a minority of the population. Sabah has more than 30 different ethnic groups, and alcohol has a traditional role in the cultural practices of many of these groups. In 2009, the Intervention Group for Alcohol Misuse (IGAM) was formed, under the umbrella of Mercy Malaysia by a group of healthcare workers, academics, members of the Clergy and people who were previously alcohol-dependent concerned about the harmful effects of excessive alcohol consumption. IGAM in collaboration with other bodies have organized public seminars, visited villages and schools, encouraged the formation of a support group and trained healthcare professionals in health promotion intervention. The focus later changed to empowering communities to find solutions to alcohol-related harm in their community in a way which is sensitive to their culture. A standard tool-kit was developed using WHO materials as a guide. Village committees were formed and adapted the toolkit according to their needs. This strategy has been shown to be effective, in that 90% of the 20 committees formed are actively and successfully involved in health promotion to reduce alcohol-related harm in their communities.

Topics: Alcohol Drinking; Alcoholism; Community Networks; Culture; Ethnicity; Harm Reduction; Health Promotion; Humans; Malaysia

Alcohol-dependence (AD) is a ravaging public health and social problem. AD diagnosis depends on questionnaires and some biomarkers, which lack specificity and sensitivity, however, often leading to less precise diagnosis, as well as delaying treatment. This represents a great burden, not only on AD individuals but also on their families. Metabolomics using nuclear magnetic resonance spectroscopy (NMR) can provide novel techniques for the identification of novel biomarkers of AD. These putative biomarkers can facilitate early diagnosis of AD.. To identify novel biomarkers able to discriminate between alcohol-dependent, non-AD alcohol drinkers and controls using metabolomics.. Urine samples were collected from 30 alcohol-dependent persons who did not yet start AD treatment, 54 social drinkers and 60 controls, who were then analysed using NMR. Data analysis was done using multivariate analysis including principal component analysis (PCA) and orthogonal partial least square-discriminate analysis (OPLS-DA), followed by univariate and multivariate logistic regression to develop the discriminatory model. The reproducibility was done using intraclass correlation coefficient (ICC).. The OPLS-DA revealed significant discrimination between AD and other groups with sensitivity 86.21%, specificity 97.25% and accuracy 94.93%. Six biomarkers were significantly associated with AD in the multivariate logistic regression model. These biomarkers were cis-aconitic acid, citric acid, alanine, lactic acid, 1,2-propanediol and 2-hydroxyisovaleric acid. The reproducibility of all biomarkers was excellent (0.81-1.0).. This study revealed that metabolomics analysis of urine using NMR identified AD novel biomarkers which can discriminate AD from social drinkers and controls with high accuracy.

Topics: Adult; Alcohol Drinking; Alcoholism; Biomarkers; Cross-Sectional Studies; Female; Humans; Magnetic Resonance Spectroscopy; Malaysia; Male; Metabolomics; Middle Aged; Phenotype; Reproducibility of Results; Valerates; Young Adult

At present, much of the attention within tuberculosis (TB) management is spent on microbiological cure, and its impact on health-related quality of life (HRQoL) is either undervalued or seldom considered. The aim of this study was to evaluate the impact of TB treatment on HRQoL of new smear positive pulmonary tuberculosis (PTB) patients. Moreover, we also aimed to determine whether the selected socio-demographic and clinical variables were predictive of variability in the HRQoL scores over time.. This was a prospective follow-up of new smear positive PTB patients who were diagnosed at the chest clinic of Penang General Hospital between March 2010 and February 2011. All eligible patients (i.e., a new case of smear positive PTB, literate and aged 18 years or above) were asked to self-complete the SF-36v2 questionnaire at the start of their treatment, and then subsequently after the intensive phase and at the end of the treatment. A score on a health domain or component summary measure that was less than 47 norm-based scoring (NBS) point was considered indicative of impaired function within that health domain or dimension. Likewise, an individual having mental component summary (MCS) score ≤ 42 NBS point was considered to be at the risk of depression. Repeated measures ANOVA test was performed to examine how the summary scores varied over time, and to determine whether independent variables were predictive of variability in the physical component summary (PCS) and MCS scores over time.. A total of 216 patients completed the SF-36v2 questionnaire at the start of their treatment. Out of these, 177 and 153 completed the questionnaire at the second and third follow-ups, respectively. The mean PCS scores at the start of the treatment, after the intensive phase and at the end of treatment were 41.9 (SD 5.1), 45.8 (SD 4.8) and 46.0 (SD 6.9), respectively. Similarly, the mean MCS scores at the start of the treatment, after the intensive phase and at the end of the treatment were 39.9 (SD 7.3), 45.0 (SD 6.8) and 46.8 (SD 7.8), respectively. More than 23% of the patients were at the risk of depression at the end of their TB treatment. Patient's age and being a smoker were predictive of differences in the PCS scores. Similarly, monthly income, being a smoker and TB-related symptoms at the start of the treatment were predictive of differences in the MCS scores.. Although HRQoL improved with the treatment, the scores on component summary measures showed compromised physical and mental health among study patients even at the end of their TB treatment.

Topics: Alcoholism; Analysis of Variance; Female; Follow-Up Studies; Health Status Indicators; Humans; Longitudinal Studies; Malaysia; Male; Middle Aged; Prospective Studies; Quality of Life; Smoking; Socioeconomic Factors; Surveys and Questionnaires; Tuberculosis, Pulmonary

Depression among adolescents has been recognized as a major public health issue. The objective of this study was to determine the prevalence and correlates of depression among school-going adolescents in Malaysia. Data from the Malaysia Global School-based Health Survey (GSHS) 2012 were analyzed with additional data from the validated DASS21 (Depression, Anxiety, and Stress) questionnaire. The study revealed that 17.7% of respondents had depressive symptoms. Multivariate analysis further showed that feeling lonely (adjusted odds ratio [aOR] = 2.99; 95% CI = 2.57-3.47), Indian ethnicity (aOR = 2.00; 95% CI = 1.63-2.44), using drugs (aOR = 1.85; 95% CI = 1.21-2.82), and being bullied (aOR = 1.79; 95% CI = 1.60-1.99) were significantly associated with depressive symptoms. Lack of parental supervision, alcohol use, and tobacco use were also significant risk factors. Addressing depressive symptoms among adolescents may have implications for managing their risks of being bullied and substance use. This study also highlights the need to further investigate depressive symptoms among adolescents of Indian ethnicity.

Topics: Adolescent; Alcoholism; Bullying; Depression; Ethnicity; Female; Health Surveys; Humans; India; Loneliness; Malaysia; Male; Multivariate Analysis; Parent-Child Relations; Prevalence; Risk Factors; Students; Tobacco Use

To determine the prevalence of alcohol-use disorder and associated correlates amongst bipolar patients in a university hospital in Malaysia.. In this cross-sectional study, a total of 121 bipolar disorder patients were included. Their alcohol use disorders were assessed with the Mini International Neuropsychiatric Interview (plus version) and the Addiction Severity Index-Lite-Clinical Factors version. The number of lifetime hospitalizations and the survival days (the number of days between the last discharge and the most current readmission) were calculated.. The prevalence of alcohol-use disorder amongst bipolar patients was 18.2%. Indian ethnicity was the only demographic factor that was statistically associated with alcohol-use disorder (p < 0.03). Those with alcohol-use disorder had a significantly higher rate of suicidal attempt (p < 0.01) and more psychiatric hospitalizations than those without after adjusting for gender, race, employment status, education level and duration of illness (p < 0.01).. The prevalence of alcohol-use disorder was low in bipolar patients but highin the general population of Malaysia. Since alcohol-use disorder, as well as the potential interactions with the course of the disorder, is highly prevalent amongst bipolar patients, alcohol use should be addressed in these patients.

Topics: Adult; Alcoholism; Asian People; Bipolar Disorder; Cross-Sectional Studies; Female; Hospitalization; Hospitals, University; Humans; Interview, Psychological; Kaplan-Meier Estimate; Malaysia; Male; Prevalence; Risk Factors; Severity of Illness Index; Sex Distribution; Suicide, Attempted

This paper reports the characteristics and psychopathology of alcohol dependents with alcohol induced psychotic disorder admitted to the Seremban Hospital. The method is that of a case study of all alcohol dependents with alcohol induced psychotic disorder admitted to the Psychiatric Ward, Hospital Seremban over 3 years (1993-1995). There were 34 subjects, 30 Indians, 3 Chinese and 1 Malay with a mean age of 43 years. 32 were men and predominantly of Social Class IV and V (91%). They had a mean duration of drinking of 14.2 years and had a mean weekly consumption of 69.5 units of alcohol. There was a family history of alcohol dependence in (44%). The majority (68%) consumed samsu with beer the second choice. Auditory hallucinations (26) and delusions (16) were common while visual hallucinations (3) and depression (2) were less frequent. Speech disorder occurred in 4 subjects. 2 developed delirium tremens and 1 died. Liver function test was normal in 55%. All except the death from delirium tremens responded to treatment with a combination of anxiolytics, thiamine and antipsychotics and were rapidly discharged. The mean stay was 7 days. However, (68%) did not return for follow up and only 4 were abstinent from alcohol at the time of follow up.

Topics: Adult; Alcoholism; Anti-Anxiety Agents; Antipsychotic Agents; Diazepam; Drug Therapy, Combination; Female; Haloperidol; Hospitals; Humans; Longitudinal Studies; Malaysia; Male; Psychotic Disorders; Thiamine

This study examines the usefulness of the "CAGE", (which is an acronym for "cut down", "annoyed", "guilty" and "eye-opener"), a 4-question screening test to identify excessive drinkers among Malaysian inpatients. The CAGE questionnaire after translation and back translation was administered to all inpatients in the General Hospital, Kuala Lumpur. The author interviewed 'blindly' all who score positive on the CAGE score and 10% of all negatives using the DSM III interview schedule for alcohol abuse dependence. The results show that the CAGE performs best at a cut-off point of 2 and above, with a sensitivity of 92%, specificity of 62%, positive predictive values of 38% and Kappa (K) of 0.37 with a DSM III R diagnosis for alcohol abuse/dependence. The poor agreement with a DSM III diagnosis indicates that the CAGE is not useful in the Malaysian population. Reasons suggested for this are: cultural factors in the Malaysian population resulting in the overrating of the question of 'guilt' by Muslims and translations into the local languages which are only the closest approximations.

Topics: Alcoholism; Cross-Sectional Studies; Culture; Guilt; Hospitals, General; Humans; Interview, Psychological; Islam; Language; Malaysia; Predictive Value of Tests; Self-Assessment; Sensitivity and Specificity; Single-Blind Method; Surveys and Questionnaires

Topics: Adult; Alcoholism; Cross-Sectional Studies; Developing Countries; Ethnicity; Female; Humans; Incidence; Malaysia; Male; Mass Screening; Patient Admission

This study establishes the prevalence rate for alcoholism among the inpatients of the General Hospital, Kuala Lumpur, as 11%, but as 25% among the drinking population. It also describes the demographic profile of the alcoholic as compared to the non-alcoholic drinker and the non-drinker and suggests that certain vulnerability factors could contribute to the development of alcoholism. A trend noted is also the changing racial trends in the use of alcohol.

Topics: Alcohol Drinking; Alcoholism; Female; Hospitals, General; Humans; Inpatients; Life Style; Malaysia; Male; Prevalence; Surveys and Questionnaires

The aim of this study was to compare and validate two simple methods of detecting excessive alcohol drinkers in a Malaysian hospital population. All 621 patients in the Medical, Surgical and Orthopaedic units of the General Hospital Kuala Lumpur were screened with the "CAGE" Questionnaire (a four question screening test to discriminate excessive drinkers) and two questions on the frequency and quantity of drinking called the Consumption Index. All CAGE scores had poor agreement (K = 0.37 to K = 0.1) with a psychiatric diagnosis of alcohol abuse and dependence using DSM III diagnosis. Reasons why the Consumption Index is a better screening instrument than the CAGE are discussed.

Topics: Alcohol Drinking; Alcoholism; Cross-Cultural Comparison; Cross-Sectional Studies; Developing Countries; Hospitalization; Humans; Incidence; Malaysia; Mass Screening; Observer Variation; Personality Inventory; Psychometrics

Topics: Adult; Alcoholism; Female; Humans; Malaysia; Male; Psychoses, Alcoholic

Demographic characteristics of all patients with a diagnosis of alcoholism or alcoholic psychoses admitted between 1975 and 1978 to the Psychiatry Department, General Hospital, Kuala Lumpur, were examined. The diagnosis of alcoholism or alcoholic psychoses accounted for 2% of the total psychiatric admissions. Males greatly predominated over females and Indians greatly predominated over Malays and Chinese. Reasons for these differences are discussed.

Topics: Adult; Alcoholism; Cross-Cultural Comparison; Ethnicity; Female; Humans; Malaysia; Male; Middle Aged

Marchiafava-Bignami disease, a rare affliction of alcoholic males, is described in a severely malnourished Malaysian Indian male who took no alcohol. It is the second report of the disease in an Asian and represents one of the few cases which have occurred in non-alcoholics. Besides the pathognomonic demyelination of the central portion of the corpus callosum, there were striking demyelinative plaques in the subcortical white matter. In addition, neuropathological features of Wernicke's disease were found suggesting that severe malnutrition with thiamine deficiency was probably the cause of his demise.

Topics: Alcoholism; Australia; Brain Diseases; Corpus Callosum; Humans; Malaysia; Male; Psychoses, Alcoholic; Syndrome; Wernicke Encephalopathy

A review of 352 patients with primary liver cell carcinoma treated by the author is presented. The poor rate of resectability (7 per cent) has necessitated various forms of treatment over the years. These are described in detail. Based on this experience, the current form of treatment for nonresectable carcinoma is summarized. Although it is too early to assess this form of treatment, initial results appear to be promising. A second report in the near future is planned.

Topics: Age Factors; Alcoholism; alpha-Fetoproteins; Blood Donors; Carcinoma, Hepatocellular; Developing Countries; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Hepatectomy; Hepatic Artery; Hepatitis B Antigens; Humans; Liver Cirrhosis; Liver Neoplasms; Malaysia; Male; Mycotoxins; Nutrition Disorders; Prognosis; Racial Groups