Development, validation, and evaluation of allergic rhinitis symptoms and impact assessment (ARSIA) questionnaire.

INTRODUCTION: Allergic rhinitis (AR) is an inflammatory disease of the nasal mucosa. It is among the most common diseases globally and usually persists throughout life. Allergic Rhinitis and Its Impact on Asthma (ARIA) is a wellestablished guideline applicable to AR and was updated regularly since 2001, aiming to improve the care for AR patients. We proposed a new questionnaire that addresses the severity of allergic rhinitis symptoms, specifically nasal symptoms, and its impact on quality of life in terms of specific vital activities such as sleeping, working, school performance, leisure, or sport, based on the ARIA guideline. The objective was to develop, validate and evaluate Allergic Rhinitis Symptoms and Impact Assessment (ARSIA) questionnaire among allergic rhinitis patients in Hospital Sultan Abdul Halim, Sungai Petani (HSAH), and Hospital Universiti Sains Malaysia (HUSM). MATERIALS AND METHODS: This is a prospective observational study to develop, validate and evaluate the ARSIA questionnaire based on ARIA guidelines. The sample will be obtained from the list of patients under follow-up in the ORL clinic HSAH and HUSM with ages of 18 to 60 years, patients clinically diagnosed with allergic rhinitis, and with positive skin prick test. RESULTS: A total of 150 patients with a positive skin prick test participated in this study. In the 'nasal symptom' and 'impact on daily activities' domains, calculated Cronbach's alpha shows a value of 0.878 and 0.811 respectively. The inter-item correlation was calculated to analyse internal consistency reliability. Items B3 and B4 were dropped from the questionnaire as both showed a low correlation with other items. New Cronbach's alpha for the daily activities domain was 0.830, which showed better internal consistency reliability. All of the items were analysed for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Clinician diagnosis from the proforma was used as a comparison to the participant's responses. In the analysis, a cut-off points of 12 was used to classify the patient's nasal symptoms into intermittent or persistent, with a sensitivity of 75%, specificity of 86%, PPV of 95%, and NPV of 51%. Whereas, a cut-off point of 15 was used to classify the rhinitis impact on daily activities into mild or moderate/severe, with a sensitivity of 58%, specificity of 100%, PPV of 100%, and NPV of 42%. The only item in the 'control' domain has been dropped out following a consensus of experts and judgement as it has not been used in the clinician diagnosis and thus, is unable to test for sensitivity, specificity, PPV, and NPV. CONCLUSION: This newly developed, validated, and evaluated questionnaire is a good tool for the evaluation of allergic rhinitis symptoms and their impact on daily activities. It is important to understand that AR symptoms could have a significant impact on daily activities. Although further study and testing are needed, it provides an initial means for evaluating the patient condition and control level, as well as patients' perception of their rhinitis control.

A 10-year systematic review and meta-analysis of determinants of postpartum depression in the Association of Southeast Asian Nations countries.

INTRODUCTION: Postpartum depression (PPD) is a mental and emotional condition that can affect women during their first postnatal year and concern globally. This study aimed to determine the overall prevalence and determinants of postpartum depression (PPD) in Association of Southeast Asian Nations (ASEAN) countries. MATERIALS AND METHODS: A systematic search of observational studies conducted in ASEAN countries between 1 January 2010 and 31 December 2020 was performed in the Medline, PubMed and Google Scholar databases. The quality of studies was evaluated based on The Joanna Briggs Institute Checklist. The analysis was performed with Review Manager software version 5.4. Metaanalysis of the estimates from primary studies was conducted by adjusting for possible publication bias and heterogeneity. RESULTS: Twenty-five studies including 19924 postnatal mothers were included in this review. The pooled prevalence of PPD is 22.32% (95% CI: 18.48, 26.17). Thailand has the highest prevalence of PPD with a pooled prevalence of 74.1% (95% CI: 64.79, 83.41). The prevalence of PPD was highest when the assessment for PPD was conducted up to 6 weeks postpartum with a pooled prevalence of 25.24% (95% CI: 14.08, 36.41). The identified determinants of PPD were unplanned pregnancy, term pregnancy, lack of family support and physical violence. There were limited studies done and high heterogeneity in terms of quality, methodology, culture, screening method and time of PPD measurement. CONCLUSIONS: Approximately one in five postpartum women in ASEAN countries had PPD. The risk factor that lowers the risk of PPD is unplanned and term pregnancies, while women with a lack of family support and experienced physical violence increase the risk of PPD. Robust prevalence studies are needed to assess the magnitude of this problem in ASEAN countries.

Waste bones ash as an alternative source of P for struvite precipitation.

Struvite precipitation has been widely applied for the removal of ammonium-nitrogen (NH4-N) from wastewater. Due to the high cost of phosphorus (P) reagents, the current research trend was directed to find alternative sources of P, in order to maintain a sustainable NH4-N removal process. The current study investigated waste bones ashes as alternative sources of P. Different types of bones' ashes were characterized, in which the ash produced from waste fish bones was the highest in P content (17%wt.). The optimization of the factors affecting P extraction from ash by acidic leaching showed that applying 2M H2SO4 and 1.25 kg H2SO4/kg ash achieved the highest P recovery (95%). Thereafter, the recovered P was successfully used in struvite precipitation, which achieved more than 90% NH4-N removal and high purity struvite.

Thermoluminescence dosimetry properties and kinetic parameters of lithium potassium borate glass co-doped with titanium and magnesium oxides.

Lithium potassium borate (LKB) glasses co-doped with TiO2 and MgO were prepared using the melt quenching technique. The glasses were cut into transparent chips and exposed to gamma rays of (60)Co to study their thermoluminescence (TL) properties. The TL glow curve of the Ti-doped material featured a single prominent peak at 230 °C. Additional incorporation of MgO as a co-activator enhanced the TL intensity threefold. LKB:Ti,Mg is a low-Z material (Z(eff)=8.89) with slow signal fading. Its radiation sensitivity is 12 times lower that the sensitivity of TLD-100. The dose response is linear at doses up to 10(3) Gy. The trap parameters, such as the kinetics order, activation energy, and frequency factor, which are related to the glow peak, were determined using TolAnal software.

The National Mental Health Registry (NMHR).

The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.

Fetus-in-fetu in a 6-month-old.

Fetus-in-fetu is a malformed parasitic monozygotic diamniotic twin found inside the body of the living child or adult. We report a case of lumbar mass having superficial rudimentary phallus, labioscrotal fold, testes, pedunculated thumb-like digit and rudimentary pelvis in addition to bowel loops in a 6-month-old Nigerian girl. The mass was excised and the baby did well. We propose based on these that dizygotic parasitic foetiform twin could exist.