Knowledge and Perception of Paediatric Drug Dosing: Impact of Paediatric Drug Dosing Workshop.

BACKGROUND: Paediatric patients frequently encounter medication errors caused by the requirement for individualised drug dose estimates based on weight, age variance, and drug pharmacokinetics. One thing contributing to drug dosing errors is the lack of healthcare personnel's knowledge of paediatric drug dosing. The present study aimed to evaluate the knowledge and perception regarding the workshop on paediatric drug dosing among undergraduate pharmacy students. METHOD: A prospective pre-post study was conducted. A virtual workshop on paediatric drug dosing was designed and developed by the clinical pharmacy lecturer from Universiti Sultan Zainal Abidin (UniSZA) for pharmacy students. An online questionnaire with 15 questions regarding knowledge of paediatric drug dosing and perception of the virtual workshop on paediatric drug dosing was used to evaluate pharmacy students' knowledge pre- and post-workshop. RESULT: Twenty-six students took part in the study (100%). In the pre-workshop on paediatric drug dosing calculation, most students had poor knowledge of the paediatric drug dosing calculation, scored 8 out of 15, 26.92% between 9 to 11 and only 11.54% scored ≥ 12. There was a statistically significant difference in median knowledge score between pre- and post-workshop (p< 0.05). Among the students, 73.08% stated that they strongly agreed that the online workshop attracted their attention and 76.92% of students strongly agreed that they were able to calculate paediatric drug dosing after joining the online workshop. CONCLUSION: Results demonstrate that pharmacy students have insufficient knowledge of paediatric drug dosing calculations. Virtual workshop is one strategy that could improve the pharmacy students' knowledge.

WSSV early protein WSSV004 enhances viral replication by suppressing LDH activity.

White spot syndrome virus (WSSV) is known to upregulate glycolysis to supply biomolecules and energy for the virus's replication. At the viral genome replication stage, lactate dehydrogenase (LDH), a glycolytic enzyme, shows increased activity without any increase in expression. In the present study, yeast 2-hybrid screening was used to identify WSSV proteins that interacted with LvLDH isoform 1 and 2, and these included the WSSV early protein WSSV004. The interaction between WSSV004 and LvLDH1/2 was confirmed by co-immunoprecipitation. Immunofluorescence showed that WSSV004 co-localized with LvLDH1/2 in the cytoplasm. dsRNA silencing experiments showed that WSSV004 was crucial for WSSV replication. However, although WSSV004 silencing led to the suppression of total LvLDH gene expression during the viral late stage, there was nevertheless a significant increase in LvLDH activity at this time. We also used affinity purification-mass spectrometry to identify cellular proteins that interact with WSSV004, and found a total of 108 host proteins and 3 WSSV proteins with which it potentially interacts. Bioinformatics analysis revealed that WSSV004 and its interacting proteins might be responsible for various biological pathways during infection, including vesicular transport machinery and RNA-related functions. Collectively, our study suggests that WSSV004 serves as a multifunctional modulator to facilitate WSSV replication.

Coding genomes with gapped pattern graph convolutional network.

MOTIVATION: Genome sequencing technologies reveal a huge amount of genomic sequences. Neural network-based methods can be prime candidates for retrieving insights from these sequences because of their applicability to large and diverse datasets. However, the highly variable lengths of genome sequences severely impair the presentation of sequences as input to the neural network. Genetic variations further complicate tasks that involve sequence comparison or alignment. RESULTS: Inspired by the theory and applications of "spaced seeds," we propose a graph representation of genome sequences called "gapped pattern graph." These graphs can be transformed through a Graph Convolutional Network to form lower-dimensional embeddings for downstream tasks. On the basis of the gapped pattern graphs, we implemented a neural network model and demonstrated its performance on diverse tasks involving microbe and mammalian genome data. Our method consistently outperformed all the other state-of-the-art methods across various metrics on all tasks, especially for the sequences with limited homology to the training data. In addition, our model was able to identify distinct gapped pattern signatures from the sequences. AVAILABILITY AND IMPLEMENTATION: The framework is available at https://github.com/deepomicslab/GCNFrame.

White spot syndrome virus (WSSV) modulates lipid metabolism in white shrimp.

In addition to the Warburg effect, which increases the availability of energy and biosynthetic building blocks in WSSV-infected shrimp, WSSV also induces both lipolysis at the viral genome replication stage (12 hpi) to provide material and energy for the virus replication, and lipogenesis at the viral late stage (24 hpi) to complete virus morphogenesis by supplying particular species of long-chain fatty acids (LCFAs). Here, we further show that WSSV causes a reduction in lipid droplets (LDs) in hemocytes at the viral genome replication stage, and an increase in LDs in the nuclei of WSSV-infected hemocytes at the viral late stage. In the hepatopancreas, lipolysis is triggered by WSSV infection, and this leads to fatty acids being released into the hemolymph. ß-oxidation inhibition experiment reveals that the fatty acids generated by WSSV-induced lipolysis can be diverted into ß-oxidation for energy production. At the viral late stage, WSSV infection leads to lipogenesis in both the stomach and hepatopancreas, suggesting that fatty acids are in high demand at this stage for virion morphogenesis. Our results demonstrate that WSSV modulates lipid metabolism specifically at different stages to facilitate its replication.

On triangle inequalities of correlation-based distances for gene expression profiles.

BACKGROUND: Distance functions are fundamental for evaluating the differences between gene expression profiles. Such a function would output a low value if the profiles are strongly correlated-either negatively or positively-and vice versa. One popular distance function is the absolute correlation distance, [Formula: see text], where [Formula: see text] is similarity measure, such as Pearson or Spearman correlation. However, the absolute correlation distance fails to fulfill the triangle inequality, which would have guaranteed better performance at vector quantization, allowed fast data localization, as well as accelerated data clustering. RESULTS: In this work, we propose [Formula: see text] as an alternative. We prove that [Formula: see text] satisfies the triangle inequality when [Formula: see text] represents Pearson correlation, Spearman correlation, or Cosine similarity. We show [Formula: see text] to be better than [Formula: see text], another variant of [Formula: see text] that satisfies the triangle inequality, both analytically as well as experimentally. We empirically compared [Formula: see text] with [Formula: see text] in gene clustering and sample clustering experiment by real-world biological data. The two distances performed similarly in both gene clustering and sample clustering in hierarchical clustering and PAM (partitioning around medoids) clustering. However, [Formula: see text] demonstrated more robust clustering. According to the bootstrap experiment, [Formula: see text] generated more robust sample pair partition more frequently (P-value [Formula: see text]). The statistics on the time a class "dissolved" also support the advantage of [Formula: see text] in robustness. CONCLUSION: [Formula: see text], as a variant of absolute correlation distance, satisfies the triangle inequality and is capable for more robust clustering.

Diets enriched with palm olein, cocoa butter, and extra virgin olive oil exhibited similar lipid response: a randomized controlled study in young healthy adults.

Vegetable oils having unsaturated fatty acids in the sn-2 position of triglyceride (TG) backbone might not raise serum cholesterol levels. We investigated the chronic effects of diets enriched with palm olein (IV64) (PO), cocoa butter (CB), or extra virgin olive oil (EVOO) with oleic acid primarily at the sn-2 position (66%, 75%, 87% sn-2 oleic acid, respectively) of the TG molecule in 40 healthy volunteers participated in this randomized, controlled, single-blinded, crossover trial. Following a 2-week run-in period, the subjects were given standardization meals (breakfast, lunch, and dinner) cooked with palm olein (IV72). Subjects were randomized to 1 of the 3 intervention groups; receiving baked products (brownies for breakfast and cookies for teatime) prepared with respective test fats accompanied with standardized low-fat meals for breakfast, lunch, and dinner prepared with palm olein (IV72) for all groups for 4 weeks in a crossover manner with 2-week washout period (given standardization meals). Anthropometric measurements, blood samples, and dietary intakes were measured before run-in and pre- and post-intervention. No significant difference was observed on the primary outcome of the study total: high-density lipoprotein cholesterol. All 3 test fats were found to exhibit similar lipid responses (total cholesterol, TG, lipoprotein (a), apolipoprotein-A1, apolipoprotein-B/A-1). Statistical difference was found on low-density lipoprotein cholesterol (CB>EVOO by 0.3 mmol/L, P = .003), high-density lipoprotein cholesterol (PO>CB by 0.04 mmol/L, P = .02) and apolipoprotein-B (EVOO

White Spot Syndrome Virus Triggers a Glycolytic Pathway in Shrimp Immune Cells (Hemocytes) to Benefit Its Replication.

White spot syndrome virus (WSSV) is the causative agent of a shrimp disease that inflicts in huge economic losses in shrimp-farming industry. WSSV triggers aerobic glycolysis in shrimp immune cells (hemocytes), but how this virus regulates glycolytic enzymes or pathway is yet to be characterized. Therefore, mRNA levels and activity of four important glycolytic enzymes, Hexokinase (HK), Phosphofructokinase (PFK), Pyruvate kinase (PK), and Lactate dehydrogenase (LDH), were measured in WSSV-infected shrimp hemocytes. Gene expression of HK and PFK, but not LDH or PK, was increased at the viral genome replication stage (12 hpi); furthermore, activity of these enzymes, except HK, was concurrently increased. However, there was no increased enzyme activity at the viral late stage (24 hpi). In vivo dsRNA silencing and glycolysis disruption by 2-DG further confirmed the role of glycolysis in virus replication. Based on tracing studies using stable isotope labeled glucose, glycolysis was activated at the viral genome replication stage, but not at the viral late stage. This study demonstrated that WSSV enhanced glycolysis by activating glycolytic enzyme at the viral genome replication stage, providing energy and biomolecules for virus replication.

Effect of soy-based meal replacement on weight loss: A systematic review and meta-analyses protocol.

Background: Obesity is a complex and multifactorial disease that is strongly associated with multiple comorbidities and mortality. Weight reduction in overweight and obese patients was highly desired to minimize future complications. Meal replacement is emerging as one of the effective tools to promote weight loss. Isoflavones and soy protein present in soybean are able to promote weight loss and alleviate obesity. Aim: Our systematic review aims to investigate the weight loss effect of soy-based meal replacement among the overweight and obese population. Methods: We will conduct a systematic review of RCTs that evaluated the effect of a soy-based meal replacement on weight loss in overweight and obese patients. The primary outcome of this review is weight loss. Besides that, we will assess BMI, body fat, waist circumference and hip circumference as the secondary outcome. We will search PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. Two reviewers will independently screen titles and abstracts, review full texts, extract information and assess the risk of bias of individual studies. We will conduct meta-analyses using a random-effect model if sufficient data are available. If meta-analysis is not performed, we will present a systematic qualitative synthesis. Summary: This systematic review will identify the weight loss effect of soy-based meal replacement among the overweight and obese adult population. We expect the result may strengthen the evidence on the role of soy-based meal replacement in optimal body weight management.

An exploratory study on the knowledge, attitude and practice of sharp disposal among type 2 diabetes mellitus patients in Northern Peninsular Malaysia.

BACKGROUND: The use of exogenous insulin exposes the patients to sharps (insulin pen needles and lancets). Improper sharps disposal increases the risk of transmitting diseases such as hepatitis B, hepatitis C, Human Immunodeficiency Virus and other blood borne diseases. AIMS: To assess the knowledge, attitude and practices of sharp disposal among type 2 diabetes mellitus patients in the Northern Peninsular of Malaysia. METHODS: A self-administered, questionnaire-based, cross-sectional study was conducted at nine health clinics in the three Northern Peninsular Malaysia states. This study (NMRR-20-1757-56045 IIR) was approved by Medical Research and Ethics Committee, Malaysia. RESULTS: A total of 312 subjects were recruited in this study. The majority (46.15%) of the subjects had moderate knowledge regarding sharps disposal ranging from 60% to 70% of the knowledge score. The majority (59.60%) of the subjects had a positive attitude towards proper sharps disposal and 13.30% of the subjects had a strongly positive attitude. Sharps disposal practices among type 2 diabetes mellitus patients were poor since only two subjects reported correctly disposing of their used sharps. CONCLUSION: The study showed that the majority of the subjects had moderate knowledge, a positive attitude and poor sharp disposal practice.

Both simulation and sequencing data reveal coinfections with multiple SARS-CoV-2 variants in the COVID-19 pandemic.

SARS-CoV-2 is a single-stranded RNA betacoronavirus with a high mutation rate. The rapidly emerging SARS-CoV-2 variants could increase transmissibility and diminish vaccine protection. However, whether coinfection with multiple SARS-CoV-2 variants exists remains controversial. This study collected 12,986 and 4,113 SARS-CoV-2 genomes from the GISAID database on May 11, 2020 (GISAID20May11), and Apr 1, 2021 (GISAID21Apr1), respectively. With single-nucleotide variant (SNV) and network clique analyses, we constructed single-nucleotide polymorphism (SNP) coexistence networks and discovered maximal SNP cliques of sizes 16 and 34 in the GISAID20May11 and GISAID21Apr1 datasets, respectively. Simulating the transmission routes and SNV accumulations, we discovered a linear relationship between the size of the maximal clique and the number of coinfected variants. We deduced that the COVID-19 cases in GISAID20May11 and GISAID21Apr1 were coinfections with 3.20 and 3.42 variants on average, respectively. Additionally, we performed Nanopore sequencing on 42 COVID-19 patients and discovered recurrent heterozygous SNPs in twenty of the patients, including loci 8,782 and 28,144, which were crucial for SARS-CoV-2 lineage divergence. In conclusion, our findings reported SARS-CoV-2 variants coinfection in COVID-19 patients and demonstrated the increasing number of coinfected variants.

In Vitro Neurotoxicity of Chinese Krait (Bungarus multicinctus) Venom and Neutralization by Antivenoms.

Bungarus multicinctus, the Chinese krait, is a highly venomous elapid snake which causes considerable morbidity and mortality in southern China. B. multicinctus venom contains pre-synaptic PLA2 neurotoxins (i.e., ß-bungarotoxins) and post-synaptic neurotoxins (i.e., α-bungarotoxins). We examined the in vitro neurotoxicity of B. multicinctus venom, and the efficacy of specific monovalent Chinese B. multicinctus antivenom, and Australian polyvalent elapid snake antivenom, against venom-induced neurotoxicity. B. multicinctus venom (1-10 µg/mL) abolished indirect twitches in the chick biventer cervicis nerve-muscle preparation as well as attenuating contractile responses to exogenous ACh and CCh, but not KCl. This indicates a post-synaptic neurotoxic action but myotoxicity was not evident. Given that post-synaptic α-neurotoxins have a more rapid onset than pre-synaptic neurotoxins, the activity of the latter in the whole venom will be masked. The prior addition of Chinese B. multicinctus antivenom (12 U/mL) or Australian polyvalent snake antivenom (15 U/mL), markedly attenuated the neurotoxic actions of B. multicinctus venom (3 µg/mL) and prevented the inhibition of contractile responses to ACh and CCh. The addition of B. multicinctus antivenom (60 U/mL), or Australian polyvalent snake antivenom (50 U/mL), at the t90 time point after the addition of B. multicinctus venom (3 µg/mL), did not restore the twitch height over 180 min. The earlier addition of B. multicinctus antivenom (60 U/mL), at the t20 or t50 time points, also failed to prevent the neurotoxic effects of the venom but did delay the time to abolish twitches based on a comparison of t90 values. Repeated washing of the preparation with physiological salt solution, commencing at the t20 time point, failed to reverse the neurotoxic effects of venom or delay the time to abolish twitches. This study showed that B. multicinctus venom displays marked in vitro neurotoxicity in a skeletal muscle preparation which is not reversed by antivenom. This does not appear to be related to antivenom efficacy, but due to the irreversible/pseudo-irreversible nature of the neurotoxins.

Pharmacokinetics and Biodistribution of Thymoquinone-loaded Nanostructured Lipid Carrier After Oral and Intravenous Administration into Rats.

BACKGROUND: Thymoquinone (TQ), an active compound isolated from Nigella sativa, has been proven to exhibit various biological properties such as antioxidant. Although oral delivery of TQ is valuable, it is limited by poor oral bioavailability and low solubility. Recently, TQ-loaded nanostructured lipid carrier (TQ-NLC) was formulated with the aim of overcoming the limitations. TQ-NLC was successfully synthesized by the high-pressure homogenization method with remarkable physiochemical properties whereby the particle size is less than 100 nm, improved encapsulation efficiency and is stable up to 24 months of storage. Nevertheless, the pharmacokinetics and biodistribution of TQ-NLC have not been studied. This study determined the bioavailability of oral and intravenous administration of thymoquinone-loaded nanostructured lipid carrier (TQ-NLC) in rats and its distribution to organs. MATERIALS AND METHODS: TQ-NLC was radiolabeled with technetium-99m before the administration to the rats. The biodistribution and pharmacokinetics parameters were then evaluated at various time points. The rats were imaged at time intervals and the percentage of the injected dose/gram (%ID/g) in blood and each organ was analyzed. RESULTS: Oral administration of TQ-NLC exhibited greater relative bioavailability compared to intravenous administration. It is postulated that the movement of TQ-NLC through the intestinal lymphatic system bypasses the first metabolism and therefore enhances the relative bioavailability. However, oral administration has a slower absorption rate compared to intravenous administration where the AUC0-∞ was 4.539 times lower than the latter. CONCLUSION: TQ-NLC had better absorption when administered intravenously compared to oral administration. However, oral administration showed greater bioavailability compared to the intravenous route. This study provides the pharmacokinetics and biodistribution profile of TQ-NLC in vivo which is useful to assist researchers in clinical use.

Penaeus vannamei serine proteinase inhibitor 7 (LvSerpin7) acts as an immune brake by regulating the proPO system in AHPND-affected shrimp.

Acute hepatopancreatic necrosis disease (AHPND) is a recently emerged disease in aqua cultured shrimp that is caused by virulent strains of Vibrio parahaemolyticus (VP). Our previous study used transcriptomics to identify key pathogenic factors in the stomach of AHPND-infected shrimp (Litopenaeus vannamei), and here we used a different subset of the same data to construct a gene-to-gene expression correlation network to identify immune-responsive genes. LvSerpin7 was found to have the highest number of correlations after infection, and it also showed a significant increase in mRNA expression. LvSerpin7 is expressed in all tissues but its expression levels are highest in hemocytes. After successfully silencing LvSerpin7 transcript prior to AHPND challenge, mortality was significantly increased relative to the controls and reached 100% within 36 h post infection. Compared to the controls, the phenoloxidase (PO) activity also increased in both hemolymph and stomach. Recombinant LvSerpin7 inhibited shrimp PO activity in vitro, and we also found that rLvSerpin7 inhibited the growth of AHPND-causing bacteria. These results suggest that LvSerpin7 might reduce the toxic effects that result from unregulated activation of the PO defense system by AHPND-causing bacteria.

Intake of Palm Olein and Lipid Status in Healthy Adults: A Meta-Analysis.

It is not clear whether a saturated fatty acid-rich palm olein diet has any significant adverse effect on established surrogate lipid markers of cardiovascular disease (CVD) risk. We reviewed the effect of palm olein with other oils on serum lipid in healthy adults. We searched in MEDLINE and CENTRAL: Central Register of Controlled Trials from 1975 to January 2018 for randomized controlled trials of ≥2 wk intervention that compared the effects of palm olein (the liquid fraction of palm oil) with other oils such as coconut oil, lard, canola oil, high-oleic sunflower oil, olive oil, peanut oil, and soybean oil on changes in serum lipids. Nine studies were eligible and were included, with a total of 533 and 542 subjects on palm olein and other dietary oil diets, respectively. We extracted and compared all the data for serum lipids, such as total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglyceride, and TC/HDL cholesterol ratio. When comparing palm olein with other dietary oils, the overall weighted mean differences for TC, LDL cholesterol, HDL cholesterol, triglycerides, and the TC/HDL cholesterol ratio were -0.10 (95% CI: -0.30, 0.10; P = 0.34), -0.06 (95% CI: -0.29,0.16; P = 0.59), 0.02 (95% CI: -0.01, 0.04; P = 0.20), 0.01 (95% CI: -0.05, 0.06; P = 0.85), and -0.15 (95% CI: -0.43, 0.14; P = 0.32), respectively. Overall, there are no significant differences in the effects of palm olein intake on lipoprotein biomarkers (P > 0.05) compared with other dietary oils. However, dietary palm olein was found to have effects comparable to those of other unsaturated dietary oils (monounsaturated fatty acid- and polyunsaturated fatty acid-rich oils) but differed from that of saturated fatty acid-rich oils with respect to the serum lipid profile in healthy adults.

Large-scale 3D chromatin reconstruction from chromosomal contacts.

BACKGROUND: Recent advances in genome analysis have established that chromatin has preferred 3D conformations, which bring distant loci into contact. Identifying these contacts is important for us to understand possible interactions between these loci. This has motivated the creation of the Hi-C technology, which detects long-range chromosomal interactions. Distance geometry-based algorithms, such as ChromSDE and ShRec3D, have been able to utilize Hi-C data to infer 3D chromosomal structures. However, these algorithms, being matrix-based, are space- and time-consuming on very large datasets. A human genome of 100 kilobase resolution would involve ∼30,000 loci, requiring gigabytes just in storing the matrices. RESULTS: We propose a succinct representation of the distance matrices which tremendously reduces the space requirement. We give a complete solution, called SuperRec, for the inference of chromosomal structures from Hi-C data, through iterative solving the large-scale weighted multidimensional scaling problem. CONCLUSIONS: SuperRec runs faster than earlier systems without compromising on result accuracy. The SuperRec package can be obtained from http://www.cs.cityu.edu.hk/~shuaicli/SuperRec .

The rate of progression of type 2 diabetes mellitus to end stage renal disease - A single centred retrospective study from Malaysia.

INTRODUCTION: In Malaysia, 61% of dialysis cases are secondary to diabetes. To date, we are still lacking of data on the rate of progression of type 2 diabetes mellitus (T2DM) to end stage renal disease (ESRD) in Malaysia. MATERIALS AND METHODS: This was a retrospective study conducted at nephrology unit of a tertiary hospital in Kedah. All diabetic ESRD patients who fulfilled the inclusion criteria were identified and recruited for analysis. RESULTS: The mean duration of DM to ESRD was found to be 14.37 ±â€¯4.42 years. Mean duration for the onset of diabetic nephropathy was 8.73 ±â€¯3.37 years. There was a relative short duration from diabetic nephropathy to ESRD noted, which was 5.63 ±â€¯2.06 years. The mean duration of DM to ESRD for patients receiving RAAS blocker was found to be 18.23 ±â€¯2.38 years as compared to 11.41 ±â€¯2.94 years for those who did not (95% CI: -0.64 to -2.46). For different type of RAAS blockers, namely ACE inhibitor and angiotensin receptor blocker (ARB), there was no significant difference observed pertaining to mean duration of DM to ESRD; 17.89 ±â€¯1.97 years for ACEi and 19.00 ±â€¯4.16 years for ARB (95% CI: -4.74 to 2.52). DISCUSSION: Time frame from diabetic nephropathy to ESRF among Malaysian population was shorter as compared to findings from other countries with an average period of 15 to 25 years. RAAS blockers should be initiated early in diabetic patients.

Interesterified Palm Olein (IEPalm) and Interesterified Stearic Acid-Rich Fat Blend (IEStear) Have No Adverse Effects on Insulin Resistance: A Randomized Control Trial.

Chemically-interesterified (CIE) fats are trans-fat free and are increasingly being used as an alternative to hydrogenated oils for food manufacturing industries to optimize their products' characteristics and nutrient compositions. The metabolic effects of CIE fats on insulin activity, lipids, and adiposity in humans are not well established. We investigated the effects of CIE fats rich in palmitic (C16:0, IEPalm) and stearic (C18:0, IEStear) acids on insulin resistance, serum lipids, apolipoprotein concentrations, and adiposity, using C16:0-rich natural palm olein (NatPO) as the control. We designed a parallel, double-blind clinical trial. Three test fats were used to prepare daily snacks for consumption with a standard background diet over a period of 8 weeks by three groups of a total of 85 healthy, overweight adult volunteers. We measured the outcome variables at weeks 0, 6, and at the endpoint of 8. After 8 weeks, there was no significant difference in surrogate biomarkers of insulin resistance in any of the IE fat diets (IEPalm and IEStear) compared to the NatPO diet. The change in serum triacylglycerol concentrations was significantly lower with the IEStear diet, and the changes in serum leptin and body fat percentages were significantly lower in the NatPO-diet compared to the IEPalm diet. We conclude that diets containing C16:0 and C18:0-rich CIE fats do not affect markers of insulin resistance compared to a natural C16:0-rich fat (NatPO) diet. Higher amounts of saturated fatty acids (SFAs) and longer chain SFAs situated at the sn-1,3 position of the triacylglycerol (TAG) backbones resulted in less weight gain and lower changes in body fat percentage and leptin concentration to those observed in NatPO and IEStear.

Diabetes knowledge, attitude, and practice among type 2 diabetes mellitus patients in Kuala Muda District, Malaysia - A cross-sectional study.

Diabetes is among leading public health concerns in Malaysia due to premature and preventable mortality involving macro and microvascular complications. Diabetes knowledge, attitude, and practice (KAP) are vital in diabetes management. The present study assessed the level of diabetes KAP among type 2 diabetes patients with associated and correlated factors through a self-administered questionnaire-based study on a convenience sample of 386 type 2 diabetes mellitus patients in Kuala Muda District, Kedah, Malaysia. Majority of the respondents possessed levels above the cut-off points for poor levels in knowledge (63.21%), attitude (62.69%), and practices (58.03%). Age, academic qualification, occupation, monthly income, current therapy type, comorbid diseases, and therapy preference were associated with KAP whereas the associations of disease duration, the best source of information about diabetes, and health status satisfaction were witnessed for attitude and practice. Academic qualification had strongest correlation for knowledge (r = 0.785), attitude (r = 0.725), and practice (r = 0.709). Knowledge level was significantly correlated with attitude level (r = 0.735), practice level (r = 0.786), income (r = 0.556), occupation (r = 0.358), age (r = 0.173), current therapy type (r = 0.133), and diabetes education exposure (r = 0.113). Attitude level had significant correlations with practice level (r = 0.679), income (r = 0.357), occupation (r = 0.348), health status satisfaction (r = 0.147), age (r = 0.145), and gender (r = 0.109). Practice level correlated significantly with income (r = 0.448), occupation (r = 0.317), age (r = 0.173), health status satisfaction (r = 0.167), and current therapy type (r = 0.118). All associations and correlations were significant at P < 0.005. Although overall having good levels of diabetes KAP, educational interventions are required to further improve diabetes KAP.