Fenofibrate for the prevention of progression of non-proliferative diabetic retinopathy:review,consensus recommendations and guidance for clinical practice

The prevalence of diabetic retinopathy(DR),and associated morbidity is high in the Asia-Pacific region.Emerging evidence suggests a potential role for fenofibrate in the prevention of progression of DR,especially in patients with cardiovascular risk,and pre-existing mild-to-moderate DR.Fenofibrate has also been found to reduce maculopathy,and the need for laser treatment in these patients.Considering these benefits of fenofibrate,a group of experts from the fields of endocrinology and ophthalmology convened in May 2017,to discuss on the the mechanism of action,and clinical efficacy of fenofibrate in DR.The findings from key clinical studies on fenofibrate in DR were reviewed by the experts,and consensus statements were derived to define the role of fenofibrate in the prevention and treatment of DR.The statements were rated based on the GRADE criteria.An algorithm was also developed for the screening and treatment of DR in patients with type 2 diabetes(T2D),and the place of fenofibrate was defined in the algorithm.The expert recommendations,and the algorithm provided in this review will serve as a guide to the clinicians to reconsider the adjunctive use of fenofibrate for preventing the progression of DR in selected T2D patients.

Ambient Air Pollution and Pulmonary Tuberculosis in Malaysia

Introduction: The possible impact of ambient air pollution exposure on the development of active tuberculosis (TB) remains obscure. This study investigated the potential role of ambient air pollution in activating pulmonary TB (PTB) compared to extrapulmonary TB (EPTB). Materials and Methods: Data on TB cases were obtained from national surveillance data in Malaysia during 2013 and air pollution data were obtained from 52 air-monitoring stations around the country for the 3-year period of 2011-2013. Analyses were performed to estimate the odds of PTB vs. EPTB with changes in the 3-year (2011-2013) average Air Pollutant Index (API) and specific ambient air pollutants. Results: Results showed that the 95th-percentile of API levels during 2011-2013 was moderate and it was not associated with PTB. However, the odds of active PTB compared to EPTB was significantly elevated with the 95th-percentile levels for particulate matter with an aerodynamic diameter of 10 μm or less (aOR = 1.006, 95% CI: 1.002, 1.011), p-value Conclusions: These results provide suggestive evidence of the effects of ambient air pollution on development of active pulmonary TB compared to extrapulmonary TB. Additional research on the impacts of ambient air pollution on TB is warranted.

Translation, Cross-Cultural Adaptation, Reliability and Validity of the Malay Version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) V3.1

Introduction: A psychoactive substance has become an overwhelming public health burden globally. It causes social problems for the user and surrounding people which may affect work or study and cause negative economic impact. Objective: This study aims to translate and culturally adapt the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into Malay and to assess its reliability and validity. Methods: The Malay version of the ASSIST v 3.1 was developed after the translation and back-translation, which included the stages recommended by Beaton. The ASSIST v 3.1 was administered to 125 respondents. The Malay ASSIST v 3.1 was completed twice by each respondent 7 to 14-day intervals to assess test-retest reliability based on the intra-rater and interrater correlation coefficient. Results: Majority of the respondents were male, Malay and currently employed. The intra-rater reliability is 0.84 and the test-retest reliability (ICC = 0.97) were excellent. Conclusion: Malay ASSIST v3.1 was a valid and reliable tool to screen substances abuse at varying degree. Nonetheless, further studies are needed to assess its responsiveness.