Principle investigator: Dato ’ Dr. Hajah Marlia Mohammed Salleh Co-investigators:

1. HEALTH SCREENING STUDY AMONG HOSPITAL STAFF Principle investigator: Dato’ Dr. HajahMarlia Mohammed Salleh Co-investigators: Dr. Thillainathan Dr. Ng KokHuan Presenter: YANTIE SHAHIDA BT ABDUL MANAN PegawaiPendidikanKesihatan JabatanKesihatanNegeri Pahang

2. Health Screening i • We often assume that when a person is not sick - he or she must be in good health, but this is not always the case. • The root of many common diseases such as HPT, DM, MI and cancer often set in years before the illness actually surfaces. • Therefore, early detection of risk factors is essential (Patel et al. 2011).

3. Health Screening ii • As it not only improves chances of successfully treating early stages of medical conditions but also of preventing or delaying disease, thus maintaining a high quality of life and prolonged life expectancy. • CVD is one of the most prevalent and devastating health problems in the world and is responsible for approximately 30% of deaths worldwide (WHO, 2005) which equate to about 16.6 million deaths. (Erhardt, Moller & Puig, 2007). • Our study emphasized on coronary risk.

4. Objectives • General To investigate the health status of the staff • Specific Screening on => Obesity => BMI => MI risk => Procam => Lifestyle factors

5. Study Design & Sample Selection • Cross-sectional study • All hospital staff with age ≥ 40 years old • Duration: 3 months • Study centre: HTAA • Participants were asked to fast for at least 8 hours before the study begun

6. Instrument Personal Particulars Family Medical history Health status screening questionnaire Personal Life style Habits Basic health screening PROCAM Screening Biometry measurements

7. Statistical Analysis • SPSS 17.0 for Windows was utilized. • Patients’ socio-demographic data was descriptively presented as frequencies and percentages. • Procam calculator was used to determine the risk of MI.

8. Procedure • Briefing. • Agreement of participation. • On the day of participation eligible participants were asked to • complete the instruments- BSSK/W/I/2008 • biometry assessment • Blood pressure (Bp) • Waist circumference (WC) • Weight and height • Blood test => glucose, lipid profile

9. Results: Demography • A total of 398 participants were recruited • only 353 included in the analysis • 97 male and 256 female • The average mean age for male participants was 48.59 • and female was 47.82 years

10. Life Style i Healthy

11. Life Style ii Healthy

12. Life Style iii Healthy Calculation of marks for life style health score: Yes = 5 mark No = 0 mark E.g- Scores for depression (yes, no) Sum of depression symptoms 1 + 2 / Total scores x 100 = 5 + 0 / 10 x 100 = 50% of risk of unhealthy life style

13. Life Style iii Score interpretation - 0- <50 – Healthy - >50 -100 – Unhealthy lifestyle

14. Procami • The PROCAM Quick Check: • allows rapid initial assessment of coronary risk. • suitable for men and women aged 20-75 years. • provides an estimation of risk sufficiently accurate to determine if further examination by a physician is advisable. • The PROCAM Risk Scores? • It was developed based on 450 coronary events occurring in a cohort of about 5,000 men aged 35-65 years at recruitment and with at least 10 years of unbroken follow-up. • Generally two type => PROCAM Quick Check and the PROCAM Health Check. Empana et al. 2003

15. Procam ii Assessment • Age • Gender • Glucose • Smoking • Anamnenies (Family medical history) • Blood pressure • Weight • Hypertension history Website: http://www.chd-taskforce.com/procam_interactive.html

16. Risk Factors: MI n = 32 (12.5%) Ranging from 1 - 6.22 fold increased risk compared to risk of average person with same age n = 20 (20.6%) Ranging from 1 – 3.08 fold increased risk compared to risk of average person with same age n =18 (18.5%) The risk is lower than risk of average person with same age Normal reading: BMI <25; WC<90 (M) <80 (F); BP<100

17. Discussion & Conclusion i • Female tend to possess better life style scores than male in terms of all lifestyle scores • Eating habits • Usage of substances • Physical activities • Majority of the staff were with healthy lifestyle => lifestyle score (mean scores> 75.5). • Procam results showed that the staff were at risk of CORONARY diseases particularly MI.

18. Discussion & Conclusion ii Limitation: • The instruments used was not tested on its psychometric. • Since the results was based on a sample of hospital staff therefore, we can’t generalize the results to other cohorts. • Suggestion: • Future studies should also involved psychometric evaluation and quality of life assessments. • For intervention study with longitudinal designed should be implemented.

19. the screening was strongly supported by hospital director

20. The staffs concentrated filling in bssk/w/i/2008 form

21. Too scared! But it’s a must for age > 40 years

22. Screening! Screening! Health screening!

23. References Patel, J. V., Gill, P. S., Chackathayil, J., Ojukwu, H., Stemman, P., et al. 2011. Short-Term Effects of Screening for Cardiovascular Risk in the Deaf Community: A Pilot Study. Cardiology Research and Practice. 10.4061/2011/493546 WHO. World Health Organization. 2005. Cardiovascular disease: Prevention and control. Geneva. Empanaa, J.P., Ducimetie`reb, P., Arveilerc, D., Ferrie`resd, J., Evanse, A., et al. 2003. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? European Heart Journal 24, 1903–1911. International task force for prevention of coronary disease. 2010. http://www.chd-taskforce.com/procam_interactive.html Erhardt, L., Moller, R. & Puig, J.G. 2007. Comprehensive cardiovascular risk management – what does it mean in practice? 3(5): 587–603.

24. Thank you